Surgical removal of melanoma is the most common treatment. In some cases, it may be combined with other treatments to prevent the spread or recurrence of more advanced cancer.
The entire tumor is cut away along with a wide margin of healthy tissue to make sure no cancer cells remain in the skin. The area affected will depend on the size and depth of the cancer. The remaining skin will need to be stitched together. If the area is too big, skin from another area of the body may be needed to cover the area. Skin scarring may be permanent.
In Mohs surgery, the visible part of the tumor is removed. The surrounding tissue is then removed in layers and examined under a microscope for the presence of cancer cells. This process is repeated until the most recent removed layer are free of cancer cells. This helps preserve as much tissue as possible.
Mohs surgery is used less often for melanoma. It is generally only used for stage 0—melanoma in situ.
If melanoma is found on a finger or toe, amputation of the part of all of digit may be necessary. This is not a common procedure.
Cancer can spread to the lymph nodes near the main tumor. Once there, it can travel to other parts of the body through the lymphatic system. During surgery, some or all of the lymph nodes suspected of having cancer will be removed and examined under a microscope. Removing lymph nodes may create permanent problems with the drainage of lymph fluid from the limbs called lymphedema. Talk to your doctor about the risks and benefits of having lymph node dissection.
Surgery is not generally used for metastatic melanoma except in cases where it may relieve symptoms, prolong life, or improve quality of life.
Dawn ME, Dawn AG, Miller SJ. Mohs surgery for the treatment of melanoma in situ: a review. Dermatol Surg. 2007;33(4):395-402.
Melanoma. EBSCO DynaMed Plus website. Available at: http://www.dynamed.com/topics/dmp~AN~T115302/Melanoma. Updated January 10, 2017. Accessed March 16, 2017.
Melanoma. Merck Manual Professional Version website. Available at: http://www.merckmanuals.com/professional/dermatologic-disorders/cancers-of-the-skin/melanoma. Updated February 2017. Accessed March 16, 2017.
Surgery for melanoma skin cancer. American Cancer Society website. Available at: https://www.cancer.org/cancer/melanoma-skin-cancer/treating/surgery.html. Updated May 20, 2016. Accessed March 16, 2017.
Treatment option overview. National Cancer Institute website. Available at: https://www.cancer.gov/types/skin/patient/melanoma-treatment-pdq#section/_135 Updated March 10, 2017. Accessed March 16, 2017.
Walling HW, Scupham RK, Bean AK, Ceilley RI. Staged excision versus Mohs micrographic surgery for lentigo maligna and lentigo maligna melanoma. J Am Acad Dermatol. 2007;57(4):659-664.
Last reviewed March 2017 by Mohei Abouzied, MD, FACP
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
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