Surgery is usually the main treatment for melanoma. Often this means your primary care doctor or dermatologist removes suspicious tissue, and has it checked for cancer (biopsied), before you ever see a specialist at SCCA. If your tumor is removed very early, you may not need any other treatment.
Our skin cancer surgeon team includes experts in surgical oncology, reconstruction and head and neck surgery. This team specializes in the treatment of melanoma and you can feel confident knowing that the surgeon who cares for you is best-suited for your specific diagnosis.
If your melanoma is localized, meaning it is just on your skin, you may need only a simple excision (removing it by cutting it out).
- Your doctor removes the tumor, along with a margin of normal-looking skin around the tumor. If the melanoma is thicker, your surgeon will have to cut wider margins. This is important so that the melanoma does not grow back at the original location later.
- If the doctor did not take wide margins during your original biopsy, you may need another excision to remove more skin, including very small lymph vessels near the tumor where cancer cells might have spread.
- Depending on where your melanoma is and how large the margins need to be, you might need only a local numbing medicine or you might have general anesthesia.
SCCA melanoma surgeons and plastic surgeons coordinate to treat tumors in sensitive locations, like the face or hand.
Sentinel lymph node mapping and biopsy
Thicker melanomas tend to spread to nearby lymph nodes, which need to be checked for cancer and possibly removed.
A tracer substance and a dye are injected near your tumor to find the lymph node or nodes where your cancer would spread first (sentinel nodes). Your surgeon removes only the nodes where the substance appears, and a pathologist checks the nodes for cancer cells.
- If cancer is found, your surgeon removes the lymph nodes in that area.
- If cancer is not found, the rest of your lymph nodes will be left in place.
SCCA's David R. Byrd, MD, brought this technique, sentinel lymph node mapping and biopsy, to the Northwest in the 1990s.
Preventing and treating lymphedema
Lymphedema is not common, but it is a possible complication. So after any lymph node surgery, we refer our patients to physical therapists (PTs) with expertise in preventing, detecting and managing lymphedema.
We have several resources for lymphedema treatment, including PTs who provide complete decongestive therapy and specialized reconstructive surgeons who offer advanced surgical treatments, such as lymph vessel reconnection surgery and lymph-node transfer.