Many people are frightened at the idea of having treatment for cancer, because of the side effects that can occur. Treatment can be given for different reasons and the potential benefits will vary depending upon the individual situation. Making decisions about treatment in these circumstances is always difficult, and you may need to discuss the treatment options in detail with your doctor or Skin Cancer Specialist Nurse.
Surgery is the main treatment option for most cases of melanoma, and usually cures early stage melanomas. The surgery will leave a scar on the skin. However, if the surgery is not done the melanoma is likely to spread into the deeper layers of the skin and then to other areas of the body.
If you have been offered surgery to cure your melanoma, deciding whether to accept the treatment may not be difficult. However, if a cure is unlikely and the treatment is being given to control the cancer for a period of time, it may be more difficult to decide whether to go ahead with treatment.
When a diagnosis of melanoma is made by biopsy, the site will probably need to be excised again in order to reduce the risk of the melanoma coming back in the vicinity of your scar. This procedure is called a ‘wide local excision‘ and is offered to every patient diagnosed with a melanoma, unless there are exceptional reasons not to proceed with this. The tumour is cut out, along with a predetermined amount of normal non-cancerous skin at the edges. The normal, healthy skin around the edges of the cancer is referred to as the margin. The size of the margin depends on the Breslow thickness of the tumour but varies from 1cm to 2cm. The sample will be viewed under a microscope to make sure that no cancer cells remain in the skin. When the original melanoma is thicker, the wider excision is done at the same time as the sentinel lymph node biopsy.
In many cases, after the wider excision has been done it is possible to close the wound by simply stitching the edges together. However, in areas where the skin is tight, such as on the leg below the knee or on the scalp, it may not be possible to close the skin directly and your doctor may recommend that you have a skin graft or a repair with a flap. More complicated wounds, particularly in visible parts of your body such as your face, may require complicated reconstructive surgery under the care of your plastic surgeon.
Lymph Node Surgery:
If it has been detected that the melanoma has spread to the lymph nodes that drain the original melanoma (primary), your surgeon is likely to offer you a lymph node dissection in the area that is affected. You can get more information about these procedures by clicking on the links at the left-hand side of this page.