Surgery plays an important role in the melanoma treatment landscape. For most patients, regardless of stage, surgery is the first treatment they will undergo. In fact, for patients with early-stage disease (stage 0 – 2), surgery may be the only treatment your melanoma requires! For patients with advanced melanoma, surgery is usually combined with systemic treatment options like targeted therapy or immune-based options.
The Goals for Melanoma Surgery:
For patients with melanoma that remains localized in the skin and has not spread beyond its primary site, the goal of surgery is to remove all detectible traces of the cancer from the body. For many patients with early-stage disease, surgery may be the only treatment needed.
Even after successful surgery, some patients may be at increased risk of recurrence. For these patients, adjuvant therapy – an additional treatment given after surgery to reduce this risk – may be appropriate. Talk to your doctor about your treatment options and any concerns.
For patients with advanced melanoma, or melanoma that has spread beyond its site of origin, surgery may be used to remove the primary site and affected lymph nodes before beginning a systemic treatment such as an immunotherapy or a targeted therapy regimen.
In some cases, systemic treatments (immunotherapies or targeted therapies) are started before surgery and then continued after the surgery is performed. This is called neoadjuvant therapy and research suggests that it can further improve patient outcomes and reduce the likelihood of melanoma returning.
- Wide Local Excision for Melanoma: A Wide Local Excision (WLE), sometimes described as a Wide Excision, is the most common surgical procedure used to remove melanoma.
- Sentinel Lymph Node Biopsy for Melanoma: A Sentinel Lymph Node Biopsy (SLNB) is a surgical procedure used to help determine if melanoma – and other cancers – have spread beyond its site of origin. SLNB is an important tool to help your doctor determine the stage, or extent, of your melanoma. This, in turn, will give you additional information to base future treatment decisions.
- Mohs Surgery for Melanoma: For non-melanoma skin cancers, such as basal cell carcinomas and squamous cell carcinomas, an alternative ‘tissue-sparing’ procedure is frequently performed called Mohs Micrographic Surgery. Mohs surgery is also sometimes used to treat melanoma in situ (stage 0), especially if it is lentigo maligna melanoma, a subtype of melanoma that typically occurs on sun-damaged skin.
- Complete Lymph Node Dissection for Melanoma: A Complete Lymph Node Dissection (CLND), sometimes called a lymphadenectomy, is a surgical procedure where all lymph nodes in a specific region are removed due to cancer cells being detected in some or all of the lymph nodes.