Removing the cancer surgically is almost always the primary treatment for melanoma.
For cancers that have not spread beyond the epidermis, surgery alone may be curative. The type of surgery you may need will depend on your cancer’s size, location and other factors.
Melanoma surgery may involve:
- Wide local excision. This surgical procedure removes the cancer along with some surrounding healthy tissue, so that the remaining bordering tissue or margins are free from cancer. Oftentimes, skin cancers are like icebergs in that just a small portion is visible on the surface of the skin, but below the skin the cancer can be much larger. In these cases, our surgeons may repair the surgery site with a skin graft.
- Sentinel lymph node biopsy. This is usually performed at the same time as a local wide excision. The surgeon injects a dye near the tumor and uses a device to identify which lymph nodes the melanoma is most likely to have spread to first. These are then removed for pathology analysis.
- Staged excision. Also known as “slow” Mohs surgery or “modified” Mohs surgery. This option may be best for melanomas in highly cosmetically sensitive areas, such as the face. During a staged excision, the tumor is removed in steps over a series of days and the tissue is mapped an analyzed after each step to ensure full removal of cancer with limited damage to normal tissues. During the multiday tumor removal, the surgical site is left open and only repaired once all tumor-laden skin has been completely removed.
- Lymph node dissection. If cancer is found in the lymph node basin or tumor area, your surgeon may remove additional lymph nodes to be examined for cancer by the Roswell Park pathology department.
- Plastic and reconstructive surgery. Our onsite plastic & reconstructive surgeons offer many procedures that can restore or improve your appearance and/or function of body structures. These surgeons will collaborate with your clinical care team to plan appropriate treatment. Some patients may have their tumor removed and plastic and reconstructive surgery to repair the site on the same day.