Surgery to remove the lymph nodes for melanoma
Surgery to remove the lymph nodes
If melanoma has spread to your lymph node, your doctor may talk to you about surgery to remove them. This operation is called a lymph node dissection or lymphadenectomy.
Having lymph nodes removed can cause side effects. It is quite a big operation and can leave a large scar. It can also cause, or put you at higher risk of, lymphoedema. Lymphoedema is chronic swelling in an area near the area of surgery, usually an arm or leg.
Your cancer team will talk to you about these risks before you make a decision about surgery. They will explain other treatments that may also be helpful or that are less likely to have risks for you.
This operation is sometimes used if melanoma has spread to the following places:
- Nearby lymph nodes (stage 3 melanoma). If this happens, and you cannot have treatment with targeted or immunotherapy drugs, or you have already had these treatments you may have surgery. The aim is to remove the cancer cells. This reduces the risk of melanoma coming back in the same area and causing symptoms.
- Lymph nodes further away from the melanoma (stage 4 or advanced melanoma). The aim is to reduce any symptoms caused by the cancer in the lymph nodes, such as discomfort or pain.
Your surgeon will remove your lymph nodes under a general anaesthetic. You are likely to be in hospital overnight and may need to stay in for 3 to 5 days.
After your operation
After the operation, you may have a small tube (drain) in place. This lets any fluid that builds up around the wound drain out of the body into a small bottle.
The nurse will remove the tube when most of the fluid has drained away. This is usually within a few days. You might go home with the drain in place. It can be removed by a practice nurse at your GP surgery or a district nurse at home.
The wound will be covered with a dressing. Your stitches or staples will be removed 10 to 14 days later. If you have dissolvable stitches, these will not need to be removed.
You will probably have some discomfort or pain afterwards, but you can have regular painkillers to help with this.
After your operation, you may see a physiotherapist. They will show you some exercises to help you move normally again.
Before you go home, your nurse will give you advice about looking after the wound. They will also tell you who to contact if you have any problems or signs of infection including:
- wound redness or swelling
- the wound feeling painful or hot to touch
- pus leaking from the wound.
If you develop an infection this can be treated with antibiotics.
Some people get a small collection of fluid around the wound scar. This is called a seroma. It usually goes away within a few weeks. Sometimes your surgeon may need to drain the fluid with a needle and syringe.
It may take some time to recover following this operation. Your surgeon or nurse will explain what to expect. They will give you advice about driving, heavy lifting and other activities.
Further treatment
After surgery to remove the lymph nodes, your doctor will explain any further treatment you need. These may include targeted therapy or immunotherapy drugs to:
- reduce the risk of melanoma coming back
- treat the melanoma if it was not possible to remove all the cancer during surgery
- treat melanoma in other areas of the body.
You may have radiotherapy if the surgeon is not able to remove all the cancer in the area of the lymph nodes. This is to treat any remaining cancer.
About our information
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References
Below is a sample of the sources used in our melanoma information. If you would like more information about the sources we use, please contact us at cancerinformationteam@macmillan.org.uk
Michielin O, van Akkooi ACJ, Ascierto PA, et al. Cutaneous melanoma: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up. Annals of Oncology. 2019; 30, 12, 1884-1901 [accessed May 2022].
Michielin O, van Akkooi ACJ, Ascierto PA, et al. ESMO consensus conference recommendations on the management of locoregional melanoma: under the auspices of the ESMO Guidelines Committee. Annals of Oncology. 2020; 31, 11, 1449-1461 [accessed May 2022].
Peach H, Board R, Cook M, et al. Current role of sentinel lymph node biopsy in the management of cutaneous melanoma: A UK consensus statement. Journal of Plastic, Reconstructive & Aesthetic Surgery. 2020; 73, 1, 36-42 [accessed May 2022].
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Reviewers
This information has been written, revised and edited by Macmillan Cancer Support’s Cancer Information Development team. It has been reviewed by expert medical and health professionals and people living with cancer. It has been approved by Senior Medical Editor, Dr Samra Turajlic, Consultant Medical Oncologist.
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