Surgery for advanced melanoma

Surgery for advanced melanoma is not commonly done. But some people might have surgery if:

• there is only 1 tumour
• there are a few tumours, but they are all in 1 area
• the tumours are not too big
• a tumour is causing difficult symptoms.

This may be when the melanoma has spread to:

• areas of skin or lymph nodes far away from where the melanoma started
• the brain
• the liver
• the lung.

The type of operation you have depends on where the melanoma has spread. Your operation will be done by a specialist surgeon. The type of surgeon will depend on the part of the body that is affected.

Surgery to remove secondary melanoma in the brain, liver or lung is a big operation. The surgeon will check first to make sure it is suitable for you. They will talk to you about the possible benefits and risks of the surgery before you decide.

You usually need scans to check the melanoma has not spread anywhere else. You will also have other tests to make sure you are well enough to cope with the operation.

Before your operation, the surgeon and nurse will talk it over with you. It is important that you understand what it may involve. They will explain what to expect and how to prepare for your surgery.

You may have other treatments before or after your operation.

Melanoma can spread to lymph nodes far away from the primary melanoma. The lymph nodes may become enlarged or feel hard. If this is uncomfortable or painful, you may have an operation to remove them.

You will have the operation under general anaesthetic. You may be in hospital for a few days. The type of operation you have depends on where the lymph nodes are. Your surgeon or specialist nurse will tell you more about what to expect.

You may have a small tube (drain) to remove any fluid that builds up around your wound. The drain is connected to a small bottle. Your nurse will remove the drain when most of the extra fluid has drained away. This is usually within a few days.

Some people 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 7 to 10 days after the operation. If you have dissolvable stitches, they will not need to be removed. The hospital nurses can show you how to take care of your wound. Or they can arrange for a district nurse to do it for you at home.

If your lymph nodes have been removed, you may develop swelling in an arm, leg or other part of the body. This will depend on where in the body the lymph nodes were removed. This is called lymphoedema. 

We have more information about how to reduce your risk of lymphoedema.

Surgery to remove secondary melanoma from the lungs or liver is a big operation.

You may be in hospital for up to a week. But it may take several weeks or longer to recover. You may have surgery after you have finished immunotherapy or targeted treatments. These may help to shrink the cancer.

An operation to remove secondary tumours in the liver is called a liver resection. It takes several hours and is done in a specialist liver unit. After surgery, the remaining liver can grow bigger and work as it did before.

Surgery to the lung will depend on how much of the lung is affected. It may be a small section of the lung, or a larger area. Removing part of the lung will not affect your breathing.