Surgery

Surgery is the best way to remove early melanomas. Later stages usually require more extensive treatment.

Simple Excision – Thin melanomas are surgically removed, along with a small amount of non-cancerous skin at the edges. This procedure can result in a complete cure of most patients with thin melanomas (stage 1).

Re-excision (Wide Local Excision) - After a biopsy has confirmed the diagnosis of melanoma, the site will be excised again. This procedure removes more tissue around the primary melanoma for examination to confirm that no cancer cells remain. If a large area of tissue is removed, a skin graft may be done at the same time.

Therapeutic Lymph Node Dissection – This procedure is performed when the lymph nodes nearest the melanoma feels abnormally large or hard. The lymph nodes are surgically removed and examined microscopically for evidence of melanoma cells. Your doctor may perform a procedure called Lymph Node Mapping. This procedure is used when there are several lymph node basins that drain from one primary tumor site, allowing the doctor to identify the nodes that are suspected of containing melanoma cells.

Moh’s Surgery - Using a microscope to examine the tissue, the surgeon excises the growth layer by layer until only healthy tissue remains. Each section is microscopically reviewed by the Mohs surgeon (who is trained in the interpretation of horizontally oriented pathology specimens). In cases where microscopic examination reveals tumor in one or more of the subdivided specimens, a corresponding mark is drawn on the Mohs map. The concept of orienting the tissue specimens horizontally, which allows for review of 100 percent of the surgical margin, is unique and is what sets Mohs micrographic surgery apart from all other skin cancer removal techniques.

(Information provided by Chiron)