Surgery is the most common and effective treatment for melanoma. The surgical procedure used depends on the stage and location of the cancer, the patient’s overall health, and a variety of other factors. Dr. Patel, can you tell us more about surgery for the early stages of melanoma?
Absolutely, Dr. Mayzik. Surgery in these early stages generally involves removal of the primary tumor, as well as a border of skin around the melanoma, called the margin. The margin is examined under a microscope to be sure all the cancerous cells have been removed and that the cancer has not spread. The size of the margin depends on the extent of the melanoma.
Stage 0 melanoma is usually treated by surgically removing the area of abnormal cells and a five to nine millimeter margin of normal skin around it.
Stage I and stage II melanoma are treated by surgically removing the melanoma, as well as a one to two centimeter margin of normal skin, depending on the thickness of the melanoma.
Because the cancer may have spread to lymph nodes near the melanoma, many providers recommend lymph node removal and a sentinel lymph node biopsy. The sentinel node is the first lymph node where the primary melanoma drains cancer cells into the lymph system.
In some cases of stage II melanoma, for example if a tumor is found to be more than four millimeters thick or if lymph nodes do contain cancer, some providers may suggest additional treatment, called adjuvant therapy, after surgery.