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Melanoma is a type of skin cancer. It often starts as a mole or dark spot on the skin. It spreads faster than many other types of cancer. And it can be fatal if not treated. Melanoma is often diagnosed after removal of the entire mole. Once a diagnosis is made, the area around the melanoma is also removed. If the cancer is caught early, it has a high chance of being cured.
Lymph nodes are small masses of tissue that are part of the body’s immune system. The sentinel node is the first lymph node a tumor drains into. So, it’s the first place that cancer is likely to spread. Depending on the thickness of your tumor, either the sentinel node or all the nearby lymph nodes may need to be removed. A sentinel node biopsy is a test often done during melanoma removal surgery. This helps the doctor know which lymph nodes to remove. If you will have a sentinel node biopsy, your doctor can tell you more about what to expect.
Prepare for the surgery as you’ve been told. In addition:
Tell your doctor about all medicines you take. This includes over-the-counter medicines, herbs and other supplements. It also includes any blood thinners, such as warfarin, clopidogrel, or daily aspirin. You may need to stop taking some or all of them before surgery.
Follow any directions you are given for taking medicines and for not eating or drinking before surgery.
If you’re having a sentinel node biopsy, you may have an injection of harmless dye the day before surgery.
The surgery takes about 2 to 3 hours. You go home the same day.
An IV (intravenous) line is put into a vein in your arm or hand. This line supplies fluids and medicines.
You will be given medicine to keep you pain free during surgery. This may be general anesthesia, which puts you into a deep sleep. A tube may be inserted into your throat to help you breathe. Or you may have sedation, which makes you relaxed and sleepy. If you have sedation, local anesthesia will be injected to numb the area being worked on. The anesthesiologist will discuss your options with you.
If you’re having a sentinel node biopsy, harmless blue dye is injected to help the doctor locate lymph nodes where cancer may have spread.
An incision is made at the tumor site. The tumor is removed along with some of the normal tissue around it. This helps ensure that any cancer cells that may have spread to nearby skin are removed.
One or more lymph nodes near the tumor may be removed. These are checked for cancer cells (a sign that cancer has spread).
The incision may be closed with stitches or staples. In some cases, a skin graft or flap may be needed to help close the site. This can come from your own body, a donor, or manmade sources. The doctor will discuss the different types of grafts with you before the surgery.
You’ll be taken to a room to wake up from the anesthesia. You may feel sleepy and nauseated. If a breathing tube was used, your throat may be sore at first. You’ll be given medicine to manage pain. When it’s time for you to be released from the hospital, have an adult family member or friend ready to drive you.
Once at home, follow the instructions you’ve been given. Your doctor will tell you when you can return to your normal routine. Be sure to:
Take all medicine as directed.
Care for your incision as instructed.
Don't do heavy lifting or strenuous activities.
Don't drive until your doctor says it’s OK. Don’t drive if you’re taking medicine that makes you sleepy or drowsy.
Follow your doctor’s guidelines for showering. Avoid swimming, bathing, using a hot tub, and other activities that cause the incision to be covered with water until your doctor says it’s OK.
Call your healthcare provider right away if you have any of the following:
Chest pain or trouble breathing (call 911)
Fever of 100.4°F (38°C) or higher, or as directed by your healthcare provider
Symptoms of infection at an incision site, such as increased redness or swelling, warmth, worsening pain, or foul-smelling drainage
Pain that cannot be controlled with medicine
You will have follow-up visits so your doctor can see how well you’re healing. If needed, stitches or staples will be removed at one of these visits. You and your doctor can also discuss any further treatments you may need.
Risks and possible complications include:
Scarring at the surgery site
Problems with the skin graft (if one was used)
Failure to remove all of the cancer, requiring further treatments
Risks of anesthesia
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