What is Malignant melanoma?
Malignant melanoma is a type of cancer of the pigment producing cells within the skin. They are usually dark and irregular patches and the complexity of the treatment is related to their size and depth. Each requires a bespoke surgical management strategy. Malignant melanoma is most commonly caused by sun damage especially sunburn, but this may have occurred many years ago and have been forgotten.
What are the non-surgical and surgical options available?
There are no non-surgical options for primary malignant melanoma. With surgery, complete removal of the cancer is recommended for diagnostic purposes. Once a formal diagnosis has been made further surgery is usually advised. The surgery – as well as the type of anaesthesia used – will be dependant on the size and depth of the melanoma. A reconstruction (the process by which the resultant hole is closed) will be planned for this second surgery. In certain circumstances further tests (such as CT scans, ultrasound or sentinel lymph node biopsy) are required to investigate whether the melanoma has spread to lymph nodes or other areas of the body. If necessary, a multidisciplinary approach is advocated with oncology input.
How long do the results last for?
The aim of melanoma surgery is to control the local disease to prevent recurrence. 20% of cases are advised to also have the lymph nodes removed to prevent melanoma recurring in the local area lymph nodes. There are nationally agreed guidelines on management and follow on care and screening, but as new research comes out, the treatments on offer will change. Each patient’s case will be reviewed in line with best current evidence.
What are the risks?
The trade off is always the scar, which should be actively managed during the first year or two of maturation. This is usually of good quality, whereby the scar is thin and pale, making it especially easy to camouflage, but ethnicity and genetic factors can affect the appearance significantly. A small risk of recurrence is always sited before the operation. Infection, bruising, bleeding and swelling are risks of any surgery. If lymph nodes are also removed, there is the additional risk of lymphatic drainage problems (lymphoedema).
What are the success rates?
This is all dependent on the depth of the original melanoma and/or the severity of spread at the initial presentation. If melanoma is caught very early, then it can be completely treated with a single surgery. In late melanoma, often multiple surgeries are required for local control.
How much does the surgery cost?
The indicative prices below include the surgical fee, any anaesthetic used and the associated fees from the consultant administering this, in addition to the hospital fee and all tests and follow up. An accurate breakdown and a detailed quote will be given following the initial consultation.
From £400 for biopsy under local anaesthetic
From £1,600 for removal and reconstruction under local anaesthetic.
From £5,000 for lymph node removal under general anaesthetic.
What general advice is there?
As the range of options is varied between individuals, Chris will design a bespoke package of care for surgery, follow on care and screening (if required).
Facts for Malignant melanoma
- Surgery duration: 30 minutes - 2 hours
- Type of anaesthesia: Usually local anaesthetic, occasionally general anaesthetic
- Time in hospital: Up to 2 days
- Time off work: Up to 2 weeks
- Recovery time: Up to 2 weeks
- First follow up appointment: 1 week
- Total number of follow up appointments: 2-10
- Pain management: Simple pain relief (paracetamol and/or ibuprofen) once discharged, occasionally tramadol at night
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