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Melanoma: The Negative Impact

By: Morag Currin
Posted: August 1, 2011, from the August 2011 issue of Skin Inc. magazine.

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People with melanoma may opt to treat it through surgery, chemotherapy, radiation therapy, biological therapy or they may undergo a combination of treatments. At any stage of the disease, people with melanoma may have treatment to control pain and other symptoms of the cancer, to relieve the side effects of therapy, and to ease emotional and practical problems. This kind of treatment is called symptom management, supportive care or palliative care.

Surgery. Surgery is the usual treatment for melanoma—the surgeon removes the tumor and some normal tissue around it. This procedure reduces the chance that cancer cells will be left in the area. The width and depth of the surrounding skin that needs to be removed depends on the thickness of the melanoma and how deeply it has invaded the skin. If a large area of tissue is removed, the surgeon may do a skin graft. For this procedure, the doctor uses skin from another part of the body to replace the skin that was removed. Lymph nodes near the tumor may be removed as well because cancer can spread through the lymphatic system. If the pathologist finds cancer cells in the lymph nodes, it may mean that the disease has also spread to other parts of the body. Two procedures are used to remove the lymph nodes.

Sentinel lymph node biopsy. A sentinel lymph node biopsy is done after the biopsy of the melanoma but before the wider excision of the tumor. If a sentinel node contains cancer cells, the surgeon removes the rest of the lymph nodes in the area. However, if a sentinel node does not contain cancer cells, no additional lymph nodes are removed.

Dissection. A lymph node dissection is when all the lymph nodes in the area of the melanoma are removed.

Skin side effects of surgery. Scarring can be a problem for some clients. Generally, scars fade with time, and how noticeable the scar is depends on where the melanoma was, how well the person heals and whether the person develops raised scars, known as keloids. Skin grafts can reduce the scarring caused by the removal of a large growth; however, scars will still be noticeable. Scar tissue is usually weaker, less elastic, more prone to re-injury and can be much more sensitive to pain than normal, healthy tissue. Specialized massage techniques for tissue adhesion can be performed.