Dr. Vernon Sondak in the surgery room at Moffitt

Surgery is the main form of melanoma treatment. When skin cancer is detected early, surgery can often cure it and might be the only type of treatment a patient needs. However, when melanoma is found after it has started to metastasize, or spread to other parts of the body, a patient might require additional forms of treatment, such as chemotherapy or radiation therapy, in addition to a melanoma surgery.

Many types of melanoma surgery can be performed on an outpatient basis. The recovery time will depend on the extent of the surgery, but most people can resume their normal activities in a week or two.

Types of melanoma surgery

Skin cancer specialists have several surgical options to consider for patients diagnosed with melanoma. Melanoma treatment, including the type of surgery to perform, depends on many factors, such as whether the cancer is in its early stages or has spread to tissues beyond its original site.

At Moffitt Cancer Center, we take a highly individualized approach to treating melanoma. Patients receive treatment from a multispecialty team of skin cancer experts in our Cutaneous Oncology Program, one of the most advanced programs of its kind in the country. When recommending a particular type of melanoma surgery, our exceptionally experienced specialists will consider the patient’s specific diagnosis, overall health condition and other factors. Patients may also receive reconstructive or cosmetic surgery from surgeons in our Reconstructive Oncology Program.

Wide local excision of melanoma

Wide local excision is the most common form of surgery for melanoma in stages 1 and 2. This procedure is designed to remove a melanoma lesion, as well as a small margin of healthy skin around it. Usually, this is a fairly minor outpatient surgery during which the skin is numbed before the cancerous tumor and surrounding tissue are removed. The incision is stitched closed after the procedure is complete, and a sample of the tissue that was removed is sent to a lab to be checked for signs of cancer.

Mohs surgery for melanoma

Also called Mohs micrographic surgery, this procedure is named for physician Frederic E. Mohs, who developed the tissue-sparring technique. It’s most commonly used to treat other forms of skin cancer, but it may be appropriate for early-stage melanoma, especially a type of malignancy called lentigo maligna melanoma. This type of melanoma is typically slow-growing and often resembles an irregularly shaped freckle on the head or neck.

Mohs surgery is usually an outpatient procedure during which the patient receives a local anesthetic to numb the surgery site. The surgeon then removes the cancerous lesion and a layer of surrounding skin. Patients with basal cell or squamous cell carcinomas are usually bandaged, then told to wait at the surgery center while the removed tissue is examined under a microscope. If cancer cells are discovered in the layer of skin near the lesion, the patient is unbandaged so the Mohs surgeon can remove another layer of skin for analysis. This procedure is repeated until no cancer cells are detected in the excised tissue.

Mohs surgery for melanoma is modified to become a procedure known as “slow Mohs.” This procedure is essentially the same as regular Mohs surgery but takes place over a period of days instead of hours. This is because melanoma cells are harder to detect under a microscope than other types of skin cancer. In recent years, cancer specialists have refined the Mohs method by adding special chemical stains to the tissue that’s removed during Mohs surgery. The addition of these stains makes melanoma easier to spot under a microscope, but the process takes longer. Therefore, the patient is usually bandaged and sent home after Mohs surgery, then brought back a day later to receive the lab results. If melanoma is detected in the layer of tissue that was surgically removed, the patient will undergo another round of Mohs surgery.

At Moffitt, if our skin cancer specialists determine that Mohs surgery is an appropriate treatment for melanoma, the procedure is offered in conjunction with the University of South Florida Department of Dermatology.

Lymph node dissection as a melanoma treatment

This type of melanoma surgery is also known as a lymphadenectomy. It’s performed when the results of a lymph node biopsy indicate that the melanoma has spread into the patient’s lymphatic system. A lymph node dissection is a procedure during which the lymph nodes close to the melanoma are removed, then sent to a lab to be examined for signs of cancer. If cancer is discovered, the patient may be treated with radiation or chemotherapy.

Patients will usually receive general anesthesia before a lymph node dissection, but it’s typically an outpatient procedure that allows the patient to go home later the same day.

Amputation to remove melanoma

It’s rarely necessary. But in some cases when melanoma has spread far beyond its original site, amputation of a finger, ear or some other part of the body may be the best treatment option to relieve pain and slow the cancer’s progression.

The cancer surgeons at Moffitt have extensive experience performing both minor and complex limb amputations. Our cutaneous oncology team also includes plastic surgeons who specialize in performing reconstructive procedures to help minimize the adverse effects of amputation and other melanoma surgeries that require the removal of large sections of skin.

Why Moffitt Is Your Top Choice for Melanoma Surgery

Moffitt Cancer Center provides patients with a complete range of melanoma surgery options, from traditional excisions to more advanced operations. We have a team of expert surgeons who specialize in the removal of skin cancers, and each patient receives an individualized treatment plan that is tailored to his or her exact needs. Furthermore, we offer surgery, chemotherapy, radiation therapy and clinical trials in a single location, providing a streamlined experience when more than one type of treatment is required.

Moffitt is also the only Florida-based Comprehensive Cancer Center designated by the National Cancer Institute. As a result of our comprehensive and urgent approach to melanoma treatment, our patients have survival rates significantly above the national average for cancer centers throughout the nation.

For more information about melanoma surgery at Moffitt, call 1-888-663-3488 or complete a new patient registration form online. Your cancer diagnosis is our top priority, and we’re committed to connecting every new patient with a cancer expert as quickly as possible. Referrals are not required to meet with our team.