There are multiple types of melanoma surgeries and procedures to treat and prevent the spread or return of this aggressive cancer. Melanoma highly treatable — and even curable — when found and treated early.
At Penn Medicine, our multidisciplinary team of melanoma surgeons has the expertise to treat all forms of melanoma, no matter where it occurs.
Melanoma Surgery: The Penn Medicine Advantage
At Penn’s Abramson Cancer Center, our surgeons at the Tara Miller Melanoma Center specialize in complex melanoma surgery for tumor removal and reconstruction surgeries. We’re nationally known for our use of Mohs surgery to treat high-risk melanoma. Meet your melanoma team.
Surgery for Melanoma Skin Cancer
Surgery is the first treatment for many types of melanoma and the primary treatment for people with localized melanoma (stages I, II and III), with the goal of removing tumors as completely as possible. We specialize in precise techniques that reduce surgery’s effects on your appearance. Surgery for melanoma skin cancer includes:
Wide Local Excision
Your surgeon removes the tumor and a margin (border) of surrounding healthy tissue to ensure that no cancer remains. We use wide local excision for melanoma tumors that have not spread to other areas. Depending on the site and extent of the surgery, a skin graft may be necessary. A skin graft is a procedure using the skin from another part of the body to close the wound and reduce scarring.
Mohs Surgery
Mohs surgery is a highly skilled and precise surgical technique for the removal of various types of face, head and neck skin cancers, including basal cell carcinoma, squamous cell carcinoma and melanoma. This type of surgery can also be used to remove rare or high-risk skin cancers that occur on the trunk and extremities.
The surgeon removes the tumor and a thin margin of tissue, examining it under a microscope for signs of cancer. If the margin contains cancer cells, the surgeon removes and examines another layer until no cancer remains.
Our dermatology surgeons specialize in Mohs micrographic surgery to treat melanoma that has a higher risk of complications. Our surgeons examine the tissue in our on-site lab for a faster procedure. They may do reconstruction during the same procedure.
Sentinel Lymph Node Biopsy (SLNB)
The sentinel lymph node biopsy (SLNB) procedure checks lymph nodes near a melanoma tumor to see if cancer has spread there. Near the tumor, we inject dyes that travel to nearby lymph nodes. We remove the closest lymph node or nodes (sentinel nodes), which pick up the dye, and check them for cancer. In some cases, our surgeons coordinate with our dermatologists to perform a SLNB with Mohs surgery.
If you have been diagnosed with melanoma, SLNB may be used to help determine the stage of your cancer. Melanoma often spreads first to the lymph nodes, so we look at them to determine how much it may have progressed. This helps us to better understand your particular melanoma so we can develop a treatment plan that’s right for you.
Lymph Node Dissection
Your surgeon may detect an enlarged lymph node on examination or imaging. If that node contains cancer, we may operate to remove the remaining nearby lymph nodes. A possible side effect of lymph node dissection is lymphedema, when fluid builds up in an arm or leg nearest the dissection.
Isolated Limb Perfusion (ILP)
Isolated limb perfusion is used in conjunction with surgery to deliver a high-dose of chemotherapy directly to your affected limb. If you have melanoma that is not contained to one location in your body, ILP may be used to limit recurrence of melanoma. ILP allows for a much more targeted and higher dose of chemotherapy than you’d be able to receive intravenously.
Surgery for Mucosal Melanoma
Surgery is usually the first treatment for mucosal melanoma. We perform a wide excision to remove the tumor.
Surgery for Eye (Ocular) Melanoma
Depending on the tumor’s size and location, we may recommend surgery to remove ocular melanoma. Our team discusses all appropriate options with you to decide which treatments best meet your needs, goals and preferences.
Our cancer surgeons, ophthalmologists and ocular plastic surgeons have specialized training and experience in delicate eye surgeries. When possible, we remove only the part of the eye with melanoma to help preserve eye function and appearance.
Surgeries to treat ocular melanoma include:
- Partial removal: Our surgeons perform several types of procedures to remove just the melanoma tumor or the tumor plus part of the eye.
- Enucleation: We may remove the entire eyeball if the tumor is large or your vision has been lost. During the same procedure, the surgeon usually places an orbital implant and attaches it to muscles for movement.
- Orbital exenteration: This procedure removes the entire eyeball and some nearby tissues, such as parts of the eyelid, muscles, nerves or other tissues. We can also place an orbital implant during this procedure.
- Prosthetic eye: You may see an ocularist (specialist in prosthetic eyes) after receiving an orbital implant. The ocularist fits you with an artificial eye, a thin shell that covers the implant and matches your other eye.
- Isolated limb perfusion (ILP): This treatment option is for people with stage 3 (locally advanced) melanoma in an arm or leg, when the melanoma cannot be removed surgically. This highly specialized technique, offered at few centers, isolates the affected area and infuses the melanoma with high-dose chemotherapy.
- Isolated limb infusion (ILI): This technique also provides an infusion of high-dose chemotherapy to treat stage 3 (locally advanced) melanoma in an arm or leg. Unlike ILP, ILI requires no incisions — we perform the procedure percutaneously (through the skin).
Supplementing Melanoma Surgery With Other Treatments
Depending on your needs, we may recommend other cancer treatments, either in combination with or instead of surgery:
- Before surgery: Some types of treatment can start to treat the melanoma tumor before surgery. These treatments can also help prevent melanoma from spreading to other parts of the body (metastatic melanoma).
- After surgery: Some cancer treatments can help prevent melanoma from coming back after your initial treatment (cancer recurrence).
- Instead of surgery: Surgery might not be an option for you if a tumor is in a hard-to-reach or critical area, such as certain parts of the brain. Instead, you might have radiation therapy, immunotherapy, targeted therapy, chemotherapy or a combination of treatments.
At the Tara Miller Melanoma Center, our team has years of experience in all available treatments for melanoma, including:
We also offer services and therapies to help you and your family during melanoma treatment. Learn more about our patient and family support services.
Emphasis on Patient Education
Your care team helps you understand melanoma, your treatment options and ways to prevent cancer from recurring (coming back). Find these common questions to ask your doctor about melanoma.
Leading Research and Clinical Trials
Many of our clinical trials evaluate ways to combine surgery with other treatments, including immunotherapy, targeted therapy and radiation therapy. You may be eligible to receive promising new treatments before they’re available to the public. Learn more about our research at the Tara Miller Melanoma Center.
Request an Appointment to Discuss Melanoma Surgery Options
Call 800-789-7366 to schedule an appointment with one of our melanoma experts. You can also request an appointment using our online form.