NCCN Guidelines for Patients® | Melanoma - page 35

35
NCCN Guidelines for Patients
®
: Melanoma
Version 1.2013
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Part 4: Overview of melanoma treatments
Definitions:
General anesthesia:
A controlled loss of
wakefulness from drugs
Lentigo maligna
melanoma:
The slowest
growing type of melanoma;
it starts in sun-exposed
skin and is commonly
mistaken for a sunspot
Local anesthesia:
A
controlled loss of feeling
in a small area of the
body due to drugs being
administered to that area
Lymph node:
Small
groups of special disease-
fighting cells located
throughout the body
Primary treatment:
The
main treatment used to rid
the body of cancer
Skin biopsy:
Removal of
a sample of tissue from the
skin to test for disease
4.1 Surgery
Generally, surgery is the primary treatment for melanoma skin cancer. Thus,
almost all patients with melanoma will have surgery after the skin biopsy. The
goal of surgery is to remove all of the cancer from your body. There are different
types of surgery used for melanoma. The two main types of surgery used for
melanoma are a wide excision and a lymph node dissection.
Wide excision
A wide excision is surgery that removes the entire melanoma tumor along with
some normal-looking tissue surrounding it (Figure 10). The normal-looking
tissue is called the surgical margin. The size of the surgical margin, measured
in cm (
c
enti
m
eters) depends mostly on the thickness of the tumor. Depending
on the size of the surgical margin and the location of the melanoma, a wide
excision may be done using local anesthesia that is injected into the area to
numb it before the surgery. When wider margins are removed, or when wide
excision is combined with lymph node surgery, general anesthesia is usually
needed. For lentigo maligna melanoma, particularly on the face, different types
of surgery may be recommended to very carefully examine the surgical margins.
Figure 10. Area of
wide excision with
a 1.5 cm margin
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