Melanomas

Melanomas are cancers of the pigment cells in the skin, rather than cancers of the skin cells. When caught early they are very treatable.

Melanomas need to be removed surgically with a clear margin of normal tissue. The margin of normal tissue required depends on the depth of the melanoma (how deeply it extends into the skin and subcutaneous tissues).

Sometimes the amount of tissue removed will need special techniques to close the wounds, such as flap repairs or skin grafts. If a melanoma is beyond a certain depth, a sentinel node biopsy may also be needed. This is a technique to remove certain lymph nodes to check for melanoma cells which may have spread to the lymph nodes. (see sentinel node biopsy under breast cancer)

Portacaths

For patients who need chemotherapy or other treatments administered intravenously over long periods of time, a portacath may be recommended.

A portacath consists of a metal chamber with a plastic dome, connected to a long piece of tubing. The tubing is placed into a vein, and passed into the major blood vessel in the centre of the chest; the other end is passed under the skin to a “pocket” created under the skin, usually next to the breastbone or sternum. The tubing is connected to the metal chamber, which is placed into the pocket. 

This is usually done under a general anaesthetic as a day case in one of the hospitals.

Biopsies for lymphoma diagnosis

Patients with possible lymphoma ( a cancer of the cells of the lymphatic system which affects the lymph nodes) may need one of the lymph nodes removed to obtain a diagnosis of which specific lymphoma subtype they may have. This guides their further treatment.

Nodal Clearances

Sometimes patients may need a group of lymph nodes removed, particularly in the setting of metastatic cancer (cancer which has spread from its original site). Occasionally, there may be evidence of metastatic cancer, even though the original cancer can not be found. It may be necessary to remove all/most of the lymph nodes in the armpit (axillary clearance), the groin (inguinal clearance) or one side of the neck (neck clearance).