If the sentinel lymph node biopsy showed that the melanoma has spread to your lymph nodes (regional melanoma), they will be removed in an operation called a lymph node dissection or lymphadenectomy.
This is performed under a general anaesthetic and requires a stay in hospital. The lymph nodes you have removed are likely to be near the location of the primary melanoma. There are large groups of lymph nodes in the neck, armpits and groin.
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Like most treatments, having your lymph nodes removed can cause side effects, such as:
- Wound pain – Most people will have some pain after the operation. This usually improves as the wound heals. For some people, however, pain may continue after the wound has healed, especially if lymph nodes were removed from the neck. Talk to your medical team about how to manage your pain.
- Neck/shoulder/hip stiffness and pain – These are the most common problems if lymph nodes in your neck, armpit or groin were removed. You may find that you cannot move the affected area as freely as you could before the surgery. It may help to see a physiotherapist.
- Seroma/lymphocoele – This is a collection of fluid in the area where the lymph glands have been removed. It is a common side effect of lymph node surgery. Sometimes this fluid needs to be drained by having a needle inserted into the fluid-filled cavity.
If lymph nodes have been surgically removed, swelling of the neck, arm or leg is the most common problem that can occur.
Occasionally it can affect the breast tissues. This is called lymphoedema and it happens due to a build-up of lymph fluid in the affected part of the body.
The likelihood of lymphoedema following treatment depends on the extent of the surgery and whether you’ve had radiotherapy that has damaged your lymph nodes. It can develop a few weeks, or even several years, after treatment.
Although lymphoedema may be permanent, it can usually be managed.
How to prevent and/or manage lymphoedema
Below are some steps you can take that may help you prevent and/or manage lymphoedema:
- Keep the skin healthy and unbroken. This will reduce the risk of infection.
- Wear a professionally fitted compression garment if recommended by a physiotherapist or occupational therapist.
- Always wear gloves for gardening, outdoor work and housework.
- Moisturise your skin daily to prevent dry, irritated skin.
- Use sunscreen to protect your skin from sunburn.
- Don’t pick or bite your nails, or push back your cuticles.
- Avoid scratches from pets, insect bites, thorns, or pricking your fingers.
- Do light exercise to help the lymph flow, such as swimming, bike riding or light weights.
- Massage the affected area to help move fluid.
- See a lymphoedema practitioner – talk to your doctor or visit Australasian Lymphology Association.
- Seek medical help urgently if you think you may have an infection.