Removing the lymph nodes

If your doctor’s examination, ultrasound or lymph node biopsy shows that the melanoma has spread to your lymph nodes (regional melanoma or stage III), you will have scans regularly and, in some cases, may be offered immunotherapy or targeted therapy (systemic treatment). If melanoma has spread to lymph nodes and caused a lump, the lymph nodes will be removed in an operation called a lymph node dissection or lymphadenectomy. This is performed under a general anaesthetic and requires a longer stay in hospital. Usually only the lymph nodes near the melanoma are removed.

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Side effects of lymph node dissection

Having your lymph nodes removed can cause side effects, such as:

Wound pain – Most people will have some pain after the operation, which usually improves as the wound heals. For some people, the pain may be ongoing, 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 do gentle exercises or see a physiotherapist.

Seroma/lymphocele – 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 is drained by having a needle inserted into the fluid-filled cavity after surgery.


Lymphoedema

If lymph nodes have been surgically removed, your neck, arm or leg may swell. This is called lymphoedema. It happens when lymph fluid builds up in the affected part of the body because the lymphatic system is not working as it should.

The chance of developing lymphoedema following melanoma treatment depends on the extent of the surgery and whether you’ve had radiation therapy that has damaged the lymph nodes. It can develop a few weeks, or even several years, after treatment.

Although lymphoedema may be permanent, it can usually be managed, especially if treated at the earliest sign of swelling or heaviness.

How to prevent and/or manage lymphoedema

  • Keep the skin healthy and unbroken to reduce the risk of infection.
  • Wear a professionally fitted compression garment if recommended by your doctor or lymphoedema practitioner.
  • Always wear gloves for gardening, outdoor work and housework.
  • Moisturise your skin daily to prevent dry, irritated skin.
  • Protect your skin from the sun.
  • Don’t pick or bite your nails, or cut your cuticles.
  • Try to avoid scratches from pets, insect bites, thorns, or pricking your fingers.
  • Do regular exercise to help the lymph fluid flow, such as swimming, bike riding or yoga.
  • Massage the affected area to help move lymph fluid.
  • Avoid having blood taken or blood pressure done on the arm on the affected side.
  • Visit the Australasian Lymphology Association (ALA) to find a lymphoedema practitioner or ask your doctor for a referral.
  • If your skin feels swollen or hot, see your doctor as soon as possible as these may be signs of infection.

For more on this, see Lymphoedema.


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Apple devices

The iBooks application must be installed on your Apple device before you can read the EPUB.
Different ways to download an EPUB file to your Apple device:

  • email EPUB files to yourself and transfer the attachment to iBooks.
  • copy EPUB files into DropBox (or a similar service) and use the DropBox app to send them to iBooks.
  • open EPUB files directly from Mobile Safari and open them in iBooks, where they are saved automatically by downloading the EPUB from the website.

Need more help? Visit: http://support.apple.com/kb/HT4059

Kobo

To download an EPUB file to your Kobo from a Windows computer:

  • download and save the EPUB directly onto your desktop.
  • connect your Kobo to your computer using the USB cable and tap “Connect” on your eReader.
  • select “Open folder to view files” to view the contents of your Kobo.
  • navigate to where you have stored your EPUB file in “Finder”, in documents or downloads, and drag and drop it into the Kobo window. You can now disconnect your Kobo to read the eBook.

To download an EPUB to your Kobo from a Mac:

  • download and save the EPUB directly onto your desktop.
  • connect your Kobo to your computer using the USB cable and tap “Connect” on your eReader.
  • open your “Finder” application.
  • select “Kobo eReader” from the listed devices to view the contents of your Kobo.
  • navigate to where you have stored your EPUB file in “Finder”, probably in documents or downloads, and drag and drop it into the Kobo window. You can now disconnect your Kobo to read the eBook.

Turn on your Kobo and your EPUB will be located in “eBooks”, while a PDF will be located in “Documents”.
Need more information? Visit: http://www.kobo.com/help/koboaura/response/?id=3784&type=3

Sony Reader

To download an EPUB file on your Sony Reader™:

  • ensure you have already installed the Reader™ Library for PC/Mac software
  • select the eBook you want from our website and click the link to download it.
  • connect the Reader™ to your computer.
  • open the Reader™ Library software and click “Library” in the left-hand pane and select the eBook to view it.

Need more help? Visit: https://au.readerstore.sony.com/apps_and_devices/

Amazon Kindle 2nd Generation devices

EPUB files can’t be read on the Amazon Kindle™. However, like most eReaders, Kindle™ 2nd Generation devices are able to display PDFs. We recommend that you download the PDF version of this booklet if you would like to read it on a Kindle™.
To transfer a PDF to your Kindle™ via USB cable from your computer or Mac:

  • download the PDF directly onto your computer.
  • connect the USB cable to your computer’s USB port, and the micro USB end of the cable to your Kindle™. Note: the Kindle™ won’t be available as a reading device while it is connected to your computer until it has been disconnected.
  • open the Kindle™ drive and several folders will appear inside. The “Documents” folder is where you will need to copy or drag the PDF to.
  • safely eject your Kindle™ from your computer and unplug the USB cable. Your content will appear on the Home Screen.

Kindle also provides a Kindle Personal Documents Service that allows users to send documents as an attachment directly to your eReader. For more information on this service, visit http://www.amazon.com/gp/help/customer/display.html/ref=help_search_1-1?ie=UTF8&nodeId=200767340&qid=1395967989&sr=1-1
For more information on accessing a PDF on your Kindle™, visit www.amazon.com/manageyourkindle, log in to your account and click on Personal Document Settings.
Need more help? Visit https://www.amazon.com/gp/help/customer/display.html?nodeId=200375630

Android and PC

You can also download and open eBooks on Android devices and PCs with appropriate apps or software installed. Suitable eReader apps for Android include Google Play Books, FBReader and Moon+ Reader. Suitable software for PCs include Calibre and Adobe Digital Editions.


This information was last reviewed in January 2019
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