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.

Learn more about:

Side effects of lymph node dissection
Lymphoedema

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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.

This information was last reviewed in January 2019. View who reviewed this content.

A/Prof Victoria Atkinson, Senior Staff Specialist, Princess Alexandra Hospital, Visiting Medical Oncologist, Greenslopes Private Hospital, and The University of Queensland Clinical School of Medicine, QLD; Adjunct Prof John Kelly AM, Consultant Dermatologist, Victorian Melanoma Service, and Department of Medicine at Alfred Health, Monash University, VIC; Dr Alex Chamberlain, Dermatologist, Glenferrie Dermatology, Victorian Melanoma Service and Monash Univeristy, VIC; Alison Button-Sloan, Melanoma Patients Australia; Peter Cagney, Consumer; Prof Brendon J Coventry, Associate Professor of Surgery, The University of Adelaide, Surgical Oncologist, Royal Adelaide Hospital, and Research Director, Australian Melanoma Research Foundation, SA; Dr David Gyorki, Consultant Surgical Oncologist, Peter MacCallum Cancer Centre, VIC; Liz King, Skin Cancer Prevention Manager, Cancer Council NSW; Shannon Jones, SunSmart Health Professionals Coordinator, Cancer Council Victoria; Caitriona Nienaber, 13 11 20 Consultant, Cancer Council WA; Prof Richard Scolyer, Senior Staff Specialist, Tissue Pathology and Diagnostic Oncology, Royal Prince Alfred Hospital, Co-Medical Director, Melanoma Institute Australia and Clinical Professor, The University of Sydney, NSW; Heather Walker, Chair, Cancer Council National Skin Cancer Committee, Cancer Council Australia. We also thank the health professionals, consumers and editorial teams who have worked on previous editions of this title.

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