Treatment of melanoma:Treatments for melanoma include surgery, radiotherapy and chemotherapy.

Melanoma is treated most effectively when the cancer is in its early stages, when it is still confined to the epidermis.

Surgery

Melanomas are always removed by surgery. The tumour is cut out, along with an area of normal-looking skin from around the melanoma. Sometimes, if the melanoma is at an early stage, the whole melanoma is removed at the initial biopsy and no further treatment is needed.

People with a melanoma which has grown deeper into the skin need to be admitted to hospital so a larger amount of skin can be removed. This ensures all the cancer cells have been removed. This usually requires a general anaesthetic.

The surgeon will also remove a margin of normal-looking skin around the cancer. The amount removed will depend on the size of the melanoma, and may be from 5 mm to 2 cm. In most cases the wound can be stitched together.

Skin grafts: Sometimes a skin graft is required to cover the wound. For the graft, the surgeon will take a layer of skin from another part of your body and place it over the wound. The other possibility is to do a 'flap', where the surgeon will close the wound using a nearby flap of skin. Most people will not need a graft or flap.

After the operation: The wound will be covered with a dressing and left undisturbed for several days. It will then be checked to see if it is healing properly. You will also have dressings on any area from which the skin was taken for a graft.

You may be uncomfortable for some days after your operation. If you have pain, your doctor will prescribe painkillers for you.

If you have a skin graft, the area where the skin is grafted on may look unattractive immediately after the operation, but eventually it will heal and the redness will fade. There is a risk of infection, haematoma (clotting) and scarring following surgery for melanoma. Occasionally, the skin graft is not successful.

Recovery time from removal of a melanoma will depend on the thickness of the tumour and the extent of surgery required.

Lymph node biopsy and dissection

If there are signs that the melanoma might have spread to your lymph nodes, your doctor may recommend that you have a fine needle aspiration biopsy or a sentinel node biopsy.

In a fine needle aspiration biopsy, the doctor inserts a needle into the node suspected of being affected by cancer and draws tissue into the syringe. This tissue is then examined under a microscope to see if it contains cancer cells. Occasionally, a node is removed surgically ('open biopsy') so that the tissue can be examined.

If cancer cells are found in the node/s, the nodes may be surgically removed ('dissected').

A sentinel node biopsy locates the lymph nodes that drain fluid from the area where the melanoma developed. A harmless dye or radioactive chemical is injected into the site of the melanoma. After about an hour, the surgeon passes a hand-held machine called a 'counter' over the area, and the sentinel nodes are revealed by the dye or chemical.

Once identified, the sentinel nodes are removed and checked for cancer cells. Surrounding nodes may then be removed if cancer is evident to try to stop the spread of cancer beyond the lymph nodes into other parts of the body.

Radiotherapy

Radiotherapy treats cancer by using radiation to kill or injure cancer cells. The radiation can be targeted onto cancer sites in your body. Treatment is carefully planned to do as little harm as possible to your normal body tissue. The treatment is usually given over several weeks. This will depend on the size and type of the cancer and on your general health.

Chemotherapy

This is the treatment of cancer with anti-cancer drugs. The aim is to kill all cancer cells while doing the least possible damage to normal cells.

The drugs work by stopping cancer cells from growing and reproducing themselves. Chemotherapy can be given before or after surgery and is usually given by injecting the drugs into a vein (intravenous treatment).

There are other ways of having chemotherapy, including tablets. Chemotherapy is occasionally used as palliative treatment for melanoma that cannot be treated by other methods. Chemotherapy usually does not cure melanoma.