How do I prepare for surgery for Melanoma

Preparing for Melanoma Surgery: A Practical Guide

I'm glad you're thinking ahead about preparation—being ready can help reduce anxiety and improve your surgical experience. Let me walk you through what you should expect and how to get ready.

Understanding Your Surgery

First, it helps to know what type of surgery you're having. According to the NCCN Guidelines for Patients: Melanoma, melanoma surgery typically involves:

• Excision (surgical removal of the melanoma with surrounding healthy skin margins to ensure all cancer cells are removed)
• Sentinel lymph node biopsy (SLNB) - a procedure to check if cancer has spread to nearby lymph nodes
• Possibly complete lymph node dissection (CLND) if lymph nodes contain cancer cells

The specific surgery depends on your melanoma's stage and location.

Key Questions to Ask Your Surgical Team

Before your surgery, make sure you have clear answers to these questions:

1. What type of surgery am I having, and why? (excision, SLNB, lymph node removal, or a combination?)
2. Where will the incisions be, and how large will they be?
3. What should I do about medications I'm currently taking? (especially blood thinners like aspirin)
4. When should I stop eating and drinking before surgery? (typically 6-8 hours before)
5. What type of anesthesia will be used? (local, regional, or general)
6. What are the possible side effects or complications I should watch for?
7. How long is the recovery period, and when can I return to normal activities?
8. Will I have stitches or staples, and when will they be removed?
9. What signs of infection or problems should prompt me to call you?

Practical Pre-Surgery Preparation

Medical Preparation:

• Provide a complete list of all medications and supplements you take
• Inform your surgeon about any allergies (especially to anesthesia or latex)
• Get pre-operative blood work or imaging if ordered
• Arrange transportation home (you won't be able to drive after anesthesia)
• Have someone stay with you for at least 24 hours post-surgery

Physical Preparation:

• Follow fasting instructions carefully (no food or drink after midnight, typically)
• Shower the night before or morning of surgery
• Wear loose, comfortable clothing
• Remove nail polish, makeup, and jewelry
• Arrange time off work for recovery

Mental Preparation:

• Write down your questions and concerns
• Discuss any anxiety with your care team
• Bring a trusted person to your appointment
• Understand that surgery is typically curative for early-stage melanoma

After Surgery: What to Expect

According to the NCCN Guidelines, after your surgery you may receive:

• Adjuvant therapy (additional treatment after surgery) such as:
  • Immunotherapy drugs like nivolumab or pembrolizumab
  • Targeted therapy if you have a BRAF mutation
  • Observation and close follow-up

Your pathology report (detailed analysis of the removed tissue) will guide these decisions.

Important Reminders

• Wound care is critical—follow your surgeon's instructions exactly about keeping the area clean and dry
• Sun protection becomes even more important after melanoma surgery
• Follow-up appointments are essential to monitor for recurrence
• Self-skin exams using the ABCDE rule (Asymmetry, Border irregularity, Color variation, Diameter >6mm, Evolving/changing) help catch any new concerns early

Moving Forward

Your surgical team wants you to succeed. Don't hesitate to ask questions—no question is too small. Being informed and prepared helps you feel more in control and supports better outcomes.

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This information is for educational purposes only. Always consult your healthcare team for personalized medical advice and decisions.

Sources: NCCN Guidelines for Patients: Melanoma, 2025