It is the initial treatment for almost all melanomas. One of the following operations can be used:

• Conservative rescission: Any cancer remaining after the biopsy is removed, along with a small amount of skin around the cancer, usually less than 1cm.
• Wide surgical removal: The cancer and part of the skin around the tumor are removed.

It may be necessary to take part of the skin from another area of ​​the body to make a graft in the place where the cancer has been removed.

Surgery is a traditional form of cancer treatment. It is most effective in eliminating most cancers before they spread to lymph nodes or distant sites (metastasized). It can be used alone or in combination with other treatments, such as radiotherapy and chemotherapy. If the cancer has not metastasized, surgery can cure it.

However, it is not always possible to be sure before the surgery whether the cancer has spread or not. Often, during surgery, the lymph nodes near the tumor are removed to find out if the cancer has spread to them. If affirmative, there is a high risk of recurrence and it may be necessary to administer chemotherapy or radiotherapy to prevent it.

If the cancer has metastasized, surgery is not the main treatment. However, it can be used to reduce the size of the tumor (a procedure called surgical debulking or cytoreductive surgery), so that radiotherapy and chemotherapy are more effective, or to relieve symptoms such as severe pain or nausea and vomiting due to a intestinal obstruction caused by a tumor. Surgical removal of metastases does not usually achieve healing because it is difficult to locate all tumors. The remaining tumors continue to grow. However, in certain types of cancer with a very small number of metastases, particularly in the liver, brain or lungs, the surgical removal of metastases is beneficial.

Surgery is not the treatment of choice for all types of incipient cancer, since some tumors are located in inaccessible places. In other cases, removal of the cancer may require the removal of a necessary organ, or surgery may impair its function. Then radiotherapy is usually preferred with or without chemotherapy.

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