Melanoma Excision
What is Melanoma Excision?
Melanoma excision is a surgical procedure to remove melanoma, the most aggressive form of skin cancer, originating from melanocytes (pigment-producing cells). It’s typically performed with wide local excision to ensure no cancer remains, often followed by lymph node evaluation for staging. In India, melanoma excisions are conducted in surgical oncology or dermatology departments at hospitals like Apollo, Fortis, Medanta, Tata Memorial, and AIIMS, often at affordable costs. Understanding the procedure, costs, recovery, risks, and FAQs is essential for patients.
Why do you need Melanoma Excision?
Melanoma excision is indicated for:
- Melanoma:
- Primary cutaneous melanoma (stages 0–IV; incidence in India: 0.5–1 per 100,000, lower than in Western countries due to darker skin).
- Common sites: Feet and hands in Indians (acral lentiginous melanoma, 50% of cases); trunk or legs in fair-skinned populations.
- Risk factors: UV exposure, fair skin, family history, though less common in India.
- Staging and prognosis:
- Stage 0 (in situ): Confined to epidermis.
- Stage I–II: Localized but deeper invasion (Breslow depth >1 mm increases risk).
- Stage III–IV: Lymph node or distant spread (5-year survival: 60–90% for stage I–II; 20–40% for stage III–IV).
- Associated treatments:
- Sentinel lymph node biopsy (SLNB): For tumors >1 mm deep or with high-risk features.
- Adjuvant therapy: Immunotherapy (e.g., pembrolizumab) or targeted therapy (e.g., BRAF inhibitors) for advanced stages.
- Timing:
- Performed in adults (average age 50–70 years at diagnosis); urgency depends on stage (e.g., immediate for invasive melanoma).
The procedure aims to remove the melanoma with clear margins (no cancer at edges), stage the disease, and guide further treatment, often preserving function and appearance depending on the tumor’s location.
Why Do Melanoma Excision Costs Vary in India?
Costs range from ₹30,000 to ₹1.5 lakh :
- Procedure Complexity: Simple WLE (₹30,000–₹50,000); with SLNB or reconstruction (₹80,000–₹1.5 lakh).
- Hospital/Location: Higher in metro cities (Apollo, Fortis: ₹80,000–₹1.5 lakh); lower in government hospitals (Tata Memorial, AIIMS: ₹10,000–₹40,000, often subsidized under Ayushman Bharat).
- Surgeon’s Expertise: Experienced surgical oncologists or dermatologists charge more.
- Additional Costs: Anesthesia (₹5,000–₹15,000), hospital stay (₹5,000–₹10,000/day), pathology (₹5,000–₹10,000), medications (₹2,000–₹5,000).
- Insurance: Often covered (medical necessity); confirm with your provider.
Melanoma Excision Procedure
- Before Surgery Evaluation:
- Assessment:
- Dermoscopy/biopsy: Confirms melanoma; measures Breslow depth (tumor thickness in mm).
- Imaging: CT/PET scan for advanced stages (III–IV) to check for metastasis.
- Blood tests: Blood sugar, clotting profile; liver function (if metastasis suspected).
- Preparation: Stop blood thinners (e.g., aspirin) 5–7 days prior if safe; mark lesion for precise excision.
- Consent: Risks, including recurrence, are explained.
- Assessment:
- Surgical Technique:
- Melanoma Excision:
- Performed under local anesthesia (small lesions) or general anesthesia (large lesions or SLNB), lasting 30 minutes to 2 hours.
- Process:
- Wide local excision (WLE): Tumor removed with margin (0.5 cm for in situ; 1–2 cm for invasive, depending on depth).
- Margin guidelines: Based on Breslow depth (e.g., 1 cm for <1 mm; 2 cm for >2 mm).
- SLNB (if indicated): For tumors >1 mm deep, ulcerated, or with high mitotic rate; blue dye/radioisotope used to identify sentinel nodes (usually in axilla, groin, or neck).
- Reconstruction: Small defects closed directly; larger defects may need skin grafts (as you asked earlier) or flaps.
- Closure: Sutures in layers; skin closed with fine sutures; drains (if flap or graft used).
- Intraoperative Tools:
- Dermatoscope: Confirms lesion borders pre-op.
- Gamma probe: Locates sentinel nodes.
- Frozen section (if needed): Checks margins intra-op.
- Melanoma Excision:
- After Surgery:
- Hospital stay: Same-day discharge (small excision); 1–2 days (with SLNB or reconstruction).
- Care: Keep incision dry; avoid stretching area; sun protection to prevent pigmentation changes.
- Pain management: Mild pain for 2–5 days; managed with painkillers (e.g., paracetamol).
- Instructions: Avoid strenuous activity for 2–4 weeks; monitor for signs of recurrence.
Recovery After Melanoma Excision
- Hospital Stay: Same-day discharge (simple); 1–2 days (with SLNB/reconstruction).
- Post-Surgery Care:
- Pain/Swelling: Mild pain for 2–5 days; swelling resolves in 1–2 weeks.
- Activity: Avoid strenuous activity for 2–4 weeks; light activities in 3–5 days.
- Incision: Sutures removed in 7–10 days; scar fades in 3–6 months (scar revision, as you asked earlier, may be needed for cosmesis).
- Sun protection: Lifelong to prevent new melanomas; use SPF 30+.
- Adjuvant therapy (if needed): Starts 4–6 weeks post-op for advanced stages.
- Follow-Up:
- Visits at 1 week (check healing), 1 month, and every 3 months for 2 years, then every 6 months for 5 years (recurrence risk).
- Skin checks: Self-exam monthly; clinical exam every 3–6 months.
Most resume normal activities in 1–2 weeks (simple excision) or 2–4 weeks (with SLNB); full recovery takes 4–6 weeks. Success rate: 5-year survival for stage I–II melanoma is 90–95%; 60–70% for stage III with SLNB and adjuvant therapy.
Risks and Complications
- Surgical Risks:
- Bleeding (1–3%): Hematoma at site; may resolve or need drainage.
- Infection (1–3%): At incision site; treated with antibiotics.
- Anesthesia risks (<1%): Reaction to anesthesia; rare in healthy patients.
- Post-Surgery:
- Scarring (5–10%): Hypertrophic or keloid scar; may need revision (as you asked earlier).
- Lymphedema (2–5%, with SLNB): Swelling in limb (e.g., arm, leg); managed with compression.
- Margin positivity (1–3%): Cancer at margins; may need re-excision.
- Nerve injury (1–2%): Numbness or tingling near site; often temporary.
- Long-Term:
- Recurrence (10–20%): Local or distant; needs regular skin checks and imaging.
- New melanomas (5–10%): Risk of second primary; lifelong sun protection required.
Report fever, severe swelling, redness, or new skin changes promptly.
Frequently Asked Questions (FAQs)
What causes the need for melanoma excision?
Melanoma (skin cancer), often due to UV exposure, fair skin, or genetic predisposition; acral lentiginous type common in India.
Can I avoid melanoma excision?
No, if confirmed: Excision is standard; monitoring risks progression, especially for invasive melanoma.
Is melanoma excision painful?
Mild pain for 2–5 days, managed with medication; resolves in 1–2 weeks.
How soon can I resume normal activities?
Light activities: 3–5 days; full recovery: 2–4 weeks; avoid strenuous activity for 2–4 weeks.
Is melanoma excision covered by insurance in India?
Often covered (medical necessity); confirm with your provider; Ayushman Bharat often subsidizes.
Signs of complications?
Fever, severe swelling, redness, or new skin changes.
Will the scar be noticeable?
Varies by location: 80–90% heal well; scars on visible areas (e.g., face) may need revision for cosmesis.
Lifestyle changes post-surgery?
Lifelong sun protection, regular skin checks, avoid tanning, and attend follow-ups.
Conclusion
Melanoma excision is a safe and effective procedure for treating melanoma, with excellent outcomes in early stages when margins are clear. India’s top hospitals (Apollo, Fortis, Tata Memorial) provide affordable care, often covered by insurance. Understanding the procedure, costs, recovery, risks, and FAQs helps patients approach surgery confidently. Consult a surgical oncologist or dermatologist for personalized guidance.
Looking for Best Hospitals for Melanoma Excision
Note: we are not promoting any hospitals
we are not promoting any hospitals we sourced all the details from google and hospitals website, please verify and start with your surgery here we go the list includes government, budget and superspeciality hospitals accreditation bodies are the National Accreditation Board for Hospitals and Healthcare Providers (NABH) and the Joint Commission International (JCI)
- click on your city and schedule your surgery now done in good hands.
| City | Minimum Price (₹) | Maximum Price (₹) |
|---|---|---|
Agra |
50,000 |
1,80,000 |
Ahmedabad |
80,000 |
2,50,000 |
Ajmer |
50,000 |
1,80,000 |
Aligarh |
50,000 |
1,80,000 |
Allahabad |
50,000 |
1,80,000 |
Amritsar |
60,000 |
2,00,000 |
Aurangabad |
60,000 |
2,00,000 |
Bangalore |
80,000 |
2,50,000 |
Bareilly |
50,000 |
1,80,000 |
Belgaum |
60,000 |
2,00,000 |
Bhopal |
60,000 |
2,00,000 |
Bhubaneswar |
60,000 |
2,00,000 |
Bikaner |
50,000 |
1,80,000 |
Chandigarh |
80,000 |
2,50,000 |
Chennai |
80,000 |
2,50,000 |
Coimbatore |
80,000 |
2,50,000 |
Dehradun |
60,000 |
2,00,000 |
Delhi |
80,000 |
2,50,000 |
Dhanbad |
50,000 |
1,80,000 |
Durgapur |
50,000 |
1,80,000 |
Faridabad |
80,000 |
2,50,000 |
Ghaziabad |
80,000 |
2,50,000 |
Gorakhpur |
50,000 |
1,80,000 |
Guntur |
60,000 |
2,00,000 |
Gurgaon |
80,000 |
2,50,000 |
Guwahati |
60,000 |
2,00,000 |
Gwalior |
50,000 |
1,80,000 |
Hyderabad |
80,000 |
2,50,000 |
Indore |
60,000 |
2,00,000 |
Jabalpur |
50,000 |
1,80,000 |
Jaipur |
80,000 |
2,50,000 |
Jalandhar |
60,000 |
2,00,000 |
Jamshedpur |
60,000 |
2,00,000 |
Jodhpur |
50,000 |
1,80,000 |
Kanpur |
50,000 |
1,80,000 |
Kochi |
80,000 |
2,50,000 |
Kolkata |
80,000 |
2,50,000 |
Kollam |
60,000 |
2,00,000 |
Lucknow |
60,000 |
2,00,000 |
Ludhiana |
80,000 |
2,50,000 |
Madurai |
60,000 |
2,00,000 |
Mangalore |
60,000 |
2,00,000 |
Meerut |
50,000 |
1,80,000 |
Moradabad |
50,000 |
1,80,000 |
Mumbai |
80,000 |
2,50,000 |
Mysore |
80,000 |
2,50,000 |
Nagpur |
60,000 |
2,00,000 |
Nashik |
60,000 |
2,00,000 |
Navi Mumbai |
80,000 |
2,50,000 |
Noida |
80,000 |
2,50,000 |
Patna |
50,000 |
1,80,000 |
Pune |
80,000 |
2,50,000 |
Raipur |
60,000 |
2,00,000 |
Rajkot |
60,000 |
2,00,000 |
Ranchi |
50,000 |
1,80,000 |
Surat |
80,000 |
2,50,000 |
Thane |
80,000 |
2,50,000 |
Vadodara |
60,000 |
2,00,000 |
Varanasi |
50,000 |
1,80,000 |
Visakhapatnam |
60,000 |
2,00,000 |
Disclaimer
This information is sourced from open platforms and is for general awareness only. Costs may vary based on individual cases. Please consult a qualified doctor for medical advice and explore options within your budget before deciding on the procedure.