Melanoma and Sentinel Node Biopsy

What is Melanoma?

Melanoma is a type of skin cancer that develops in the cells that produce melanin, the pigment that gives skin its colour. It's the most serious type of skin cancer because it can spread quickly to other parts of the body if not caught early.

Dr Muzib Abdul-Razak is a highly skilled head and neck surgeon at Hills Surgical Oncology and specialises in the treatment of melanoma, particularly when it affects the head and neck region.

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What is a Sentinel Node Biopsy?

A sentinel node biopsy is a surgical procedure used to determine if cancer has spread beyond its original site to the nearby lymph nodes. The sentinel node is the first lymph node to which cancer is likely to spread from the primary tumour. Dr Muzib Abdul-Razak is experienced in performing sentinel node biopsies to both identify and remove any spreading cancer at Hills Surgical Oncology.

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Why is a Sentinel Node Biopsy important for melanoma?

Sentinel node biopsy is crucial in the management of melanoma for several reasons:

• Staging: It helps determine the stage of the cancer, which guides treatment decisions.
• Prognosis: The results can provide important information about the likely outcome of the disease.
• Treatment planning: It can help decide if further treatment, such as more extensive surgery or other therapies, is needed.
• Avoiding unnecessary surgery: If the sentinel node is cancer-free, it may spare the patient from having all the lymph nodes in the area removed.

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Who needs a Sentinel Node Biopsy?

Not all melanoma patients need a sentinel node biopsy. It's typically recommended for:

• Melanomas that are more than 1mm thick
• Thinner melanomas with certain high-risk features
• Patients without evidence of metastasis (cancer spread) to other parts of the body

Dr Muzib Abdul-Razak will carefully assess your individual case to determine if a sentinel node biopsy is necessary.

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How do I prepare for a Sentinel Node Biopsy?

Preparing for a sentinel node biopsy involves several steps:

• Medical evaluation: Dr Abdul-Razak will perform a thorough examination and may order additional tests.
• Medication review: Inform your doctor about all medications and supplements you're taking.
• Fasting: You may need to avoid eating or drinking for several hours before the procedure.
• Arrange for help: Plan for someone to drive you home after the procedure.

The team at Hills Surgical Oncology will provide you with detailed instructions to ensure you're fully prepared for your sentinel node biopsy.

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What happens during a Sentinel Node Biopsy?

A sentinel node biopsy is typically performed under general anaesthesia. Here's what you can expect:

• Anaesthesia: You'll be put to sleep for the procedure.
• Injection of dye or radioactive tracer: This helps identify the sentinel node(s).
• Locating the sentinel node: Using specialised equipment, Dr Abdul-Razak will locate the sentinel node(s).
• Removal of the sentinel node: A small incision is made to remove the identified sentinel node(s).
• Closure: The incision is closed with stitches.

The procedure usually takes about 1 to 2 hours.

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What should I expect after a Sentinel Node Biopsy?

After your sentinel node biopsy at Hills Surgical Oncology:

• Recovery room: You'll spend some time in a recovery room as you wake up from anaesthesia.
• Going home: Most patients can go home the same day.
• Pain management: You may experience some discomfort, which can be managed with pain medication.
• Dressing care: You'll receive instructions on how to care for your incision.
• Follow-up appointment: Dr Muzib Abdul-Razak will schedule a follow-up visit to discuss the results of the biopsy.

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What is the recovery process like after a Sentinel Node Biopsy?

Recovery from a sentinel node biopsy is generally quick. Here's what you can expect:

1. Rest: Take it easy for the first day or two after the procedure.
2. Wound care: Keep the incision site clean and dry. Follow Dr Abdul-Razak's instructions for caring for the site.
3. Pain management: Take pain medication as prescribed if needed.
4. Return to activities: Most people can return to normal activities within a few days.
5. Follow-up care: Attend all scheduled follow-up appointments with Dr Abdul-Razak to discuss the results and any further treatment plans.

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Are there any risks or complications associated with a Sentinel Node Biopsy?

While sentinel node biopsy is generally safe, like all surgical procedures, it carries some risks. These may include:

• Infection at the biopsy site
• Bleeding or bruising
• Lymphedema (swelling due to build-up of lymph fluid)
• Allergic reaction to the dye or tracer used
• False-negative results (cancer is present but not detected)

Dr Muzib Abdul-Razak at Hills Surgical Oncology takes every precaution to minimise these risks and will discuss them with you in detail before the procedure.

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How long does it take to get the results of a Sentinel Node Biopsy?

The time it takes to get results can vary, but typically:

• Preliminary results may be available within 24 to 48 hours.
• Final, detailed results usually take about 5 to 7 days.

Dr Muzib Abdul-Razak will schedule a follow-up appointment to discuss the results with you as soon as they're available.

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What Happens if the Sentinel Node Biopsy is Positive?

If cancer cells are found in the sentinel node:

• Further testing may be done to determine the extent of spread.
• Additional treatment may be recommended, such as:
  • Removal of more lymph nodes (lymph node dissection)
  • Radiation therapy
  • Systemic therapies like immunotherapy or targeted therapy

Dr Muzib Abdul-Razak and the team at Hills Surgical Oncology will work closely with you to develop a comprehensive treatment plan tailored to your specific needs.

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What Happens if the Sentinel Node Biopsy is Negative?

If no cancer cells are found in the sentinel node:

• It's likely that the cancer has not spread to the lymph nodes.
• Further lymph node surgery may not be necessary.
• Your doctor will continue to monitor you closely with regular follow-ups.

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How Does Sentinel Node Biopsy Affect the Long-Term Outlook for Melanoma?

Sentinel node biopsy plays a significant role in determining the prognosis and treatment plan for melanoma patients:

• It provides valuable information about the stage of the cancer.
• A negative result is associated with a better prognosis.
• For positive results, early detection of spread to lymph nodes allows for timely and appropriate treatment.
• It helps guide decisions about the need for additional treatments to reduce the risk of recurrence.

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Can Melanoma come back after a negative Sentinel Node Biopsy?

While a negative sentinel node biopsy is a good sign, it doesn't guarantee that melanoma won't come back. Melanoma can sometimes recur locally or spread to other parts of the body. That's why ongoing follow-up care is crucial.

Dr Abdul-Razak will provide you with a tailored follow-up plan, which may include:

• Regular skin checks
• Imaging tests
• Blood tests
• Self-examination instructions

Early detection of any recurrence is key to successful treatment.

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Why Choose Hills Surgical Oncology for Your Melanoma Care and Sentinel Node Biopsy?

When dealing with melanoma, choosing the right medical team is crucial. Here's why Hills Surgical Oncology, led by Dr Muzib Abdul-Razak, is an excellent choice:

• Expertise: As a specialist head and neck surgeon and surgical oncologist in Sydney, Dr Abdul-Razak has extensive experience in melanoma treatment and sentinel node biopsies.
• Advanced techniques: We use the latest surgical techniques and technologies to ensure the best possible outcomes for our patients.
• Comprehensive care: From initial diagnosis to treatment and long-term follow-up, we provide support at every step of your journey.
• Convenient locations: With clinics in Wahroonga and the Hills area, we're easily accessible to patients across Sydney.
• Patient-centred approach: We understand that every patient is unique, and we tailor our care to meet your individual needs.
• Multidisciplinary team: We work closely with other specialists to ensure you receive comprehensive cancer care.

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Take home message

Melanoma is a serious form of skin cancer, but with early detection and appropriate treatment, many patients have excellent outcomes. Sentinel node biopsy is a crucial tool in the management of melanoma, providing valuable information to guide treatment decisions.

At Hills Surgical Oncology, Dr Muzib Abdul-Razak and his team are committed to providing expert, compassionate care to patients with melanoma. If you're in the Hills area, Norwest, Wahroonga, or anywhere in Sydney and have concerns about melanoma or need a sentinel node biopsy, don't hesitate to reach out.

Remember, when it comes to melanoma, early detection and treatment are key. Regular skin checks and prompt attention to any suspicious skin changes can make a significant difference in outcomes. We're here to provide the expert care you need throughout your melanoma journey.