Melanoma Surgery in India & UAE

Melanoma surgery in India from $2,500. Wide local excision, SLNB, lymph node dissection. Expert skin cancer surgeons at Apollo, Medanta, Fortis.

Estimated cost: $2,500 – $6,500 · Average stay: 2–5 days

Melanoma surgery is the primary treatment for localised melanoma. The standard surgical approach is wide local excision (WLE) with margins of 1–2 cm around the primary tumour, combined with sentinel lymph node biopsy (SLNB) to assess regional lymph node spread. If sentinel nodes are positive, completion lymphadenectomy or close surveillance is offered based on current guidelines.

For advanced (metastatic) melanoma, surgery may be performed to remove isolated metastases (isolated limb perfusion for in-transit disease; resection of oligometastases) as part of a multimodality plan with immunotherapy or targeted therapy (BRAF/MEK inhibitors).

India's surgical oncology teams are experienced in melanoma surgery. Apollo, Tata Memorial, Medanta, and Fortis perform wide local excision and SLNB according to international guidelines. The cost of melanoma surgery in India ($2,500–$6,500) compares to $10,000–$30,000 in the United States.

What is Melanoma Surgery?

Wide local excision (WLE) removes the primary melanoma with a margin of surrounding normal skin determined by the Breslow thickness of the tumour: 1 cm margin for melanomas ≤1 mm thick, 1–2 cm margin for 1–2 mm thick, 2 cm margin for >2 mm thick. The wound is closed primarily, with a skin graft or local flap if the defect is too large for primary closure.

Sentinel lymph node biopsy (SLNB): a radiotracer and/or blue dye injected around the primary tumour identifies the sentinel node(s) in the regional lymph node basin. These are removed and analysed; if the sentinel node contains melanoma cells, it signifies regional nodal spread and guides further treatment decisions.

Who Needs Melanoma Surgery?

All localised melanomas (Stage I–III without distant metastases) are primarily treated with surgery. SLNB is recommended for melanomas >0.8 mm Breslow thickness (or <0.8 mm with ulceration or high mitotic rate). Completion lymphadenectomy is considered for patients with macroscopic nodal disease. Surgery for Stage IV melanoma (distant metastases) is used selectively for isolated resectable oligometastases where complete resection is achievable.

How is Melanoma Surgery Performed?

WLE is performed under local or general anaesthesia. The surgeon marks the appropriate margin around the primary lesion, excises the skin and subcutaneous tissue to deep fascia, and closes the wound. A full-thickness skin graft (from thigh) or local rotation flap reconstructs large defects.

SLNB is combined with WLE on the same day. Technetium-99m sulphur colloid is injected around the primary (or biopsy scar) 2–4 hours before surgery. In the operating room, blue dye is also injected. A gamma probe guides excision of the "hot" blue sentinel node(s). These are sent for frozen section or definitive formalin pathology. Results typically available within 24–72 hours.

Procedure Steps

1. Pre-operative staging: dermoscopy, chest CT, PET-CT for Stage IIB/C and above.
2. SLNB: radiotracer injected 2–4 hours pre-operatively under skin around primary.
3. Anaesthesia: local (for small primary) or general (for SLNB and large excisions).
4. Wide local excision: 1–2 cm margin marked; full-thickness excision to deep fascia.
5. Wound closure: primary closure or skin graft/flap for large defects.
6. SLNB: blue dye injected; gamma probe identifies hot node(s); excision.
7. Sentinel node(s) sent for pathology; all specimens labelled for orientation.
8. Dressings; drain if indicated; wound care instructions.
9. Post-operative: wound review at 7–10 days; pathology discussion.

Cost Comparison Worldwide

Country — Range — Savings

--- — --- — ---

India — $2,500 – $6,500 — Save 75%

UAE — $5,000 – $11,000 — Save 60%

United States — $10,000 – $30,000 — —

United Kingdom — $7,000 – $18,000 — —

Wide local excision with SLNB in India costs $2,500–$4,500 including surgery, pathology, and hospital stay. Complex reconstruction (skin graft, free flap) adds $1,500–$2,000. The same procedure costs $10,000–$20,000 in Western countries.

Recovery & Follow-up

Simple WLE recovery: wound heals in 10–14 days; return to normal activity within 2 weeks. WLE + SLNB: 2–5 day hospital stay; arm or leg swelling after axillary or groin SLNB resolves within 2–4 weeks. Avoid sun exposure to the scar permanently. Long-term surveillance: skin examination every 3–6 months for 5 years.

Recovery Tips

• Keep the surgical wound clean and dry until healing is confirmed at 10–14 days.
• Report signs of wound infection: increasing redness, warmth, discharge, or fever.
• Avoid sun exposure to the scar and surrounding skin; use SPF50+ sunscreen.
• Blue dye used in SLNB causes blue-green urine and skin discolouration for 24 hours — this is normal.
• Begin long-term surveillance: self-examination of all skin monthly; specialist review every 3–6 months.

Risks & Complications

WLE risks include wound infection (2–5%), haematoma, seroma, scarring, and temporary numbness around the scar. SLNB carries risks of seroma, wound infection, and temporary arm or leg swelling (lymphoedema in 5–10%). The theoretical risk of blue dye anaphylaxis (1:10,000) is managed by anaesthetic standby during SLNB.

Why GAF Healthcare

Gaf Healthcare works with skin cancer surgery teams at India's JCI-accredited hospitals where SLNB is performed according to current NCCN and ESMO guidelines. We arrange pre-operative dermoscopy review and PET-CT staging, and coordinate pathology including BRAF mutation testing for Stage III–IV patients to guide targeted therapy decisions.

Frequently Asked Questions

Do I need SLNB for all melanomas?

No. SLNB is recommended for melanomas >0.8 mm Breslow thickness. For thin melanomas (≤0.8 mm without adverse features), the risk of nodal disease is below 5% and SLNB adds little additional information.

What happens if my sentinel node is positive?

Positive sentinel nodes in melanoma were previously treated with completion lymphadenectomy. Current guidelines (MSLT-II trial data) show that surveillance with ultrasound gives equivalent melanoma-specific survival to completion dissection, while avoiding lymphoedema. Your oncologist will discuss the options based on your specific pathology.

Should I have immunotherapy after melanoma surgery?

Stage IIB/C and III patients benefit from adjuvant immunotherapy (pembrolizumab or nivolumab) or targeted therapy (dabrafenib + trametinib for BRAF V600E mutated tumours). India's oncology centres initiate adjuvant therapy; follow-up cycles can be given by your home oncologist.

Is melanoma surgery different from skin cancer surgery?

Melanoma requires wider margins (1–2 cm) and routine SLNB — more extensive than excision for non-melanoma skin cancers (BCC, SCC) which typically require 3–5 mm margins without SLNB.

Can melanoma recur after surgery?

Yes. Recurrence risk depends on stage, Breslow thickness, ulceration, and lymph node status. Regular surveillance (skin examination, imaging) detects early recurrence amenable to further treatment.