Research to determine the value of providing patients with the services of a support clinic following dissection surgery.
One of the most significant surgeries which has to be performed in patients with melanoma which has spread to lymph nodes is an ilio-inguinal dissection. This operation involves taking out affected lymph nodes in the groin and the pelvis. It entails a week in hospital, followed by four to six weeks’ convalescence and up to six months for full recovery. This surgery can have wide-ranging physical impacts including lymphoedema (swelling of a limb) but also impacts on family life, work, psychological state and more.
Thanks to a two-year grant from Friends of the Mater, MIA is conducting qualitative research to determine the value of providing such patients with the services of a dissection clinic. The clinic is offered to patients who have undergone groin dissection as well as lymph nodes removed from the armpit (axillary dissection) or the neck (neck dissection) if the melanoma has spread to these areas. The clinic provides physiotherapy to assist with lymphoedema assessment and an ongoing relationship with a surgical clinical nurse consultant (CNC). The CNC offers information regarding the surgery, its effects and guidance about how best to navigate its impact on life. The CNC first sees the patient prior to the surgery and then in hospital and subsequently in the clinic at varying intervals.
Patients were surveyed before and after their surgery using a quality of life survey and a depression scale. A similar study was conducted with a cohort of patients who did not have access to the dissection clinic, for comparison purposes. Detailed analysis of the results is still pending, but early findings show that patients facing dissections find the clinic extremely valuable and need such services for up to a year. Without such a clinic, their experience is typically that they do not cope very well after the surgery. Earlier referrals for lymphoedema treatment and also to a psychologist may also be beneficial.