“I did then what I knew how to do. Now that I know better, I do better”

Maya Angelou, author

The quote has face validity in life. In this case, it has a critical application in medicine.

The specific topic is Stage III melanoma, when skin cancer has spread to the lymph nodes. The traditional standard of care has been surgical removal of the lymph nodes. Unfortunately, as a new paper from researchers at the University of Colorado shows, that surgery doesn’t improve life expectancy over other treatments and often introduces complications.

Now that we have immunotherapy, patients with Stage III melanoma do better without the surgery than they do with it.(1) Not only can immunotherapy alone solve the immediate challenge from skin cancer but it also reduces the chance of recurrence more than lymph surgery does. In addition to the risk involved in normal surgeries (infections, incomplete cancer removal…