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Update: World is crumbling now, but still worried

Update: World is crumbling now, but still worried

Posted By
DT1985
2/10/2020 4:35pm
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Replies: 7

Went to the VA today. Unfortunately, not in situ...

Pathology says it is 1.5mm deep and the doctor doesn’t think it is ulcerative (he is just a general surgeon). They want to do mohs next week as well as STNB. Doc doesn’t think it has spread to nodes yet but wants to be sure. However due to my job, having any type of surgery has major implications/consequences from performing my duties. I have brought all of my pathology reports to an actual Melanoma Specialist. Hopefully they get back to me soon.

So I ask you guys for the time being....At 1.5mm do you think it’s necessary? The mohs I know is needed anyways but is the STNB?

Guess this puts me at a stage 1 or 2. But can that even be determined before the mohs?

As always, thank you everyone for your help.

eHi there, I am sorry you have to deal with Melanoma as well. I am not an expert and there are others, more knowledgable but at least here in Germany, if its deeper than 1mm without ulceration, they do an SLNB to make sure it has not reached the lymph nodes. Probability is very slim, in your case I think around 7% , but my initial melanoma was not much deeper than yours and a small number of cells had reached 2 sentinel lymph nodes, which upgraded me from stage I to IIIa.
I am happy to say that 1 year has passed and I am fine with no evidence of disease (NED). My advice would be to do an SLNB in any case. I am sure you will be luckier than me and once you know, your nodes are clean, you will be close to being cured , statistically that is.

I wish you the best of luck. Take care

Christian

Thank you very much. Hope all is well with you

did you have drug therapy or just excision?

Sorry you are worried, but as my brother in law says - Don't bother worry! I know....any melanoma diagnosis is something to worry about. And my brother in law mixes his messages, which drives my sister crazy - but I like it. Like you must be, given the mention of the VA in your prior post, he was career military - Air Force - so - thank you for your service.

Now...to the worry. Here is a link to a break down of melanoma staging: https://www.aimatmelanoma.org/stages-of-melanoma/

Stage II would require that your lesion is deeper than 2 mm with no ulceration or 1.o1 to 2mm with ulceration.

You won't know if you are Stage III or not, unless you determine the status of your sentinel node(s) {there may be 1-3} via a sentinel lymph node biopsy. SLNB is recommended for melanoma lesions that are 0.8mm or greater and should be done at the same time as the wide local excision. If the SLNB is postponed until after the WLE, the lymph flow will have been disrupted and finding the sentinel node will not be possible. For some stage III patients (patients for whom melanoma is found in a node, but generally not in the rest of their body) there are some adjuvant treatment options. For patients with Stage I or II disease, the odds of recurrence are fairly low and basic close follow-up should be arranged and maintained.

Hope that helps. Will keep fingers crossed that you will soon have your wide excision via MOHs along with your sentinel node biospy with no problems and the process will yield a non-ulcerated lesion measuring pretty much as you have already been advised (it may be a little deeper given you had a shave biopsy and a bit more of the lesion will be removed with the WLE - and your path report should tell you whether or not ulceration was noted) with negative SLNB.

Hope that helps. Celeste

Thank you for replying. Path report made no mention of ulceration unfortunately. The general surgeon also said “I dont think I saw any”...hence why I’ve brought my case to the actual melanoma docs.

I had SLNB and got 4 nodes removed. I could do anything short of bench presses next day.

I appreciate that.