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We had our 2nd opinion....

We had our 2nd opinion....

Posted By
1/12/2019 1:26am
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Replies: 4

We just got home from the 2nd Dr. He has the same thing in mind without it being as invasive and/or exploratory. Harold is having the wide line excision and radio active dye injection on Feb 18th. IF and only IF the dye shows up in any of his lymph nodes in any of his lymph nodes anywhere they will be removed. The wide line excision is being done so there will be clear and clean margins from where the mole was.
SAME exact thing as the other one said, with the exception of 2 weeks off work not 6 - 8.



Janner - (1/13/2019 - 11:39am)

Basically, having the wide local excision and the SLNB is standard of care for everyone with a stage 2a melanoma.  I'm confused about your one statement.  The SLNB is designed to identify at least one lymph node - that's the purpose.  You want to see if the first lymph node in the chain has any melanoma.  So you will want to have at least one lymph node removed otherwise the procedure failed  Are you meaning to say if there is melanoma in that lymph node they will remove the rest of the lymph nodes?   If so, research CLND (complete lymph node dissection).  Standards have changed regarding that procedure in recent years.

As for time off work, that is totally dependent upon location and individual and how extensive the surgery was.  Some need more, some need less. 

His surgeon told us that if he doesn't see the radiation tracer in any of the lymph nodes he isn't going to remove any of the lymph nodes at all.

Janner - (1/14/2019 - 11:56am)

Yes, but that isn't the goal of the whole procedure.  You WANT the tracer to go to the 1st lymph node - the sentinel node.  Sometimes it goes to more than one node.  The tracer shows the drainage pathway from the original tumor to the first lymph node and it is only rarely that it doesn't go anywhere.  Typically those cases have had a lot of surgery at the original site prior to the SLNB and the drainage path has been disturbed.  You want the tracer to go to the nearest lymph node(s) so you can check for traces of melanoma.  Does the surgeon do a lot of SLNB?  Because that's a question I would be asking.

Edwin - (1/13/2019 - 5:08pm)

I had a CLND in August 2014.   At the time that was the standard of care for melanoma.   It is no longer standard care.   I would have been better off without the CLND.    After my CLND melanoma spread to my bones.   That area of my neck is still sore sometimes.   In April 2018 a surgeon did not want remove a melanoma tumor in my neck due to the CLND in that area.  In August 2014 a SLNB found melanoma in one lymph node.  So 14 more lymph nodes were removed none of which had cancer.   If you surgeon plans a possible CLND, you should seek a second opinion before your SLNB.