Hi Everyone - My brother and I went to see the surgeon yesterday and while I am trying to remain positive it has not been easy! I wanted to post the pathology results because I finally got them yesterday from the nurse.
Diagnosis:
Superficial Spreading Melanoma
Breslow Depth: At least 4.90 mm
Clark Level: at least IV
Ulceration: Not Identified
Mitotic Index: 7 Mitosis/MM2
Microsatellitosis: Not Identified
Lymph-vascular Invasion: Not Identified
Perineural Invasion: Not Identified
Tumor Infiltrating Lymphocytes: Present, non brisk
Tumor regression: Not Identified
Vertical Growth Phase: Present
Tumor Stage: T4B
Margins: Peripheral margins involved, deep margins involved

The sections show the microscopic features of an atypical nevomelanocytic lesion most consistent with melanoma. There is an asymmetric proliferation of atypical melanocytes along the dermoepidermal junction as single cells and large confluent and irregular nests. The nests vary in shape, size, and distance from one to the another. There is focal intraepidermal (pagetoid) spread of melanocytes above the basal cell layer. The atypical melanocytes and nests invade into the dermis to a measured depth of 4.90mm, as measured from the top of the spread. The individual melanocytes are enlarged and show smoky cytoplasms. The nuciel are also enlarged and hyperchromatic and many show prominent red nucleoli.

Surgery is on 8/15. Surgeon is going to remove the tumor on the scalp and get clean margins (2cm) around it and then graft skin from his groin to cover the area. He will wear a VAC pump for 5 days over the wound. Surgeon will also do the lymph node biopsy; however, my brother is having a CT scan next Monday, 8/5, and if the cancer has spread then he said it wouldn't be necessary. My brother is a heavy smoker and the surgeon told him he must quit yesterday because the graft will not be successful if he has nicotine in his body. Kept hearing over and over from the surgeon...very serious, tumor thickness is very high, deep depth, etc.

Next steps: CT scan Monday morning, blood work, and meet with Oncologist Monday afternoon. Nurse said we would have results of scan when we meet with his Oncologist. I asked my brother if he wanted to get 2nd opinion and he said absolutely not. He wanted it scheduled, done and didn't want to drive 4 hours to Houston. In a way I don't blame him and I can't force him.

I am not even close to being a doctor but when I look at the pathology report and listened to the surgeon yesterday it all sounds very bad. With that being said, I know that he will get through this and it is far from a death sentence! The treatments that are now available will get rid of this nasty and horrible cancer if that is where this is headed. The surgeon said that it's almost better if it has spread because then they can get it with treatments vs. if it hasn't he will have to come back every three months for a scan. I can't imagine having to go through the waiting every three months. What is worse?

My brother is a Vet...a proud man, a very hard worker, very stubborn and has never had surgery. After the appointment he hugged me and sobbed and sobbed and told me he was so scared. This has brought him to his knees. He doesn't have a significant other and currently lives in a sober house (successfully completed rehab for alcoholism in Nov of last year) and has to now move out of the house because all of the men in the house smoke and he absolutely cannot be around 2nd hand smoke. I keep telling him he is a Warrior and he will survive this!

Cyndie in Texas

I remember when I first joined this website I was just looking for a sign of hope. Just looking for someone who had the same surgeries, diagnoses , or anything I could relate my story to with a positive outcome. I’m coming up on three years and just had clean scans. I was diagnosed with stage IIIc melanoma and not a good outlook. I had the highest Motoic(sp)rate that any doctor in Chicago has seen or I have found on this website. It was 50! My doctors were sure they were going to find it somewhere else in my body. I was told hope for the best but expect the worst. And that it wasn’t a fact of if it was coming back it was a when it comes back outlook. I had a complete neck dissection where they removed 98 lymph nodes and the cancer being in six of them . I had four high doses of yervoy. Inflamed my pituitary knocked out my thyroid and adrenal’s. my son at the time was just a little over two years old.
I was scared shitless to say the least!

Fast forward to three years I’m still here now with two kids my daughter is now nine months old. I still suffer daily with my adrenals and thyroid but you know what I’m still here. I just want someone to read this that is nervous or scared and know that there is hope.

I pray every day for each one of you. I pray for the ones we have lost and for the families that have suffered. I pray that sometime soon there will be a cure. I know some people feel alone and they don’t have anyone to talk to you but this board is truly amazing. Some people on this board take a lot of time out of the day to respond and comfort people as best as they can. There’s too many names to list but those people are amazing ! I don’t post on here often and I’m sorry for that I’m just not good with coming out of my own shell about this.

God bless everyone

Believe it or not, a safety testing on the active ingredients in sunscreen has never-before been conducted. This is because the chemicals were approved decades ago, before anyone thought they could be absorbed into the body.

https://www.wakingtimes.com/2019/07/31/fda-analysis-reveals-sunscreen-ch...

Hi Family, well, spoke with my onco, shes not giving me a referral because Kaiser is NOT done treating me, another words, that appt i have with Dr. Jang is like Part 3 to my treatment, most likely Proleukin (IL2) inpatient or clinical trials. She also went on to say that Dr. Jang has experience treating Melanoma as well as 2 other oncologists that work with him. She went on to explain that Jang may not be a quote
"Melanoma Specialist" unlike Dr. Hamid (the one i want) who chose to be a quote Specialist in Melanoma and ONLY treat Melanoma wich was Hamids choice as a medical doctor...Talking with her about it kinda set my mind at ease, ill still see the cat Aug 15th to see what his plan will be, but a referral isnt happening til Jang cannot treat me any further due to disease progression, "Then" a referral would most likely be granted to Hamid of the Angeles Clinic. I kinda get it, makes sence, im still PISSED though, i want HAMID!.....
So, thats where im at, if theres anyone else here at MRF who has taken IL-2 PROLEUKIN med, please reply as well, i wanna know how you all did...and what about these Chemo based meds, Dacarbazine or Paclitaxel and Carnoplatin?? I was offered this after Pembro failed, but went ahead with the Ipi/Nivo last year in May...thanks guys for helping me, lets check this Jang cat out ok?

Excellent case presentations of actual patients and how they were treated by 3 of the best in the business!!! I can't remember if you have to join Research to practice to watch these video's but if you do it doesn't cost anything and they don't spam you afterwards. First 30 min is adjuvant patients. Best Wishes!!!Ed https://www.researchtopractice.com/ASCOMelanoma19/Video?playlistIndex=0#...

My husband, Pete, now 61, was diagnosed with Stage IV malignant melanoma in February 2017. He had a huge lymph node removed from his right neck region along with 33 other nodes which were clean. This surgery took place at MD Anderson in Houston. In July of that year, after recovering from surgery, a PET scan revealed a lot of growth: Spine and brain mets, mets to hip bones. He underwent some local radiation to the neck and then targeted radiation to the brain mets at the base of his skull. He then started on Yervon/nivolumab and progressed to just nivolumab. He tolerated his immunosuppression fairly well. Main side effects have included itching, fatigue, a "foggy brain" and some sporadic morning nausea but so far his PET scans have revealed no progression. Doc doesn't know how he walks with the spine in the shape it is and recommends lifting "nothing heavier than a jug of milk" He is stubborn, however, and continues to "work out" daily (although not to the extent that he did before all this). I know this has really helped with his physical and emotional strength. Bottom line, he is coming close to the two-year mark of immunosupression. A success story for sure! He We are very thankful to have come to this point. Soon will be the two-year mark and he will make a decision to continue or stop the therapy. There doesn't seem to be clear-cut evidence one way or other, although the oncologist recommends continuation..

This month the insurance denied doctor's request for a PET scan on the basis that the brain MRI and past PET scans have not changed.. Doc is recommending a bone scan/CT instead but this will very different than the PET scan so he wanted to go over the interpretation with us after it is done.

Just wanted to get his experience out there to give others hope who are immunosupression - we do certainly believe it saved his life! (oh, and PRAYERS)

Sabrina

Good morning, My husband Ken got his results back from his Pet Scan and final impression was an isolated 3.2 lymph node in inguinal node. Already biopsied and confirmed Melanoma. We see the surgeon next week to discuss removal. Ken had a 4 year response to Yervoy before this latest recurrance. Oncologist is suggesting the Yervoy/Opdivo combo. My question is why does he have to do both? Wouldn't Nivo be sufficient and if he was to progress add the Yervoy? I know he had a 4 year response but we all know Yervoy can have some nasty side effects which luckily he tolerated well. Final decision obviously will be after surgery. Thank you all.

Cammy & Ken