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onc says bump is an intranist?

Forums General Melanoma Community onc says bump is an intranist?

  • Post
    triciad
    Participant

    Hi Everyone,

    Last Saturday, I noticed a small bump close to where my original tumor was found.  I went to the dermatologist on Monday, and she tried to do a punch biopsy, but it was too deep.  She immediately paged my oncologist and surgeon to set up appoinments and talk with them.

    Hi Everyone,

    Last Saturday, I noticed a small bump close to where my original tumor was found.  I went to the dermatologist on Monday, and she tried to do a punch biopsy, but it was too deep.  She immediately paged my oncologist and surgeon to set up appoinments and talk with them.

    So, I met with my oncologist today for our regular 3 minute visit.  He walked into the room and said, "I know all about it.  It's an in-transit.  We're scheduling you for a brain MRI and a pet/ct.  If all are negative, then meet with the surgeon on Monday.  If something else shows up…come back to me.  Don't worry, I'm going to make sure you are fine."   And that was it.

    Can anyone help me out here?  What is an in-transit?  What does it do to my current staging of 3B?  I'm one week shy of being 2 years NED.  This is the second time I'll be getting a cancer diagnosis for my birthday on Tuesday.  Shouldn't I be getting diamonds or a fabulous vacations somewhere?

    If anyone can explain these in-transits to me I will be forever grateful!

    Tricia

     

Viewing 13 reply threads
  • Replies
      jim Breitfeller
      Participant

      Tricia,

      in-transit metastasis

      Type: Term
       

      Definitions:
      1. in melanoma, a metastatic deposit occurring in the lymphatic pathway between the primary tumor and its draining lymph nodes.

       

      Warm regards

       

      Jimmy B

      jim Breitfeller
      Participant

      Tricia,

      in-transit metastasis

      Type: Term
       

      Definitions:
      1. in melanoma, a metastatic deposit occurring in the lymphatic pathway between the primary tumor and its draining lymph nodes.

       

      Warm regards

       

      Jimmy B

      Fen
      Participant

      Tricia –  find an melanoma specialist who will spend more than 3 minutes with you.  A dr. who won't take the time to examine, explain, and reassure needs to be fired.  do it.

      fen

      Fen
      Participant

      Tricia –  find an melanoma specialist who will spend more than 3 minutes with you.  A dr. who won't take the time to examine, explain, and reassure needs to be fired.  do it.

      fen

      lhaley
      Participant

      Tricia,

      First of all a 3 minute visit would have me looking for a different oncologist!  If all you had was an in-transit from your primary your staging would be 3B so I don't think it changes. 

      I've been dealing with a new lump that developed 4 weeks after the last surgery (I'm stage IV). The scans were clear, so that same day they did a fine needle aspiration.  That came back clear also. My oncologist is still suspicious so it was removed today. The local dermatologist did the surgery and his gut feeling is it's a lipoma, which is benign. I'm not getting my hopes up but just wanted you to realize that until tested they just don't know.

      It's your oncologists attitude that concerns me. I understand the PET to see if it shows up and if there is any other spread. I don't know when your last one was. I think the brain MRI is a bit overkill for an intransit. While many might do this he seems to have really frightened you with little talk or explainations. 

      My dermatologist did an excisional cut. He ended up getting out 3 nodules and had to go down to the muscle. He didn't even attempt a punch. He did this vs my surgeon who did the fna to get the procedure done quickly since it has interuppted my radiation and they are trying to decide the next step.

      Your profile isn't complete so I don't know if your Dr is a mel specialist or where you live. Please find someone who will give you more time!

      Linda

      stage IV for 5 years, hoping to be NED for 6 weeks

      lhaley
      Participant

      Tricia,

      First of all a 3 minute visit would have me looking for a different oncologist!  If all you had was an in-transit from your primary your staging would be 3B so I don't think it changes. 

      I've been dealing with a new lump that developed 4 weeks after the last surgery (I'm stage IV). The scans were clear, so that same day they did a fine needle aspiration.  That came back clear also. My oncologist is still suspicious so it was removed today. The local dermatologist did the surgery and his gut feeling is it's a lipoma, which is benign. I'm not getting my hopes up but just wanted you to realize that until tested they just don't know.

      It's your oncologists attitude that concerns me. I understand the PET to see if it shows up and if there is any other spread. I don't know when your last one was. I think the brain MRI is a bit overkill for an intransit. While many might do this he seems to have really frightened you with little talk or explainations. 

      My dermatologist did an excisional cut. He ended up getting out 3 nodules and had to go down to the muscle. He didn't even attempt a punch. He did this vs my surgeon who did the fna to get the procedure done quickly since it has interuppted my radiation and they are trying to decide the next step.

      Your profile isn't complete so I don't know if your Dr is a mel specialist or where you live. Please find someone who will give you more time!

      Linda

      stage IV for 5 years, hoping to be NED for 6 weeks

      Carol Taylor
      Participant

      Tricia,

      Definitely find a doctor who'll give you more time, definitely a mel spec. I'm including this link in case you need help locating one near you:

      http://www.aimatmelanoma.org/aim-for-answers/finding-the-right-doctor.html

      If by chance you really do have full confidence in this doctor and really don't want another one, please have a good long talk with him and be clear about your expectations and get your questions answered.

      Lord, in Your mercy, please just pave the way for Tricia. Thank You. Amen.

      Grace and peace,

      Carol

      Carol Taylor
      Participant

      Tricia,

      Definitely find a doctor who'll give you more time, definitely a mel spec. I'm including this link in case you need help locating one near you:

      http://www.aimatmelanoma.org/aim-for-answers/finding-the-right-doctor.html

      If by chance you really do have full confidence in this doctor and really don't want another one, please have a good long talk with him and be clear about your expectations and get your questions answered.

      Lord, in Your mercy, please just pave the way for Tricia. Thank You. Amen.

      Grace and peace,

      Carol

      Kimmer
      Participant

      Tricia,

      As I understand an in-transit is a metastasis that is more than 2cm away from the primary tumor.  Someone described mine as being 'trapped' between the primary and the closest lymph node basin. 

      It sounds like you know my old onc, who I called Buzzkill for the entire 2 years that I saw him.  I put up with him for about 23 months too long.  He never told me that I would be fine though…lol.  But here I am and I can share a little bit of my experience with you.

      I don't know how anyone can be so sure that you have a recurrence without first doing an excision and getting the pathology.  At least that is the way mine was handled.  (on my birthday as a matter of fact)  It came back as a pin point of melanoma cells encapsulated in a little ball of fat.  I had scans after that and then a wide excision.  Both were negative for any further metastasis.  I have had a couple of oncs tell me that mine was probably an incomplete resection of the primary tumor; it was on my finger which is an awkward location.

      That was a little more than 5 years ago.  I am stage 3b.

      Best of luck to you…sending the very best thoughts your way.

      k.

      Kimmer
      Participant

      Tricia,

      As I understand an in-transit is a metastasis that is more than 2cm away from the primary tumor.  Someone described mine as being 'trapped' between the primary and the closest lymph node basin. 

      It sounds like you know my old onc, who I called Buzzkill for the entire 2 years that I saw him.  I put up with him for about 23 months too long.  He never told me that I would be fine though…lol.  But here I am and I can share a little bit of my experience with you.

      I don't know how anyone can be so sure that you have a recurrence without first doing an excision and getting the pathology.  At least that is the way mine was handled.  (on my birthday as a matter of fact)  It came back as a pin point of melanoma cells encapsulated in a little ball of fat.  I had scans after that and then a wide excision.  Both were negative for any further metastasis.  I have had a couple of oncs tell me that mine was probably an incomplete resection of the primary tumor; it was on my finger which is an awkward location.

      That was a little more than 5 years ago.  I am stage 3b.

      Best of luck to you…sending the very best thoughts your way.

      k.

      Teodora
      Guest

      Hi Tricia,

      Stage IIIB

      One of the following applies:

      T1b toT4b,N1a or N2a,M0:The melanoma can be of any thickness and is ulcerated.It had spread o 1 to 3 lymph nodes near the affected skin area, but the nodes are not enlarged and the melanoma is found only when they are viewd under microscope.There is no distant spread.

       

      T1a  toT4a,Nb1 or N2b,M0:The melanoma can be of any thickness, but it is not ulcerated.It has spread to 1 to 3 lypph nodes near the affected skin area.The nodes are enlarged because of the melanoma.There is no distant spread.

       

      T1a to T4a, N2c,M0:The melanoma can be of any thickness,but it is not ulcerated.It has spread to small areas of nearby skin or lymphatic channels around the original tumor,but the nodes do not contain melanoma.There is no distant spread.

      Stage IIIC

      One of the following applies:

      T1b to T4b,N1b orN2b,M0: The melanoma can be of any thickness and is ulcerated.It had spread o 1 to 3 lymph nodes near the affected skin area, the nodes are not enlarged  because of the melanoma.There is no distant spread.

      T1b to T4b,N2c,M0: The melanoma can be of any thichness and it is ulcerated.It has spread to small areas of nearby skin or lymphatic channels around the original tumor but the nodes do not contain melanoma.There is no distant spread.

      Any T,N3,M0: The melanoma can be of any thickness and may be or may not be ulcerated.It had spread to 4 or more nearby lymph nodes or to nearby lymph nodes that are clumped together, or it has spread to nearby skin or lymphatic channels around te original tumor and to nearby lymph nodes.The nodes are enlarged because of the melanoma.There is no distant spread.

       

      Since you didn't create profile/no information on primary/lymph nodes involvement, you can make an approximate  assessment  where you stand stage wise.Stage IV  is anything with distant spread involved so It is very important to do PET/CAT scans to determine your exact staging.

      Best wishes,

      Teodora

       

       

       

       

       

       

      Teodora
      Guest

      Hi Tricia,

      Stage IIIB

      One of the following applies:

      T1b toT4b,N1a or N2a,M0:The melanoma can be of any thickness and is ulcerated.It had spread o 1 to 3 lymph nodes near the affected skin area, but the nodes are not enlarged and the melanoma is found only when they are viewd under microscope.There is no distant spread.

       

      T1a  toT4a,Nb1 or N2b,M0:The melanoma can be of any thickness, but it is not ulcerated.It has spread to 1 to 3 lypph nodes near the affected skin area.The nodes are enlarged because of the melanoma.There is no distant spread.

       

      T1a to T4a, N2c,M0:The melanoma can be of any thickness,but it is not ulcerated.It has spread to small areas of nearby skin or lymphatic channels around the original tumor,but the nodes do not contain melanoma.There is no distant spread.

      Stage IIIC

      One of the following applies:

      T1b to T4b,N1b orN2b,M0: The melanoma can be of any thickness and is ulcerated.It had spread o 1 to 3 lymph nodes near the affected skin area, the nodes are not enlarged  because of the melanoma.There is no distant spread.

      T1b to T4b,N2c,M0: The melanoma can be of any thichness and it is ulcerated.It has spread to small areas of nearby skin or lymphatic channels around the original tumor but the nodes do not contain melanoma.There is no distant spread.

      Any T,N3,M0: The melanoma can be of any thickness and may be or may not be ulcerated.It had spread to 4 or more nearby lymph nodes or to nearby lymph nodes that are clumped together, or it has spread to nearby skin or lymphatic channels around te original tumor and to nearby lymph nodes.The nodes are enlarged because of the melanoma.There is no distant spread.

       

      Since you didn't create profile/no information on primary/lymph nodes involvement, you can make an approximate  assessment  where you stand stage wise.Stage IV  is anything with distant spread involved so It is very important to do PET/CAT scans to determine your exact staging.

      Best wishes,

      Teodora

       

       

       

       

       

       

      triciad
      Participant

      Hi Everyone,

      Thanks for all of your help…as usual.  I'm sorry that I haven't created a profile, but I haven't figured that out, yet.  This is my first and only bulletin board, so I have a lot to learn.  You all have me wondering just how long most doctors spend with patients during a visit.  I thought the :"3 minute visit" was normal.  I guess you now see why EVERYTHING I've learned about melanoma comes from this board and the amazing people here.  I am truly grateful to al of you! 

      Yes, my doctor is a melanoma specialist, and I live in NJ.  I'm going to start a new topic about the average time doctors spend with their patients…I hope you all will reply…this could be very interesting.

      Have a great weekend, and again, thanks for all of your help!!!!

      Tricia

      triciad
      Participant

      Hi Everyone,

      Thanks for all of your help…as usual.  I'm sorry that I haven't created a profile, but I haven't figured that out, yet.  This is my first and only bulletin board, so I have a lot to learn.  You all have me wondering just how long most doctors spend with patients during a visit.  I thought the :"3 minute visit" was normal.  I guess you now see why EVERYTHING I've learned about melanoma comes from this board and the amazing people here.  I am truly grateful to al of you! 

      Yes, my doctor is a melanoma specialist, and I live in NJ.  I'm going to start a new topic about the average time doctors spend with their patients…I hope you all will reply…this could be very interesting.

      Have a great weekend, and again, thanks for all of your help!!!!

      Tricia

        Teodora
        Guest

         Tricia,

        If you are from New Jersey,one of the US top melanoma centers-Sloan Kettering in New York is right next to you;contact Dr Jedd Wolchok, he is one of the Yervoy creators and one of the best melanoma specialists and ask for consultation.

        Dr.Wolchok :tel 646 888 2395

        http://www.mskcc.org/prg/prg/bios/608.cfm 

         

        Good Luck,

        Teodora

        Teodora
        Guest

         Tricia,

        If you are from New Jersey,one of the US top melanoma centers-Sloan Kettering in New York is right next to you;contact Dr Jedd Wolchok, he is one of the Yervoy creators and one of the best melanoma specialists and ask for consultation.

        Dr.Wolchok :tel 646 888 2395

        http://www.mskcc.org/prg/prg/bios/608.cfm 

         

        Good Luck,

        Teodora

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