Surgery or Not

Melanoma most often follws the lymph path unless it is deep enough to get ino the blood stream.  Of course with mlanma there is not any "always".  From the lower leg, either the knee or groin lymph nodes are apt to have the mel found before it goes elsewhere.  It then tends to work its way through the nodes from the sentinel node.  l have never heard them referred to as a brrier as such, but from the progression, I have long questioned  removal of the complete node group.  In the past couple of years the complete removal question has been raised more often and is under study. 

   This is one reason that I suspected that my recent breast growth was not melanoma.  It didn't follow a "normal" path.   But because of mels doing its own thing at times, I wanted it out to be sure.  I didn't get hyper, but still felt better when the doc took it out and said, "It's not black." Then the pathologist agreed.

Melanoma most often follws the lymph path unless it is deep enough to get ino the blood stream.  Of course with mlanma there is not any "always".  From the lower leg, either the knee or groin lymph nodes are apt to have the mel found before it goes elsewhere.  It then tends to work its way through the nodes from the sentinel node.  l have never heard them referred to as a brrier as such, but from the progression, I have long questioned  removal of the complete node group.  In the past couple of years the complete removal question has been raised more often and is under study. 

   This is one reason that I suspected that my recent breast growth was not melanoma.  It didn't follow a "normal" path.   But because of mels doing its own thing at times, I wanted it out to be sure.  I didn't get hyper, but still felt better when the doc took it out and said, "It's not black." Then the pathologist agreed.

Meloma can go anywhere, but most often it follows either the lympn channels, hence the use of SNB's or, if deep enough, may be spread through the blood steam. This is why depth is so importand a factor.  Tumors in the lower foot/leg tend to go up the lymph chain to the knee or groin nodes.  From the Sentinel Node it then tends to work it way through the group of nodes.  As we know nothing is an "ALWAYS" with melanoma.  The most common organ metastisis is the lungs, sometimes the liver.  I have read that about 40% will have ait metastize to the brain if not stopped before.  I have not read that the lymph node are called a barrier to melanoma, but from wht I have seen of the more common progression and the number and location of the lymph nodes involved it has never made sense to me to rmove the complete chain after finding several clear node when following the lyhmp fluid path flow.  I never had any idea that we have a lymph system with its own channels, valves, ettc that arry lymph fluid from various placece in the body to a loction near the heart where it finally feeds into the blood stream and is integrated with the blood.  The lymph fluid is pumped by our muscles, not having an equivalent device to the heart.  This is one reason that total lack of activity is apt to make lympedema worse.  Need some activity, but not t oo much.  Elevation helps the fluid not have to be pumped towards the heart by ths muscles and lets it flow more naturally. 

Meloma can go anywhere, but most often it follows either the lympn channels, hence the use of SNB's or, if deep enough, may be spread through the blood steam. This is why depth is so importand a factor.  Tumors in the lower foot/leg tend to go up the lymph chain to the knee or groin nodes.  From the Sentinel Node it then tends to work it way through the group of nodes.  As we know nothing is an "ALWAYS" with melanoma.  The most common organ metastisis is the lungs, sometimes the liver.  I have read that about 40% will have ait metastize to the brain if not stopped before.  I have not read that the lymph node are called a barrier to melanoma, but from wht I have seen of the more common progression and the number and location of the lymph nodes involved it has never made sense to me to rmove the complete chain after finding several clear node when following the lyhmp fluid path flow.  I never had any idea that we have a lymph system with its own channels, valves, ettc that arry lymph fluid from various placece in the body to a loction near the heart where it finally feeds into the blood stream and is integrated with the blood.  The lymph fluid is pumped by our muscles, not having an equivalent device to the heart.  This is one reason that total lack of activity is apt to make lympedema worse.  Need some activity, but not t oo much.  Elevation helps the fluid not have to be pumped towards the heart by ths muscles and lets it flow more naturally. 

No, all my groin lymph node were not removed.  The Melanoma was so far advanced from 3 1/2 years of misdiagnosis and then 7 month of slow rolling by the local general surgeon, that by statistics I should be dead. The Surgical and Medical Onc at UVA moved fast when I learned to get on their list and have done wonders for me.  Many of my groin lymph nodes were so matted and grown that they were not sure what was lymph nodes and what was soft tissue growths. There was also extra-capsular extensions, so they removed extra soft tissue. The surgeon had sections reviewed by a pathologist as he was operating and went past where any more melanoma was found. A month later x-rays and CT scans found innumerable tumors in my lung`s, I am sure that they were there previously, just to small to show on the scans. Two year later I felt another soft tissue tumor that had zero SUV uptake on PE@T scans. Since I could see that it was fast growing I asked for it's removal. The Oncologist showed it to me upon removal and we agreed that it appeared to be another black melanoma. The pathology report agreed with our inclination. That area has been free from further growth and from any Lymphedema for the two and a half years since then.

I am not in the medical profession and tend to look at things from more of a physical engineering stand point. I have never seen the inside of a lymph node. I do look at them as something that will at least slow down the speed of spread of malignant cells to other locations in the body, if the malignant cells have not entered into the bloodstream.

It seems to me that the Lymphedema would likely be much worse if all nodes in the flow path were removed. As long as some are there, the lymph fluid is more likely to find it's way in a more normal flow.

I will be very interested in what the studies on this subject show.

I do understand where you are coming from as a young mother that wants to be with your children grow up. What this disease can do to disrupt young lives is very bad. Learn (as you are doing) and be self vigilant.  i have four childrn and netx month expect my 15th living gramdchild.

I will be praying for you as I do for all afflicted with this disease. May God be merciful for your family.

JerryfromFauq active Stage IV since Feb 2007.

No, all my groin lymph node were not removed.  The Melanoma was so far advanced from 3 1/2 years of misdiagnosis and then 7 month of slow rolling by the local general surgeon, that by statistics I should be dead. The Surgical and Medical Onc at UVA moved fast when I learned to get on their list and have done wonders for me.  Many of my groin lymph nodes were so matted and grown that they were not sure what was lymph nodes and what was soft tissue growths. There was also extra-capsular extensions, so they removed extra soft tissue. The surgeon had sections reviewed by a pathologist as he was operating and went past where any more melanoma was found. A month later x-rays and CT scans found innumerable tumors in my lung`s, I am sure that they were there previously, just to small to show on the scans. Two year later I felt another soft tissue tumor that had zero SUV uptake on PE@T scans. Since I could see that it was fast growing I asked for it's removal. The Oncologist showed it to me upon removal and we agreed that it appeared to be another black melanoma. The pathology report agreed with our inclination. That area has been free from further growth and from any Lymphedema for the two and a half years since then.

I am not in the medical profession and tend to look at things from more of a physical engineering stand point. I have never seen the inside of a lymph node. I do look at them as something that will at least slow down the speed of spread of malignant cells to other locations in the body, if the malignant cells have not entered into the bloodstream.

It seems to me that the Lymphedema would likely be much worse if all nodes in the flow path were removed. As long as some are there, the lymph fluid is more likely to find it's way in a more normal flow.

I will be very interested in what the studies on this subject show.

I do understand where you are coming from as a young mother that wants to be with your children grow up. What this disease can do to disrupt young lives is very bad. Learn (as you are doing) and be self vigilant.  i have four childrn and netx month expect my 15th living gramdchild.

I will be praying for you as I do for all afflicted with this disease. May God be merciful for your family.

JerryfromFauq active Stage IV since Feb 2007.