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Staging

  • Post
    justlittleoleme
    Participant
    We had surgery on 9/23. Pathology is back and there is no staging information. Dr.’s nurse said because tumor was below skin they don’t stage the cancer. The report states it is metastatic melanoma. Originally we were told stage 3 since it is a local recurrence. I am confused since metastatic melanoma is stage 4. I would like your thoughts since staging between 3/4 makes a difference with regards go the treatments available.

    Also, we are approaching two weeks post op. One of the dr’s we are consulting with wants a brain MRI to rule out brain involvement. Our local hospital said we need to wait until 8 weeks post op. The consulting dr has him scheduled 10/14 for the MRI. Do we need to be concerned about the MRI and his internal stitches? Anyone ever encounter this?

    Thanks, barb

Viewing 14 reply threads
  • Replies
      Janner
      Participant

      Pathology reports never "stage" because they are only looking at one piece of tissue, not the whole body.  Doctor's do the staging.

      Local recurrences or "in transit" mets are not stage IV, but stage IIIB or IIIC.  You can see a breakdown in staging at this site:  http://www.clevelandclinicmeded.com/medicalpubs/diseasemanagement/dermatology/cutaneous-malignant-melanoma/#s0110

      The difference between B and C depends on if there is any lymph node involvement.  Stage IV would be a recurrence (either skin or organ) that is beyond the nearest lymph drainage basin.

      Best wishes,

      Janner

        justlittleoleme
        Participant

        Janner,

        Thanks for the information.  His previous pathology did stage which is why I was looking for staging on this pathology report.    His previous pathology gave the stage and the information on the mitoses. 

        Barb

        justlittleoleme
        Participant

        Janner,

        Thanks for the information.  His previous pathology did stage which is why I was looking for staging on this pathology report.    His previous pathology gave the stage and the information on the mitoses. 

        Barb

        justlittleoleme
        Participant

        Janner,

        Thanks for the information.  His previous pathology did stage which is why I was looking for staging on this pathology report.    His previous pathology gave the stage and the information on the mitoses. 

        Barb

      Janner
      Participant

      Pathology reports never "stage" because they are only looking at one piece of tissue, not the whole body.  Doctor's do the staging.

      Local recurrences or "in transit" mets are not stage IV, but stage IIIB or IIIC.  You can see a breakdown in staging at this site:  http://www.clevelandclinicmeded.com/medicalpubs/diseasemanagement/dermatology/cutaneous-malignant-melanoma/#s0110

      The difference between B and C depends on if there is any lymph node involvement.  Stage IV would be a recurrence (either skin or organ) that is beyond the nearest lymph drainage basin.

      Best wishes,

      Janner

      Janner
      Participant

      Pathology reports never "stage" because they are only looking at one piece of tissue, not the whole body.  Doctor's do the staging.

      Local recurrences or "in transit" mets are not stage IV, but stage IIIB or IIIC.  You can see a breakdown in staging at this site:  http://www.clevelandclinicmeded.com/medicalpubs/diseasemanagement/dermatology/cutaneous-malignant-melanoma/#s0110

      The difference between B and C depends on if there is any lymph node involvement.  Stage IV would be a recurrence (either skin or organ) that is beyond the nearest lymph drainage basin.

      Best wishes,

      Janner

      KatyWI
      Participant

      Hi Barb,

      The local recurrence IS metastatic, but he is still stage III since the mets are close to the original tumor.  Anything that isn't a primary tumor is metastatic.  Another example of metastatic but stage III is when someone has local lymph node involvement; the mm found in the lymph nodes is considered metastatic melanoma.  A really dramatic example is Donna, whose leg was covered in mets before she became a shining beacon of how well ipi CAN work.  She would still be considered stage III.

      Waiting for the MRI doesn't make sense to me; tell the consulting doctor what the local hospital said and ask him to explain.  The internal stitches would not be metallic (he doesn't have any staples, does he?) so I can't figure out how a brain MRI could be affected by stitches anywhere NOT in the brain.

      Katy

      KatyWI
      Participant

      Hi Barb,

      The local recurrence IS metastatic, but he is still stage III since the mets are close to the original tumor.  Anything that isn't a primary tumor is metastatic.  Another example of metastatic but stage III is when someone has local lymph node involvement; the mm found in the lymph nodes is considered metastatic melanoma.  A really dramatic example is Donna, whose leg was covered in mets before she became a shining beacon of how well ipi CAN work.  She would still be considered stage III.

      Waiting for the MRI doesn't make sense to me; tell the consulting doctor what the local hospital said and ask him to explain.  The internal stitches would not be metallic (he doesn't have any staples, does he?) so I can't figure out how a brain MRI could be affected by stitches anywhere NOT in the brain.

      Katy

      KatyWI
      Participant

      Hi Barb,

      The local recurrence IS metastatic, but he is still stage III since the mets are close to the original tumor.  Anything that isn't a primary tumor is metastatic.  Another example of metastatic but stage III is when someone has local lymph node involvement; the mm found in the lymph nodes is considered metastatic melanoma.  A really dramatic example is Donna, whose leg was covered in mets before she became a shining beacon of how well ipi CAN work.  She would still be considered stage III.

      Waiting for the MRI doesn't make sense to me; tell the consulting doctor what the local hospital said and ask him to explain.  The internal stitches would not be metallic (he doesn't have any staples, does he?) so I can't figure out how a brain MRI could be affected by stitches anywhere NOT in the brain.

      Katy

      James from Sydney
      Participant

      Hi Barb, our son was staged 3c after they found Metastatic Melanoma in his Parotid Gland as well as 3 lymph nodes nearby. There was no sign of any Primary on his skin, its referred to as Occult or Unknown Primary. He did a Pet Scan prior to surgery to rule out further spread however no MRI was done just CT Scans..

      best wishes

      James

      James from Sydney
      Participant

      Hi Barb, our son was staged 3c after they found Metastatic Melanoma in his Parotid Gland as well as 3 lymph nodes nearby. There was no sign of any Primary on his skin, its referred to as Occult or Unknown Primary. He did a Pet Scan prior to surgery to rule out further spread however no MRI was done just CT Scans..

      best wishes

      James

      James from Sydney
      Participant

      Hi Barb, our son was staged 3c after they found Metastatic Melanoma in his Parotid Gland as well as 3 lymph nodes nearby. There was no sign of any Primary on his skin, its referred to as Occult or Unknown Primary. He did a Pet Scan prior to surgery to rule out further spread however no MRI was done just CT Scans..

      best wishes

      James

      Jessmoon
      Participant

      It should be safe to have an MRI.  My husband has a wider excision of his intiial lesion completed on 9/14/11 and had an MRI of his brain on 9/22.  Sutures should not contain metal.

      Jessmoon
      Participant

      It should be safe to have an MRI.  My husband has a wider excision of his intiial lesion completed on 9/14/11 and had an MRI of his brain on 9/22.  Sutures should not contain metal.

      Jessmoon
      Participant

      It should be safe to have an MRI.  My husband has a wider excision of his intiial lesion completed on 9/14/11 and had an MRI of his brain on 9/22.  Sutures should not contain metal.

      shellebrownies
      Participant

      My husband had an MRI the morning after his lymphectomy while he was still in the hospital. But, if he had metal staples put in during the surgery, they would not be able to MRI until they were removed. Perhaps that's the issue?

      Michelle, wife of Don

      shellebrownies
      Participant

      My husband had an MRI the morning after his lymphectomy while he was still in the hospital. But, if he had metal staples put in during the surgery, they would not be able to MRI until they were removed. Perhaps that's the issue?

      Michelle, wife of Don

      shellebrownies
      Participant

      My husband had an MRI the morning after his lymphectomy while he was still in the hospital. But, if he had metal staples put in during the surgery, they would not be able to MRI until they were removed. Perhaps that's the issue?

      Michelle, wife of Don

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