Newly Diagnosed…what should we expect next?

Hi. I'm sorry to see that you've joined us here.

MD Anderson has an excellent melanoma clinic so you're in very good hands.

I don't know how to advise you on your first 3 questions but I can tell you that if the melanoma has spread to his lymph nodes it would put him at Stage III. If it has spread beyond the lymph nodes to other organs it would put him at Stage IV.

When they say they're going to check his lymph nodes, they're going to feel around his neck, armpits, and groin for swollen lymph nodes. But since his melanoma was found on his shoulder, they are going to pay particular close attention to the armpit closest to where the lesion was because that's the first place the melanoma will spread to. They may do an ultrasound on that armpit or may even schedule a CAT scan to get a closer look at things. Assuming they find a suspicious lymph node, what the doctor may do is something called a fine needle aspiration where they draw cells from a suspicious lymph node to see if any of them are abnormal. If abnormal cells are found then the affected lymph node(s) will need to be surgically removed. Your doctor may recommend doing a sentinel lymph node biopsy or a lymphadenectomy.

I need to stop here because this is where I'm at with my melanoma, which is Stage III. Someone at Stage IV can give you better information about that particular stage than I can.

The waiting for tests and test results is very difficult. You won't know right away how much his melanoma has spread (if it even has spread). For me, from the time I had my fine needle aspiration to when I found out I had melanoma was about 4 weeks.

Hang in there. We are here for you.

Hi. I'm sorry to see that you've joined us here.

MD Anderson has an excellent melanoma clinic so you're in very good hands.

I don't know how to advise you on your first 3 questions but I can tell you that if the melanoma has spread to his lymph nodes it would put him at Stage III. If it has spread beyond the lymph nodes to other organs it would put him at Stage IV.

When they say they're going to check his lymph nodes, they're going to feel around his neck, armpits, and groin for swollen lymph nodes. But since his melanoma was found on his shoulder, they are going to pay particular close attention to the armpit closest to where the lesion was because that's the first place the melanoma will spread to. They may do an ultrasound on that armpit or may even schedule a CAT scan to get a closer look at things. Assuming they find a suspicious lymph node, what the doctor may do is something called a fine needle aspiration where they draw cells from a suspicious lymph node to see if any of them are abnormal. If abnormal cells are found then the affected lymph node(s) will need to be surgically removed. Your doctor may recommend doing a sentinel lymph node biopsy or a lymphadenectomy.

I need to stop here because this is where I'm at with my melanoma, which is Stage III. Someone at Stage IV can give you better information about that particular stage than I can.

The waiting for tests and test results is very difficult. You won't know right away how much his melanoma has spread (if it even has spread). For me, from the time I had my fine needle aspiration to when I found out I had melanoma was about 4 weeks.

Hang in there. We are here for you.

Hi. I'm sorry to see that you've joined us here.

MD Anderson has an excellent melanoma clinic so you're in very good hands.

I don't know how to advise you on your first 3 questions but I can tell you that if the melanoma has spread to his lymph nodes it would put him at Stage III. If it has spread beyond the lymph nodes to other organs it would put him at Stage IV.

When they say they're going to check his lymph nodes, they're going to feel around his neck, armpits, and groin for swollen lymph nodes. But since his melanoma was found on his shoulder, they are going to pay particular close attention to the armpit closest to where the lesion was because that's the first place the melanoma will spread to. They may do an ultrasound on that armpit or may even schedule a CAT scan to get a closer look at things. Assuming they find a suspicious lymph node, what the doctor may do is something called a fine needle aspiration where they draw cells from a suspicious lymph node to see if any of them are abnormal. If abnormal cells are found then the affected lymph node(s) will need to be surgically removed. Your doctor may recommend doing a sentinel lymph node biopsy or a lymphadenectomy.

I need to stop here because this is where I'm at with my melanoma, which is Stage III. Someone at Stage IV can give you better information about that particular stage than I can.

The waiting for tests and test results is very difficult. You won't know right away how much his melanoma has spread (if it even has spread). For me, from the time I had my fine needle aspiration to when I found out I had melanoma was about 4 weeks.

Hang in there. We are here for you.

Hi There!

While no melanoma diagnosis is a good diagnosis, your husbands's would definitly be considered low risk.  He is at Stage 1b.

I will do my best to answer your questions.

1.  All you have to do is ask.  You have the right to know all information regardding your health.

2. first appointment should consist of a complete check of his body for any other melanoma on the skin.  Also will be given full labs including blood test and likely will be scheduled for full body PET/CT scan and MRI of the brain.  Doctor should also explain the procedure necessary to remove the tumor.  For stage 1 it will be a wide margin excision.  This would be where they remove the actual tumor and a margin of skin surronding the tumor, in order to remove any floating cancerous cells around the tumor.  The margin they remove depends on the size of the tumor.  It sounds like your husbands is small fortunetly.  For stage 1 they do not always do a sentinal node biopsy.  But being that you dr has already mentioned the lymph nodes I am guessing that they will.  This is where they shoot a dye in the area of the tumor and see which lymph node drains the dye.  This most likely the node that would have drained the tumor and therefore most likely the node to contain cancerous cells.  Sometime it is more then 1 node.  They remove this node and test it for the presence of cancerous cells.  If it comes back positive then additional treatment is done, if not, being that it is only at stage 1, there would most likely be no further treatment other then close monitoring of the skin periodically to ensure no other melanoma's are showing up.  This sentinal node biopsy is done at the same time as the wide margin excision, so ther will be one operation done.  Please note each doctor is different so what I have described is both based on what I have went through and research, but you doctor could be different. 

3. I would ask anything you need to ask to feel as comfortable as possible about your situation going forward.  This your health and so do not be shy.  If you are not already, I would ask to be reffered to a melanoma specialist, as not al cancers are the same.  This is very important.  There are cutting edge treatments available to melanoma patients who have progressed to stage 3 or 4 that a non melanoma specialist may not be aware of.  I hope your husband won't ever have to worry about those type of treatments but it is best to be in place where they are available if need be.

Also, if you Dr. does not mention the sentinal node biopsy procedure you might want to ask about that.  

4. Yes if it has spread to a lymph node, it automatically becomes at least stage 3. Assuming the scans come back clear (cancerous nodes do not always show up positive on scans I believe), you would know on your follow up appointment after the surgery.  This assuming he has the sentinal node biopsy done of course.  

I hope this helps and my best advice would be not to worry about the lymph nodes until you are told there is something there.  No need to worry until you have something to worry about.  And even then there are treatments available now that as soon as 5 years ago were not available, they are making amazing progress in treatment of melanoma.

Jeff

Hi There!

While no melanoma diagnosis is a good diagnosis, your husbands's would definitly be considered low risk.  He is at Stage 1b.

I will do my best to answer your questions.

1.  All you have to do is ask.  You have the right to know all information regardding your health.

2. first appointment should consist of a complete check of his body for any other melanoma on the skin.  Also will be given full labs including blood test and likely will be scheduled for full body PET/CT scan and MRI of the brain.  Doctor should also explain the procedure necessary to remove the tumor.  For stage 1 it will be a wide margin excision.  This would be where they remove the actual tumor and a margin of skin surronding the tumor, in order to remove any floating cancerous cells around the tumor.  The margin they remove depends on the size of the tumor.  It sounds like your husbands is small fortunetly.  For stage 1 they do not always do a sentinal node biopsy.  But being that you dr has already mentioned the lymph nodes I am guessing that they will.  This is where they shoot a dye in the area of the tumor and see which lymph node drains the dye.  This most likely the node that would have drained the tumor and therefore most likely the node to contain cancerous cells.  Sometime it is more then 1 node.  They remove this node and test it for the presence of cancerous cells.  If it comes back positive then additional treatment is done, if not, being that it is only at stage 1, there would most likely be no further treatment other then close monitoring of the skin periodically to ensure no other melanoma's are showing up.  This sentinal node biopsy is done at the same time as the wide margin excision, so ther will be one operation done.  Please note each doctor is different so what I have described is both based on what I have went through and research, but you doctor could be different. 

3. I would ask anything you need to ask to feel as comfortable as possible about your situation going forward.  This your health and so do not be shy.  If you are not already, I would ask to be reffered to a melanoma specialist, as not al cancers are the same.  This is very important.  There are cutting edge treatments available to melanoma patients who have progressed to stage 3 or 4 that a non melanoma specialist may not be aware of.  I hope your husband won't ever have to worry about those type of treatments but it is best to be in place where they are available if need be.

Also, if you Dr. does not mention the sentinal node biopsy procedure you might want to ask about that.  

4. Yes if it has spread to a lymph node, it automatically becomes at least stage 3. Assuming the scans come back clear (cancerous nodes do not always show up positive on scans I believe), you would know on your follow up appointment after the surgery.  This assuming he has the sentinal node biopsy done of course.  

I hope this helps and my best advice would be not to worry about the lymph nodes until you are told there is something there.  No need to worry until you have something to worry about.  And even then there are treatments available now that as soon as 5 years ago were not available, they are making amazing progress in treatment of melanoma.

Jeff

Hi There!

While no melanoma diagnosis is a good diagnosis, your husbands's would definitly be considered low risk.  He is at Stage 1b.

I will do my best to answer your questions.

1.  All you have to do is ask.  You have the right to know all information regardding your health.

2. first appointment should consist of a complete check of his body for any other melanoma on the skin.  Also will be given full labs including blood test and likely will be scheduled for full body PET/CT scan and MRI of the brain.  Doctor should also explain the procedure necessary to remove the tumor.  For stage 1 it will be a wide margin excision.  This would be where they remove the actual tumor and a margin of skin surronding the tumor, in order to remove any floating cancerous cells around the tumor.  The margin they remove depends on the size of the tumor.  It sounds like your husbands is small fortunetly.  For stage 1 they do not always do a sentinal node biopsy.  But being that you dr has already mentioned the lymph nodes I am guessing that they will.  This is where they shoot a dye in the area of the tumor and see which lymph node drains the dye.  This most likely the node that would have drained the tumor and therefore most likely the node to contain cancerous cells.  Sometime it is more then 1 node.  They remove this node and test it for the presence of cancerous cells.  If it comes back positive then additional treatment is done, if not, being that it is only at stage 1, there would most likely be no further treatment other then close monitoring of the skin periodically to ensure no other melanoma's are showing up.  This sentinal node biopsy is done at the same time as the wide margin excision, so ther will be one operation done.  Please note each doctor is different so what I have described is both based on what I have went through and research, but you doctor could be different. 

3. I would ask anything you need to ask to feel as comfortable as possible about your situation going forward.  This your health and so do not be shy.  If you are not already, I would ask to be reffered to a melanoma specialist, as not al cancers are the same.  This is very important.  There are cutting edge treatments available to melanoma patients who have progressed to stage 3 or 4 that a non melanoma specialist may not be aware of.  I hope your husband won't ever have to worry about those type of treatments but it is best to be in place where they are available if need be.

Also, if you Dr. does not mention the sentinal node biopsy procedure you might want to ask about that.  

4. Yes if it has spread to a lymph node, it automatically becomes at least stage 3. Assuming the scans come back clear (cancerous nodes do not always show up positive on scans I believe), you would know on your follow up appointment after the surgery.  This assuming he has the sentinal node biopsy done of course.  

I hope this helps and my best advice would be not to worry about the lymph nodes until you are told there is something there.  No need to worry until you have something to worry about.  And even then there are treatments available now that as soon as 5 years ago were not available, they are making amazing progress in treatment of melanoma.

Jeff

Sorry about your diagnosis- I was also just diagnosed last week and was able to obtain my report by going to the dermatologists office and filling out some paperwork.  It did help put my mind at ease to see all the information we had in front of me.  My first appointment is next week so I can't help you out there but I there is a list of questions on this website http://www.melanoma.org/learn-more/melanoma-101/preparing-your-melanoma-doctors-visit

Hope that helps!

Sorry about your diagnosis- I was also just diagnosed last week and was able to obtain my report by going to the dermatologists office and filling out some paperwork.  It did help put my mind at ease to see all the information we had in front of me.  My first appointment is next week so I can't help you out there but I there is a list of questions on this website http://www.melanoma.org/learn-more/melanoma-101/preparing-your-melanoma-doctors-visit

Hope that helps!

Sorry about your diagnosis- I was also just diagnosed last week and was able to obtain my report by going to the dermatologists office and filling out some paperwork.  It did help put my mind at ease to see all the information we had in front of me.  My first appointment is next week so I can't help you out there but I there is a list of questions on this website http://www.melanoma.org/learn-more/melanoma-101/preparing-your-melanoma-doctors-visit

Hope that helps!

It is always good to get a copy of all the reports, lab works and even dr notes and scan them to your computer. You never know when you might need them in the future to get into a clinical trial…waiting on hospitals to send them for you wastes precious time.  If it has spread to lymph nodes it will probably change  the stage. Mine ended up in a lymph node by my heart and was 6.8 centimeters…I am stage 4.- Lynn

It is always good to get a copy of all the reports, lab works and even dr notes and scan them to your computer. You never know when you might need them in the future to get into a clinical trial…waiting on hospitals to send them for you wastes precious time.  If it has spread to lymph nodes it will probably change  the stage. Mine ended up in a lymph node by my heart and was 6.8 centimeters…I am stage 4.- Lynn

It is always good to get a copy of all the reports, lab works and even dr notes and scan them to your computer. You never know when you might need them in the future to get into a clinical trial…waiting on hospitals to send them for you wastes precious time.  If it has spread to lymph nodes it will probably change  the stage. Mine ended up in a lymph node by my heart and was 6.8 centimeters…I am stage 4.- Lynn

For a Stage I, 0.5mm, I really doubt they would do a full body PET/CT scan and MRI of the brain. 

For a Stage I, 0.5mm, I really doubt they would do a full body PET/CT scan and MRI of the brain. 

For a Stage I, 0.5mm, I really doubt they would do a full body PET/CT scan and MRI of the brain. 

1. It sounds like your husband caught this lesion very, very early so his prognosis will be excellent. Good for him!

2. MD Anderson is one of the best melanoma centers in the country, so it's great that he is going there for follow-up.

3. From now on, you should ALWAYS get copies of every report and every scan image even if you have to pay something to get them. Keep them all together in one place and NEVER give your originals away– if any healthcare provider or insurance company wants to see them, they can look at your copies. But if they want to keep them, tell them to make copies and return the originals to you. Too often valuable time is wasted waiting for one doctor to send reports and films to another, or the recipient's staff mis-files the reports, or whatever. And I have had radiologists say that copies of scan images are of poor quality and they need to see the original. So you get them and hang onto them. 

4. Lastly, SNB is surgery and it leaves a long incision and uncomfortable stitches. Like any medical procedure, it should only be done if necessary. It used to be that they only did SNBs if the original lesion was 0.76mm or deeper; now I think the recommendation is 1.0mm or deeper. In either case, your husband will probably not need an SNB– which is a good thing. However, that is the beauty of going to MD Anderson. They know their stuff. So if they look at the path report and check your husband out, they will be able to tell you whether or not an SNB is in order. No need for you to fret and second guess yourself. 

I think your husband's outlook if very, very good. Let us know what you learn after your visit to MD Anderson.

1. It sounds like your husband caught this lesion very, very early so his prognosis will be excellent. Good for him!

2. MD Anderson is one of the best melanoma centers in the country, so it's great that he is going there for follow-up.

3. From now on, you should ALWAYS get copies of every report and every scan image even if you have to pay something to get them. Keep them all together in one place and NEVER give your originals away– if any healthcare provider or insurance company wants to see them, they can look at your copies. But if they want to keep them, tell them to make copies and return the originals to you. Too often valuable time is wasted waiting for one doctor to send reports and films to another, or the recipient's staff mis-files the reports, or whatever. And I have had radiologists say that copies of scan images are of poor quality and they need to see the original. So you get them and hang onto them. 

4. Lastly, SNB is surgery and it leaves a long incision and uncomfortable stitches. Like any medical procedure, it should only be done if necessary. It used to be that they only did SNBs if the original lesion was 0.76mm or deeper; now I think the recommendation is 1.0mm or deeper. In either case, your husband will probably not need an SNB– which is a good thing. However, that is the beauty of going to MD Anderson. They know their stuff. So if they look at the path report and check your husband out, they will be able to tell you whether or not an SNB is in order. No need for you to fret and second guess yourself. 

I think your husband's outlook if very, very good. Let us know what you learn after your visit to MD Anderson.

1. It sounds like your husband caught this lesion very, very early so his prognosis will be excellent. Good for him!

2. MD Anderson is one of the best melanoma centers in the country, so it's great that he is going there for follow-up.

3. From now on, you should ALWAYS get copies of every report and every scan image even if you have to pay something to get them. Keep them all together in one place and NEVER give your originals away– if any healthcare provider or insurance company wants to see them, they can look at your copies. But if they want to keep them, tell them to make copies and return the originals to you. Too often valuable time is wasted waiting for one doctor to send reports and films to another, or the recipient's staff mis-files the reports, or whatever. And I have had radiologists say that copies of scan images are of poor quality and they need to see the original. So you get them and hang onto them. 

4. Lastly, SNB is surgery and it leaves a long incision and uncomfortable stitches. Like any medical procedure, it should only be done if necessary. It used to be that they only did SNBs if the original lesion was 0.76mm or deeper; now I think the recommendation is 1.0mm or deeper. In either case, your husband will probably not need an SNB– which is a good thing. However, that is the beauty of going to MD Anderson. They know their stuff. So if they look at the path report and check your husband out, they will be able to tell you whether or not an SNB is in order. No need for you to fret and second guess yourself. 

I think your husband's outlook if very, very good. Let us know what you learn after your visit to MD Anderson.