- August 17, 2010 at 12:29 am
Yes, get some quality sleep tonight; no dark shadowy figure with a swath in hand is going to whisk you away right now.
Here is the good stuff: It is good your doc did the SNB. It is good there were no extra-nodal extensions, It is good you are generallly in good health.
Here is the questionable stuff: Did the path report from surgery mention any "matting" of the node? Did the path report mention the type of melanoma e.g. Superficial Spreading or Nodular? The prophalactic(sp) approach you mention is indeed an Elective Lymph Node Dissection which is precautionary surgery, however, as with any surgery there are potential trade-offs and as always….risks.
One trade-off is the risk of lymphadema, where because all the chained lymph nodes are removed the lymph fluid has no place to go and one ends up swelling up like a dead hog lying in the hot sun. This can be mitigated somewhat by leaving the post surgery JP drains in place until the flow of lymph is minimal…………………….that minimal flow means the lymph fluid will have time to find another route rather than pooling. Another trade off in thinking is that by removing healthy parts of the immune system (lymph nodes), it diminishes the possibility of the natural defence against melanoma. Both ways of thinking can be disputed, so the decision making process becomes one of which makes sense to you as an individual and not based upon "group thinking".
SK is a leader in innovation with regards to melanoma diagnosis and treatment, but just because they are is no reason for a patient to be passive and simply say "yes, doctor", second opinions are important in the decision making process as well as your own gut feelings.
Your remarks about others thinking you should be on some adjunct therapy are rewarding, When I was first diagnosed, people poo-pooed me with "it's only skin cancer. So it is good your surrounds realize that melanoma is indeed a serious disease…………….which it is.
You will also find that historically, melanoma has been resistant to treatment and the approaches are often controversial.. That includes your ELD, Interferon, Chemo, Bio-chemo, GMCSF, diet, clinical trials and scan protocols that involve CT(with and without contrast dye, the millimeter slices of the scanners, PET Scans, MRI usage as a baseline and followup and even simple things like the LDH levels derived from blood tests.
For what it worth to you, I was diagnosed Stage III in 1987 and have been Stage IV since 1996 and have been a personal witness of the evolution of melanoma, not only in detection, but treatment and one thing I have learned that this disease is fundamentally confounding, lacks specific and sucessful treatment guidelines and has a sketchy and unpredictable outcome across the patient population treatment wise but can be a matter of disease management sans a cure.
I wish you well and do hope this helps.
Serial Cancer Patient