Advice Needed, Surgery First?

This topic has 7 replies, 7 voices, and was last updated 7 years, 1 month ago by miaka618.

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- May 6, 2017 at 5:06 pm
- Quote
luda2259
Participant
Hi,

My dad had a few moles on his back biopsied. One came back as an aggressive melanoma, about 3mm, ulcerated. He was referred to surgical oncology. He is having a WLE and a lymph node biopsy in a few days. We saw his medical oncologist and he is suggesting postponing the surgery and having a PET scan and MRI. With insurance who knows when he will get the approval for the scans. We want to go through with surgery first.
My question is, what were you initial steps? Surgery first and then scans?

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- - May 6, 2017 at 5:23 pm
  - Quote
  Ridingaroundwith27Jennifers
  Participant
  I had scans first but everyone's journey is different. Perhaps it is worth asking what they feel the benefits of scans first would be. I find open dialog with the doctors and nurses has really helped me.
- - May 6, 2017 at 5:50 pm
  - Quote
  Patrisa
  Participant
  Hi anon,
  
  scan first would be good for knowing immediately if the cancer has spread ( hopefully not!), in that case they would probably not do the biopsy and would go straight to immuno… having a positive biopsy would also require pet or mri, so in both cases you would wait… so don't know really what would be the best advice, i am maybe leaning towards pet first…but lets wait for some more credible replies from our amazing peeps here…
  
  Patrisa
- - May 6, 2017 at 8:37 pm
  - Quote
  jennunicorn
  Participant
  I had surgery first and then scans couple weeks after surgery.
- - May 6, 2017 at 9:55 pm
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  sgreenberg
  Participant
  Seven years ago, my wife had a PET first, then surgery despite the lack of findings. The lymph nodes removed were clean. A year ago, after six years of no disease, brain mets appeared. The thing is – and your onco can confirm this – melanoma micrometastasis are simply not detectable, and surgery provides no guarantee. If we had understood this, as well as the long term health implications of lymphadenectomy (removal of lymph nodes), I'm not sure we would have chosen surgery, especially not there had been targeted and immunotherapy. I'd say you need to first find an onco you trust, and then cross-examine him or her about the actually necessity of surgery. Good luck
  - May 7, 2017 at 12:20 am
    
    Quote
    Jamie1960
    Participant
    
    How were brain mets detected after such a long interval ? Were periodic scans incorporated into your wife's follow up protocol ? Thank you
- - May 6, 2017 at 11:11 pm
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  MichelleRHG
  Participant
  When my primary biopsy was dx as melanoma, I had the WLE and sentinel node biopsy, which was negative. No scans.
  8 years later when it recurred in a lymph node (confirmed by needle biopsy) I had a PET before the CLNB. Surgeon wanted to see if it was anywhere else before he performed surgery.
- - May 7, 2017 at 2:14 am
  - Quote
  miaka618
  Participant
  I think it would be better to have the scans before the surgery. If you wait until after, the area under and around the surgical site will light up and mask any possible tumors in the area. I ended up having my scans after because there was an issue with scheduling.