Anxious and have some questions

There is a problem testing the lymph nodes AFTER the wide excision.  Basically, you are testing the Sentinel Node – this means the very first lymph node that the lesion drains to.  They inject a radioactive tracer and/or dye into the lesion and trace it to the first lymph node in the chain.  The problem comes after you have the WLE.  The first node in the chain may not be the same one anymore.  Removing a large chunk of skin may change the drainage patterns.   So if the result is positive, it's positive.  But if it is negative, there will always be a question to whether or not this was THE sentinel node. 

The first surgeon may understand that there is limited data in doing a SNB after the WLE.  He also may want to save face.  Who knows?  A second opinion never hurts, but my problem is with any doctor that says they can guarantee they will find the sentinel node — I wouldn't believe them. 

As for risks, yes, there are risks.  It is surgery, typically done under a general anesthesia.  There is the risk of lymphedema and other surgical complications.  Not common, but certainly a possibility.  You'd want to have someone who is VERY experienced in SNBs doing this (if you decide to go that route).

No way to predict spread at this point.  Too variable.   Just take it one day at a time.  This isn't a death sentence, but it is something to be respectful of. 

Hang in there!

There is a problem testing the lymph nodes AFTER the wide excision.  Basically, you are testing the Sentinel Node – this means the very first lymph node that the lesion drains to.  They inject a radioactive tracer and/or dye into the lesion and trace it to the first lymph node in the chain.  The problem comes after you have the WLE.  The first node in the chain may not be the same one anymore.  Removing a large chunk of skin may change the drainage patterns.   So if the result is positive, it's positive.  But if it is negative, there will always be a question to whether or not this was THE sentinel node. 

The first surgeon may understand that there is limited data in doing a SNB after the WLE.  He also may want to save face.  Who knows?  A second opinion never hurts, but my problem is with any doctor that says they can guarantee they will find the sentinel node — I wouldn't believe them. 

As for risks, yes, there are risks.  It is surgery, typically done under a general anesthesia.  There is the risk of lymphedema and other surgical complications.  Not common, but certainly a possibility.  You'd want to have someone who is VERY experienced in SNBs doing this (if you decide to go that route).

No way to predict spread at this point.  Too variable.   Just take it one day at a time.  This isn't a death sentence, but it is something to be respectful of. 

Hang in there!

There is a problem testing the lymph nodes AFTER the wide excision.  Basically, you are testing the Sentinel Node – this means the very first lymph node that the lesion drains to.  They inject a radioactive tracer and/or dye into the lesion and trace it to the first lymph node in the chain.  The problem comes after you have the WLE.  The first node in the chain may not be the same one anymore.  Removing a large chunk of skin may change the drainage patterns.   So if the result is positive, it's positive.  But if it is negative, there will always be a question to whether or not this was THE sentinel node. 

The first surgeon may understand that there is limited data in doing a SNB after the WLE.  He also may want to save face.  Who knows?  A second opinion never hurts, but my problem is with any doctor that says they can guarantee they will find the sentinel node — I wouldn't believe them. 

As for risks, yes, there are risks.  It is surgery, typically done under a general anesthesia.  There is the risk of lymphedema and other surgical complications.  Not common, but certainly a possibility.  You'd want to have someone who is VERY experienced in SNBs doing this (if you decide to go that route).

No way to predict spread at this point.  Too variable.   Just take it one day at a time.  This isn't a death sentence, but it is something to be respectful of. 

Hang in there!

Is he seeing a Melanoma Specialist either in the dermatologist or the surgeon.  If not that would be first line of action is to find one and take all my information to him and see what he says.

Judy (loving wife of Gene Stage IV and now NED)

Is he seeing a Melanoma Specialist either in the dermatologist or the surgeon.  If not that would be first line of action is to find one and take all my information to him and see what he says.

Judy (loving wife of Gene Stage IV and now NED)

Is he seeing a Melanoma Specialist either in the dermatologist or the surgeon.  If not that would be first line of action is to find one and take all my information to him and see what he says.

Judy (loving wife of Gene Stage IV and now NED)

So sorry to hear about your fiancé. My husband of 8 months just went thru this same process and was diagnosed stage IV over the course of the last months worth if tests and surgeries, He had the primary tumor removed from his scalp and removed the sentinel lymph node which as others have mentioned is determined using nuclear tracing. Technology is incredible and they do everything they can to make sure they are getting the right one or ones and nothing extra. My husband ended up only needing one removed from behind his left ear but they can be pretty much anywhere. He also did MRI And PET scans to determine where else it had spread. 

He has a melanoma specialist and had a specialized head & neck surgeon do his surgery. You're dermatologist or GP should be able to recommend a specialist even if they are far away they should review his results and pathology reports. We're at UCSF in SF, California but got a second opinion from Sloan Kettering cancer hospital in NYC. 

The most important lesson I'm learning thru this process is that you both need to be his best advocate – do your research, follow up if you don't hear back on something, be persistent. I understand exactly how scary it is but just be there and focus on how to get him thru it and get the best treatment possible.  Best of luck to you both and  if you're not sleeping I recommend Ambien – it's a stressful process and sleep is crucial for both of you. 

So sorry to hear about your fiancé. My husband of 8 months just went thru this same process and was diagnosed stage IV over the course of the last months worth if tests and surgeries, He had the primary tumor removed from his scalp and removed the sentinel lymph node which as others have mentioned is determined using nuclear tracing. Technology is incredible and they do everything they can to make sure they are getting the right one or ones and nothing extra. My husband ended up only needing one removed from behind his left ear but they can be pretty much anywhere. He also did MRI And PET scans to determine where else it had spread. 

He has a melanoma specialist and had a specialized head & neck surgeon do his surgery. You're dermatologist or GP should be able to recommend a specialist even if they are far away they should review his results and pathology reports. We're at UCSF in SF, California but got a second opinion from Sloan Kettering cancer hospital in NYC. 

The most important lesson I'm learning thru this process is that you both need to be his best advocate – do your research, follow up if you don't hear back on something, be persistent. I understand exactly how scary it is but just be there and focus on how to get him thru it and get the best treatment possible.  Best of luck to you both and  if you're not sleeping I recommend Ambien – it's a stressful process and sleep is crucial for both of you. 

So sorry to hear about your fiancé. My husband of 8 months just went thru this same process and was diagnosed stage IV over the course of the last months worth if tests and surgeries, He had the primary tumor removed from his scalp and removed the sentinel lymph node which as others have mentioned is determined using nuclear tracing. Technology is incredible and they do everything they can to make sure they are getting the right one or ones and nothing extra. My husband ended up only needing one removed from behind his left ear but they can be pretty much anywhere. He also did MRI And PET scans to determine where else it had spread. 

He has a melanoma specialist and had a specialized head & neck surgeon do his surgery. You're dermatologist or GP should be able to recommend a specialist even if they are far away they should review his results and pathology reports. We're at UCSF in SF, California but got a second opinion from Sloan Kettering cancer hospital in NYC. 

The most important lesson I'm learning thru this process is that you both need to be his best advocate – do your research, follow up if you don't hear back on something, be persistent. I understand exactly how scary it is but just be there and focus on how to get him thru it and get the best treatment possible.  Best of luck to you both and  if you're not sleeping I recommend Ambien – it's a stressful process and sleep is crucial for both of you. 

I am very sorry about your fiance  diagnosis and hope that his lymph nodes will be negative!

Becaise this melanoma presentation was very unusual, could you please describe how did it look like? was it red, pink, light brown in color? Scaly or smooth? Was it blanching when you pressed on it? Was is changing over those 5 years it was present on his skin? Thank you.

I am very sorry about your fiance  diagnosis and hope that his lymph nodes will be negative!

Becaise this melanoma presentation was very unusual, could you please describe how did it look like? was it red, pink, light brown in color? Scaly or smooth? Was it blanching when you pressed on it? Was is changing over those 5 years it was present on his skin? Thank you.

I am very sorry about your fiance  diagnosis and hope that his lymph nodes will be negative!

Becaise this melanoma presentation was very unusual, could you please describe how did it look like? was it red, pink, light brown in color? Scaly or smooth? Was it blanching when you pressed on it? Was is changing over those 5 years it was present on his skin? Thank you.