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Appointment at Moffitt today
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Appointment at Moffitt today

› Forums › General Melanoma Community › Appointment at Moffitt today

  • Post
    • June 25, 2013 at 1:28 am
    flvermonter
    Participant

      Hello,

      Hello,

      We had our appointment at Moffitt, but didn't take out my husbands drain.  Still running around 100ccs and needs to be a a rate of 30 ccs in 24hrs.  However, got the report from Dr Zager, and confirmation that the two upcoming appointments (one with Onc for the lung and one with Onc for melanoma) is the game plan.  They will do another PET scan in 3 months to see if any other spots show up, but nothing about other treatments.  My husband's right hand and arm are very swollen and I thought that area along with his right leg and foot are from the same surgery.  Dr Z said no, the arm and hand swelling is from the surgery removing the lymphnodes, but the leg and foot are something else.  So appointment tomorrow am with his Med Dr.  Also an appointment for the lymphedema to be a glove or arm cover to help with the swelling.

       

      He is the path report from the surgery.   Subscapularis nodule, greater than 50% of the tumor is necrotic.  Lymph node level 1 and 2 right axillary contents with metastic melanoma in 3 of the 13 nodes.   Subscapularis node no. 2 had 4 of 4 nodes with metastic melanoma.  Soft tissue Latissimus tissue, no evidence of malignancy.  Axillary vein nodule, melanoma in 1 of 1.  Additiona latissimus tissue 1 of 1 metastatic.  Level 3 right axilla, 9 of 10 metastatic melanoma.

      all of that sounds terrible.  Help me understand this and the treatment.  Will radiation to the melanoma area kill any cancer surrounding the surgical site?  I believe and will know after meeting with lung onc, they are comfortable they can manage reradicate the lung cancer. Any one had any radiation instead of infusion for melanoma?  How did it work?  My husband has been blessed with no metastica to the brain to date.

       

      Thanks for your help and please know that it is appreciated.  PS I asked about clear margins and Dr Z said he took everything he could.  What does that mean, that no clear margins?

       

      Thanks, Mary

    Viewing 5 reply threads
    • Replies
        • June 26, 2013 at 2:31 am
        flvermonter
        Participant

          Hi,

          Any thoughts of how the radiation will affect my husband physically?  Wasn't sure if I had asked in an unclear way or not in the prior post. 

           

          Thanks, Mary

          • June 26, 2013 at 2:31 am
          flvermonter
          Participant

            Hi,

            Any thoughts of how the radiation will affect my husband physically?  Wasn't sure if I had asked in an unclear way or not in the prior post. 

             

            Thanks, Mary

            • June 26, 2013 at 2:31 am
            flvermonter
            Participant

              Hi,

              Any thoughts of how the radiation will affect my husband physically?  Wasn't sure if I had asked in an unclear way or not in the prior post. 

               

              Thanks, Mary

              • June 26, 2013 at 8:57 pm
              Jim M.
              Participant

                Hi Mary,

                 I wrote to you before. Like I said, Dr. Z is a great doctor. At your husband's next appt. just clarify with the onc. what Dr. Z meant. It should all be in the chart. Or ask to speak with Roz, his nurse, or if Z is in speak to him. He should have been more specific. I can't help you interpret the report very well but whichever onc. you meet with should be able to tell you.

                  My onc., Dr. Weber, was the one who told me radiation to the surgical site reduces the possibility of a local recurrence from 60 to 10%. It targets cancer cells the surgery missed. I was told that no surgery will get 100% of cancer cells. That is maybe what Z meant. Your husband may very well have clean margins. I did 30 treatments of radiation and it was a high dose. You don't feel it at first but with more treatments the skin turns red (mine didn't blister) and you feel some fatigue. Toward the end there's some pain and tightness of the area getting radiation. I applied Miaderm radiation cream after each treatment. It cannot be applied before a treatment. Look it up on-line. I really think the cream protected me from getting more severe side effects.

                 God Bless you both and best of success,

                 Jim M.

                • June 26, 2013 at 8:57 pm
                Jim M.
                Participant

                  Hi Mary,

                   I wrote to you before. Like I said, Dr. Z is a great doctor. At your husband's next appt. just clarify with the onc. what Dr. Z meant. It should all be in the chart. Or ask to speak with Roz, his nurse, or if Z is in speak to him. He should have been more specific. I can't help you interpret the report very well but whichever onc. you meet with should be able to tell you.

                    My onc., Dr. Weber, was the one who told me radiation to the surgical site reduces the possibility of a local recurrence from 60 to 10%. It targets cancer cells the surgery missed. I was told that no surgery will get 100% of cancer cells. That is maybe what Z meant. Your husband may very well have clean margins. I did 30 treatments of radiation and it was a high dose. You don't feel it at first but with more treatments the skin turns red (mine didn't blister) and you feel some fatigue. Toward the end there's some pain and tightness of the area getting radiation. I applied Miaderm radiation cream after each treatment. It cannot be applied before a treatment. Look it up on-line. I really think the cream protected me from getting more severe side effects.

                   God Bless you both and best of success,

                   Jim M.

                  • June 26, 2013 at 8:57 pm
                  Jim M.
                  Participant

                    Hi Mary,

                     I wrote to you before. Like I said, Dr. Z is a great doctor. At your husband's next appt. just clarify with the onc. what Dr. Z meant. It should all be in the chart. Or ask to speak with Roz, his nurse, or if Z is in speak to him. He should have been more specific. I can't help you interpret the report very well but whichever onc. you meet with should be able to tell you.

                      My onc., Dr. Weber, was the one who told me radiation to the surgical site reduces the possibility of a local recurrence from 60 to 10%. It targets cancer cells the surgery missed. I was told that no surgery will get 100% of cancer cells. That is maybe what Z meant. Your husband may very well have clean margins. I did 30 treatments of radiation and it was a high dose. You don't feel it at first but with more treatments the skin turns red (mine didn't blister) and you feel some fatigue. Toward the end there's some pain and tightness of the area getting radiation. I applied Miaderm radiation cream after each treatment. It cannot be applied before a treatment. Look it up on-line. I really think the cream protected me from getting more severe side effects.

                     God Bless you both and best of success,

                     Jim M.

                    • June 26, 2013 at 3:22 pm
                    POW
                    Participant

                      Hi, Mary-

                      It so happens that an important paper comparing lymph node dissection with and without follow-up radiotherapy was presented last month at the ASCO meetings. 

                      Henderson, et al "Adjuvant radiotherapy after lymphadenectomy in melanoma patients: Final results of an intergroup randomized trial" http://meetinglibrary.asco.org//content/112086-132
                       
                      Here is a news report summarizing the results of that trial (which is a little easier to read): http://news.cancerconnect.com/adjuvant-radiotherapy-for-the-management-of-high-risk-malignant-melanoma/
                       
                      The news report says: 
                      "After a median follow-up of 40 months, the researchers found that the risk of lymph-node field relapse was significantly reduced in the patients receiving adjuvant radiation therapy compared to their counterparts in the observation group. There were 20 relapses in the radiotherapy group, compared to 34 in the observation group. Although there was a significant improvement in the risk of local relapse within the affected nodal basins, there were no differences in relapse-free survival or overall survival. Side effects were generally mild. The most common grade 3 and 4 adverse events were seroma, radiation dermatitis, and wound infection." [My emphasis]
                       
                      I hope this answers your question.
                       
                       
                       
                       
                      • June 26, 2013 at 3:22 pm
                      POW
                      Participant

                        Hi, Mary-

                        It so happens that an important paper comparing lymph node dissection with and without follow-up radiotherapy was presented last month at the ASCO meetings. 

                        Henderson, et al "Adjuvant radiotherapy after lymphadenectomy in melanoma patients: Final results of an intergroup randomized trial" http://meetinglibrary.asco.org//content/112086-132
                         
                        Here is a news report summarizing the results of that trial (which is a little easier to read): http://news.cancerconnect.com/adjuvant-radiotherapy-for-the-management-of-high-risk-malignant-melanoma/
                         
                        The news report says: 
                        "After a median follow-up of 40 months, the researchers found that the risk of lymph-node field relapse was significantly reduced in the patients receiving adjuvant radiation therapy compared to their counterparts in the observation group. There were 20 relapses in the radiotherapy group, compared to 34 in the observation group. Although there was a significant improvement in the risk of local relapse within the affected nodal basins, there were no differences in relapse-free survival or overall survival. Side effects were generally mild. The most common grade 3 and 4 adverse events were seroma, radiation dermatitis, and wound infection." [My emphasis]
                         
                        I hope this answers your question.
                         
                         
                         
                         
                        • June 26, 2013 at 3:22 pm
                        POW
                        Participant

                          Hi, Mary-

                          It so happens that an important paper comparing lymph node dissection with and without follow-up radiotherapy was presented last month at the ASCO meetings. 

                          Henderson, et al "Adjuvant radiotherapy after lymphadenectomy in melanoma patients: Final results of an intergroup randomized trial" http://meetinglibrary.asco.org//content/112086-132
                           
                          Here is a news report summarizing the results of that trial (which is a little easier to read): http://news.cancerconnect.com/adjuvant-radiotherapy-for-the-management-of-high-risk-malignant-melanoma/
                           
                          The news report says: 
                          "After a median follow-up of 40 months, the researchers found that the risk of lymph-node field relapse was significantly reduced in the patients receiving adjuvant radiation therapy compared to their counterparts in the observation group. There were 20 relapses in the radiotherapy group, compared to 34 in the observation group. Although there was a significant improvement in the risk of local relapse within the affected nodal basins, there were no differences in relapse-free survival or overall survival. Side effects were generally mild. The most common grade 3 and 4 adverse events were seroma, radiation dermatitis, and wound infection." [My emphasis]
                           
                          I hope this answers your question.
                           
                           
                           
                           
                          • June 26, 2013 at 7:55 pm
                          flvermonter
                          Participant
                            thank you do much. that helps slot.
                            • June 26, 2013 at 7:55 pm
                            flvermonter
                            Participant
                              thank you do much. that helps slot.
                              • June 26, 2013 at 7:55 pm
                              flvermonter
                              Participant
                                thank you do much. that helps slot.
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