› Forums › General Melanoma Community › Check ups post Stage 2 Melanoma
- This topic has 18 replies, 4 voices, and was last updated 11 years, 10 months ago by
DeborahG.
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- July 9, 2012 at 5:27 pm
Three years ago I was diagnosed with Stage 2 Malignant Melanoma at 29 years old. I have a family history, I am fair, and I have had many childhood burns.
Fortunately, I did not have to have chemo/radiation treatment but I do get skin checks twice a year. My doctor does a chest scan and lab work every year. Do other patients with the same history as I have also have to get these done anually? What are they looking for with these tests? And finally, is it necessary to do it for every year?
Three years ago I was diagnosed with Stage 2 Malignant Melanoma at 29 years old. I have a family history, I am fair, and I have had many childhood burns.
Fortunately, I did not have to have chemo/radiation treatment but I do get skin checks twice a year. My doctor does a chest scan and lab work every year. Do other patients with the same history as I have also have to get these done anually? What are they looking for with these tests? And finally, is it necessary to do it for every year?
I am having two biospies this Wednesday. This will be my 10th and 11th shave biopsy since my original diagnosis. All but one have come back significant abnormal but not MM. One of the moles being removed is right below my nipple–very undesirable place to have a shave biopsy! 🙁
Sometimes I feel in dark about melanoma because I was an army wife and moved frequently, changing dermatologists often and being told various things.
Any help would be appreciated. Thank you.
Sarah
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- July 9, 2012 at 7:37 pm
I was diagnosed Stage II back in 1996 and also had skins checks every six months. Once a year, I did have blood work and chest x-rays; however, it was probably due to my age and other health issues. I still have my skin checked by a doc 2x a year – once by my regular primary care doc and once by my derm.
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- July 9, 2012 at 7:37 pm
I was diagnosed Stage II back in 1996 and also had skins checks every six months. Once a year, I did have blood work and chest x-rays; however, it was probably due to my age and other health issues. I still have my skin checked by a doc 2x a year – once by my regular primary care doc and once by my derm.
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- July 9, 2012 at 7:37 pm
I was diagnosed Stage II back in 1996 and also had skins checks every six months. Once a year, I did have blood work and chest x-rays; however, it was probably due to my age and other health issues. I still have my skin checked by a doc 2x a year – once by my regular primary care doc and once by my derm.
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- July 9, 2012 at 7:39 pm
Also, why is your doc doing shave biopsies? They should never, ever be done, especially on someone who has already been diagnosed with melanoma.
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- July 9, 2012 at 7:46 pm
I've been to 5 different dermatologists and most of them have done shave biopsies. Do you think they should do MOHS? Why should they not do shave biopsies…
Thank you 🙂
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- July 9, 2012 at 8:46 pm
Mohs is really not used for melanoma with the possible exception of Lentigo Maligna. Mohs uses frozen section techniques for pathology. However, processing tissue in paraffin and using stains specific to melanocytes is a better approach for identifying melanoma in tissue. The problem with shave biopsies is that they are not a full skin thickness biopsy. Therefore, if a lesion were melanoma, it is possible the shave could cut through the middle of the lesion. Once you have cut through the lesion, you lose the depth information and you can no longer accurately stage an individual. Say a lesion was cut through and the biopsy showed 1.35mm. Even if the WLE showed an additional 1mm of melanoma, you couldn't say the lesion was 2.35mm deep. You can't line up the pathology "sections" from the biopsy with the WLE tissue so you don't know the deepest part of the lesion. The best you can say is the lesion is "at least" 1.35mm with residual melanoma seen.
Many derms do shaves because they are quick, require no stitches (or followup visits) and are easy. Most can be done in the same office setting. For me, they hurt more and don't heal as well as a punch biopsy or an excisional biopsy. They may be easy for the derm, but they are not my choice for any lesion suspected of being melanoma. Punches and excisional biopsies tend to require a little more time and there may not be that time scheduled into a normal office visit. There is a time and a place for a shave biopsy, but many melanoma patients refuse them based on the difficulties they may cause in staging. You need to do what works for YOU!
Best wishes,
Janner
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- July 9, 2012 at 8:46 pm
Mohs is really not used for melanoma with the possible exception of Lentigo Maligna. Mohs uses frozen section techniques for pathology. However, processing tissue in paraffin and using stains specific to melanocytes is a better approach for identifying melanoma in tissue. The problem with shave biopsies is that they are not a full skin thickness biopsy. Therefore, if a lesion were melanoma, it is possible the shave could cut through the middle of the lesion. Once you have cut through the lesion, you lose the depth information and you can no longer accurately stage an individual. Say a lesion was cut through and the biopsy showed 1.35mm. Even if the WLE showed an additional 1mm of melanoma, you couldn't say the lesion was 2.35mm deep. You can't line up the pathology "sections" from the biopsy with the WLE tissue so you don't know the deepest part of the lesion. The best you can say is the lesion is "at least" 1.35mm with residual melanoma seen.
Many derms do shaves because they are quick, require no stitches (or followup visits) and are easy. Most can be done in the same office setting. For me, they hurt more and don't heal as well as a punch biopsy or an excisional biopsy. They may be easy for the derm, but they are not my choice for any lesion suspected of being melanoma. Punches and excisional biopsies tend to require a little more time and there may not be that time scheduled into a normal office visit. There is a time and a place for a shave biopsy, but many melanoma patients refuse them based on the difficulties they may cause in staging. You need to do what works for YOU!
Best wishes,
Janner
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- July 9, 2012 at 8:46 pm
Mohs is really not used for melanoma with the possible exception of Lentigo Maligna. Mohs uses frozen section techniques for pathology. However, processing tissue in paraffin and using stains specific to melanocytes is a better approach for identifying melanoma in tissue. The problem with shave biopsies is that they are not a full skin thickness biopsy. Therefore, if a lesion were melanoma, it is possible the shave could cut through the middle of the lesion. Once you have cut through the lesion, you lose the depth information and you can no longer accurately stage an individual. Say a lesion was cut through and the biopsy showed 1.35mm. Even if the WLE showed an additional 1mm of melanoma, you couldn't say the lesion was 2.35mm deep. You can't line up the pathology "sections" from the biopsy with the WLE tissue so you don't know the deepest part of the lesion. The best you can say is the lesion is "at least" 1.35mm with residual melanoma seen.
Many derms do shaves because they are quick, require no stitches (or followup visits) and are easy. Most can be done in the same office setting. For me, they hurt more and don't heal as well as a punch biopsy or an excisional biopsy. They may be easy for the derm, but they are not my choice for any lesion suspected of being melanoma. Punches and excisional biopsies tend to require a little more time and there may not be that time scheduled into a normal office visit. There is a time and a place for a shave biopsy, but many melanoma patients refuse them based on the difficulties they may cause in staging. You need to do what works for YOU!
Best wishes,
Janner
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- July 9, 2012 at 7:46 pm
I've been to 5 different dermatologists and most of them have done shave biopsies. Do you think they should do MOHS? Why should they not do shave biopsies…
Thank you 🙂
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- July 9, 2012 at 7:46 pm
I've been to 5 different dermatologists and most of them have done shave biopsies. Do you think they should do MOHS? Why should they not do shave biopsies…
Thank you 🙂
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- July 9, 2012 at 9:20 pm
What about deep shave, sometimes called saucerization? I thought there were some studies indicating that was 2nd best to excisional method?
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Tagged: cutaneous melanoma
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