The information on this site is not intended or implied to be a substitute for professional medical advice, diagnosis or treatment. Content within the patient forum is user-generated and has not been reviewed by medical professionals. Other sections of the Melanoma Research Foundation website include information that has been reviewed by medical professionals as appropriate. All medical decisions should be made in consultation with your doctor or other qualified medical professional.

Dermatologist appointment

Forums General Melanoma Community Dermatologist appointment

  • Post
    vivian
    Participant

    Hello All,

    Hello All,

    I was recently diagnosed with nodular melanoma, currently staged 3a after PET/CT and SNB.  I am awaiting the CLND.  On Thursday I saw my dermatologist for the first time post diagnosis.  He did a simple full body check, without any special scopes, just his eyes.  At no point did he touch my skin (I would really rather he not touch me, but…).  Since my primary melanoma was atypical in that it was not differently colored or asymmetrical, shouldn't he have been more hands on, so to speak?  I am not feeling really confident in him since he did a shaved biopsy twice on this lesion, neither of which came back as melanoma, and by the time the excision was biopsied,  it was deep.  The SNB  was positive for one of two nodes.  The reading I have done on dermatology sites say that a shave biopsy should not be done on a suspected melanoma, so perhaps he wasn't wrong.  However, I am wondering what happens to all of you when you see your derms?  Do they just "look" ?  Since at this point I will be "watching and waiting", I want the watching to be really good.  I would love to hear what happens when you, my colleagues in this fight, visit the dermatologist. 

    Thank you and here's hoping everyone is having a wonderful Sunday,                                                                                                                                              Vivivan

    Loading spinner
Viewing 7 reply threads
  • Replies
      A
      Participant

      I am sorry about your diagnosis.

      I have a lot of atypicals moles, so dermatologist uses dermascop to look at them. He usually doesn't use it on non-atypically looking nevi.

      You mentioned that your lesion was biopsied twice with negative results. I am wondering did they shave it off completely and then it grew back or did they remove just a portion of the "bamp". Still it is very strange that the results were "normal".

      Loading spinner
      A
      Participant

      I am sorry about your diagnosis.

      I have a lot of atypicals moles, so dermatologist uses dermascop to look at them. He usually doesn't use it on non-atypically looking nevi.

      You mentioned that your lesion was biopsied twice with negative results. I am wondering did they shave it off completely and then it grew back or did they remove just a portion of the "bamp". Still it is very strange that the results were "normal".

      Loading spinner
        vivian
        Participant

        It was very strange, and everyone, dermatologist, oncologist, hematologist, and surgeons are baffled by this.  The first biospy was "lichenoid keratosis" and the second was 'likely spindle cell melanocytic neoplasm".  The time between first and third biospy (nodular melanoma 4.35 mm) was less than two months.  He did shave the first off completely, I think, because the fact that it had grown back when I saw him two weeks later freaked him out and led to the second biopsy. 

        I am going to check out my options for other derms here.

        Thank you so much for your reply.  I really appreciate having all of you to talk to!

        Loading spinner
        vivian
        Participant

        It was very strange, and everyone, dermatologist, oncologist, hematologist, and surgeons are baffled by this.  The first biospy was "lichenoid keratosis" and the second was 'likely spindle cell melanocytic neoplasm".  The time between first and third biospy (nodular melanoma 4.35 mm) was less than two months.  He did shave the first off completely, I think, because the fact that it had grown back when I saw him two weeks later freaked him out and led to the second biopsy. 

        I am going to check out my options for other derms here.

        Thank you so much for your reply.  I really appreciate having all of you to talk to!

        Loading spinner
      lhaley
      Participant

      Vivian,

      I've been to many derms over the years and they all seem to be a bit different. I've had 6 primaries and am stage IV. Only  1 time did I have a shave biopsy but it was close to my eye and was decided ahead of time that until we knew this was the safest way to go – it ended up being nothing.  My current derm uses a dermascope (I think that's what it's called) and has taken pictures to compare. He also checks my lymph nodes. I go to him every 3 months and he has set up my schedule to be between my onc appointments so there are eyes on my body every 6 weeks.  Not everyone goes that often but since I have dysplastic nevus syndrome I'm more likely to have more primaries.

      Another question you didn't bring up is does your derm look everywhere?  Not that I want my body on display but melanoma doesn't just occur where the sun shines!

      I noticed in your profile you are from Wilm. DE. That's where I grew up!!  Went to PS duPont while it was still a high school, then moved to Smyrna.  Now we live in SC.  I have gone to both Univ. of Penn's cutaneous melanoma clinic and Hopkins. Their derms are fantastic (or at least were when I was going there)!!

      Linda

      Stage IV since 06 NED 3 months (scans on Tuesday)

      Loading spinner
      lhaley
      Participant

      Vivian,

      I've been to many derms over the years and they all seem to be a bit different. I've had 6 primaries and am stage IV. Only  1 time did I have a shave biopsy but it was close to my eye and was decided ahead of time that until we knew this was the safest way to go – it ended up being nothing.  My current derm uses a dermascope (I think that's what it's called) and has taken pictures to compare. He also checks my lymph nodes. I go to him every 3 months and he has set up my schedule to be between my onc appointments so there are eyes on my body every 6 weeks.  Not everyone goes that often but since I have dysplastic nevus syndrome I'm more likely to have more primaries.

      Another question you didn't bring up is does your derm look everywhere?  Not that I want my body on display but melanoma doesn't just occur where the sun shines!

      I noticed in your profile you are from Wilm. DE. That's where I grew up!!  Went to PS duPont while it was still a high school, then moved to Smyrna.  Now we live in SC.  I have gone to both Univ. of Penn's cutaneous melanoma clinic and Hopkins. Their derms are fantastic (or at least were when I was going there)!!

      Linda

      Stage IV since 06 NED 3 months (scans on Tuesday)

      Loading spinner
        vivian
        Participant

        Hello Linda,

        What a coincidence – I grew up in Florence, SC and have lived in DE off and on for almost 40 years!  I will be thinking about you on Tuesday and "holding you in the light", as the good Quakers around here say.  The derm did check everywhere by sight (ugh), but I was thinking that since my primary melanoma was skin-colored, and I only found it from rubbing suntan lotion on my back and feeling the bump, maybe he should as well be feeling my skin.  He has never used a dermascope in all the twenty or so years I have been going to him.

        Christiana Care here has grown enormously and has an excellent cancer center now.  Eight years ago I had a stem cell transplant that saved my life from a blood/bone marrow disease. That was done at CCHS, so I completely trust them. (I did have consults at Hopkins and Sloan back then and would do so again.)  It is probable that this melanoma is a secondary cancer to the chemo, radiation and immune suppressant that gave me those eight years.  I am very hopeful that I won't have a recurrence of the melanoma, but I am also not naive.

        Thank you so much for answering my query – your signature alone makes me feel so much better.  Again, I will be thinking good, strong, positive thoughts about you on Tuesday!

        Vivian

        Loading spinner
        vivian
        Participant

        Hello Linda,

        What a coincidence – I grew up in Florence, SC and have lived in DE off and on for almost 40 years!  I will be thinking about you on Tuesday and "holding you in the light", as the good Quakers around here say.  The derm did check everywhere by sight (ugh), but I was thinking that since my primary melanoma was skin-colored, and I only found it from rubbing suntan lotion on my back and feeling the bump, maybe he should as well be feeling my skin.  He has never used a dermascope in all the twenty or so years I have been going to him.

        Christiana Care here has grown enormously and has an excellent cancer center now.  Eight years ago I had a stem cell transplant that saved my life from a blood/bone marrow disease. That was done at CCHS, so I completely trust them. (I did have consults at Hopkins and Sloan back then and would do so again.)  It is probable that this melanoma is a secondary cancer to the chemo, radiation and immune suppressant that gave me those eight years.  I am very hopeful that I won't have a recurrence of the melanoma, but I am also not naive.

        Thank you so much for answering my query – your signature alone makes me feel so much better.  Again, I will be thinking good, strong, positive thoughts about you on Tuesday!

        Vivian

        Loading spinner
        Janner
        Participant

        I've had 3 primaries and have never had a derm "feel" my skin for melanoma.  Nodular is a strange beast in that it may be skin colored and grow quickly.  But I also never have relied on my derm finding my melanomas.  I've found my three.  I, personally, think YOU ought to be the one feeling your skin and you point out anything new/changing/unusual to your derm.  I will say that only a very small population — about 8% — of the melanoma population ever have more than one primary.  In reality, you run a higher risk of a recurrence from your original primary than you would finding a second melanoma primary.  You should be pointing out anything that is new/changing/unusual to your doctor.   My cutaneous oncologist just uses "sight" to look at my skin.  He does use a magnifier but that is basically for older eyes.  He has used a dermatoscope on me, but that is only on a lesion we both think is very suspicious.  He'll use that to take a closer look.  But, as I said, I really rely on myself to find anything unusual.  I know my body better than anyone.  

        Best wishes,

        Janner

        Loading spinner
        Janner
        Participant

        I've had 3 primaries and have never had a derm "feel" my skin for melanoma.  Nodular is a strange beast in that it may be skin colored and grow quickly.  But I also never have relied on my derm finding my melanomas.  I've found my three.  I, personally, think YOU ought to be the one feeling your skin and you point out anything new/changing/unusual to your derm.  I will say that only a very small population — about 8% — of the melanoma population ever have more than one primary.  In reality, you run a higher risk of a recurrence from your original primary than you would finding a second melanoma primary.  You should be pointing out anything that is new/changing/unusual to your doctor.   My cutaneous oncologist just uses "sight" to look at my skin.  He does use a magnifier but that is basically for older eyes.  He has used a dermatoscope on me, but that is only on a lesion we both think is very suspicious.  He'll use that to take a closer look.  But, as I said, I really rely on myself to find anything unusual.  I know my body better than anyone.  

        Best wishes,

        Janner

        Loading spinner
      washoegal
      Participant

      I have a similar problem with my Derm.  He seems to like to shave first and then cut.  I have asked him not to, but he still does.  I just had one removed from my bottom of my toe.  He said was a sun freckle, I said biopsy.  Not a sun freckle on the bottom of my foot.  He did a punch.  Came back "they don't think it's melanoma"  HUH??????   Waiting for results of the cut now.  If it comes back indeterminate I'll have the sample set to my Onc. 

      It's frustrating, I suppose this this what derm's are taught.

      Loading spinner
      washoegal
      Participant

      I have a similar problem with my Derm.  He seems to like to shave first and then cut.  I have asked him not to, but he still does.  I just had one removed from my bottom of my toe.  He said was a sun freckle, I said biopsy.  Not a sun freckle on the bottom of my foot.  He did a punch.  Came back "they don't think it's melanoma"  HUH??????   Waiting for results of the cut now.  If it comes back indeterminate I'll have the sample set to my Onc. 

      It's frustrating, I suppose this this what derm's are taught.

      Loading spinner
      ChristineL
      Participant

      Hi,

      I was told by my surgeon that if my exam is not uncomfortable, they're not doing it right.  He/she should be looking between toes, in ears and mouth, on the scalp, etc.  all of which require some sort of hands-on approach.  Of course, you should be checking yourself as well, since you know your body better than him. 

      If it was me, since I have no tolerance for that, I would have called him on it right then and there.  But at the very least I'd look for someone that you are more comfortable with and someone who comes with recommendations.

      Good luck,

      ChristineL

      Loading spinner
      ChristineL
      Participant

      Hi,

      I was told by my surgeon that if my exam is not uncomfortable, they're not doing it right.  He/she should be looking between toes, in ears and mouth, on the scalp, etc.  all of which require some sort of hands-on approach.  Of course, you should be checking yourself as well, since you know your body better than him. 

      If it was me, since I have no tolerance for that, I would have called him on it right then and there.  But at the very least I'd look for someone that you are more comfortable with and someone who comes with recommendations.

      Good luck,

      ChristineL

      Loading spinner
        vivian
        Participant

        Thank you all for your replies!  Something just doesn't feel quite right with my current derm, so I am going  forward with finding another one who is  more cautious and maybe more experienced with melanoma.

        Best regards,

        Vivian

        Loading spinner
        vivian
        Participant

        Thank you all for your replies!  Something just doesn't feel quite right with my current derm, so I am going  forward with finding another one who is  more cautious and maybe more experienced with melanoma.

        Best regards,

        Vivian

        Loading spinner
Viewing 7 reply threads
  • You must be logged in to reply to this topic.
About the MRF Patient Forum

The MRF Patient Forum is the oldest and largest online community of people affected by melanoma. It is designed to provide peer support and information to caregivers, patients, family and friends. There is no better place to discuss different parts of your journey with this cancer and find the friends and support resources to make that journey more bearable.

The information on the forum is open and accessible to everyone. To add a new topic or to post a reply, you must be a registered user. Please note that you will be able to post both topics and replies anonymously even though you are logged in. All posts must abide by MRF posting policies.