› Forums › General Melanoma Community › Diagnosed with Nodular Melanoma
- This topic has 57 replies, 8 voices, and was last updated 9 years, 11 months ago by
Totally Blessed.
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- December 17, 2015 at 7:30 pm
Hi. Like many here I've been lurking and reading since my husband was diagnosed. Here's his history so far…
Nodular Malignant Melanoma removed 11/9/2015
Both radial and vertical growth.
Lymphocytic response: non-brisk
No ulceration
No Mitotic rate
Clark's level: III/IV
Breslow thickness: 1.4 mm
As mentioned above he had the tumor removed 11/9/15 by our primary Doctor. Our Doctor sent him to a dermatologist after receiving the results. The Dermatologist said he was referring my husband to the Cancer Center in Ann Arbor, Mi. We had the Ann Arbor apt last week and found out yesterday his WLE and sentinel lymph node biopsy is scheduled for February 11th.
Here's my question/concern. Even though we believe we caught this early, is it normal that a Doctor would wait this long to do this surgery?
Any thoughts would be so appreciated.
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- December 17, 2015 at 8:37 pm
Statistically – there is no problem waiting. It actually has been studied. Emotionally – not so much. Do you know if his deep margin was clear? I think I'd be more willing to wait that long if the entire lesion was removed with the biopsy. Often times, it is hard to get on a surgery schedule immediately, but it certainly wouldn't hurt to call around to find something sooner. BTW, Breast cancer surgeons do a lot of SNBs. Even for me (not an alarmist) – I'd probably be looking for something a bit earlier than that.
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- December 17, 2015 at 8:37 pm
Statistically – there is no problem waiting. It actually has been studied. Emotionally – not so much. Do you know if his deep margin was clear? I think I'd be more willing to wait that long if the entire lesion was removed with the biopsy. Often times, it is hard to get on a surgery schedule immediately, but it certainly wouldn't hurt to call around to find something sooner. BTW, Breast cancer surgeons do a lot of SNBs. Even for me (not an alarmist) – I'd probably be looking for something a bit earlier than that.
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- December 17, 2015 at 8:37 pm
Statistically – there is no problem waiting. It actually has been studied. Emotionally – not so much. Do you know if his deep margin was clear? I think I'd be more willing to wait that long if the entire lesion was removed with the biopsy. Often times, it is hard to get on a surgery schedule immediately, but it certainly wouldn't hurt to call around to find something sooner. BTW, Breast cancer surgeons do a lot of SNBs. Even for me (not an alarmist) – I'd probably be looking for something a bit earlier than that.
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- December 17, 2015 at 9:26 pm
When you say deep margin, are you referring to the intitial tumor removal? The entire tumor was removed according to what they told us and they feel they got the whole tumor. His report had no mention of deep clear margin however. I thought that was what we will want to hear once the the WLE is done – is this what you're referring to? Thank you for your response, it does put my mind a little more at ease hearing that the wait time frame has been studied.
His WLE will require a 2 cm excision around where the tumor was according to the surgeon. His tumor was on the very top of his right shoulder where you feel the bone.
Emotionally, this seems to be wearing on me more than it is on him. He has a wonderfully positive attitude.
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- December 17, 2015 at 9:26 pm
When you say deep margin, are you referring to the intitial tumor removal? The entire tumor was removed according to what they told us and they feel they got the whole tumor. His report had no mention of deep clear margin however. I thought that was what we will want to hear once the the WLE is done – is this what you're referring to? Thank you for your response, it does put my mind a little more at ease hearing that the wait time frame has been studied.
His WLE will require a 2 cm excision around where the tumor was according to the surgeon. His tumor was on the very top of his right shoulder where you feel the bone.
Emotionally, this seems to be wearing on me more than it is on him. He has a wonderfully positive attitude.
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- December 17, 2015 at 9:26 pm
When you say deep margin, are you referring to the intitial tumor removal? The entire tumor was removed according to what they told us and they feel they got the whole tumor. His report had no mention of deep clear margin however. I thought that was what we will want to hear once the the WLE is done – is this what you're referring to? Thank you for your response, it does put my mind a little more at ease hearing that the wait time frame has been studied.
His WLE will require a 2 cm excision around where the tumor was according to the surgeon. His tumor was on the very top of his right shoulder where you feel the bone.
Emotionally, this seems to be wearing on me more than it is on him. He has a wonderfully positive attitude.
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- December 17, 2015 at 10:05 pm
If it doesn't specifically say that the margins aren't clear, they probably are. Yes, I'm referring to the initial biopsy. Some biopsy types don't go deep enough to remove the entire lesion or wide enough to remove all the cells. Those margins are usually called out specifically on the biopsy report. If the deep margin was not clear, then that means the depth would have been deeper than specified — and you lose staging information. The WLE is just an insurance policy – the tissue is not analyzed to the same degree as the biopsy. The WLE is important but rarely gives you additional staging information.
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- December 17, 2015 at 10:05 pm
If it doesn't specifically say that the margins aren't clear, they probably are. Yes, I'm referring to the initial biopsy. Some biopsy types don't go deep enough to remove the entire lesion or wide enough to remove all the cells. Those margins are usually called out specifically on the biopsy report. If the deep margin was not clear, then that means the depth would have been deeper than specified — and you lose staging information. The WLE is just an insurance policy – the tissue is not analyzed to the same degree as the biopsy. The WLE is important but rarely gives you additional staging information.
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- December 18, 2015 at 2:06 am
Yes, I believe they got the whole tumor and believe margins are clear. At the same time he had the melanoma removed the primary care Doctor had also removed a Basel cell from the back of his neck. That report referred to it as a Nodular Basel cell carcinoma. The Dermatologist had to go in and remove more tissue. Report came back with clear margins.
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- December 18, 2015 at 2:06 am
Yes, I believe they got the whole tumor and believe margins are clear. At the same time he had the melanoma removed the primary care Doctor had also removed a Basel cell from the back of his neck. That report referred to it as a Nodular Basel cell carcinoma. The Dermatologist had to go in and remove more tissue. Report came back with clear margins.
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- December 18, 2015 at 2:06 am
Yes, I believe they got the whole tumor and believe margins are clear. At the same time he had the melanoma removed the primary care Doctor had also removed a Basel cell from the back of his neck. That report referred to it as a Nodular Basel cell carcinoma. The Dermatologist had to go in and remove more tissue. Report came back with clear margins.
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- December 17, 2015 at 10:05 pm
If it doesn't specifically say that the margins aren't clear, they probably are. Yes, I'm referring to the initial biopsy. Some biopsy types don't go deep enough to remove the entire lesion or wide enough to remove all the cells. Those margins are usually called out specifically on the biopsy report. If the deep margin was not clear, then that means the depth would have been deeper than specified — and you lose staging information. The WLE is just an insurance policy – the tissue is not analyzed to the same degree as the biopsy. The WLE is important but rarely gives you additional staging information.
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- December 17, 2015 at 8:51 pm
I'm new here also so I don't know if my info will help you are not. I went to my dermatologist in mid October. He removed a spot from my foot and sent it out for a biopsy. Never said anything more or if he had any suspicions that it might be something other than a spot. Got biopsy back mid November melanoma stage 1a. Referred me to the cancer institute and an surgical oncologist. Saw him day before Thanksgiving. He said I need a plastic surgeon to close the wound with a skin graft. Another two weeks saw plastic surgeon. Now had to wait to see when both doctors schedules work together to be able to operate at the same time.
My surgery is scheduled for the 7th of January. I would ask why is the surgery scheduled so far away. Your doctor might be going on vacation in January. I know from some people I have talked to with different types of cancer it usually takes about 3 months from beginning to when you have the surgery. I would not want to wait until February to have it done if you don't have to. But you are still in that 3 month window.
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- December 17, 2015 at 8:51 pm
I'm new here also so I don't know if my info will help you are not. I went to my dermatologist in mid October. He removed a spot from my foot and sent it out for a biopsy. Never said anything more or if he had any suspicions that it might be something other than a spot. Got biopsy back mid November melanoma stage 1a. Referred me to the cancer institute and an surgical oncologist. Saw him day before Thanksgiving. He said I need a plastic surgeon to close the wound with a skin graft. Another two weeks saw plastic surgeon. Now had to wait to see when both doctors schedules work together to be able to operate at the same time.
My surgery is scheduled for the 7th of January. I would ask why is the surgery scheduled so far away. Your doctor might be going on vacation in January. I know from some people I have talked to with different types of cancer it usually takes about 3 months from beginning to when you have the surgery. I would not want to wait until February to have it done if you don't have to. But you are still in that 3 month window.
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- December 17, 2015 at 8:51 pm
I'm new here also so I don't know if my info will help you are not. I went to my dermatologist in mid October. He removed a spot from my foot and sent it out for a biopsy. Never said anything more or if he had any suspicions that it might be something other than a spot. Got biopsy back mid November melanoma stage 1a. Referred me to the cancer institute and an surgical oncologist. Saw him day before Thanksgiving. He said I need a plastic surgeon to close the wound with a skin graft. Another two weeks saw plastic surgeon. Now had to wait to see when both doctors schedules work together to be able to operate at the same time.
My surgery is scheduled for the 7th of January. I would ask why is the surgery scheduled so far away. Your doctor might be going on vacation in January. I know from some people I have talked to with different types of cancer it usually takes about 3 months from beginning to when you have the surgery. I would not want to wait until February to have it done if you don't have to. But you are still in that 3 month window.
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- December 17, 2015 at 9:39 pm
My best to you!
We do know the surgeon that will be working on my husband does surgeries like this only on Thursdays. My husband is in the hands of a highly rated Cancer Center specializing in Melanoma – this is the only thing that is keeping me from jumping out of my skin with this long wait. But knowing we're within a reasonable time frame makes me feel a little better.
I feel that if (IF!) there's a node that's affected, what is this time frame doing with that affected node?!
The mind starts to run wild here…
Thank you for your response.
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- December 17, 2015 at 9:39 pm
My best to you!
We do know the surgeon that will be working on my husband does surgeries like this only on Thursdays. My husband is in the hands of a highly rated Cancer Center specializing in Melanoma – this is the only thing that is keeping me from jumping out of my skin with this long wait. But knowing we're within a reasonable time frame makes me feel a little better.
I feel that if (IF!) there's a node that's affected, what is this time frame doing with that affected node?!
The mind starts to run wild here…
Thank you for your response.
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- December 17, 2015 at 9:39 pm
My best to you!
We do know the surgeon that will be working on my husband does surgeries like this only on Thursdays. My husband is in the hands of a highly rated Cancer Center specializing in Melanoma – this is the only thing that is keeping me from jumping out of my skin with this long wait. But knowing we're within a reasonable time frame makes me feel a little better.
I feel that if (IF!) there's a node that's affected, what is this time frame doing with that affected node?!
The mind starts to run wild here…
Thank you for your response.
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- December 17, 2015 at 9:32 pm
I am sure janner is correct…….but i would want a doctor who is more understanding of what a patient goes through during any "waiting" period. I have NEVER heard of beng asked to wait 2 months for a followup procedure……
Im sure it is not a medical emergency, but seems AWFULLY long to wait! (just my 2 cents based on my last two years….)
Best of luck, and hope you can get it moved up a bit!
jenny
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- December 17, 2015 at 9:32 pm
I am sure janner is correct…….but i would want a doctor who is more understanding of what a patient goes through during any "waiting" period. I have NEVER heard of beng asked to wait 2 months for a followup procedure……
Im sure it is not a medical emergency, but seems AWFULLY long to wait! (just my 2 cents based on my last two years….)
Best of luck, and hope you can get it moved up a bit!
jenny
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- December 17, 2015 at 9:32 pm
I am sure janner is correct…….but i would want a doctor who is more understanding of what a patient goes through during any "waiting" period. I have NEVER heard of beng asked to wait 2 months for a followup procedure……
Im sure it is not a medical emergency, but seems AWFULLY long to wait! (just my 2 cents based on my last two years….)
Best of luck, and hope you can get it moved up a bit!
jenny
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- December 17, 2015 at 9:43 pm
Thank you Jenny. I know my husband isn't dealing with a report that would suggest an already spreading of cancer but I do know that there's still a slight possibility that it has. We are trusting he will have a report of clear margins and no node involvement. This has been an awful past month :(.
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- December 17, 2015 at 9:43 pm
Thank you Jenny. I know my husband isn't dealing with a report that would suggest an already spreading of cancer but I do know that there's still a slight possibility that it has. We are trusting he will have a report of clear margins and no node involvement. This has been an awful past month :(.
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- December 17, 2015 at 9:43 pm
Thank you Jenny. I know my husband isn't dealing with a report that would suggest an already spreading of cancer but I do know that there's still a slight possibility that it has. We are trusting he will have a report of clear margins and no node involvement. This has been an awful past month :(.
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- December 18, 2015 at 1:21 am
I totally agree with Jenny. My two cents also based on my last two years would be to push for a sooner date. We, like you, trusted what we thought was a great melanoma specialist with my husband's care. He too was diagnosed with nodular melanoma. Unfortunately he died after completing lymph node removal, radiation and IPI. I kick myself everyday for not be more proactive as we just "trusted" the doctor. This forum is amazing and current with all of the new research. Stay active with members here and keep asking questions.
Best wishes to you and your husband.
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- December 18, 2015 at 1:21 am
I totally agree with Jenny. My two cents also based on my last two years would be to push for a sooner date. We, like you, trusted what we thought was a great melanoma specialist with my husband's care. He too was diagnosed with nodular melanoma. Unfortunately he died after completing lymph node removal, radiation and IPI. I kick myself everyday for not be more proactive as we just "trusted" the doctor. This forum is amazing and current with all of the new research. Stay active with members here and keep asking questions.
Best wishes to you and your husband.
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- December 18, 2015 at 1:21 am
I totally agree with Jenny. My two cents also based on my last two years would be to push for a sooner date. We, like you, trusted what we thought was a great melanoma specialist with my husband's care. He too was diagnosed with nodular melanoma. Unfortunately he died after completing lymph node removal, radiation and IPI. I kick myself everyday for not be more proactive as we just "trusted" the doctor. This forum is amazing and current with all of the new research. Stay active with members here and keep asking questions.
Best wishes to you and your husband.
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- December 18, 2015 at 1:54 am
I'm so very sorry for your loss. Words can't express. 🙁
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- December 18, 2015 at 1:54 am
I'm so very sorry for your loss. Words can't express. 🙁
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- December 18, 2015 at 1:54 am
I'm so very sorry for your loss. Words can't express. 🙁
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- December 17, 2015 at 9:55 pm
Hi – I also went to UM in Ann Arbor for my WLE. They scheduled me for approximately 6 weeks out because they wanted my biopsy site to heal before they did they WLE – however, my lesion was pathologically confined to my epidermis (Stage 0) so different than your situation that way – but still anxiety-producing for sure. My advice to you would be to call the oncology nurse line at the Melanoma Clinic – the nurses I spoke to were incredibly helpful and may assist you with answers you are looking for and may even put you in personal touch with the melanoma specialists there to get an explanation or even move up your surgery date. I also had to have a complete skin/body examination and medical history done at the Melanoma Clinic before they scheduled my WLE. Did you have anything like that done yet?
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- December 17, 2015 at 9:55 pm
Hi – I also went to UM in Ann Arbor for my WLE. They scheduled me for approximately 6 weeks out because they wanted my biopsy site to heal before they did they WLE – however, my lesion was pathologically confined to my epidermis (Stage 0) so different than your situation that way – but still anxiety-producing for sure. My advice to you would be to call the oncology nurse line at the Melanoma Clinic – the nurses I spoke to were incredibly helpful and may assist you with answers you are looking for and may even put you in personal touch with the melanoma specialists there to get an explanation or even move up your surgery date. I also had to have a complete skin/body examination and medical history done at the Melanoma Clinic before they scheduled my WLE. Did you have anything like that done yet?
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- December 17, 2015 at 10:52 pm
Hi. Yes, my husband had his appointment in Ann Arbor last week. We met with 2 Dermatologits and Dr. Cohen, the surgeon who will be doing his WLE and SLNB. Both Dermatologist went over his skin from top to toe. Dr. Cohen was super to meet, very helpful with all questions. We then went to Dominoe Farms where he had his pre-op appointment.
I may give them a call tomorrow and just ask. Thank you.
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- December 17, 2015 at 10:52 pm
Hi. Yes, my husband had his appointment in Ann Arbor last week. We met with 2 Dermatologits and Dr. Cohen, the surgeon who will be doing his WLE and SLNB. Both Dermatologist went over his skin from top to toe. Dr. Cohen was super to meet, very helpful with all questions. We then went to Dominoe Farms where he had his pre-op appointment.
I may give them a call tomorrow and just ask. Thank you.
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- December 17, 2015 at 10:52 pm
Hi. Yes, my husband had his appointment in Ann Arbor last week. We met with 2 Dermatologits and Dr. Cohen, the surgeon who will be doing his WLE and SLNB. Both Dermatologist went over his skin from top to toe. Dr. Cohen was super to meet, very helpful with all questions. We then went to Dominoe Farms where he had his pre-op appointment.
I may give them a call tomorrow and just ask. Thank you.
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- December 17, 2015 at 10:53 pm
…by the way, who was the Dr. that did your WLE?
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- December 17, 2015 at 10:53 pm
…by the way, who was the Dr. that did your WLE?
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- December 17, 2015 at 10:53 pm
…by the way, who was the Dr. that did your WLE?
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- December 17, 2015 at 11:12 pm
I don't post as much as I read here … but my experience is much like your husbands. first diagnosed March 28th 2015. I was refered to U of M. Dr Cohen did the WME and the SB. Procedure completed the end of May. My expericence with U of M and Dr Cohen was great.
more details:
breslow 2.9, no ulceration, mitotic 12. To date no nodal involvment.
Wishing you and your family the best!
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- December 17, 2015 at 11:12 pm
I don't post as much as I read here … but my experience is much like your husbands. first diagnosed March 28th 2015. I was refered to U of M. Dr Cohen did the WME and the SB. Procedure completed the end of May. My expericence with U of M and Dr Cohen was great.
more details:
breslow 2.9, no ulceration, mitotic 12. To date no nodal involvment.
Wishing you and your family the best!
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- December 17, 2015 at 11:12 pm
I don't post as much as I read here … but my experience is much like your husbands. first diagnosed March 28th 2015. I was refered to U of M. Dr Cohen did the WME and the SB. Procedure completed the end of May. My expericence with U of M and Dr Cohen was great.
more details:
breslow 2.9, no ulceration, mitotic 12. To date no nodal involvment.
Wishing you and your family the best!
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- December 17, 2015 at 11:25 pm
Oh Ken — that's wonderful news, so happy to hear you're doing well :). Thank you SO much for responding. I'm feeling much better.
Continued blessings on your health.
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- December 17, 2015 at 11:25 pm
Oh Ken — that's wonderful news, so happy to hear you're doing well :). Thank you SO much for responding. I'm feeling much better.
Continued blessings on your health.
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- December 17, 2015 at 11:25 pm
Oh Ken — that's wonderful news, so happy to hear you're doing well :). Thank you SO much for responding. I'm feeling much better.
Continued blessings on your health.
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- December 18, 2015 at 5:47 am
Hi – Dr. Kelly Harms did my WLE – so far it is healing well (it has been 9 months) and the "divot" is filling in little by little over time. Just for reference, they had my WLE results within a week for me. So nervewracking! I am wishing the best for you and your husband!
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- December 18, 2015 at 5:47 am
Hi – Dr. Kelly Harms did my WLE – so far it is healing well (it has been 9 months) and the "divot" is filling in little by little over time. Just for reference, they had my WLE results within a week for me. So nervewracking! I am wishing the best for you and your husband!
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- December 18, 2015 at 5:47 am
Hi – Dr. Kelly Harms did my WLE – so far it is healing well (it has been 9 months) and the "divot" is filling in little by little over time. Just for reference, they had my WLE results within a week for me. So nervewracking! I am wishing the best for you and your husband!
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- December 18, 2015 at 6:02 pm
Good to know on the result turn around time. They did tell us they would have the node report within a week and the WLE report within two. That's going to feel like a lot longer I'm sure.
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- December 18, 2015 at 6:02 pm
Good to know on the result turn around time. They did tell us they would have the node report within a week and the WLE report within two. That's going to feel like a lot longer I'm sure.
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- December 18, 2015 at 6:02 pm
Good to know on the result turn around time. They did tell us they would have the node report within a week and the WLE report within two. That's going to feel like a lot longer I'm sure.
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- December 17, 2015 at 9:55 pm
Hi – I also went to UM in Ann Arbor for my WLE. They scheduled me for approximately 6 weeks out because they wanted my biopsy site to heal before they did they WLE – however, my lesion was pathologically confined to my epidermis (Stage 0) so different than your situation that way – but still anxiety-producing for sure. My advice to you would be to call the oncology nurse line at the Melanoma Clinic – the nurses I spoke to were incredibly helpful and may assist you with answers you are looking for and may even put you in personal touch with the melanoma specialists there to get an explanation or even move up your surgery date. I also had to have a complete skin/body examination and medical history done at the Melanoma Clinic before they scheduled my WLE. Did you have anything like that done yet?
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- December 19, 2015 at 8:01 am
From my limited experience I’d say this is par for the course. I first reported my skin lesion to my primary at the end of October. Took a month to get into the dermatologist. He only took a small shave biopsy on a large lesion. He told me I was crazy for being concerned that it was melanoma. One week later I got my results. Only they can’t guess the thickness due to the inadequate biopsy (no clear margins at 1mm deep). I was then referred to a surgical oncologist. That took a week just for the consultation. My wle and slnb are scheduled for Jan 16th. Mind you my melanoma is still on me,and looking like its really mad about the biopsy too. It’s nerve wracking to say the least. However it’s how things just work I suppose. Take some solace in the fact that all or at least most of his cancer have already been removed and the upcoming procedures are precautions and confirming tests to insure he’s OK. -
- December 19, 2015 at 8:01 am
From my limited experience I’d say this is par for the course. I first reported my skin lesion to my primary at the end of October. Took a month to get into the dermatologist. He only took a small shave biopsy on a large lesion. He told me I was crazy for being concerned that it was melanoma. One week later I got my results. Only they can’t guess the thickness due to the inadequate biopsy (no clear margins at 1mm deep). I was then referred to a surgical oncologist. That took a week just for the consultation. My wle and slnb are scheduled for Jan 16th. Mind you my melanoma is still on me,and looking like its really mad about the biopsy too. It’s nerve wracking to say the least. However it’s how things just work I suppose. Take some solace in the fact that all or at least most of his cancer have already been removed and the upcoming procedures are precautions and confirming tests to insure he’s OK. -
- December 19, 2015 at 8:01 am
From my limited experience I’d say this is par for the course. I first reported my skin lesion to my primary at the end of October. Took a month to get into the dermatologist. He only took a small shave biopsy on a large lesion. He told me I was crazy for being concerned that it was melanoma. One week later I got my results. Only they can’t guess the thickness due to the inadequate biopsy (no clear margins at 1mm deep). I was then referred to a surgical oncologist. That took a week just for the consultation. My wle and slnb are scheduled for Jan 16th. Mind you my melanoma is still on me,and looking like its really mad about the biopsy too. It’s nerve wracking to say the least. However it’s how things just work I suppose. Take some solace in the fact that all or at least most of his cancer have already been removed and the upcoming procedures are precautions and confirming tests to insure he’s OK.-
- December 21, 2015 at 8:40 pm
Thank you. I'm very sorry you're having to do this kind of waiting. My best to you.
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- December 21, 2015 at 8:40 pm
Thank you. I'm very sorry you're having to do this kind of waiting. My best to you.
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- December 21, 2015 at 8:40 pm
Thank you. I'm very sorry you're having to do this kind of waiting. My best to you.
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Tagged: cutaneous melanoma
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