› Forums › General Melanoma Community › driving me crazy 2
- This topic has 12 replies, 5 voices, and was last updated 12 years, 8 months ago by
washoegal.
- Post
-
- August 19, 2011 at 8:08 pm
just came from meeting the new surgeon…
just came from meeting the new surgeon… i told him i was hoping he was going to tell me it wasn't necessary to cut it back open. he said he couldnt do that. the notes from the original MOHS procedure were very poor. and Mohs isnt designed for melanoma because it does NOT achieve the margins needed. he and his assistant even mentioned seeing "satellite" on my back (i'll be looking that up in a minute). but he wants to also perform a sentinel lymph node biopsy. i didnt think that could be done after the MOHS. he says it not the most desirable timing, but it will be best at time of resection. thanks to everyone that commented on the last post… you have all gotten me really thinking. this new surgeon also said that my new dr wouldn't have referred me to him if she thought it was just a consult. that i should speak with her directly, but if she sent me to him its because she has concerns as well. so, im back at square on… trying to my head around all of this. but i wanted to post what he said.
- Replies
-
-
- August 19, 2011 at 8:31 pm
I'm glad you met with the surgeon. I am in complete agreement with the surgeon, which I also expressed in my prior response. I know technically that we all have choices when it comes to our health, so you can choose to have these procedures or not. But just so you know, your surgeon is absolutely correct and what he proposes to do is 100% standard protocol with melanoma. MOHS is not a proper treatment for melanoma. You really do need the WLE and SNB, especially with satellites. Those are lesions surrounding or nearby the original melanoma, which means there was more melanoma than just the original tumor. It doesn't change your stage at this point, but it is better if there are not satellite lesions. Again, I'd rather be blunt with someone if it means the possibility of life or death. We're already talking life or death with this insidious disease. You are risking your life substantially more if you don't do the WLE and SNB. I don't mean to sound rude. I'm trying to help you. This really is not an optional procedure. So do it, please, do it. My best to you.
-
- August 19, 2011 at 9:20 pm
i really appreciate the honesty… it didnt come across as rude as all. i am a very blunt person myself… i used to do a HUGE drinker/experimenter… and since 2005 when i decided to get sober i have chosen to be honest almost to a fault. so it doesnt bother me any. i dont see it as optional anymore. now i'm just trying to prepare for it. thanks again!!!
-
- August 19, 2011 at 9:20 pm
i really appreciate the honesty… it didnt come across as rude as all. i am a very blunt person myself… i used to do a HUGE drinker/experimenter… and since 2005 when i decided to get sober i have chosen to be honest almost to a fault. so it doesnt bother me any. i dont see it as optional anymore. now i'm just trying to prepare for it. thanks again!!!
-
- August 19, 2011 at 8:31 pm
I'm glad you met with the surgeon. I am in complete agreement with the surgeon, which I also expressed in my prior response. I know technically that we all have choices when it comes to our health, so you can choose to have these procedures or not. But just so you know, your surgeon is absolutely correct and what he proposes to do is 100% standard protocol with melanoma. MOHS is not a proper treatment for melanoma. You really do need the WLE and SNB, especially with satellites. Those are lesions surrounding or nearby the original melanoma, which means there was more melanoma than just the original tumor. It doesn't change your stage at this point, but it is better if there are not satellite lesions. Again, I'd rather be blunt with someone if it means the possibility of life or death. We're already talking life or death with this insidious disease. You are risking your life substantially more if you don't do the WLE and SNB. I don't mean to sound rude. I'm trying to help you. This really is not an optional procedure. So do it, please, do it. My best to you.
-
- August 19, 2011 at 8:39 pm
You said that you would listen carefully to the surgeon. Sounds like he isn't on the fence, he's saying that this needs to be done. A satelite is when they see something off of the original area that is less than 2 cm from the primary spot. For some it could be little dots or specks or melanoma for others it could be more of a bump or a lump. Anotherwords clear margins were not gotten and evidently he is suspecting that something is already coming back.
He is being proactive to order a sentinal node biopsy since he has already seen possible growth. It's always better to have this done then after the wide excision.
I personally don't see a question. It just needs to be done.
Linda
-
- August 19, 2011 at 9:24 pm
i did listen very carefully… and he is not even close to the fence. and i climbed off it myself. he was very clear about his reasoning. was not wishy-washy like the first dr. so i will proceed as they planned. i have 2 gorgeous little people (son is 5, daughter is 3) who i will do everything i can to make sure im here for… thank you again!!! i really appreciate the honest, frank responses…
-
- August 19, 2011 at 9:24 pm
i did listen very carefully… and he is not even close to the fence. and i climbed off it myself. he was very clear about his reasoning. was not wishy-washy like the first dr. so i will proceed as they planned. i have 2 gorgeous little people (son is 5, daughter is 3) who i will do everything i can to make sure im here for… thank you again!!! i really appreciate the honest, frank responses…
-
- August 19, 2011 at 8:39 pm
You said that you would listen carefully to the surgeon. Sounds like he isn't on the fence, he's saying that this needs to be done. A satelite is when they see something off of the original area that is less than 2 cm from the primary spot. For some it could be little dots or specks or melanoma for others it could be more of a bump or a lump. Anotherwords clear margins were not gotten and evidently he is suspecting that something is already coming back.
He is being proactive to order a sentinal node biopsy since he has already seen possible growth. It's always better to have this done then after the wide excision.
I personally don't see a question. It just needs to be done.
Linda
-
- August 19, 2011 at 11:51 pm
Although MOHS has its purpose, it is not usefull for melanoma. Start over. Get all pathology reports. Due to MOHS, you have no depth of invasion, You will find that most go/no go baselines are around .75 at the very outside dor a SNB, but are usually reserved for 1.25…………………….neither measurement that you, nor your doctor have.
My suggestion? Stop and start over because you may have something or you may have nothing. Hardly a basis for surgery.
Get a second opinion on whatever path you have and start from there; then get back to us.
Charlie S
-
- August 19, 2011 at 11:51 pm
Although MOHS has its purpose, it is not usefull for melanoma. Start over. Get all pathology reports. Due to MOHS, you have no depth of invasion, You will find that most go/no go baselines are around .75 at the very outside dor a SNB, but are usually reserved for 1.25…………………….neither measurement that you, nor your doctor have.
My suggestion? Stop and start over because you may have something or you may have nothing. Hardly a basis for surgery.
Get a second opinion on whatever path you have and start from there; then get back to us.
Charlie S
-
- August 20, 2011 at 1:31 am
I am glad you let us know what is happening. I can see why you are going crazy. Sound like you went from MR Over Confident to DR Conservative. I had a similar experience with a Dr Doom and I saw him only once, he took over for my original Onc and the first words out of his mouth were "If you survive Melanoma". I never went back. I was basically done with treatment except for follow-up so I had that luxury.
Your Derm wasn't 100% incorrect just way too confident, MOHS purpose as you know is to take the least amount of tissue as possible. With your depth, you would have wanted at least 1cm margins. Oh well, that's done. Now for Dr Conservative, if you feel his plan is best for you DO IT. It is not a difficult surgery. What's a couple of scar's when we are talking about melanoma? If you feel some doubt, get another opinion.
Good Luck and keep in touch,
Mary
Stage 3
-
- August 20, 2011 at 1:31 am
I am glad you let us know what is happening. I can see why you are going crazy. Sound like you went from MR Over Confident to DR Conservative. I had a similar experience with a Dr Doom and I saw him only once, he took over for my original Onc and the first words out of his mouth were "If you survive Melanoma". I never went back. I was basically done with treatment except for follow-up so I had that luxury.
Your Derm wasn't 100% incorrect just way too confident, MOHS purpose as you know is to take the least amount of tissue as possible. With your depth, you would have wanted at least 1cm margins. Oh well, that's done. Now for Dr Conservative, if you feel his plan is best for you DO IT. It is not a difficult surgery. What's a couple of scar's when we are talking about melanoma? If you feel some doubt, get another opinion.
Good Luck and keep in touch,
Mary
Stage 3
-
- You must be logged in to reply to this topic.