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Help Moving Forward from Diagnoses of T1a

Forums Cutaneous Melanoma Community Help Moving Forward from Diagnoses of T1a

  • Post
    LRS88
    Participant
      I am really struggling to move on from a T1a Melanoma diagnosis in March of this year. I am sorry if this is long but I just feel like I need to put it out there, somewhere.
      Some background: I am a 31 year old mother of 2 boys, aged 1 and 3! I had my second son in May 2019 and pretty much immediately after he was born I noticed a mole on my stomach (that I have always had) was bigger. Naturally, those around me had the explanation that I was just pregnant and that was the reason. I took a picture of it then and I am glad I did. In November of that year I went for my annual skin exam (my college years involved a lot of tanning. unfortunately, shame on me) and showed my dermatologist. She also indicated that it was most likely due to pregnancy skin stretching but to keep an eye on it. Over the winter I just had a feeling this mole was not right. In March of this year I was about to start a new job and knew I would not have insurance for a month, so I took another picture of the mole, and while there was not a huge difference.. the mole had changed. I made an appointment that day and was scheduled for an appointment on a Thursday. The dermatologist took me seriously and said while she was not overly concerned about the mole but if it seemed to be changing she wanted to remove it to be sure. She called me after hours the following Monday and said she was very surprised and she was so glad I came in because it was a very early melanoma. I have always been terrified of getting melanoma and I honestly could not believe I was hearing this. I heard her say .5mm and only a WLE would be needed. I asked to come in ASAP due to my new job. She understood and scheduled me later that week.

      I asked for a copy of the pathology report
      Diagnosis:
      Shave Method, Left Lateral Abdomen- Malignant Melanoma arising in Association with a pre-existing nevus
      Histologic Type: Superficial Spreading
      Maximum Tumor (Breslow) Thickness: 0.5 mm
      Anatomic (Clark)Level: IV
      MIotic Rate: 0 per MM squared
      Ulceration: Not identified
      Tumor Infiltrating Lymphocytes: Present
      Tumor Regression: Not Present
      Lymphovascular Invasion: Not identified
      Neurotropism: Not identified
      Tumor Size (Greatest Dimension): Not provided
      Regional Lymph Nodes: Not Applicable
      Macroscopic Satellite Nodule(s): Not identified
      Microsatellite(s): Not identified
      Margins: Peripheral Margins Involved
      Pathologic Stage Classification: pT1a

      After a WLE the pathology report stated:
      Diagnosis:
      Excision, left lateral abdomen- prior biopsy site related changes, no evidence of residual malignant melanoma

      After discussing with my dermatologist and primary care doctor they said regular, frequent skin exams (3-4x per year) are all that is recommended.
      Now that it is over with I feel like I have so many questions and cannot handle the “what if”.
      Isn’t Clark Level IV a poor prognosis factor? what does Neurotropism: Not identified mean? What if there is a single cell somewhere just waiting to spread?
      Will I be around in 10 years for my kids? Do I no longer have the option to have additional children?
      I feel like those close to me either have one of two reactions: “why are you so worried they cut it out” or “oh my gosh I would be so worried too”. I am not sure what I want to hear so I just don’t talk about it at all.
      Again, sorry if this is long and rambling.. but as I previously indicated. I am struggling.

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    • Replies
        ed williams
        Participant
          Hi there LRS88, so tumor thickness of .5mm is what is important in staging alone with some other things like ulceration (bad), high mitosis rate( again not so good to have), without getting into the weeds to much, the staging document was updated last year along with survival curves and good news is stage 1a folks have a 99% chance of having no issue at 5 years and then a big drop down to 98% at ten years, in other words 98 out of every 100 people like yourself will not have any future issues. Now, if you want to do some reading and future melanoma research then I will give you two links, first one to Neurotopism question ( don’t want that to be present in report so you are good to go there). Second link to staging document so you can read it for yourself, pg 11 and 12 should give you all you need to know. https://link.springer.com/article/10.1007%2FBF00172766 https://cancerstaging.org/CSE/Physician/Documents/Melanoma%202.2.18.pdf
          Alce123
          Participant
            Hello! Just here to give some reassurance. I was diagnosed with 1a 0.44 thickness melanoma when I was 31 as well. That was just over 3 years ago and im alive and kicking with a 6 month old son. I haven’t had anything else that’s even mildly dysplastic:)
            You’ll move on… it will just take some time.
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