How long does Melanoma stay in situ?

I so wish that the dermapathology community would settle this once and for all.

Melanoma in situ is NOT melanoma.

in situ is confined to the epidermis and as such, there is no mechanical way for it to spread.

Yes, left untreated, in situ can grow and reach the vascular level where it can morph into something else and  has a method of transport to distant areas………………………………….but in and of itself at first recognition,in situ is NOT melanoma.

Even a noted dermapath at a MRF Symposium pointed this out.

There is no science that supports the idea that a properly excised in situ with a clinical assessment by pathology that it its indeed confined to the epidermis is melanoma.

If there is any one thing that the MRF should address it is just this issue……….IN SITU IS NOT MELANOMA.

Warning shot across the bow , sure; but it is NOT melanoma and with my twenty nine year death dance with melanoma; it is my considered opinion that melanoma should be removed from in situ because it breeds nothing but creating unresolved fear in people.

It would certainly be of interest to hear a position statement from the MRF about what melanoma in situ is and is not.

This insitu thing has almost risen to the level of urban myth…………………it is NOT melanoma.  

Show me the science that says it is and I will change my mind.

Until then………………….

 

Charlie S

 

 

 

 

Googling melanoma in situ just brings up a bunch of sites that say melanoma in situ is melanoma cancer cells that are confined to the epidermis. So… are there melanoma cancer cells or not? Does that not make it melanoma in some form? If that is wrong then there certainly needs to be a revamp of how melanoma in situ is described on the internet, makes it very confusing.

I definitely feel like invasive melanoma started out invasive, as mel in situ can stay in situ for a very long time, and I don't believe I ever had mel in situ as I know the exact week my melanoma started growing on me (wish I knew it was mel then) and that it was stage 3b in just months. Hopefully better descriptions and definitons of how this all works will be easier to find on the web soon, as to stop anymore maddening confusion.

Googling melanoma in situ just brings up a bunch of sites that say melanoma in situ is melanoma cancer cells that are confined to the epidermis. So… are there melanoma cancer cells or not? Does that not make it melanoma in some form? If that is wrong then there certainly needs to be a revamp of how melanoma in situ is described on the internet, makes it very confusing.

I definitely feel like invasive melanoma started out invasive, as mel in situ can stay in situ for a very long time, and I don't believe I ever had mel in situ as I know the exact week my melanoma started growing on me (wish I knew it was mel then) and that it was stage 3b in just months. Hopefully better descriptions and definitons of how this all works will be easier to find on the web soon, as to stop anymore maddening confusion.

Googling melanoma in situ just brings up a bunch of sites that say melanoma in situ is melanoma cancer cells that are confined to the epidermis. So… are there melanoma cancer cells or not? Does that not make it melanoma in some form? If that is wrong then there certainly needs to be a revamp of how melanoma in situ is described on the internet, makes it very confusing.

I definitely feel like invasive melanoma started out invasive, as mel in situ can stay in situ for a very long time, and I don't believe I ever had mel in situ as I know the exact week my melanoma started growing on me (wish I knew it was mel then) and that it was stage 3b in just months. Hopefully better descriptions and definitons of how this all works will be easier to find on the web soon, as to stop anymore maddening confusion.

Hi Charlie, 

Thank you so much for taking the time to comment here and offer your invaluable opinion – especially when you are going through so much!

I truly want to believe what you say as I was diagnosed with in situ last month on my neck. I really struggle to reconcile the huge differences of opinion with in situ. On one hand, there is the opinion that it is not melanoma and on the other, there are opinions and stories that scare the heck out of me! 

If in situ isn't melanoma, do I still have to live in the same fear of a recuurance or another primary? Are my children at a higher risk? While I have changed my sun habits and will do monthly self checks, do I need to be seen every 3-6 months by my derm for full body checks?

Thank you!

Hi Charlie, 

Thank you so much for taking the time to comment here and offer your invaluable opinion – especially when you are going through so much!

I truly want to believe what you say as I was diagnosed with in situ last month on my neck. I really struggle to reconcile the huge differences of opinion with in situ. On one hand, there is the opinion that it is not melanoma and on the other, there are opinions and stories that scare the heck out of me! 

If in situ isn't melanoma, do I still have to live in the same fear of a recuurance or another primary? Are my children at a higher risk? While I have changed my sun habits and will do monthly self checks, do I need to be seen every 3-6 months by my derm for full body checks?

Thank you!

Hi Charlie, 

Thank you so much for taking the time to comment here and offer your invaluable opinion – especially when you are going through so much!

I truly want to believe what you say as I was diagnosed with in situ last month on my neck. I really struggle to reconcile the huge differences of opinion with in situ. On one hand, there is the opinion that it is not melanoma and on the other, there are opinions and stories that scare the heck out of me! 

If in situ isn't melanoma, do I still have to live in the same fear of a recuurance or another primary? Are my children at a higher risk? While I have changed my sun habits and will do monthly self checks, do I need to be seen every 3-6 months by my derm for full body checks?

Thank you!

It appears there is a lot of debate and gray area when diagnosing a mole as severe or Melanoma in situ. Biopsy results can differ worrying patients and there isn't one clear standard shared by everyone. Also, there is a lot of debate on whether or not in situ is cancer or pre-cancerous cells. There's a lot of debate about whether or not it will come back in a different area or will never come back. At least this has been my experience and what I have found through research. It makes it very confusing for the patient.

I so wish that the dermapathology community would settle this once and for all.

Melanoma in situ is NOT melanoma.

in situ is confined to the epidermis and as such, there is no mechanical way for it to spread.

Yes, left untreated, in situ can grow and reach the vascular level where it can morph into something else and  has a method of transport to distant areas………………………………….but in and of itself at first recognition,in situ is NOT melanoma.

Even a noted dermapath at a MRF Symposium pointed this out.

There is no science that supports the idea that a properly excised in situ with a clinical assessment by pathology that it its indeed confined to the epidermis is melanoma.

If there is any one thing that the MRF should address it is just this issue……….IN SITU IS NOT MELANOMA.

Warning shot across the bow , sure; but it is NOT melanoma and with my twenty nine year death dance with melanoma; it is my considered opinion that melanoma should be removed from in situ because it breeds nothing but creating unresolved fear in people.

It would certainly be of interest to hear a position statement from the MRF about what melanoma in situ is and is not.

This insitu thing has almost risen to the level of urban myth…………………it is NOT melanoma.  

Show me the science that says it is and I will change my mind.

Until then………………….

 

Charlie S

 

 

 

 

I so wish that the dermapathology community would settle this once and for all.

Melanoma in situ is NOT melanoma.

in situ is confined to the epidermis and as such, there is no mechanical way for it to spread.

Yes, left untreated, in situ can grow and reach the vascular level where it can morph into something else and  has a method of transport to distant areas………………………………….but in and of itself at first recognition,in situ is NOT melanoma.

Even a noted dermapath at a MRF Symposium pointed this out.

There is no science that supports the idea that a properly excised in situ with a clinical assessment by pathology that it its indeed confined to the epidermis is melanoma.

If there is any one thing that the MRF should address it is just this issue……….IN SITU IS NOT MELANOMA.

Warning shot across the bow , sure; but it is NOT melanoma and with my twenty nine year death dance with melanoma; it is my considered opinion that melanoma should be removed from in situ because it breeds nothing but creating unresolved fear in people.

It would certainly be of interest to hear a position statement from the MRF about what melanoma in situ is and is not.

This insitu thing has almost risen to the level of urban myth…………………it is NOT melanoma.  

Show me the science that says it is and I will change my mind.

Until then………………….

 

Charlie S

 

 

 

 

It depends. The first question is “Is it Melanoma”. The answer is not as simple as one would expect. From an article “The differentiation of a melanocytic nevus and melanoma is often a dilemma clinically as well as histologically. This dilemma involves inexperienced as well as knowledgeable pathologists. The provoking question turns out to be: why is this differential diagnosis often a quandary? The answer lies in the fact that there are overlapping cytological and architectural criteria used interchangeably for a melanoma and melanocytic nevus. The criteria emphasized often vary from institution to institution and pathologist to pathologist. Regrettably, similar criteria attributed to both benign and malignant melanocytic proliferations, melanocytic nevus and melanoma, are used interchangeably: thus the quandary. In summary, the dilemma of whether a pigmented melanocytic proliferation is a melanoma or melanocytic nevus perhaps rests on the recognition of overlapping criteria, and the detection of the typical or atypical pagetoid melanocyte.” My suggestion is get a second opinion from a top notch medical facility. For me that would be UCSF. At one time I was diagnosed with a Brain Tumor. Specifically a cyst in my right ventricle. I was scheduled for surgery. My cousin is a anesthesiologist here in the Bay Area. He told me to get a second opinion from UCSF. Here is the verbiage he sent to the surgeon “I wanted to let you know that I have reviewed the films on “…” and it is our impression that he does not have a cyst in his ventricle and that this is an MRI artifact. Our neuroadiologist reviewed the film and also agreed there is no mass or cyst in the ventricle. We would be glad to repeat the scan here if you wish. I would certainly recommend that it be repeated soon to confirm our suspicions that this is not a mass or cyst. This will require a discussion with the neuroradiologist who does the scan to make sure that they eradicate the imaging artifact.” My doctor, a top surgeon from Stanford told me in so many words that he thought he was more qualified then the UCSF specialists, doctors Robert Feiwell, MD and Mitchel S Berger, MD. All I can say is thank god for Robert and Mitchel. If I had listened to Doctor Lieberman and gone through with the surgery I may not be alive today or maybe I would lost the use of my limbs, who knows. Always get a second opinion.

Correction – Here is the verbiage the UCSF doctors (not my cousin, the anesthesiologist) sent to the surgeon who was about to open up my brain “I wanted to let you know that I have reviewed the films on “…” and it is our impression that he does not have a cyst in his ventricle and that this is an MRI artifact. Our neuroadiologist reviewed the film and also agreed there is no mass or cyst in the ventricle. We would be glad to repeat the scan here if you wish. I would certainly recommend that it be repeated soon to confirm our suspicions that this is not a mass or cyst. This will require a discussion with the neuroradiologist who does the scan to make sure that they eradicate the imaging artifact.” My doctor, a top surgeon from Stanford told me in so many words that he thought he was more qualified then the UCSF specialists, doctors Robert Feiwell, MD and Mitchel S Berger, MD. All I can say is thank god for Robert and Mitchel. If I had listened to Doctor Lieberman and gone through with the surgery I may not be alive today or maybe I would be alive but would not have the use of my limbs, who knows. Always get a second opinion. Always!

One last comment, there was a group of doctors belonging to the UCSF program that should be mentioned and were part of the Adult Brain Tumor Program that saved my life. They are Mitchel S. Berger MD, Nicholas M. Barbaro MD, Sandeep M. Kunwar MD, Michael H. Pitts MD, Charles B. Wilson MD, and RN’s Heidi Clay, RN MS CCRN, Lisa Hannegan, RN MS CNRN, and Marylou Muwaswes RN MS. That you all for saving my life. Thank you god for convincing me to not listen to Dr. Lieberman and for trusting UCSF. This event took place twenty years ago. The letter was dated November 28, 2000. Always get a second opinion from a top notch medical facility (e.g., UCSF).

Because in situ means it never reached the level where there are blood and lymph vessels, that means you don't have to worry about recurrance the same way someone with deeper melanoma primaries do. More than likely you will never deal with melanoma again. I've had multiple family members who've had mel in situ removed, and many years later have never dealth with melanoma again. Second primaries are not that common, can't remember the exact percentage of people that get more than one primary but it is fairly low. It's still good to see a derm, every 6 months is fine, but really it is up to you. If you're good about doing self checks and if you have a significant other in your life that can keep an eye out for your back and areas you can't see easily, then that's all you need. You know to watch for change and new lesions that show up. The genetic relation, as far as your kids are concerned, is low and melanoma in kids is much more rare than in adults, but always good to just keep an eye out, the same way any parent should be doing. It's great you caught it early and your melanoma journey ended quickly. 

Because in situ means it never reached the level where there are blood and lymph vessels, that means you don't have to worry about recurrance the same way someone with deeper melanoma primaries do. More than likely you will never deal with melanoma again. I've had multiple family members who've had mel in situ removed, and many years later have never dealth with melanoma again. Second primaries are not that common, can't remember the exact percentage of people that get more than one primary but it is fairly low. It's still good to see a derm, every 6 months is fine, but really it is up to you. If you're good about doing self checks and if you have a significant other in your life that can keep an eye out for your back and areas you can't see easily, then that's all you need. You know to watch for change and new lesions that show up. The genetic relation, as far as your kids are concerned, is low and melanoma in kids is much more rare than in adults, but always good to just keep an eye out, the same way any parent should be doing. It's great you caught it early and your melanoma journey ended quickly. 

Because in situ means it never reached the level where there are blood and lymph vessels, that means you don't have to worry about recurrance the same way someone with deeper melanoma primaries do. More than likely you will never deal with melanoma again. I've had multiple family members who've had mel in situ removed, and many years later have never dealth with melanoma again. Second primaries are not that common, can't remember the exact percentage of people that get more than one primary but it is fairly low. It's still good to see a derm, every 6 months is fine, but really it is up to you. If you're good about doing self checks and if you have a significant other in your life that can keep an eye out for your back and areas you can't see easily, then that's all you need. You know to watch for change and new lesions that show up. The genetic relation, as far as your kids are concerned, is low and melanoma in kids is much more rare than in adults, but always good to just keep an eye out, the same way any parent should be doing. It's great you caught it early and your melanoma journey ended quickly. 

Jenn, thanks for your words of wisdom – I try to cling to these and the words of others on here – just having a hard time believing my melanoma journey is really over. Thank you again and my prayers are for all of you on this amazingly helpful forum. 

Jenn, thanks for your words of wisdom – I try to cling to these and the words of others on here – just having a hard time believing my melanoma journey is really over. Thank you again and my prayers are for all of you on this amazingly helpful forum. 

Jenn, thanks for your words of wisdom – I try to cling to these and the words of others on here – just having a hard time believing my melanoma journey is really over. Thank you again and my prayers are for all of you on this amazingly helpful forum.