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.

I need help for my cousin

Forums General Melanoma Community I need help for my cousin

  • Post
    DeniseK
    Participant

      Hey Everyone, 

      I need help for my cousin.  She is not a blood cousin but she was just diagnosed with Melanoma today.  She had a biopsy of a mole behind her knee on the back side of her leg removed and it came back as melanoma.  I guess it was a  punch biopsy but she said it wasn't very deep and the derm said they caught it early.  She is asking me what questions to ask and I don't know.  It's been so long for me since my initial diagnosis I wouldn't know how to read a path report or know what to ask anymore.  I do know she will have to have a WLE but do they do a SNLB too automatically?  I told her to ask her derm to refer her to a melanoma specialist not just an oncologist.  The derm is talking to the melanoma surgeon and is getting back with her in the morning.  I am very concerned for her and she is scared to death.  She lost her daughter Amber at age 24 in 2001 to melanoma.  I told her about this website so maybe she will come for support and help with her questions.  I'm trying to find out what the depth was.  

      Any help as far as what she should be doing is appreciated.  

      Thanks everyone for your help

      Denise

    Viewing 5 reply threads
    • Replies
        JoshF
        Participant

          Denise-

          I'm sorry…that's horrible! I think for SNLB it is greater than 1mm but I'm not totally sure. I would definitely reach out to Janner. She's definitely could provide direction. I hope all goes well.

           

          Josh

            JoshF
            Participant

              Sorry…its 1mm in depth. My step mom had melanoma too…yes odd no familial ties but step mom. I believe she was .73mm in depth….they didn;t do one but she went for 2nd opinion and told her they should have and should have done it prior to surgery.

               

              Josh

              JoshF
              Participant

                Sorry…its 1mm in depth. My step mom had melanoma too…yes odd no familial ties but step mom. I believe she was .73mm in depth….they didn;t do one but she went for 2nd opinion and told her they should have and should have done it prior to surgery.

                 

                Josh

                JoshF
                Participant

                  Sorry…its 1mm in depth. My step mom had melanoma too…yes odd no familial ties but step mom. I believe she was .73mm in depth….they didn;t do one but she went for 2nd opinion and told her they should have and should have done it prior to surgery.

                   

                  Josh

                  DeniseK
                  Participant

                    Thanks Josh, I should have put ATTN JANNER LOL!!  I know she would know.  Hopefully she will answer.

                     

                    DeniseK
                    Participant

                      She just told me it was 2mm deep with the punch biopsy.  Does that mean she will have the SNLB?

                      DeniseK
                      Participant

                        She just told me it was 2mm deep with the punch biopsy.  Does that mean she will have the SNLB?

                        DeniseK
                        Participant

                          She just told me it was 2mm deep with the punch biopsy.  Does that mean she will have the SNLB?

                          DeniseK
                          Participant

                            Thanks Josh, I should have put ATTN JANNER LOL!!  I know she would know.  Hopefully she will answer.

                             

                            DeniseK
                            Participant

                              Thanks Josh, I should have put ATTN JANNER LOL!!  I know she would know.  Hopefully she will answer.

                               

                            JoshF
                            Participant

                              Denise-

                              I'm sorry…that's horrible! I think for SNLB it is greater than 1mm but I'm not totally sure. I would definitely reach out to Janner. She's definitely could provide direction. I hope all goes well.

                               

                              Josh

                              JoshF
                              Participant

                                Denise-

                                I'm sorry…that's horrible! I think for SNLB it is greater than 1mm but I'm not totally sure. I would definitely reach out to Janner. She's definitely could provide direction. I hope all goes well.

                                 

                                Josh

                                Janner
                                Participant

                                  Hi Denise,

                                  No, a SNB is not done automatically – it totally depends on the pathology.  Early stages do not need this done.  And if her lesion truly is very early, it's unlikely she will really need a melanoma specialist because the surgery itself might be considered "curative".  Now, I'm not saying anyone is truly cured, but the WLE might be the only treatment option.  Real melanoma specialists often work with people who are stage III/IV, but not as often an early stage person.  A derm might be perfectly fine.  I can only comment generally because, without the pathology report, we are speculating on what "early" really means.

                                  Best wishes,

                                  Janner

                                    Janner
                                    Participant

                                      Weird, but I didn't see the other replies before I answered.  Was the punch 2mm deep or the lesion?  Was it 1mm deep?  PATH REPORT!!!  If it was truly 1mm, then likely they would suggest doing the SNB.  But the total picture provided by the path report is really needed to make any real meaningful comments.  There are other factor to take into consideration.

                                      DeniseK
                                      Participant

                                        She said the melanoma was 2mm deep no ulceration and no word on mitotic rate.  She doesn't have the path report because she was told over the phone.  I told her to get it right away.  I feel so bad for her because she is so scared because of what she went through with her daughter.  Is 2 mm considered deep?  I know mine was something like 14mm and ulcerated so it was really bad.  I told her she will probably be a stage 1A which after surgery is 95% cured.  I guess it will depend on the surgery and reports to follow.  My heart is breaking for her because she lost her daughter to this and she's really been there for me and now she has to deal with it.  

                                        Thanks for your help!!

                                        Janner
                                        Participant
                                          2mm deep may be stage 2, so a bit more serious. Stage 1a ends at 1mm and stage 1b ends at 2mm. But ulceration may bump up the stage. Mitosis is only used to differentiate between stage 1a and 1b. So getting the path report is key to know where she really stands.
                                          smurph226
                                          Participant
                                            Hello, I am Denise’s cousin. I believe the Breslow is .5 and Clark level is two. I do not believe there is ulceration
                                            POW
                                            Participant

                                              I am very sorry to learn that you lost your daughter to melanoma and now have to face this frightening diagnosis yourself. That's so awful! However, please know that we are all here to support you and to share with you what we can of our knowledge and experience. Denise has been an amazing inspiration and helpful participant on this forum, so I'm sure she will be very helpful to you, too.

                                              As Janner (our melanoma guru) said, to be most helpful to you we will need to see your whole pathology report. However, from what you have said so far it sounds as though you caught this lesion while it is still very small. You will want a wide local excision (WLE) to make certain it is all completely gone, but you will probably not need a sentinal node biopsy (SNB).  After that, I expect that you will have no further trouble with melanoma.

                                              However, please do post your biopsy report when you can. And give Denise a hug for me! 

                                              smurph226
                                              Participant
                                                Thank you for your response. I so wish I could hug Denise but we live too far from each other. We only communicate by Facebook
                                                smurph226
                                                Participant
                                                  Thank you for your response. I so wish I could hug Denise but we live too far from each other. We only communicate by Facebook
                                                  smurph226
                                                  Participant
                                                    Thank you for your response. I so wish I could hug Denise but we live too far from each other. We only communicate by Facebook
                                                    POW
                                                    Participant

                                                      I am very sorry to learn that you lost your daughter to melanoma and now have to face this frightening diagnosis yourself. That's so awful! However, please know that we are all here to support you and to share with you what we can of our knowledge and experience. Denise has been an amazing inspiration and helpful participant on this forum, so I'm sure she will be very helpful to you, too.

                                                      As Janner (our melanoma guru) said, to be most helpful to you we will need to see your whole pathology report. However, from what you have said so far it sounds as though you caught this lesion while it is still very small. You will want a wide local excision (WLE) to make certain it is all completely gone, but you will probably not need a sentinal node biopsy (SNB).  After that, I expect that you will have no further trouble with melanoma.

                                                      However, please do post your biopsy report when you can. And give Denise a hug for me! 

                                                      POW
                                                      Participant

                                                        I am very sorry to learn that you lost your daughter to melanoma and now have to face this frightening diagnosis yourself. That's so awful! However, please know that we are all here to support you and to share with you what we can of our knowledge and experience. Denise has been an amazing inspiration and helpful participant on this forum, so I'm sure she will be very helpful to you, too.

                                                        As Janner (our melanoma guru) said, to be most helpful to you we will need to see your whole pathology report. However, from what you have said so far it sounds as though you caught this lesion while it is still very small. You will want a wide local excision (WLE) to make certain it is all completely gone, but you will probably not need a sentinal node biopsy (SNB).  After that, I expect that you will have no further trouble with melanoma.

                                                        However, please do post your biopsy report when you can. And give Denise a hug for me! 

                                                        Janner
                                                        Participant

                                                          Breslow 0.5mm and Clark Level II.  So the remaining question is mitosis.  Mitosis of <1 makes you stage IA.  Any other mitosis makes you stage IB.  The WLE is necessary, but you should discuss the SNB with your doc.  Stage 1A – probably not.  Stage IB – possibly.  Some sites do the SNB for every stage IB individual, others do it when the lesion is closer to 1mm.  Sometimes looking at the whole path report picture and seeing if it appears "low risk" or has some factors that make it a bit higher risk will determine the next step.  But regardless, I've been on this site for a very long time and 0.5mm/CL II is a low risk lesion.  I had a similar lesion removed 21 years ago (0.58mm/CL II/No SNB) and am still here to talk about it.  We can give you our best "non medical advice" if you can post your pathology report.  Sorry you have to join us here, but it sounds like things were truly caught early!

                                                          Best wishes,

                                                          Janner

                                                          smurph226
                                                          Participant
                                                            Thank you Janner. I am sure it will be ok. My daughter was diagnosed at 21 and had the snb. They said she was cured. However it spread through her blood stream and 3 years and 1 week after she passed away at 24. She was so courageous and had a smile that would brighten even the darkest room. She was an inspiration to all that had the pleasure of knowing her. I am sure you can understand my concerns with my own diagnosis.
                                                            smurph226
                                                            Participant
                                                              Thank you Janner. I am sure it will be ok. My daughter was diagnosed at 21 and had the snb. They said she was cured. However it spread through her blood stream and 3 years and 1 week after she passed away at 24. She was so courageous and had a smile that would brighten even the darkest room. She was an inspiration to all that had the pleasure of knowing her. I am sure you can understand my concerns with my own diagnosis.
                                                              smurph226
                                                              Participant
                                                                Thank you Janner. I am sure it will be ok. My daughter was diagnosed at 21 and had the snb. They said she was cured. However it spread through her blood stream and 3 years and 1 week after she passed away at 24. She was so courageous and had a smile that would brighten even the darkest room. She was an inspiration to all that had the pleasure of knowing her. I am sure you can understand my concerns with my own diagnosis.
                                                                DeniseK
                                                                Participant

                                                                  Thanks Janner,

                                                                  I know this helps her a lot with her worries. 

                                                                  DeniseK
                                                                  Participant

                                                                    Thanks Janner,

                                                                    I know this helps her a lot with her worries. 

                                                                    DeniseK
                                                                    Participant

                                                                      Thanks Janner,

                                                                      I know this helps her a lot with her worries. 

                                                                      smurph226
                                                                      Participant
                                                                        Hello Janner. I had the wide incision on my 1A melanoma. I was told that that was all the treatment I needed. I pulled my daughters original path report and her melanoma was Breslow 1.48 Clark’s IV there was no ulceration. She had SNB. They couldn’t find the path of the dye, so they pulled about 30 nodes. The tested negative. They did not do any follow up treatment. It was not the protocol. However, her melanoma spread through her blood and when rediagnosed, she lived 11 months. I am scared/concerned that that could happen to me. Any thoughts?
                                                                        smurph226
                                                                        Participant
                                                                          Hello Janner. I had the wide incision on my 1A melanoma. I was told that that was all the treatment I needed. I pulled my daughters original path report and her melanoma was Breslow 1.48 Clark’s IV there was no ulceration. She had SNB. They couldn’t find the path of the dye, so they pulled about 30 nodes. The tested negative. They did not do any follow up treatment. It was not the protocol. However, her melanoma spread through her blood and when rediagnosed, she lived 11 months. I am scared/concerned that that could happen to me. Any thoughts?
                                                                          Janner
                                                                          Participant
                                                                            Could it happen? Yes. Is it likely? No. Your daughters lesion was much higher risk than yours based on depth. The SNB is a diagnostic tool only and is not a guarantee of anything. I’m sorry the drainage path was never found with your daughter. Spreading through the blood supply is much rarer than through the lymph vessels. As for you, there is no treatment you can do other than pay attention to change. Moles or anything that seems out of the ordinary for you. Then move on. I know that is easier said than done given your history, but your risk is low and worrying only lets melanoma win again. Stage 1a is an exclusive club with an extremely high survival rate – definitely a different situation from your daughter. Hang in there and let me know if I can help.
                                                                            Janner
                                                                            Participant
                                                                              Could it happen? Yes. Is it likely? No. Your daughters lesion was much higher risk than yours based on depth. The SNB is a diagnostic tool only and is not a guarantee of anything. I’m sorry the drainage path was never found with your daughter. Spreading through the blood supply is much rarer than through the lymph vessels. As for you, there is no treatment you can do other than pay attention to change. Moles or anything that seems out of the ordinary for you. Then move on. I know that is easier said than done given your history, but your risk is low and worrying only lets melanoma win again. Stage 1a is an exclusive club with an extremely high survival rate – definitely a different situation from your daughter. Hang in there and let me know if I can help.
                                                                              POW
                                                                              Participant

                                                                                Janner, I seem to recall you mentioning at one point that there is a research effort under way to study the genetic basis (if any) for melanoma. Is that correct? If so, having 3 people in one family afflicted by melanoma might be very helpful to that research effort. Can you comment?

                                                                                POW
                                                                                Participant

                                                                                  Janner, I seem to recall you mentioning at one point that there is a research effort under way to study the genetic basis (if any) for melanoma. Is that correct? If so, having 3 people in one family afflicted by melanoma might be very helpful to that research effort. Can you comment?

                                                                                  Janner
                                                                                  Participant

                                                                                    Three people in multiple generations is what they wanted for the Familial study I was in… or multiple primaries (>2).  The genetic defect I have (CDKN2A) is dominant and does not skip generations.  However, having the gene gives you a 76% lifetime risk of getting melanoma.  Not a sure thing, but the numbers are pretty daunting.  Only 2-4% of the melanoma population have this genetic defect.  There is another gene that covers  <1% of the population and others are thought to exist.  In addition, people with DNS may have multiple generations.  The info I was given said about 10% of melanomas were thought to have some genetic basis and 90% were sporadic.

                                                                                    Janner
                                                                                    Participant

                                                                                      Three people in multiple generations is what they wanted for the Familial study I was in… or multiple primaries (>2).  The genetic defect I have (CDKN2A) is dominant and does not skip generations.  However, having the gene gives you a 76% lifetime risk of getting melanoma.  Not a sure thing, but the numbers are pretty daunting.  Only 2-4% of the melanoma population have this genetic defect.  There is another gene that covers  <1% of the population and others are thought to exist.  In addition, people with DNS may have multiple generations.  The info I was given said about 10% of melanomas were thought to have some genetic basis and 90% were sporadic.

                                                                                      Janner
                                                                                      Participant

                                                                                        Three people in multiple generations is what they wanted for the Familial study I was in… or multiple primaries (>2).  The genetic defect I have (CDKN2A) is dominant and does not skip generations.  However, having the gene gives you a 76% lifetime risk of getting melanoma.  Not a sure thing, but the numbers are pretty daunting.  Only 2-4% of the melanoma population have this genetic defect.  There is another gene that covers  <1% of the population and others are thought to exist.  In addition, people with DNS may have multiple generations.  The info I was given said about 10% of melanomas were thought to have some genetic basis and 90% were sporadic.

                                                                                        POW
                                                                                        Participant

                                                                                          Janner, I seem to recall you mentioning at one point that there is a research effort under way to study the genetic basis (if any) for melanoma. Is that correct? If so, having 3 people in one family afflicted by melanoma might be very helpful to that research effort. Can you comment?

                                                                                          Janner
                                                                                          Participant
                                                                                            Could it happen? Yes. Is it likely? No. Your daughters lesion was much higher risk than yours based on depth. The SNB is a diagnostic tool only and is not a guarantee of anything. I’m sorry the drainage path was never found with your daughter. Spreading through the blood supply is much rarer than through the lymph vessels. As for you, there is no treatment you can do other than pay attention to change. Moles or anything that seems out of the ordinary for you. Then move on. I know that is easier said than done given your history, but your risk is low and worrying only lets melanoma win again. Stage 1a is an exclusive club with an extremely high survival rate – definitely a different situation from your daughter. Hang in there and let me know if I can help.
                                                                                            smurph226
                                                                                            Participant
                                                                                              Hello Janner. I had the wide incision on my 1A melanoma. I was told that that was all the treatment I needed. I pulled my daughters original path report and her melanoma was Breslow 1.48 Clark’s IV there was no ulceration. She had SNB. They couldn’t find the path of the dye, so they pulled about 30 nodes. The tested negative. They did not do any follow up treatment. It was not the protocol. However, her melanoma spread through her blood and when rediagnosed, she lived 11 months. I am scared/concerned that that could happen to me. Any thoughts?
                                                                                              Janner
                                                                                              Participant

                                                                                                Breslow 0.5mm and Clark Level II.  So the remaining question is mitosis.  Mitosis of <1 makes you stage IA.  Any other mitosis makes you stage IB.  The WLE is necessary, but you should discuss the SNB with your doc.  Stage 1A – probably not.  Stage IB – possibly.  Some sites do the SNB for every stage IB individual, others do it when the lesion is closer to 1mm.  Sometimes looking at the whole path report picture and seeing if it appears "low risk" or has some factors that make it a bit higher risk will determine the next step.  But regardless, I've been on this site for a very long time and 0.5mm/CL II is a low risk lesion.  I had a similar lesion removed 21 years ago (0.58mm/CL II/No SNB) and am still here to talk about it.  We can give you our best "non medical advice" if you can post your pathology report.  Sorry you have to join us here, but it sounds like things were truly caught early!

                                                                                                Best wishes,

                                                                                                Janner

                                                                                                Janner
                                                                                                Participant

                                                                                                  Breslow 0.5mm and Clark Level II.  So the remaining question is mitosis.  Mitosis of <1 makes you stage IA.  Any other mitosis makes you stage IB.  The WLE is necessary, but you should discuss the SNB with your doc.  Stage 1A – probably not.  Stage IB – possibly.  Some sites do the SNB for every stage IB individual, others do it when the lesion is closer to 1mm.  Sometimes looking at the whole path report picture and seeing if it appears "low risk" or has some factors that make it a bit higher risk will determine the next step.  But regardless, I've been on this site for a very long time and 0.5mm/CL II is a low risk lesion.  I had a similar lesion removed 21 years ago (0.58mm/CL II/No SNB) and am still here to talk about it.  We can give you our best "non medical advice" if you can post your pathology report.  Sorry you have to join us here, but it sounds like things were truly caught early!

                                                                                                  Best wishes,

                                                                                                  Janner

                                                                                                  smurph226
                                                                                                  Participant
                                                                                                    Hello, I am Denise’s cousin. I believe the Breslow is .5 and Clark level is two. I do not believe there is ulceration
                                                                                                    smurph226
                                                                                                    Participant
                                                                                                      Hello, I am Denise’s cousin. I believe the Breslow is .5 and Clark level is two. I do not believe there is ulceration
                                                                                                      Janner
                                                                                                      Participant
                                                                                                        2mm deep may be stage 2, so a bit more serious. Stage 1a ends at 1mm and stage 1b ends at 2mm. But ulceration may bump up the stage. Mitosis is only used to differentiate between stage 1a and 1b. So getting the path report is key to know where she really stands.
                                                                                                        Janner
                                                                                                        Participant
                                                                                                          2mm deep may be stage 2, so a bit more serious. Stage 1a ends at 1mm and stage 1b ends at 2mm. But ulceration may bump up the stage. Mitosis is only used to differentiate between stage 1a and 1b. So getting the path report is key to know where she really stands.
                                                                                                          DeniseK
                                                                                                          Participant

                                                                                                            She said the melanoma was 2mm deep no ulceration and no word on mitotic rate.  She doesn't have the path report because she was told over the phone.  I told her to get it right away.  I feel so bad for her because she is so scared because of what she went through with her daughter.  Is 2 mm considered deep?  I know mine was something like 14mm and ulcerated so it was really bad.  I told her she will probably be a stage 1A which after surgery is 95% cured.  I guess it will depend on the surgery and reports to follow.  My heart is breaking for her because she lost her daughter to this and she's really been there for me and now she has to deal with it.  

                                                                                                            Thanks for your help!!

                                                                                                            DeniseK
                                                                                                            Participant

                                                                                                              She said the melanoma was 2mm deep no ulceration and no word on mitotic rate.  She doesn't have the path report because she was told over the phone.  I told her to get it right away.  I feel so bad for her because she is so scared because of what she went through with her daughter.  Is 2 mm considered deep?  I know mine was something like 14mm and ulcerated so it was really bad.  I told her she will probably be a stage 1A which after surgery is 95% cured.  I guess it will depend on the surgery and reports to follow.  My heart is breaking for her because she lost her daughter to this and she's really been there for me and now she has to deal with it.  

                                                                                                              Thanks for your help!!

                                                                                                              Janner
                                                                                                              Participant

                                                                                                                Weird, but I didn't see the other replies before I answered.  Was the punch 2mm deep or the lesion?  Was it 1mm deep?  PATH REPORT!!!  If it was truly 1mm, then likely they would suggest doing the SNB.  But the total picture provided by the path report is really needed to make any real meaningful comments.  There are other factor to take into consideration.

                                                                                                                Janner
                                                                                                                Participant

                                                                                                                  Weird, but I didn't see the other replies before I answered.  Was the punch 2mm deep or the lesion?  Was it 1mm deep?  PATH REPORT!!!  If it was truly 1mm, then likely they would suggest doing the SNB.  But the total picture provided by the path report is really needed to make any real meaningful comments.  There are other factor to take into consideration.

                                                                                                                Janner
                                                                                                                Participant

                                                                                                                  Hi Denise,

                                                                                                                  No, a SNB is not done automatically – it totally depends on the pathology.  Early stages do not need this done.  And if her lesion truly is very early, it's unlikely she will really need a melanoma specialist because the surgery itself might be considered "curative".  Now, I'm not saying anyone is truly cured, but the WLE might be the only treatment option.  Real melanoma specialists often work with people who are stage III/IV, but not as often an early stage person.  A derm might be perfectly fine.  I can only comment generally because, without the pathology report, we are speculating on what "early" really means.

                                                                                                                  Best wishes,

                                                                                                                  Janner

                                                                                                                  Janner
                                                                                                                  Participant

                                                                                                                    Hi Denise,

                                                                                                                    No, a SNB is not done automatically – it totally depends on the pathology.  Early stages do not need this done.  And if her lesion truly is very early, it's unlikely she will really need a melanoma specialist because the surgery itself might be considered "curative".  Now, I'm not saying anyone is truly cured, but the WLE might be the only treatment option.  Real melanoma specialists often work with people who are stage III/IV, but not as often an early stage person.  A derm might be perfectly fine.  I can only comment generally because, without the pathology report, we are speculating on what "early" really means.

                                                                                                                    Best wishes,

                                                                                                                    Janner

                                                                                                                Viewing 5 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.