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Isolated Tumor Cells SLNB Prognosis

Forums General Melanoma Community Isolated Tumor Cells SLNB Prognosis

  • Post
    Jennab0525
    Participant

      Hello everyone! I'm newly diagnosed in October and have been visiting this site daily since then. You have all been so helpful. I am posting today to find if there is any one out there with a similar situation to mine and hear how they are doing.

      My back story is this…in Dec of 2014 I went to the doctor with a mole on my upper right shoulder blade that had been changing into a red bump. Doctor thought it could possibly be Basel Cell or Sebehhoric keratosis (sp?). He chose to freeze it off and said if it comes back it's cancer and he will remove it and if not the it's a Sebehhoric Ketatosis. Next few months it continued to look like a red flat scar so I assumed it was healing, not cancer. This summer it started to raise up into a large red bump (never bled, didn't hurt). Since it was ugly when wearing tank tops I scheduled an appt with my local doctor to remove it. Two days after removal it came back melanoma. My initial diagnosis was Stage IIB (Breslow IV, lymphatic invasion present, 3.5mm, ulcerated, mioticic rate greater than 1).

      PET Scan on 10/28 came back clear (yeah!!),  then SLNB and WLE on 10/30 came back margins clear (yeah!!) BUT they found 2 isolated tumor cells in my SN (second node was clear; they removed 2 nodes total). The cells were extremely microscopic, had not even had a chance to cluster or mat. All docs (surgeon, dermatologist and oncologist) felt this was good! Unfortunately, this did elevate me to a IIIB.

      First oncologist told us I had a 40% chance of recurrence and suggested no CLND but interferon. I had done my research on interferon and did not want to go that route as I felt it was overkill with my node involvement. We went for a second opinion. Second oncologist (melanoma specialist 20+ years experience) said no CLND (less than 5% chance it would be in remaining nodes) and felt interferons risks far outweighed the benefits for someone like me. He said I am in a grey area. He feels my original tumor may not have been ulcerated and may have appeared that way because of the freezing thus giving me a better prognosis (dermatologist feels that way too). Also in breast cancer patients a node with my cancer involvement would be considered negative but they don't have that proof yet (that will come out in the MLST-II trial in 2022) also giving me a better prognosis. Concerning factors for him were the depth of the tumor. I should also mention that the second pathology report after WLE said my miotic rate was 9! The oncologist didn't really care too much about that but again was more concerned about my tumor depth. He felt my chance of recurrence was more like 20%. So we opted for the watch and wait approach which I'm comfortable with. I have another CT scan and brain MRI scheduled 12/28 and will see the ocologist for the results the same day.

      my questions for all of you are these. Given my grey area factors do I have a good prognosis? Has anyone had their initial tumor froze off therefore presenting as ulceration? In my heart I feel I am more like a stage IIB or IIA (whichever way you want to look at the ulceration) even though clinically I am considered a stage IIIB. What is everyone's thoughts on all this!?

    Viewing 14 reply threads
    • Replies
        mjanssentx
        Participant

          Jenna – I was diagnosed a 3A thirteen months ago.  The two basic options at that time was Interferon and experimental vaccines.  (I chose the Interferon for the clinical benefits of increasing the time for reoccurrence by 6-7 months to just over 13 months.)  I just couldn't go down the watch and wait scenario without trying something.

          TODAY….you have many more options that have been approved in the past 13 months including 3A, 3B, and 3C patients.  If it was me knowing everything that we know today….I would do the adjunctive Yervoy route.  BUT not at the 10 mg/kg rate…but find a way to get the 3 mg/kg rate (there have been several posts on this topic during the past weeks since approval).  Personally I think the risks for the 3 mg/kg level are worth the outcomes and side affects…but the real risks of really bad outcomes for 10 mg tip the scale to not doing it.

          I am counting down for the end of my last two Interferon shots and then I move to close monitoring (PET scans every 3 months).  

          You have to own the decisions…and there are no absolute right/wrongs in your situation…

          Best wishes

          Michel

          mjanssentx
          Participant

            Jenna – I was diagnosed a 3A thirteen months ago.  The two basic options at that time was Interferon and experimental vaccines.  (I chose the Interferon for the clinical benefits of increasing the time for reoccurrence by 6-7 months to just over 13 months.)  I just couldn't go down the watch and wait scenario without trying something.

            TODAY….you have many more options that have been approved in the past 13 months including 3A, 3B, and 3C patients.  If it was me knowing everything that we know today….I would do the adjunctive Yervoy route.  BUT not at the 10 mg/kg rate…but find a way to get the 3 mg/kg rate (there have been several posts on this topic during the past weeks since approval).  Personally I think the risks for the 3 mg/kg level are worth the outcomes and side affects…but the real risks of really bad outcomes for 10 mg tip the scale to not doing it.

            I am counting down for the end of my last two Interferon shots and then I move to close monitoring (PET scans every 3 months).  

            You have to own the decisions…and there are no absolute right/wrongs in your situation…

            Best wishes

            Michel

              Jennab0525
              Participant

                Thank you for your reply Michel. Ipi/Yervoy was also offered to me but both oncologists said the risk of colitis was high (they did not talk about the different dosage levels) so they did not like that route for me. I guess the two main factors in my case is the tumor depth (bad) and the node involvement (good). So I've been doing a ton of research on melanoma and isolated tumor cells and they appear to be very positive but of course not solidly proven yet. I guess that's why I decided on the watch and wait. Had my node involvement been greater, I probably would have done the Ipi or interferon. It wasn't an easy decision that's for sure. I don't like the thought of doing nothing but like I say, the doctors feel my prognosis is good. I've started taking 4000 iui of Vitamin D3 as well as drinking a glass of Pinot Noir once a day for reservatol (not to mention it helps with the stress!! Ha!). When I see the oncologist on the 28th I will bring up the lower does ipi and see what his thought are.  Thanks so much for your advice!!! I hope your side effects aren't too bad from the interferon!

                Jennab0525
                Participant

                  Thank you for your reply Michel. Ipi/Yervoy was also offered to me but both oncologists said the risk of colitis was high (they did not talk about the different dosage levels) so they did not like that route for me. I guess the two main factors in my case is the tumor depth (bad) and the node involvement (good). So I've been doing a ton of research on melanoma and isolated tumor cells and they appear to be very positive but of course not solidly proven yet. I guess that's why I decided on the watch and wait. Had my node involvement been greater, I probably would have done the Ipi or interferon. It wasn't an easy decision that's for sure. I don't like the thought of doing nothing but like I say, the doctors feel my prognosis is good. I've started taking 4000 iui of Vitamin D3 as well as drinking a glass of Pinot Noir once a day for reservatol (not to mention it helps with the stress!! Ha!). When I see the oncologist on the 28th I will bring up the lower does ipi and see what his thought are.  Thanks so much for your advice!!! I hope your side effects aren't too bad from the interferon!

                  Jennab0525
                  Participant

                    Thank you for your reply Michel. Ipi/Yervoy was also offered to me but both oncologists said the risk of colitis was high (they did not talk about the different dosage levels) so they did not like that route for me. I guess the two main factors in my case is the tumor depth (bad) and the node involvement (good). So I've been doing a ton of research on melanoma and isolated tumor cells and they appear to be very positive but of course not solidly proven yet. I guess that's why I decided on the watch and wait. Had my node involvement been greater, I probably would have done the Ipi or interferon. It wasn't an easy decision that's for sure. I don't like the thought of doing nothing but like I say, the doctors feel my prognosis is good. I've started taking 4000 iui of Vitamin D3 as well as drinking a glass of Pinot Noir once a day for reservatol (not to mention it helps with the stress!! Ha!). When I see the oncologist on the 28th I will bring up the lower does ipi and see what his thought are.  Thanks so much for your advice!!! I hope your side effects aren't too bad from the interferon!

                  mjanssentx
                  Participant

                    Jenna – I was diagnosed a 3A thirteen months ago.  The two basic options at that time was Interferon and experimental vaccines.  (I chose the Interferon for the clinical benefits of increasing the time for reoccurrence by 6-7 months to just over 13 months.)  I just couldn't go down the watch and wait scenario without trying something.

                    TODAY….you have many more options that have been approved in the past 13 months including 3A, 3B, and 3C patients.  If it was me knowing everything that we know today….I would do the adjunctive Yervoy route.  BUT not at the 10 mg/kg rate…but find a way to get the 3 mg/kg rate (there have been several posts on this topic during the past weeks since approval).  Personally I think the risks for the 3 mg/kg level are worth the outcomes and side affects…but the real risks of really bad outcomes for 10 mg tip the scale to not doing it.

                    I am counting down for the end of my last two Interferon shots and then I move to close monitoring (PET scans every 3 months).  

                    You have to own the decisions…and there are no absolute right/wrongs in your situation…

                    Best wishes

                    Michel

                    jennunicorn
                    Participant

                      Hi Jenna,

                      I have a similar story to yours. Back in Feb 2014 I noticed an ugly mole growing on my left calf. Watch it for a couple months and decided to contact my primary care doctor in May. She looked at it and decided not to have me see a dermotologist and just told me it was a seborric keratosis…. All summer long it got bigger and darker and uglier. In October I had a different skin issue that I saw a derm about and had them look at the mole.. hoping it could be freezed off or something because I was tired of looking at it. They said it definitley needed to be biopsied and it came back Melanoma Stage IIB ulcerated. I had my SLNB first week of November and had 4 nodes taken out, 3 had melanoma. There was no mention of doing a CLND, thank goodness.. I probably would have opted not to anyway. And my PET & MRI were clear. So I am also Stage IIIB. I was given the two options of watch and wait or Yervoy. If there was a clinical trial open for my stage I would have gone that path, but there won't be one until February, unfortunately. My oncologist did not even offer Interferon as it is considered very old and outdated and basically does nothing. So, I opted to go the Yervoy path. I get my first infusion on Tuesday.

                      I think that our stage makes it really difficult to decide what to do. There is no "right" way to go. I have anxiety issues normally… let alone now that this whole cancer thing has come up. So, for myself, waiting would be extremely hard. So, I feel like doing the treatment will make me feel like I'm "doing something". If I can't handle the side effects then I can quit and not be any worse off. I am 28, and generally a healthy person, so I am hoping that will help aid in an easier treatment course for me.

                      I truely believe our prognosis is good. Even someone with stage IV has a better prognosis than they would have had ten years ago. Science has come a long way! I hope all the best for you and that we both have no recurrences in our future! Thankfully, the advances in Melanoma treatment are amazing and continue to get better every year…. so, if something does come back, then I am confident that the great treatments that are available and will be available will take care of it. 

                      -Jenn

                        Jennab0525
                        Participant

                          Thank you for your response Jenn. I really appreciate your positive outlook on our prognosis, it was something I needed to hear! Like you, I suffered from anxiety long before my diagnosis so this has pretty much sent me over the edge!! Lol! I can't decide if this chat board helps my anxiety or worsens it as many of the stories are of people progressing to Stage IV. It seems no matter how many times the doctors, family and friends tell me I'll be ok and I will live, my thoughts still go to the negative! Maybe after I get a few clear scans under my belt I'll feel a little safer!

                          If I had been in your shoes with three positive nodes I would have definitely chose Yervoy. I REALLY hope you do well on it!! Stay strong my friend! You are young and healthy and I bet you will do great!

                          Jenna

                          Jennab0525
                          Participant

                            Thank you for your response Jenn. I really appreciate your positive outlook on our prognosis, it was something I needed to hear! Like you, I suffered from anxiety long before my diagnosis so this has pretty much sent me over the edge!! Lol! I can't decide if this chat board helps my anxiety or worsens it as many of the stories are of people progressing to Stage IV. It seems no matter how many times the doctors, family and friends tell me I'll be ok and I will live, my thoughts still go to the negative! Maybe after I get a few clear scans under my belt I'll feel a little safer!

                            If I had been in your shoes with three positive nodes I would have definitely chose Yervoy. I REALLY hope you do well on it!! Stay strong my friend! You are young and healthy and I bet you will do great!

                            Jenna

                            Jennab0525
                            Participant

                              Thank you for your response Jenn. I really appreciate your positive outlook on our prognosis, it was something I needed to hear! Like you, I suffered from anxiety long before my diagnosis so this has pretty much sent me over the edge!! Lol! I can't decide if this chat board helps my anxiety or worsens it as many of the stories are of people progressing to Stage IV. It seems no matter how many times the doctors, family and friends tell me I'll be ok and I will live, my thoughts still go to the negative! Maybe after I get a few clear scans under my belt I'll feel a little safer!

                              If I had been in your shoes with three positive nodes I would have definitely chose Yervoy. I REALLY hope you do well on it!! Stay strong my friend! You are young and healthy and I bet you will do great!

                              Jenna

                            jennunicorn
                            Participant

                              Hi Jenna,

                              I have a similar story to yours. Back in Feb 2014 I noticed an ugly mole growing on my left calf. Watch it for a couple months and decided to contact my primary care doctor in May. She looked at it and decided not to have me see a dermotologist and just told me it was a seborric keratosis…. All summer long it got bigger and darker and uglier. In October I had a different skin issue that I saw a derm about and had them look at the mole.. hoping it could be freezed off or something because I was tired of looking at it. They said it definitley needed to be biopsied and it came back Melanoma Stage IIB ulcerated. I had my SLNB first week of November and had 4 nodes taken out, 3 had melanoma. There was no mention of doing a CLND, thank goodness.. I probably would have opted not to anyway. And my PET & MRI were clear. So I am also Stage IIIB. I was given the two options of watch and wait or Yervoy. If there was a clinical trial open for my stage I would have gone that path, but there won't be one until February, unfortunately. My oncologist did not even offer Interferon as it is considered very old and outdated and basically does nothing. So, I opted to go the Yervoy path. I get my first infusion on Tuesday.

                              I think that our stage makes it really difficult to decide what to do. There is no "right" way to go. I have anxiety issues normally… let alone now that this whole cancer thing has come up. So, for myself, waiting would be extremely hard. So, I feel like doing the treatment will make me feel like I'm "doing something". If I can't handle the side effects then I can quit and not be any worse off. I am 28, and generally a healthy person, so I am hoping that will help aid in an easier treatment course for me.

                              I truely believe our prognosis is good. Even someone with stage IV has a better prognosis than they would have had ten years ago. Science has come a long way! I hope all the best for you and that we both have no recurrences in our future! Thankfully, the advances in Melanoma treatment are amazing and continue to get better every year…. so, if something does come back, then I am confident that the great treatments that are available and will be available will take care of it. 

                              -Jenn

                              jennunicorn
                              Participant

                                Hi Jenna,

                                I have a similar story to yours. Back in Feb 2014 I noticed an ugly mole growing on my left calf. Watch it for a couple months and decided to contact my primary care doctor in May. She looked at it and decided not to have me see a dermotologist and just told me it was a seborric keratosis…. All summer long it got bigger and darker and uglier. In October I had a different skin issue that I saw a derm about and had them look at the mole.. hoping it could be freezed off or something because I was tired of looking at it. They said it definitley needed to be biopsied and it came back Melanoma Stage IIB ulcerated. I had my SLNB first week of November and had 4 nodes taken out, 3 had melanoma. There was no mention of doing a CLND, thank goodness.. I probably would have opted not to anyway. And my PET & MRI were clear. So I am also Stage IIIB. I was given the two options of watch and wait or Yervoy. If there was a clinical trial open for my stage I would have gone that path, but there won't be one until February, unfortunately. My oncologist did not even offer Interferon as it is considered very old and outdated and basically does nothing. So, I opted to go the Yervoy path. I get my first infusion on Tuesday.

                                I think that our stage makes it really difficult to decide what to do. There is no "right" way to go. I have anxiety issues normally… let alone now that this whole cancer thing has come up. So, for myself, waiting would be extremely hard. So, I feel like doing the treatment will make me feel like I'm "doing something". If I can't handle the side effects then I can quit and not be any worse off. I am 28, and generally a healthy person, so I am hoping that will help aid in an easier treatment course for me.

                                I truely believe our prognosis is good. Even someone with stage IV has a better prognosis than they would have had ten years ago. Science has come a long way! I hope all the best for you and that we both have no recurrences in our future! Thankfully, the advances in Melanoma treatment are amazing and continue to get better every year…. so, if something does come back, then I am confident that the great treatments that are available and will be available will take care of it. 

                                -Jenn

                                gregor913
                                Participant
                                  The 10mg dose of ippi is given because it has been proven to work at that dose. If the side effects are to much your doctor can lower it. I’m not sure how they can only count two cells. It’s either macro or micro. It’s almost impossible to count every single cancer cell in a node. But micro is better prognosis then macro. The advances in cancer have been great. Look at the many success stories jimmy carter, on the blog, and of course all the stories you will never hear about. Statistics are old and you can’t rely on them. Every person is different. My advice after you figure out your treatment. Take a step away from this blog. It will cause your anxiety to get worse. I’m hoping cancer will one day be just a chronic illness with all the advances it looks like it might.
                                  gregor913
                                  Participant
                                    The 10mg dose of ippi is given because it has been proven to work at that dose. If the side effects are to much your doctor can lower it. I’m not sure how they can only count two cells. It’s either macro or micro. It’s almost impossible to count every single cancer cell in a node. But micro is better prognosis then macro. The advances in cancer have been great. Look at the many success stories jimmy carter, on the blog, and of course all the stories you will never hear about. Statistics are old and you can’t rely on them. Every person is different. My advice after you figure out your treatment. Take a step away from this blog. It will cause your anxiety to get worse. I’m hoping cancer will one day be just a chronic illness with all the advances it looks like it might.
                                    gregor913
                                    Participant
                                      The 10mg dose of ippi is given because it has been proven to work at that dose. If the side effects are to much your doctor can lower it. I’m not sure how they can only count two cells. It’s either macro or micro. It’s almost impossible to count every single cancer cell in a node. But micro is better prognosis then macro. The advances in cancer have been great. Look at the many success stories jimmy carter, on the blog, and of course all the stories you will never hear about. Statistics are old and you can’t rely on them. Every person is different. My advice after you figure out your treatment. Take a step away from this blog. It will cause your anxiety to get worse. I’m hoping cancer will one day be just a chronic illness with all the advances it looks like it might.
                                      gregor913
                                      Participant
                                        The 10mg dose of ippi is given because it has been proven to work at that dose. If the side effects are to much your doctor can lower it. I’m not sure how they can only count two cells. It’s either macro or micro. It’s almost impossible to count every single cancer cell in a node. But micro is better prognosis then macro. The advances in cancer have been great. Look at the many success stories jimmy carter, on the blog, and of course all the stories you will never hear about. Statistics are old and you can’t rely on them. Every person is different. My advice after you figure out your treatment. Take a step away from this blog. It will cause your anxiety to get worse. I’m hoping cancer will one day be just a chronic illness with all the advances it looks like it might.
                                        gregor913
                                        Participant
                                          The 10mg dose of ippi is given because it has been proven to work at that dose. If the side effects are to much your doctor can lower it. I’m not sure how they can only count two cells. It’s either macro or micro. It’s almost impossible to count every single cancer cell in a node. But micro is better prognosis then macro. The advances in cancer have been great. Look at the many success stories jimmy carter, on the blog, and of course all the stories you will never hear about. Statistics are old and you can’t rely on them. Every person is different. My advice after you figure out your treatment. Take a step away from this blog. It will cause your anxiety to get worse. I’m hoping cancer will one day be just a chronic illness with all the advances it looks like it might.
                                          gregor913
                                          Participant
                                            The 10mg dose of ippi is given because it has been proven to work at that dose. If the side effects are to much your doctor can lower it. I’m not sure how they can only count two cells. It’s either macro or micro. It’s almost impossible to count every single cancer cell in a node. But micro is better prognosis then macro. The advances in cancer have been great. Look at the many success stories jimmy carter, on the blog, and of course all the stories you will never hear about. Statistics are old and you can’t rely on them. Every person is different. My advice after you figure out your treatment. Take a step away from this blog. It will cause your anxiety to get worse. I’m hoping cancer will one day be just a chronic illness with all the advances it looks like it might.
                                            gregor913
                                            Participant
                                              Stage
                                              3b because I was ulcerated. Microscopic in the sentinol node. I did a clnd in left armpit. Took out another 11 nodes all negative. I’m currently recovering from clnd. Will start yervoy because interferon doesn’t have studies to back it up. Greg
                                              gregor913
                                              Participant
                                                Stage
                                                3b because I was ulcerated. Microscopic in the sentinol node. I did a clnd in left armpit. Took out another 11 nodes all negative. I’m currently recovering from clnd. Will start yervoy because interferon doesn’t have studies to back it up. Greg
                                                  aspen22
                                                  Participant

                                                    I am so sorry you are joning the melanoma club, but I am so glad to find another member with ITC in the sentinal node. My story is very similar… had a .45mm melanoma removed from my right shoulder blade in April. I had 0 mitotic rate and no ulceration, but was given the option for a LN biopsy since my clark's level was IV. Being a 33 year old mother of four, I decided to do it even though I had a 4% chance of it spreading. To my complete suprise they found a singular isolated cell in my sentinal node which was S100 negative but Melan-A positive. I had a CLND and all came back clear, along with my scans so I am 3A. 

                                                    After a ton of research I decided against Interferon and chose to take part in a clinical trial. It's a vaccine where they take 23 different anitgens from melanoma cell lines. I had to go every-other-week for a few months to get 4 injections, but now I am down to once a month. In a few months I wil be down to every three months, until I hit two years (I started this August). It is the POLY 103 vaccine. I decided to go this route becuase it was a phase III trial. The effects are very minimal (I get a little tired for a day or two, and I have reactions at the injections sites which are itchy, red, hard bumps).  A third of all trail particiapnts are on placebo, but I was ok with that since I feel my chance a reccurance is very low. Yervoy was't approved when I had to make the decision to do treatment so I have not studied much on that front. 

                                                    Melanoma is so tricky, there isn't a right answer. We just have to make decisions based on how we feel at the time and trust it's the rght answer at the time. I feel very confident that I am doing all I can do, and while the worry of recurrance is always in the back of my mind, I feel like so mmay people who had a wose prgnosis are doing great and never reccured! I plan to be one of those people. 

                                                    aspen22
                                                    Participant

                                                      I am so sorry you are joning the melanoma club, but I am so glad to find another member with ITC in the sentinal node. My story is very similar… had a .45mm melanoma removed from my right shoulder blade in April. I had 0 mitotic rate and no ulceration, but was given the option for a LN biopsy since my clark's level was IV. Being a 33 year old mother of four, I decided to do it even though I had a 4% chance of it spreading. To my complete suprise they found a singular isolated cell in my sentinal node which was S100 negative but Melan-A positive. I had a CLND and all came back clear, along with my scans so I am 3A. 

                                                      After a ton of research I decided against Interferon and chose to take part in a clinical trial. It's a vaccine where they take 23 different anitgens from melanoma cell lines. I had to go every-other-week for a few months to get 4 injections, but now I am down to once a month. In a few months I wil be down to every three months, until I hit two years (I started this August). It is the POLY 103 vaccine. I decided to go this route becuase it was a phase III trial. The effects are very minimal (I get a little tired for a day or two, and I have reactions at the injections sites which are itchy, red, hard bumps).  A third of all trail particiapnts are on placebo, but I was ok with that since I feel my chance a reccurance is very low. Yervoy was't approved when I had to make the decision to do treatment so I have not studied much on that front. 

                                                      Melanoma is so tricky, there isn't a right answer. We just have to make decisions based on how we feel at the time and trust it's the rght answer at the time. I feel very confident that I am doing all I can do, and while the worry of recurrance is always in the back of my mind, I feel like so mmay people who had a wose prgnosis are doing great and never reccured! I plan to be one of those people. 

                                                      aspen22
                                                      Participant

                                                        I am so sorry you are joning the melanoma club, but I am so glad to find another member with ITC in the sentinal node. My story is very similar… had a .45mm melanoma removed from my right shoulder blade in April. I had 0 mitotic rate and no ulceration, but was given the option for a LN biopsy since my clark's level was IV. Being a 33 year old mother of four, I decided to do it even though I had a 4% chance of it spreading. To my complete suprise they found a singular isolated cell in my sentinal node which was S100 negative but Melan-A positive. I had a CLND and all came back clear, along with my scans so I am 3A. 

                                                        After a ton of research I decided against Interferon and chose to take part in a clinical trial. It's a vaccine where they take 23 different anitgens from melanoma cell lines. I had to go every-other-week for a few months to get 4 injections, but now I am down to once a month. In a few months I wil be down to every three months, until I hit two years (I started this August). It is the POLY 103 vaccine. I decided to go this route becuase it was a phase III trial. The effects are very minimal (I get a little tired for a day or two, and I have reactions at the injections sites which are itchy, red, hard bumps).  A third of all trail particiapnts are on placebo, but I was ok with that since I feel my chance a reccurance is very low. Yervoy was't approved when I had to make the decision to do treatment so I have not studied much on that front. 

                                                        Melanoma is so tricky, there isn't a right answer. We just have to make decisions based on how we feel at the time and trust it's the rght answer at the time. I feel very confident that I am doing all I can do, and while the worry of recurrance is always in the back of my mind, I feel like so mmay people who had a wose prgnosis are doing great and never reccured! I plan to be one of those people. 

                                                      gregor913
                                                      Participant
                                                        Stage
                                                        3b because I was ulcerated. Microscopic in the sentinol node. I did a clnd in left armpit. Took out another 11 nodes all negative. I’m currently recovering from clnd. Will start yervoy because interferon doesn’t have studies to back it up. Greg
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