Looking for some advice

I provided my last update here: https://melanoma.org/legacy/find-support/patient-community/mpip-melanoma-patients-information-page/another-update-1

Here’s some info from my pathology report(s):
Tumor Site: Skin of scalp and neck
Histologic Type: Melanoma arising from blue nevus
Maximum Tumor (Breslow) Thickness in Millimeters: At least: 8.00 Millimeters (mm)
Tumor Extent:
Macroscopic Satellite Nodule(s): Not identified
Ulceration: Not identified
Anatomic (Clark) Level: V (Melanoma invades subcutis)
Accessory Findings:
Mitotic Rate: None identified
Microsatellite(s): Not identified
Lymphovascular Invasion: Not identified
Neurotropism: Not identified
Tumor Regression: Not identified
Perineurial Invasion: Appreciated
LYMPH NODES:
Number of Lymph Nodes Involved: 0
Number of Lymph Nodes Examined: 2
Number of Sentinel Nodes Examined: 2
PATHOLOGIC STAGE CLASSIFICATION (pTNM, AJCC 8th Edition):
Primary Tumor (pT): pT4a
Regional Lymph Nodes (pN): pN0

So, it was a large enough tumor that had invaded my nerves and the subcutaneous region. Obviously given its size, it’s a cause for concern.

WLE & SNB were clear – no evidence of residual cellular blue nevus or melanoma, but as can be seen from Tex’s history that doesn’t necessarily matter. He had distant metastasis within 6 months, and he thinks it may have spread via his blood and left the lymph nodes alone. He also had melanoma in his scalp (as did I), but his tumor was a different size and I think it was ulcerated and it wasn’t melanoma ex blue nevus like mine so technically different types of melanoma.

Now, I don’t have intravascular invasion, and the nerves it invaded didn’t go anywhere important, but despite the intravascular invasion the depth of the tumor just worries the hell out of me.

Up until now I’ve been dealing with a surgical oncologist and he is going to close me up on Friday. I have a 5cm x 5cm hole in my scalp, you could almost fit a hockey puck in there, and you can see my freaking skull. It’s unnerving. I’m looking forward to it being closed.

Once he is done I’ve asked to be seen by the melanoma specialist at Duke – Dr. April Salama. Some of the great people on here have worked with her in the past.

I want her to establish a baseline PET scan, because the CT they did of my abdomen, while it said no evidence of metastasis it did note 3 lesions that were too small to classify – one of which hasn’t changed since it was last identified (march of 2019), so I want these lesions monitored to see what they are.

My question really is – how does my approach sound to you? Should I be doing anything else? I’m going to leave it up to Dr. Salama to determine next steps after the baseline. I guess I’d really like to be put on some sort of immunotherapy just to be safe, or safer really, as a preventative. This melanoma had some nasty, nasty chromosomal aberrations. I don’t think I’m BRAF positive, but I’ll let her decide that as I’m not a pathologist. I’m assuming I should be put on Nivolumab (Op Divo).

I just don’t want to do nothing and find out in a few months i have distant metastasis. If it can be prevented I would love to act now.

Thank you for listening/reading.

Thoughts?