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Melanoma Stage 1 A … need some advise!
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Melanoma Stage 1 A … need some advise!

› Forums › General Melanoma Community › Melanoma Stage 1 A … need some advise!

  • Post
    • December 28, 2016 at 9:42 pm
    MelissaMW
    Participant

      Hello, my name is Melissa. I'm a mom of a 9 month old daughter and I was just diagnosed with a 1 a Melanoma. Right now I'm very confused and worried. I had a mole checked out on my forearm a week ago and wasn't expecting these results at all. I do not now how to cope with this right now since I just lost my mother to a stage III cancer with peritoneal carcinosis. My Dermatologist keeps telling me to not worry since I caught it early. He also tells me that I do not have to go see an oncologist. He did refer me to an plastic surgeon to get more skin cut out. I was wondering if you could give me some more info? Should I go see an oncologist? Really how bad is this diagnosis? Also, I'm very fair and blonde so I have lots of moles an freckles all over the place. How do I know which ones are dangerous? How am I even able to check all of them and notice changes?

       

      This is what my report reads

       

      -early malignant melanoma, superficial spreading type

      – possibly arising at the site of a precursor nevus

      -breslow depth 0.24mm 

      -clarks level II

      -no ulceration present 

      -dermal mitocic index zero per square millimeter

      -no microsstellitosis present 

      -no lymph-vascular invasion identified

      -in situ melanoma closely approximately and may involve a lateral edge of the biopsy 

       

       

      Really looking forward to any advise and help. Thanks. 

       

       

       

    Viewing 8 reply threads
    • Replies
        • December 28, 2016 at 10:09 pm
        Sophietx
        Participant

          Sorry that you are here. From what I know. If you are really worried than you might want to consider 2nd opinion on pathology. That's what I would do if my melanoma was invasive. Always good to have a 2nd opinion – preferably from a melanoma center. Also I would transfer your care to a melanoma center. And consider getting mole mapping. I had melanoma in situ and I am scheduled for it next month. Stage 1 has excellent prognosis. Good luck!

          • December 28, 2016 at 10:09 pm
          Sophietx
          Participant

            Sorry that you are here. From what I know. If you are really worried than you might want to consider 2nd opinion on pathology. That's what I would do if my melanoma was invasive. Always good to have a 2nd opinion – preferably from a melanoma center. Also I would transfer your care to a melanoma center. And consider getting mole mapping. I had melanoma in situ and I am scheduled for it next month. Stage 1 has excellent prognosis. Good luck!

            • December 28, 2016 at 10:09 pm
            Sophietx
            Participant

              Sorry that you are here. From what I know. If you are really worried than you might want to consider 2nd opinion on pathology. That's what I would do if my melanoma was invasive. Always good to have a 2nd opinion – preferably from a melanoma center. Also I would transfer your care to a melanoma center. And consider getting mole mapping. I had melanoma in situ and I am scheduled for it next month. Stage 1 has excellent prognosis. Good luck!

              • December 29, 2016 at 10:13 am
              JC
              Participant

                the number one prognostic indicator is depth, and yours was .24. excellent prognosis

                • December 29, 2016 at 10:13 am
                JC
                Participant

                  the number one prognostic indicator is depth, and yours was .24. excellent prognosis

                  • December 29, 2016 at 10:13 am
                  JC
                  Participant

                    the number one prognostic indicator is depth, and yours was .24. excellent prognosis

                    • December 29, 2016 at 1:26 pm
                    Janner
                    Participant

                      Oncologists generally don't see people at stage 1a because they have nothing to offer them.  Stage 1a is basically considered 'cured' after surgery.  Not to say you have 100% survival rates because stage 1a doesn't (high 90's), but there is absolutely no treatment besides surgery that can be offered to stage 1a.  And in the realm of stage 1a, yours is considered very early.

                      As for your other moles, monitor for change!  It's not common to have more than one melanoma primary – about 10% do.  Consider having baseline photos taken so you can monitor.   There are some derms out there that do Mole Mapping – actively taking photos and monitoring at each visit – but they are hard to find.  2nd to that is having whole body photography which gives you baseline photos you can use to monitor yours for change. 

                      • December 29, 2016 at 1:26 pm
                      Janner
                      Participant

                        Oncologists generally don't see people at stage 1a because they have nothing to offer them.  Stage 1a is basically considered 'cured' after surgery.  Not to say you have 100% survival rates because stage 1a doesn't (high 90's), but there is absolutely no treatment besides surgery that can be offered to stage 1a.  And in the realm of stage 1a, yours is considered very early.

                        As for your other moles, monitor for change!  It's not common to have more than one melanoma primary – about 10% do.  Consider having baseline photos taken so you can monitor.   There are some derms out there that do Mole Mapping – actively taking photos and monitoring at each visit – but they are hard to find.  2nd to that is having whole body photography which gives you baseline photos you can use to monitor yours for change. 

                          • December 29, 2016 at 1:55 pm
                          JC
                          Participant

                            and remember nothing is 100% survival.  anything can happen – car crash, incident, other illness. . . it's life, anything can happen so don't let the fact that this is not 100% survival get you down, nothing in life is 100% survival.  high 90's is pretty darn good.

                             

                             

                            • December 29, 2016 at 1:55 pm
                            JC
                            Participant

                              and remember nothing is 100% survival.  anything can happen – car crash, incident, other illness. . . it's life, anything can happen so don't let the fact that this is not 100% survival get you down, nothing in life is 100% survival.  high 90's is pretty darn good.

                               

                               

                              • December 29, 2016 at 8:56 pm
                              MelissaMW
                              Participant

                                Thank you so much for this. I just got back from the plastic surgeon today and I'm having a WLE done on the 3rd. I also did manage to find a dermatologist that does mole mapping and have an appointment for that on the 5th. Wish you all a happy new year! 

                                • December 29, 2016 at 8:56 pm
                                MelissaMW
                                Participant

                                  Thank you so much for this. I just got back from the plastic surgeon today and I'm having a WLE done on the 3rd. I also did manage to find a dermatologist that does mole mapping and have an appointment for that on the 5th. Wish you all a happy new year! 

                                  • December 29, 2016 at 8:56 pm
                                  MelissaMW
                                  Participant

                                    Thank you so much for this. I just got back from the plastic surgeon today and I'm having a WLE done on the 3rd. I also did manage to find a dermatologist that does mole mapping and have an appointment for that on the 5th. Wish you all a happy new year! 

                                    • December 29, 2016 at 1:55 pm
                                    JC
                                    Participant

                                      and remember nothing is 100% survival.  anything can happen – car crash, incident, other illness. . . it's life, anything can happen so don't let the fact that this is not 100% survival get you down, nothing in life is 100% survival.  high 90's is pretty darn good.

                                       

                                       

                                      • December 29, 2016 at 11:45 pm
                                      MelissaMW
                                      Participant

                                        I was also wondering what you guys think on having a sentinel lymph node biopsy done? My surgeon doesn't seem to think it's neccassary with my diagnosis. 

                                        • December 29, 2016 at 11:47 pm
                                        jennunicorn
                                        Participant

                                          Too invasive for such a low risk. Likely insurance would not cover either. Really no need to do SLNB for your case.

                                          • December 29, 2016 at 11:47 pm
                                          jennunicorn
                                          Participant

                                            Too invasive for such a low risk. Likely insurance would not cover either. Really no need to do SLNB for your case.

                                            • December 29, 2016 at 11:47 pm
                                            jennunicorn
                                            Participant

                                              Too invasive for such a low risk. Likely insurance would not cover either. Really no need to do SLNB for your case.

                                              • January 1, 2017 at 2:14 am
                                              MelissaMW
                                              Participant

                                                I didn't mention that I had a shave biopsy done. I'm worried that they weren't able to determine the full depth of it. My husband says it's clear by reading the report that they were able to determine the full depth. Is that right? Should I insist on having the SLNB done anyways just to be sure because of this? Just trying to make the right the discussions here and really appreciate all the help.

                                                • January 1, 2017 at 2:14 am
                                                MelissaMW
                                                Participant

                                                  I didn't mention that I had a shave biopsy done. I'm worried that they weren't able to determine the full depth of it. My husband says it's clear by reading the report that they were able to determine the full depth. Is that right? Should I insist on having the SLNB done anyways just to be sure because of this? Just trying to make the right the discussions here and really appreciate all the help.

                                                  • January 1, 2017 at 2:14 am
                                                  MelissaMW
                                                  Participant

                                                    I didn't mention that I had a shave biopsy done. I'm worried that they weren't able to determine the full depth of it. My husband says it's clear by reading the report that they were able to determine the full depth. Is that right? Should I insist on having the SLNB done anyways just to be sure because of this? Just trying to make the right the discussions here and really appreciate all the help.

                                                    • January 1, 2017 at 3:13 pm
                                                    Janner
                                                    Participant

                                                      Shave biopsies are perfectly fine IF the deep margin is clear.  A shave biopsy with a clear deep margin is just as accurate as any other type of biopsy and would not change the determination to have a SNB.  At .24mm, most shave biopsies will have clear margins because that is so shallow.  I had a shave biopsy on my 3rd melanoma with a clear deep margin and my melanoma was .88mm.  (I did not have a SNB as my lesion was under 1mm).

                                                      • January 1, 2017 at 3:13 pm
                                                      Janner
                                                      Participant

                                                        Shave biopsies are perfectly fine IF the deep margin is clear.  A shave biopsy with a clear deep margin is just as accurate as any other type of biopsy and would not change the determination to have a SNB.  At .24mm, most shave biopsies will have clear margins because that is so shallow.  I had a shave biopsy on my 3rd melanoma with a clear deep margin and my melanoma was .88mm.  (I did not have a SNB as my lesion was under 1mm).

                                                        • January 1, 2017 at 3:13 pm
                                                        Janner
                                                        Participant

                                                          Shave biopsies are perfectly fine IF the deep margin is clear.  A shave biopsy with a clear deep margin is just as accurate as any other type of biopsy and would not change the determination to have a SNB.  At .24mm, most shave biopsies will have clear margins because that is so shallow.  I had a shave biopsy on my 3rd melanoma with a clear deep margin and my melanoma was .88mm.  (I did not have a SNB as my lesion was under 1mm).

                                                          • January 1, 2017 at 4:19 pm
                                                          MelissaMW
                                                          Participant

                                                            Thank you Janner! Happy new year to you! 

                                                            • January 1, 2017 at 4:19 pm
                                                            MelissaMW
                                                            Participant

                                                              Thank you Janner! Happy new year to you! 

                                                              • January 1, 2017 at 4:19 pm
                                                              MelissaMW
                                                              Participant

                                                                Thank you Janner! Happy new year to you! 

                                                                • December 29, 2016 at 11:45 pm
                                                                MelissaMW
                                                                Participant

                                                                  I was also wondering what you guys think on having a sentinel lymph node biopsy done? My surgeon doesn't seem to think it's neccassary with my diagnosis. 

                                                                  • December 29, 2016 at 11:45 pm
                                                                  MelissaMW
                                                                  Participant

                                                                    I was also wondering what you guys think on having a sentinel lymph node biopsy done? My surgeon doesn't seem to think it's neccassary with my diagnosis. 

                                                                  • December 29, 2016 at 1:26 pm
                                                                  Janner
                                                                  Participant

                                                                    Oncologists generally don't see people at stage 1a because they have nothing to offer them.  Stage 1a is basically considered 'cured' after surgery.  Not to say you have 100% survival rates because stage 1a doesn't (high 90's), but there is absolutely no treatment besides surgery that can be offered to stage 1a.  And in the realm of stage 1a, yours is considered very early.

                                                                    As for your other moles, monitor for change!  It's not common to have more than one melanoma primary – about 10% do.  Consider having baseline photos taken so you can monitor.   There are some derms out there that do Mole Mapping – actively taking photos and monitoring at each visit – but they are hard to find.  2nd to that is having whole body photography which gives you baseline photos you can use to monitor yours for change. 

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