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my story and wondering if anyone has info on this new study

Forums Cutaneous Melanoma Community my story and wondering if anyone has info on this new study

  • Post
    carli
    Participant
      I was diagnosed with MM in Dec. 2011. I had a WLE 1 full cm. margin to level of fascia one week after being diagnosed. I went to an oncologist a month later, even though my derm said it was not necessary. The oncologist said, “They took a pretty big chunk out of your leg.” She reassured me that I had done everything that is required for my stage and that my scar looked great. I know that I have learned a lot about this over the last year and a half and I wanted to get opinions from all of you on my path report.

      I was diagnosed with MM in Dec. 2011. I had a WLE 1 full cm. margin to level of fascia one week after being diagnosed. I went to an oncologist a month later, even though my derm said it was not necessary. The oncologist said, “They took a pretty big chunk out of your leg.” She reassured me that I had done everything that is required for my stage and that my scar looked great. I know that I have learned a lot about this over the last year and a half and I wanted to get opinions from all of you on my path report. I have visited this site often over the past year and have finally built up the courage to join. I realize that support is necessary forever. I am a 35 year old mother and I always worry about this cancer returning. I sometimes feel like I worry about this too much and I could use your advice and opinions. I know you are not all drs.but I believe patients have a lot to share too, especially on the more personal levels. Thank you. I am also wondering if anyone knows anything more about this study that was just published in the, Journal of American Surgeons. When I read studies like this I realize that this is something that will affect me forever. I do appreciate my life and try to live each day to it’s potential, but some days I wake up with MEL on my mind.

      http://www.journalacs.org/article/S1072-7515(13)00225-1/abstract

      The original mole was one that I had forever. It started to change after my pregnancy. My daughter is now 10

      FINAL DIAGNOSES: Melanoma, narrowly excised in planes of sections examined (skin, left medial lower leg, shave biopsy)
      Histological subtype: spitzoid
      Breslow thickness: .31mm
      Clark level : II
      Ulceration: none
      Mitotic rate: none
      vertical growth phase: no
      vascular invasion: no
      angiotropism: no
      neural invasion: no
      microsatellites: no
      features of regression:
      Early (TILS) Yes, non-brisk
      Intermediate (angiofibroplasia with or without TILS): No
      Late ( fibrosis and loss of rete ridges) : no
      precursor lesion: none identified
      predominant cell type: spitzoid
      microscopic description: Sections of a scoop excision of skin reveal an atypical compound melanocytic proliferation. The junctional melanocytes are plemorphic and show both prominent nucleoli and nuclear pseudo inclusions. There are expansile nests and single cells with focal pagetoid upward migration. The underlying papillary dermis contains fibroplasia. Patchy perivascular lymphocytic infiltrates and a rare nested melanocytes. Dermal mitotic figures are not identified.

    Viewing 14 reply threads
    • Replies
        JC
        Participant

          Perhaps I'm reading the study incorrectly, but it doesn't appear to be anything new…those with higher risk lesions tend to recur earlier, those who recur later can be those who did not have higher risk lesions ( thin and nonulcerated) which is the same information represented in the overall statistics given for Stage1 Melanomas. There will be percentage that recur- no 100% clear rhyme or reason. That's just the way it is and this is the part of (any) cancer survivorship

          JC
          Participant

            Perhaps I'm reading the study incorrectly, but it doesn't appear to be anything new…those with higher risk lesions tend to recur earlier, those who recur later can be those who did not have higher risk lesions ( thin and nonulcerated) which is the same information represented in the overall statistics given for Stage1 Melanomas. There will be percentage that recur- no 100% clear rhyme or reason. That's just the way it is and this is the part of (any) cancer survivorship

              becky15
              Participant
                But remember that stage 1 can be as deep as 2mm if not ulcerated, a far cry from 0.3mm
                becky15
                Participant
                  But remember that stage 1 can be as deep as 2mm if not ulcerated, a far cry from 0.3mm
                  becky15
                  Participant
                    But remember that stage 1 can be as deep as 2mm if not ulcerated, a far cry from 0.3mm
                  JC
                  Participant

                    Perhaps I'm reading the study incorrectly, but it doesn't appear to be anything new…those with higher risk lesions tend to recur earlier, those who recur later can be those who did not have higher risk lesions ( thin and nonulcerated) which is the same information represented in the overall statistics given for Stage1 Melanomas. There will be percentage that recur- no 100% clear rhyme or reason. That's just the way it is and this is the part of (any) cancer survivorship

                    HopefulOne
                    Participant

                      Hi there – first off, happy to hear they have taken care of your melanoma. Unfortunately I don't fully understand your pathology report. I will share, however, my thoughts – not to scare you but to hopefully educate you and ensure this doesn't happen to you. My husband had melanoma 18 years ago – Stage 1. Every year he followed up with his dermatologist who assured him he was fine. When he found a lump under his right arm pit in September 2012, he went to his dermatologist concerned it was cancer. The dermatologist assured him he was fine. But my husband knew something was wrong. He got an appointment with a surgical oncologist who immediately upon hearing my husband's story of melanoma and felt the lump said it was the melanoma that had returned. He subsequently had that and 30 other lymph nodes taken out, 11 of which were positive for melanoma. He was diagnosed Stage 3C, just in May, his melanoma returned as a tumor at his spinal cord. He's now Stage 4. Again, not to scare you, but this is my message: if you've had melanoma CONTINUE to be monitored. DEMAND appropriate tests (CT, MRI, PET) at certain intervals. Take that study with you and say you want to be monitored. Listen to your intuitition – thank god my husband did. I only wish I had learned more about the disease and been the nervous nelly that had suggested my husband had tests earlier to have caught the melanoma's return before it had spread so much. I was very happy to have seen this study and hopefully it educates people to be followed up for life. Hopefully it never returns … but if, god forbid, it does … you can catch it earlier. Best of luck to you!

                      HopefulOne
                      Participant

                        Hi there – first off, happy to hear they have taken care of your melanoma. Unfortunately I don't fully understand your pathology report. I will share, however, my thoughts – not to scare you but to hopefully educate you and ensure this doesn't happen to you. My husband had melanoma 18 years ago – Stage 1. Every year he followed up with his dermatologist who assured him he was fine. When he found a lump under his right arm pit in September 2012, he went to his dermatologist concerned it was cancer. The dermatologist assured him he was fine. But my husband knew something was wrong. He got an appointment with a surgical oncologist who immediately upon hearing my husband's story of melanoma and felt the lump said it was the melanoma that had returned. He subsequently had that and 30 other lymph nodes taken out, 11 of which were positive for melanoma. He was diagnosed Stage 3C, just in May, his melanoma returned as a tumor at his spinal cord. He's now Stage 4. Again, not to scare you, but this is my message: if you've had melanoma CONTINUE to be monitored. DEMAND appropriate tests (CT, MRI, PET) at certain intervals. Take that study with you and say you want to be monitored. Listen to your intuitition – thank god my husband did. I only wish I had learned more about the disease and been the nervous nelly that had suggested my husband had tests earlier to have caught the melanoma's return before it had spread so much. I was very happy to have seen this study and hopefully it educates people to be followed up for life. Hopefully it never returns … but if, god forbid, it does … you can catch it earlier. Best of luck to you!

                        HopefulOne
                        Participant

                          Hi there – first off, happy to hear they have taken care of your melanoma. Unfortunately I don't fully understand your pathology report. I will share, however, my thoughts – not to scare you but to hopefully educate you and ensure this doesn't happen to you. My husband had melanoma 18 years ago – Stage 1. Every year he followed up with his dermatologist who assured him he was fine. When he found a lump under his right arm pit in September 2012, he went to his dermatologist concerned it was cancer. The dermatologist assured him he was fine. But my husband knew something was wrong. He got an appointment with a surgical oncologist who immediately upon hearing my husband's story of melanoma and felt the lump said it was the melanoma that had returned. He subsequently had that and 30 other lymph nodes taken out, 11 of which were positive for melanoma. He was diagnosed Stage 3C, just in May, his melanoma returned as a tumor at his spinal cord. He's now Stage 4. Again, not to scare you, but this is my message: if you've had melanoma CONTINUE to be monitored. DEMAND appropriate tests (CT, MRI, PET) at certain intervals. Take that study with you and say you want to be monitored. Listen to your intuitition – thank god my husband did. I only wish I had learned more about the disease and been the nervous nelly that had suggested my husband had tests earlier to have caught the melanoma's return before it had spread so much. I was very happy to have seen this study and hopefully it educates people to be followed up for life. Hopefully it never returns … but if, god forbid, it does … you can catch it earlier. Best of luck to you!

                          JC
                          Participant

                            I'm a different Anonymous than the poster, but that story is exactly what scares the heck out of me as a Stage I patient

                            JC
                            Participant

                              I'm a different Anonymous than the poster, but that story is exactly what scares the heck out of me as a Stage I patient

                              JC
                              Participant

                                I'm a different Anonymous than the poster, but that story is exactly what scares the heck out of me as a Stage I patient

                                Janner
                                Participant

                                  I haven't had time to look at the study you posted, but your pathology looks extremely low risk stage IA.  Easy to say, but I honestly wouldn't be wasting any time worrying about it.  First, it helps nothing, and second, it's unlikely you'll ever experience a recurrence from this lesion.  Why waste time worrying when you could be doing much more productive things?!?!???

                                  The other thing I might suggest is staying off this site.  Most people like you, a year and a half after diagnosis from an early stage lesion, have moved on.  You see those that recur, you don't see the vast majority of success stories.  This place is really more geared to newly diagnosed and those actively fighting melanoma.  I think you might ease your anxiety and worrying a bit if you could move your focus away from a site like this.  It's a great place if you have questions, but it will never give you a realistic view of people who are stage IA.

                                  Best wishes,

                                  Janner

                                  Janner
                                  Participant

                                    I haven't had time to look at the study you posted, but your pathology looks extremely low risk stage IA.  Easy to say, but I honestly wouldn't be wasting any time worrying about it.  First, it helps nothing, and second, it's unlikely you'll ever experience a recurrence from this lesion.  Why waste time worrying when you could be doing much more productive things?!?!???

                                    The other thing I might suggest is staying off this site.  Most people like you, a year and a half after diagnosis from an early stage lesion, have moved on.  You see those that recur, you don't see the vast majority of success stories.  This place is really more geared to newly diagnosed and those actively fighting melanoma.  I think you might ease your anxiety and worrying a bit if you could move your focus away from a site like this.  It's a great place if you have questions, but it will never give you a realistic view of people who are stage IA.

                                    Best wishes,

                                    Janner

                                    Janner
                                    Participant

                                      I haven't had time to look at the study you posted, but your pathology looks extremely low risk stage IA.  Easy to say, but I honestly wouldn't be wasting any time worrying about it.  First, it helps nothing, and second, it's unlikely you'll ever experience a recurrence from this lesion.  Why waste time worrying when you could be doing much more productive things?!?!???

                                      The other thing I might suggest is staying off this site.  Most people like you, a year and a half after diagnosis from an early stage lesion, have moved on.  You see those that recur, you don't see the vast majority of success stories.  This place is really more geared to newly diagnosed and those actively fighting melanoma.  I think you might ease your anxiety and worrying a bit if you could move your focus away from a site like this.  It's a great place if you have questions, but it will never give you a realistic view of people who are stage IA.

                                      Best wishes,

                                      Janner

                                      KnowThyself
                                      Participant

                                        I was also recently diagnosed level II, stage 1A, .8mm deep, non ulcerated…. I worried myself into a depressed state, wondering about all the 'what if's"…. Sometimes all it takes is that one person to give their honest human advice, to make a world of difference in what you feel… That one person for me, was my primary care physician. He was there when i was born, he was there for the first biopsy just this past April, and after a full excision, and a wide excision with a skin graft, they still didnt get it all, so im due for another surgery… I hadnt received an actual depth on any of my path reports up until this most recent one. .8mm…Borderline concerning to me.  However, this lesion was so "histologically difficult and borderline in nature" between severe atypia and and the differential diagnosis of malignant melanoma, I was wondering if they were taking all the necessary precautions if it were in fact the latter of the two…. I hadn't returned to my primary doc since the original biopsy, and i value his opinion, so I wanted to see him before I went through with this next surgery to make sure it was absolutely necessary…..He started by weighing out the pros and cons to continuing with surgery until we get it all… He said absolutely go ahead with it, however not to worry about anything else in the meantime. If it were going to spread, it would have, and it also wouldnt have been such a low risk lesion, low stage, thin, no mitotic rate… It would have been big and obvious, and there would be much less question about it. Just clean margins alone would be so very reassuring…. SO, with that said, if yours is gone, and you have clean margins, and no other symptoms, just keep an eye on yourself. You know your body better than anyone, but as far as standard of care for these stage 1 melanomas, you and I are being taken care of.  If you need your own honest human opinion, go to someone whose opinion you value. whose word you trust. And that will be all you need. 🙂 Best wishes and good luck.

                                        KnowThyself
                                        Participant

                                          I was also recently diagnosed level II, stage 1A, .8mm deep, non ulcerated…. I worried myself into a depressed state, wondering about all the 'what if's"…. Sometimes all it takes is that one person to give their honest human advice, to make a world of difference in what you feel… That one person for me, was my primary care physician. He was there when i was born, he was there for the first biopsy just this past April, and after a full excision, and a wide excision with a skin graft, they still didnt get it all, so im due for another surgery… I hadnt received an actual depth on any of my path reports up until this most recent one. .8mm…Borderline concerning to me.  However, this lesion was so "histologically difficult and borderline in nature" between severe atypia and and the differential diagnosis of malignant melanoma, I was wondering if they were taking all the necessary precautions if it were in fact the latter of the two…. I hadn't returned to my primary doc since the original biopsy, and i value his opinion, so I wanted to see him before I went through with this next surgery to make sure it was absolutely necessary…..He started by weighing out the pros and cons to continuing with surgery until we get it all… He said absolutely go ahead with it, however not to worry about anything else in the meantime. If it were going to spread, it would have, and it also wouldnt have been such a low risk lesion, low stage, thin, no mitotic rate… It would have been big and obvious, and there would be much less question about it. Just clean margins alone would be so very reassuring…. SO, with that said, if yours is gone, and you have clean margins, and no other symptoms, just keep an eye on yourself. You know your body better than anyone, but as far as standard of care for these stage 1 melanomas, you and I are being taken care of.  If you need your own honest human opinion, go to someone whose opinion you value. whose word you trust. And that will be all you need. 🙂 Best wishes and good luck.

                                          KnowThyself
                                          Participant

                                            I was also recently diagnosed level II, stage 1A, .8mm deep, non ulcerated…. I worried myself into a depressed state, wondering about all the 'what if's"…. Sometimes all it takes is that one person to give their honest human advice, to make a world of difference in what you feel… That one person for me, was my primary care physician. He was there when i was born, he was there for the first biopsy just this past April, and after a full excision, and a wide excision with a skin graft, they still didnt get it all, so im due for another surgery… I hadnt received an actual depth on any of my path reports up until this most recent one. .8mm…Borderline concerning to me.  However, this lesion was so "histologically difficult and borderline in nature" between severe atypia and and the differential diagnosis of malignant melanoma, I was wondering if they were taking all the necessary precautions if it were in fact the latter of the two…. I hadn't returned to my primary doc since the original biopsy, and i value his opinion, so I wanted to see him before I went through with this next surgery to make sure it was absolutely necessary…..He started by weighing out the pros and cons to continuing with surgery until we get it all… He said absolutely go ahead with it, however not to worry about anything else in the meantime. If it were going to spread, it would have, and it also wouldnt have been such a low risk lesion, low stage, thin, no mitotic rate… It would have been big and obvious, and there would be much less question about it. Just clean margins alone would be so very reassuring…. SO, with that said, if yours is gone, and you have clean margins, and no other symptoms, just keep an eye on yourself. You know your body better than anyone, but as far as standard of care for these stage 1 melanomas, you and I are being taken care of.  If you need your own honest human opinion, go to someone whose opinion you value. whose word you trust. And that will be all you need. 🙂 Best wishes and good luck.

                                            carli
                                            Participant
                                              Thanks for the reply. It helps when others shed light on all this information. Is there ever really 100% in anything.? .. probably not. It is so true that we have to really accept this as cancer survivors.
                                              carli
                                              Participant
                                                Thanks for the reply. It helps when others shed light on all this information. Is there ever really 100% in anything.? .. probably not. It is so true that we have to really accept this as cancer survivors.
                                                carli
                                                Participant
                                                  Thanks for the reply. It helps when others shed light on all this information. Is there ever really 100% in anything.? .. probably not. It is so true that we have to really accept this as cancer survivors.
                                                  carli
                                                  Participant
                                                    Very sorry to hear about husband. Thank you for sharing your story.
                                                    carli
                                                    Participant
                                                      Very sorry to hear about husband. Thank you for sharing your story.
                                                      carli
                                                      Participant
                                                        Very sorry to hear about husband. Thank you for sharing your story.
                                                        carli
                                                        Participant
                                                          I did not know that stage 1 could be that deep. I thought stage 1 was considered 1mm or less.
                                                          carli
                                                          Participant
                                                            I did not know that stage 1 could be that deep. I thought stage 1 was considered 1mm or less.
                                                            carli
                                                            Participant
                                                              I did not know that stage 1 could be that deep. I thought stage 1 was considered 1mm or less.
                                                              Janner
                                                              Participant

                                                                Stage 1A cannot be more than 1mm, but stage IB can be up to 2mm.  Stage II starts at 2.01mm or sooner if you have ulceration.

                                                                Janner
                                                                Participant

                                                                  Stage 1A cannot be more than 1mm, but stage IB can be up to 2mm.  Stage II starts at 2.01mm or sooner if you have ulceration.

                                                                  Janner
                                                                  Participant

                                                                    Stage 1A cannot be more than 1mm, but stage IB can be up to 2mm.  Stage II starts at 2.01mm or sooner if you have ulceration.

                                                                    Richard_K
                                                                    Participant
                                                                      Manner, As usual, good advice.
                                                                      Richard_K
                                                                      Participant
                                                                        Manner, As usual, good advice.
                                                                        Richard_K
                                                                        Participant
                                                                          Manner, As usual, good advice.
                                                                          Richard_K
                                                                          Participant
                                                                            Janner not Manner, darn auto correct!
                                                                            Richard_K
                                                                            Participant
                                                                              Janner not Manner, darn auto correct!
                                                                              Richard_K
                                                                              Participant
                                                                                Janner not Manner, darn auto correct!
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