› Forums › Cutaneous Melanoma Community › new…looking for info…
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justme123.
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- February 14, 2012 at 8:19 pm
Hi, new here and looking for some info, input, people's 2cents etc. As you can see below, I have quite a few questions!
Hi, new here and looking for some info, input, people's 2cents etc. As you can see below, I have quite a few questions!
my husband was diagnosed with melanoma just over a month ago. Clark level II, Breslow 0.19mm so pretty small. But it is on his face… so they have done a wide excision biopsy and skin graft. Healing well. The pathology came back a few days ago saying that the wide excision biopsy has no evidence of residual in situ or malignant melanoma. However, they didn't do a sentinel lymph node biopsy because it is on his face… so we don't actually know whether or not there is any cancer in his lymph nodes.
However, we just got a call from our local cancer centre saying that the radiation oncologist wants to meet with him… no other information. So as I now sit around wondering…
Does anybody have any input or info about a similar type/stage of melanoma? what is normally done for treament if the wide exision biopsy comes back clear? from what I read online, it should just be done with now (aside from long term monitoring), so I am really confused about this oncologist appointment… Has anyone here had radiation therapy for melanoma?
thanks a bunch!
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- February 14, 2012 at 8:36 pm
My husband had radiation to the area where they took 43 lymph nodes and the parotid gland. My understanding is that radiation in normal doses (2 grey) isn't effective against melanoma. My husband's radiation oncologist did 5 treatments total at 6 grey.
Ask lots of questions before you sign on for radiation. There are some side effects that are life long. My husband has fibrosis in the area they did the radiation. He has permanent hair loss. He is still trying to regain strength in the shoulder below the radiation site. That's not to say he wouldn't do it all over again. Because I am pretty sure he would.
Are you seeing a melanoma specialist? Before I would do anything else, I would seek their opinion. Melanoma is a different cancer than any other and regular oncologists just don't know it like a melanoma specialist.
Did they stage him at all?
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- February 14, 2012 at 8:50 pm
I feel like I don't know anything… My understanding is that at Breslow 0.19 and Clark II he is Type1a, however, without the sentinel lymph node biopsy I don't think there is any way to accurately stage is there? We don't live in a large centre (only about 200,000 people)… I don't know if there are specifically any melanoma specialists in our city. …and we're in Canada, so we pretty much just have to take whatever treatment we can get, unless we choose to go to the US. Next week will be his first meeting with an oncologist, so hopefully that will give us some more info.
Thanks for the reply.
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- February 14, 2012 at 8:50 pm
I feel like I don't know anything… My understanding is that at Breslow 0.19 and Clark II he is Type1a, however, without the sentinel lymph node biopsy I don't think there is any way to accurately stage is there? We don't live in a large centre (only about 200,000 people)… I don't know if there are specifically any melanoma specialists in our city. …and we're in Canada, so we pretty much just have to take whatever treatment we can get, unless we choose to go to the US. Next week will be his first meeting with an oncologist, so hopefully that will give us some more info.
Thanks for the reply.
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- February 14, 2012 at 8:50 pm
I feel like I don't know anything… My understanding is that at Breslow 0.19 and Clark II he is Type1a, however, without the sentinel lymph node biopsy I don't think there is any way to accurately stage is there? We don't live in a large centre (only about 200,000 people)… I don't know if there are specifically any melanoma specialists in our city. …and we're in Canada, so we pretty much just have to take whatever treatment we can get, unless we choose to go to the US. Next week will be his first meeting with an oncologist, so hopefully that will give us some more info.
Thanks for the reply.
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- February 14, 2012 at 8:36 pm
My husband had radiation to the area where they took 43 lymph nodes and the parotid gland. My understanding is that radiation in normal doses (2 grey) isn't effective against melanoma. My husband's radiation oncologist did 5 treatments total at 6 grey.
Ask lots of questions before you sign on for radiation. There are some side effects that are life long. My husband has fibrosis in the area they did the radiation. He has permanent hair loss. He is still trying to regain strength in the shoulder below the radiation site. That's not to say he wouldn't do it all over again. Because I am pretty sure he would.
Are you seeing a melanoma specialist? Before I would do anything else, I would seek their opinion. Melanoma is a different cancer than any other and regular oncologists just don't know it like a melanoma specialist.
Did they stage him at all?
-
- February 14, 2012 at 8:36 pm
My husband had radiation to the area where they took 43 lymph nodes and the parotid gland. My understanding is that radiation in normal doses (2 grey) isn't effective against melanoma. My husband's radiation oncologist did 5 treatments total at 6 grey.
Ask lots of questions before you sign on for radiation. There are some side effects that are life long. My husband has fibrosis in the area they did the radiation. He has permanent hair loss. He is still trying to regain strength in the shoulder below the radiation site. That's not to say he wouldn't do it all over again. Because I am pretty sure he would.
Are you seeing a melanoma specialist? Before I would do anything else, I would seek their opinion. Melanoma is a different cancer than any other and regular oncologists just don't know it like a melanoma specialist.
Did they stage him at all?
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- February 14, 2012 at 9:19 pm
I also am Clarks level II with Breslow depth of .20mm. I go to the derm every 3 months for checkups & full body checks. My understanding is that a SNB isn't needed unless the depth is above .75mm. Also, seeing an oncologists is only needed if there was active disease. Since my WLE I have had a few biopsies, blood work & a chest xray.
You caught it early! Good luck to you, and hopefully someone with more experience will chime in with more info.
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- February 14, 2012 at 9:19 pm
I also am Clarks level II with Breslow depth of .20mm. I go to the derm every 3 months for checkups & full body checks. My understanding is that a SNB isn't needed unless the depth is above .75mm. Also, seeing an oncologists is only needed if there was active disease. Since my WLE I have had a few biopsies, blood work & a chest xray.
You caught it early! Good luck to you, and hopefully someone with more experience will chime in with more info.
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- February 14, 2012 at 9:19 pm
I also am Clarks level II with Breslow depth of .20mm. I go to the derm every 3 months for checkups & full body checks. My understanding is that a SNB isn't needed unless the depth is above .75mm. Also, seeing an oncologists is only needed if there was active disease. Since my WLE I have had a few biopsies, blood work & a chest xray.
You caught it early! Good luck to you, and hopefully someone with more experience will chime in with more info.
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- February 14, 2012 at 9:39 pm
Typically for a lesion that small, the wide excision is all that is done. There is no SNB because the odds that it has spread at that depth are very small. I am not sure why a radiation oncologist would want to talk to you. If the margins were clear and adequate, that's considered the entire treatment for stage IA/IB. (You didn't mention what the mitosis is from the pathology report – that's the missing piece to determine stage IA vs IB). Radiation isn't overly effective against melanoma, but it can be used to cleanup areas – especially those where margins might be questionable. I would think radiation would also cause problems with the skin graft healing. I honestly have never heard of anyone having radiation for a lesion like yours. Typically it might be done after a lymph node removal where there might have been extracapsular extension – or possibly on a local recurrence. I just haven't seen it used as a first line treatment for a lesion like that. (I've been stage I for 20 years (3 primaries) and monitoring these boards for over 10 years). I would definitely want a second opinion before I'd consider any radiation treatment as it definitely seems out of the norm.
Best wishes,
Janner
.58mm/Clark II in 1992
in situ in 2000
.88mm/Clark III in 2001
No SNB for any of them
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- February 14, 2012 at 9:39 pm
Typically for a lesion that small, the wide excision is all that is done. There is no SNB because the odds that it has spread at that depth are very small. I am not sure why a radiation oncologist would want to talk to you. If the margins were clear and adequate, that's considered the entire treatment for stage IA/IB. (You didn't mention what the mitosis is from the pathology report – that's the missing piece to determine stage IA vs IB). Radiation isn't overly effective against melanoma, but it can be used to cleanup areas – especially those where margins might be questionable. I would think radiation would also cause problems with the skin graft healing. I honestly have never heard of anyone having radiation for a lesion like yours. Typically it might be done after a lymph node removal where there might have been extracapsular extension – or possibly on a local recurrence. I just haven't seen it used as a first line treatment for a lesion like that. (I've been stage I for 20 years (3 primaries) and monitoring these boards for over 10 years). I would definitely want a second opinion before I'd consider any radiation treatment as it definitely seems out of the norm.
Best wishes,
Janner
.58mm/Clark II in 1992
in situ in 2000
.88mm/Clark III in 2001
No SNB for any of them
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- February 14, 2012 at 9:39 pm
Typically for a lesion that small, the wide excision is all that is done. There is no SNB because the odds that it has spread at that depth are very small. I am not sure why a radiation oncologist would want to talk to you. If the margins were clear and adequate, that's considered the entire treatment for stage IA/IB. (You didn't mention what the mitosis is from the pathology report – that's the missing piece to determine stage IA vs IB). Radiation isn't overly effective against melanoma, but it can be used to cleanup areas – especially those where margins might be questionable. I would think radiation would also cause problems with the skin graft healing. I honestly have never heard of anyone having radiation for a lesion like yours. Typically it might be done after a lymph node removal where there might have been extracapsular extension – or possibly on a local recurrence. I just haven't seen it used as a first line treatment for a lesion like that. (I've been stage I for 20 years (3 primaries) and monitoring these boards for over 10 years). I would definitely want a second opinion before I'd consider any radiation treatment as it definitely seems out of the norm.
Best wishes,
Janner
.58mm/Clark II in 1992
in situ in 2000
.88mm/Clark III in 2001
No SNB for any of them
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- February 16, 2012 at 2:54 pm
Thanks all for your comments!
So I have done a bunch more reading on this… I have access to all scientific journals etc which is really nice. It looks like there are a number of recent (2010-2012) papers citing that adjuvent radiation therapy is being recommended for even type I melanoma after wide excision biopsy. About 45- >50 Gy total dose, fractionated in 1.8-2Gy doses. This is especially for head/neck melanoma's since lymph node disection or even biopsy isn't recommended. Will be interesting to see what the oncologist has to say next week.
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- February 16, 2012 at 2:54 pm
Thanks all for your comments!
So I have done a bunch more reading on this… I have access to all scientific journals etc which is really nice. It looks like there are a number of recent (2010-2012) papers citing that adjuvent radiation therapy is being recommended for even type I melanoma after wide excision biopsy. About 45- >50 Gy total dose, fractionated in 1.8-2Gy doses. This is especially for head/neck melanoma's since lymph node disection or even biopsy isn't recommended. Will be interesting to see what the oncologist has to say next week.
-
- February 16, 2012 at 2:54 pm
Thanks all for your comments!
So I have done a bunch more reading on this… I have access to all scientific journals etc which is really nice. It looks like there are a number of recent (2010-2012) papers citing that adjuvent radiation therapy is being recommended for even type I melanoma after wide excision biopsy. About 45- >50 Gy total dose, fractionated in 1.8-2Gy doses. This is especially for head/neck melanoma's since lymph node disection or even biopsy isn't recommended. Will be interesting to see what the oncologist has to say next week.
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- August 21, 2012 at 6:34 pm
They do not recommend SNB's unless the Breslow is at least .75 or at least a high miotic rate. Yours is very thin. Continue to go to a dermatologist and watch your skin for future issues.
Consider it as a warning.
Best of luck
Linda
mel since 1979, now stage IV Live life and enjoy everyday!
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- August 21, 2012 at 6:34 pm
They do not recommend SNB's unless the Breslow is at least .75 or at least a high miotic rate. Yours is very thin. Continue to go to a dermatologist and watch your skin for future issues.
Consider it as a warning.
Best of luck
Linda
mel since 1979, now stage IV Live life and enjoy everyday!
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- August 21, 2012 at 6:34 pm
They do not recommend SNB's unless the Breslow is at least .75 or at least a high miotic rate. Yours is very thin. Continue to go to a dermatologist and watch your skin for future issues.
Consider it as a warning.
Best of luck
Linda
mel since 1979, now stage IV Live life and enjoy everyday!
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- August 22, 2012 at 4:54 am
Hard to add much to what Janner said. She covered the subject quite well. Radiation is usely just effective as a kind of "mop up" for possible escaped miscellanous cells or to reduce a tumor burden to allow for an operation.
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- August 22, 2012 at 4:54 am
Hard to add much to what Janner said. She covered the subject quite well. Radiation is usely just effective as a kind of "mop up" for possible escaped miscellanous cells or to reduce a tumor burden to allow for an operation.
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- August 22, 2012 at 4:54 am
Hard to add much to what Janner said. She covered the subject quite well. Radiation is usely just effective as a kind of "mop up" for possible escaped miscellanous cells or to reduce a tumor burden to allow for an operation.
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Tagged: cutaneous melanoma
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