› Forums › General Melanoma Community › Newbie ????
- This topic has 27 replies, 4 voices, and was last updated 8 years, 9 months ago by
Millykamp.
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- July 30, 2015 at 4:30 am
Hi
I was just diagnose with Melanoma 2 weeks ago and is being sent to see an oncologist at the university of Michigan in a few weeks and already know I will have to undergo surgery to re excision and sentinel lymph node biopsy
i am not sure what I am. So confusing.. here is my report ::::::
Malignant Melanoma invasive to Clark IV, Breslow depth 1.33 vertical and T2a
nudular type
ulceration is absent
mitoioc rate is 8
tumor regression is equivocal
So does this mean I am a stage 1a or am I stage 2a? How was the sentinel lymph node biopsy I read mix view on it, reading it painful and burns. I have been told I will be sleeping the whole time. I am just overwhelm….
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- July 30, 2015 at 9:37 am
Hi – going by this document:
https://www.nhmrc.gov.au/_files_nhmrc/publications/attachments/cp111.pdf
The mention of T2A suggests that you are stage 1B (not stage 1A) – see page 23 of the pdf
That said, I'm no expert and really the best person to ask is your doc. The SLNB is recommended because your melanoma is just that bit over 1mm deep – 1mm is kind of the cutoff for when a SLNB is done (in Australia, at least).
Is this your first wide level excision? I've had 2 done so far – one with .5mm margins and 1 with 1cm margins. A melanoma that is 1.33mm deep will require 1-2cm margins, so expect a cut of about 10cm long, and stitches for about two weeks.
I've never had a SNLB but hopefully someone else can fill you in on that.
I didn't find the WLE that uncomfortable – the anaesthetic injection is the worst part. Mine was done under local anaesthetic, whereas you will be under full anaesthetic for yours as you are having the SLNB as well.
Clark level is not really used much anymore, but it's still reported as it can be of some diagnostic use in thin melanomas. The breslow depth is the most important indicator – shallower is better than deeper. You read about mels as thin as 0.3mm or less, and as deep as 9mm or more. So yours is not overly thick, but thick enough to warrant a SNLB.
Ulceration is not good, so it's great that you have no ulceration present. Mitotic rate more or less indicates rate of growth – 0 is ideal (eg not growing). 8 is kind of high but I have read about much higher – pretty much anything over 1 is not great. Tumor regression is a mixed bag – it basically means your immune system has started to eat away at the base of the mel, making it regress. Some studies say it's a bad sign as you don't really know how deep the melanoma once was. Other studies see it as a good sign. So I just consider it neutral, neither here nor there.
All the best and keep posting as you need to. I'm a newbie here myself but these people are a fountain of information and comfort in an hour of need.
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- July 30, 2015 at 9:37 am
Hi – going by this document:
https://www.nhmrc.gov.au/_files_nhmrc/publications/attachments/cp111.pdf
The mention of T2A suggests that you are stage 1B (not stage 1A) – see page 23 of the pdf
That said, I'm no expert and really the best person to ask is your doc. The SLNB is recommended because your melanoma is just that bit over 1mm deep – 1mm is kind of the cutoff for when a SLNB is done (in Australia, at least).
Is this your first wide level excision? I've had 2 done so far – one with .5mm margins and 1 with 1cm margins. A melanoma that is 1.33mm deep will require 1-2cm margins, so expect a cut of about 10cm long, and stitches for about two weeks.
I've never had a SNLB but hopefully someone else can fill you in on that.
I didn't find the WLE that uncomfortable – the anaesthetic injection is the worst part. Mine was done under local anaesthetic, whereas you will be under full anaesthetic for yours as you are having the SLNB as well.
Clark level is not really used much anymore, but it's still reported as it can be of some diagnostic use in thin melanomas. The breslow depth is the most important indicator – shallower is better than deeper. You read about mels as thin as 0.3mm or less, and as deep as 9mm or more. So yours is not overly thick, but thick enough to warrant a SNLB.
Ulceration is not good, so it's great that you have no ulceration present. Mitotic rate more or less indicates rate of growth – 0 is ideal (eg not growing). 8 is kind of high but I have read about much higher – pretty much anything over 1 is not great. Tumor regression is a mixed bag – it basically means your immune system has started to eat away at the base of the mel, making it regress. Some studies say it's a bad sign as you don't really know how deep the melanoma once was. Other studies see it as a good sign. So I just consider it neutral, neither here nor there.
All the best and keep posting as you need to. I'm a newbie here myself but these people are a fountain of information and comfort in an hour of need.
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- July 30, 2015 at 9:37 am
Hi – going by this document:
https://www.nhmrc.gov.au/_files_nhmrc/publications/attachments/cp111.pdf
The mention of T2A suggests that you are stage 1B (not stage 1A) – see page 23 of the pdf
That said, I'm no expert and really the best person to ask is your doc. The SLNB is recommended because your melanoma is just that bit over 1mm deep – 1mm is kind of the cutoff for when a SLNB is done (in Australia, at least).
Is this your first wide level excision? I've had 2 done so far – one with .5mm margins and 1 with 1cm margins. A melanoma that is 1.33mm deep will require 1-2cm margins, so expect a cut of about 10cm long, and stitches for about two weeks.
I've never had a SNLB but hopefully someone else can fill you in on that.
I didn't find the WLE that uncomfortable – the anaesthetic injection is the worst part. Mine was done under local anaesthetic, whereas you will be under full anaesthetic for yours as you are having the SLNB as well.
Clark level is not really used much anymore, but it's still reported as it can be of some diagnostic use in thin melanomas. The breslow depth is the most important indicator – shallower is better than deeper. You read about mels as thin as 0.3mm or less, and as deep as 9mm or more. So yours is not overly thick, but thick enough to warrant a SNLB.
Ulceration is not good, so it's great that you have no ulceration present. Mitotic rate more or less indicates rate of growth – 0 is ideal (eg not growing). 8 is kind of high but I have read about much higher – pretty much anything over 1 is not great. Tumor regression is a mixed bag – it basically means your immune system has started to eat away at the base of the mel, making it regress. Some studies say it's a bad sign as you don't really know how deep the melanoma once was. Other studies see it as a good sign. So I just consider it neutral, neither here nor there.
All the best and keep posting as you need to. I'm a newbie here myself but these people are a fountain of information and comfort in an hour of need.
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- July 30, 2015 at 9:38 am
I should add – the 10cm long cut thing is only if it is somewhere where that kind of cut can happen. On your face, for example, it would be a different story. Both of my WLEs have been on limbs (arm and leg) so it's been a standard excision. On your face it would be a different kind of thing to suit the geography, so to speak.
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- July 30, 2015 at 10:22 am
Yes they had already did rhe wide excisions. 24mm by 9mm. And I am having it done again on the same spot, I am wondering if o have enough skin there…. So stage 1b is good then. I don't have much to worry about. I am just worry what if it ended being more when I go down..
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- July 30, 2015 at 10:40 am
Hi – are you sure that 24 x 9mm is a wide excision? Perhaps it was a standard excision (mole plus 2mm margins) required for biopsy/pathology. I had this done, it would have been about 24x9mm, then once it came back as mel I had a standard 1cm wide excision (as in, 1cm clear on each side of my melanoma – top, bottom, left, right). This left a 10cm scar. The reason the scar is so long is that it is extended out on either side to allow for the right shape would to stitch shut. Don't worry about finding enough skin to stitch, your doctor will find a way. Perhaps with different surgery technique you end up with a different wound/scar. For my 0.5cm wide excision (for a melanoma in situ) I have an 8cm scar. It would be great if someone else could post re your staging – it looks like 1 B to me based on that document, but I really couldn't say for sure.
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- July 30, 2015 at 1:05 pm
Well I am not sue if I am reading it right but it said area taken is 24mm by 9mm by 9mm…after the stiches was taken out I had measure my scars iit is about 8cm long.. And ugly.. Hate to see what it will look like when they go into it again.. But I would rather have all these scars rhan cancer living in me
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- July 30, 2015 at 1:05 pm
Well I am not sue if I am reading it right but it said area taken is 24mm by 9mm by 9mm…after the stiches was taken out I had measure my scars iit is about 8cm long.. And ugly.. Hate to see what it will look like when they go into it again.. But I would rather have all these scars rhan cancer living in me
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- July 30, 2015 at 1:05 pm
Well I am not sue if I am reading it right but it said area taken is 24mm by 9mm by 9mm…after the stiches was taken out I had measure my scars iit is about 8cm long.. And ugly.. Hate to see what it will look like when they go into it again.. But I would rather have all these scars rhan cancer living in me
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- July 30, 2015 at 10:40 am
Hi – are you sure that 24 x 9mm is a wide excision? Perhaps it was a standard excision (mole plus 2mm margins) required for biopsy/pathology. I had this done, it would have been about 24x9mm, then once it came back as mel I had a standard 1cm wide excision (as in, 1cm clear on each side of my melanoma – top, bottom, left, right). This left a 10cm scar. The reason the scar is so long is that it is extended out on either side to allow for the right shape would to stitch shut. Don't worry about finding enough skin to stitch, your doctor will find a way. Perhaps with different surgery technique you end up with a different wound/scar. For my 0.5cm wide excision (for a melanoma in situ) I have an 8cm scar. It would be great if someone else could post re your staging – it looks like 1 B to me based on that document, but I really couldn't say for sure.
-
- July 30, 2015 at 10:40 am
Hi – are you sure that 24 x 9mm is a wide excision? Perhaps it was a standard excision (mole plus 2mm margins) required for biopsy/pathology. I had this done, it would have been about 24x9mm, then once it came back as mel I had a standard 1cm wide excision (as in, 1cm clear on each side of my melanoma – top, bottom, left, right). This left a 10cm scar. The reason the scar is so long is that it is extended out on either side to allow for the right shape would to stitch shut. Don't worry about finding enough skin to stitch, your doctor will find a way. Perhaps with different surgery technique you end up with a different wound/scar. For my 0.5cm wide excision (for a melanoma in situ) I have an 8cm scar. It would be great if someone else could post re your staging – it looks like 1 B to me based on that document, but I really couldn't say for sure.
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- July 30, 2015 at 10:22 am
Yes they had already did rhe wide excisions. 24mm by 9mm. And I am having it done again on the same spot, I am wondering if o have enough skin there…. So stage 1b is good then. I don't have much to worry about. I am just worry what if it ended being more when I go down..
-
- July 30, 2015 at 10:22 am
Yes they had already did rhe wide excisions. 24mm by 9mm. And I am having it done again on the same spot, I am wondering if o have enough skin there…. So stage 1b is good then. I don't have much to worry about. I am just worry what if it ended being more when I go down..
-
- July 30, 2015 at 9:38 am
I should add – the 10cm long cut thing is only if it is somewhere where that kind of cut can happen. On your face, for example, it would be a different story. Both of my WLEs have been on limbs (arm and leg) so it's been a standard excision. On your face it would be a different kind of thing to suit the geography, so to speak.
-
- July 30, 2015 at 9:38 am
I should add – the 10cm long cut thing is only if it is somewhere where that kind of cut can happen. On your face, for example, it would be a different story. Both of my WLEs have been on limbs (arm and leg) so it's been a standard excision. On your face it would be a different kind of thing to suit the geography, so to speak.
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- July 30, 2015 at 6:03 pm
Sorry you had to join us. A WLE should be 2.0 cm in all directions. 9 mm is only 0.9 cm so you didn't have an adequet WLE. Also, having a WLE should be done at the same time as an SNB, not prior or else it will interfere with tumor drainage tracts.
I only know this because the same thing happened to me. 2.06 mm with WLE and NO MENTION of doing a SNB. Was sent to medical onc. who finally sent me to a surgical one. Found 2 nodes but we never will really know if they were the true SNB.
Either way, my nodes are still negative but progressed to stage IV via the blood stream. NED for the past 5 years though.
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- July 30, 2015 at 6:03 pm
Sorry you had to join us. A WLE should be 2.0 cm in all directions. 9 mm is only 0.9 cm so you didn't have an adequet WLE. Also, having a WLE should be done at the same time as an SNB, not prior or else it will interfere with tumor drainage tracts.
I only know this because the same thing happened to me. 2.06 mm with WLE and NO MENTION of doing a SNB. Was sent to medical onc. who finally sent me to a surgical one. Found 2 nodes but we never will really know if they were the true SNB.
Either way, my nodes are still negative but progressed to stage IV via the blood stream. NED for the past 5 years though.
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- July 30, 2015 at 7:34 pm
I am seeing a dr at U of M in a few weeks that specialist in melanoma and been name the top dr since 1997… I did get a call that I have to go back in for 2 no biaopy on one of the shave mole. The report needs more reading on it. Not sure what that means.
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- July 30, 2015 at 7:34 pm
I am seeing a dr at U of M in a few weeks that specialist in melanoma and been name the top dr since 1997… I did get a call that I have to go back in for 2 no biaopy on one of the shave mole. The report needs more reading on it. Not sure what that means.
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- July 30, 2015 at 7:34 pm
I am seeing a dr at U of M in a few weeks that specialist in melanoma and been name the top dr since 1997… I did get a call that I have to go back in for 2 no biaopy on one of the shave mole. The report needs more reading on it. Not sure what that means.
-
- July 30, 2015 at 6:03 pm
Sorry you had to join us. A WLE should be 2.0 cm in all directions. 9 mm is only 0.9 cm so you didn't have an adequet WLE. Also, having a WLE should be done at the same time as an SNB, not prior or else it will interfere with tumor drainage tracts.
I only know this because the same thing happened to me. 2.06 mm with WLE and NO MENTION of doing a SNB. Was sent to medical onc. who finally sent me to a surgical one. Found 2 nodes but we never will really know if they were the true SNB.
Either way, my nodes are still negative but progressed to stage IV via the blood stream. NED for the past 5 years though.
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