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Janner.
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- August 26, 2016 at 5:43 pm
This board has been a blessing. I was diagnosed with malignant melanoma 3 weeks ago from today.
I noticed two "funny" looking moles on my lower leg and had the dermatologist check them. She did a biopsy and both came back as melanomas. Since then, I had a fully body check, had 2 more that looked suscpicios send back for biopsy and both came back normal. As for the two melanomas I had them both removed with a wide local excision 1 week ago. Lab on the skin removed came back clear and with clear margins so both were completely excised. I'm aware of how lucky I am. However, I had a couple of questions about the initial biopsy report:
2 moles,
2-3 cm from each other,
one .15mm and the other .65 mm Breslow thickness,
no ulceration,
mitotic index Zero per mm square,
deep margin absent on one and "positive at one side" on the other,
regression absent,
microsatellitosis absent,
perineural invasion absent,
Lymphovascular invasion absent, AJCC/TNM classification: pT1a NX on both.
(no Clark scale mentioned, but I read that classification is considered outdate by some in the medical community, hence why probably not reported here. Report shows a primary pathologist and another pathologist of the same lab concurring with results).
Comment from pathologist: he "suspects synchronous primaries, presence of two close to each other may indicate the alternative of local epidermotropic metastasis"
Surgen that removed the moles suspect that proximity of the two moles is coincidental and not metastasis as they are so thin and no other involment is evident as far as they can tell.
No other test are planned according to both derm and surgeon. Surgen is a national expert in Moh's surgery (melanoma experience is all over his credentials).
Questions I still have for this board (whatever answers I can get I'll be immensely grateful)
Has anyone had 2 primaries so close two each other? Can I assume one of them appeared first (the deeper one) longer in the past and the other one just appeared as a local metastasis of the primary some time after? The fact that they were so close to each other worries me. Given the fact that I have so many moles all over my body and that a skin check where the derm just looks at moles with a naked eye seems to me a little superficial given the stakes.
Do I ask for more tests?
We were already planning to start trying for our first baby in the fall. I read most studies can't find a correlation between pregnancy and melanoma diagnosis and/or prognosis but I read a lot of post on the board of women that reported anecdotal evidence of what they thought happened to them- pregnancy bringing on or worsening their melanoma. Any suggestions, personal experiences any of you can bring will be so appreciated. This whole thing has put quite a damp on all the excitement of having our first baby. I'm 33 and waiting 2-3 yrs before getting pregannt (as some suggest) is harder for us.
Thank you in advance for your time, patience, compassion and input. Wishing every one on here the best of luck!
I.
- Replies
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- August 26, 2016 at 8:30 pm
Hi,
Sorry you are dealing with this. I had a melanoma diagnosis after my pregnancy. I will always suspect that my pregnancy made the existing tumor become more aggressive, which I think is what some studies suggest. Where our cases are quite different though is that I waited and enjoyed my baby before I worried about cancer at 28. I gave that sucker 4 – 5 months to grow like crazy. There was no chance I thought I had stage 3 cancer. If you look closer at *most* not all of the anecdotes there was already a great than stage 1 diagnosis or it was post pregnancyz.
Unfortunately, melanoma is not uncommon in young adult females. I would not wait at all to get pregnant. Of course you have to do what you are comfortable with but you really are lucky that you caught yours very early and now you know to stay on top of it. I'm sorry I know you probably don't feel that way as you are adjusting to the new diagnosis.
Good luck
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- August 26, 2016 at 8:46 pm
I should also add that my understanding is that the recommendation is 2-3 years bc that is when it's mostly likely to come back, but also bc typically at stage 3 you are scanned every few months for 2-3 years. You can't be scanned if pregnant but at stage 1 you won't be scanned at all.
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- August 26, 2016 at 8:46 pm
I should also add that my understanding is that the recommendation is 2-3 years bc that is when it's mostly likely to come back, but also bc typically at stage 3 you are scanned every few months for 2-3 years. You can't be scanned if pregnant but at stage 1 you won't be scanned at all.
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- August 26, 2016 at 8:46 pm
I should also add that my understanding is that the recommendation is 2-3 years bc that is when it's mostly likely to come back, but also bc typically at stage 3 you are scanned every few months for 2-3 years. You can't be scanned if pregnant but at stage 1 you won't be scanned at all.
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- August 26, 2016 at 8:30 pm
Hi,
Sorry you are dealing with this. I had a melanoma diagnosis after my pregnancy. I will always suspect that my pregnancy made the existing tumor become more aggressive, which I think is what some studies suggest. Where our cases are quite different though is that I waited and enjoyed my baby before I worried about cancer at 28. I gave that sucker 4 – 5 months to grow like crazy. There was no chance I thought I had stage 3 cancer. If you look closer at *most* not all of the anecdotes there was already a great than stage 1 diagnosis or it was post pregnancyz.
Unfortunately, melanoma is not uncommon in young adult females. I would not wait at all to get pregnant. Of course you have to do what you are comfortable with but you really are lucky that you caught yours very early and now you know to stay on top of it. I'm sorry I know you probably don't feel that way as you are adjusting to the new diagnosis.
Good luck
-
- August 26, 2016 at 8:30 pm
Hi,
Sorry you are dealing with this. I had a melanoma diagnosis after my pregnancy. I will always suspect that my pregnancy made the existing tumor become more aggressive, which I think is what some studies suggest. Where our cases are quite different though is that I waited and enjoyed my baby before I worried about cancer at 28. I gave that sucker 4 – 5 months to grow like crazy. There was no chance I thought I had stage 3 cancer. If you look closer at *most* not all of the anecdotes there was already a great than stage 1 diagnosis or it was post pregnancyz.
Unfortunately, melanoma is not uncommon in young adult females. I would not wait at all to get pregnant. Of course you have to do what you are comfortable with but you really are lucky that you caught yours very early and now you know to stay on top of it. I'm sorry I know you probably don't feel that way as you are adjusting to the new diagnosis.
Good luck
-
- August 26, 2016 at 8:53 pm
Hi
I am really sorry that you find yourself in this position. It's a life changer, even though your melanomas are so thin. It's something that will have an impact on your life – hopefully positive (as in, you really do value the happy times so much better after you've been through the 'fire' of a scary diagnosis).
To answer your question, no, I have not had two primaries so close to each other. I have had three separate simultaneous primaries though, which puts both of us into a small and interesting group. Mine were leg, arm and chest – nowhere near each other. There's others here too that have had three or more melanomas, but I've not heard of them being close together except in the case of Bob from Hawaii (not sure if I have this username right) who seemed to be getting 'rashes' of melanoma in a pattern that could have been the extremely rare epidermotropic metastatic melanoma. I'm not sure if that was ever found to be the case for him.
When you say 'deep margin absent', does that mean that one had the base transected so true depth couldn't be established? Or were both fully excised? If one had the base transected so no accurate depth or staging, that's a bit of a worry. Also, in my view, if both pathologists concur that there is a possibility that this could be epidermotropic melanoma, then you need to get to a melanoma specialist as recommended by MPIP or MRF. If for nothing else, to discount that possiblity. Why? Because type 1a – which you are assuming you are – is not metastatic melanoma. An excision is all that you would need. But the possibility of epidermotropic melanoma means the possibility of metastatic melanoma – epidermotropic melanoma is already metastatic disease and this is more serious and requires a different treatment path. From dermnet.nz – I have bolded part of it for you:
"Epidermotropic metastatic melanoma is rare. In this case, the metastases develop more superficially than usual, within the epidermis. Epidermotropic metastatic melanoma is often initially misdiagnosed as primary melanoma. The diagnosis of epidermotropic metastatic melanoma should be considered if multiple lesions arise with similar pathology."
I think you need to get to a melanoma specialist for a definitive diagnosis on this. Pregnancy after stage 1 melanoma would be a different proposition to pregnancy with metastatic disease. Get a definitive diagnosis quickly so you can go ahead with your life plans of becoming a mum. It seems the doctors are leaning towards synchronous primary melanomas – this is the best case scenario. But having put in print the possibility of a more serious metastatic disease, I personally would want to escalate to a true melanoma specialist facility. In particular because epidermotropic melanoma is as rare as hen's teeth, very few physicians would ever have encountered it.
A surgeon specialising in Mohs is not a melanoma specialist – I really hope you can get into one of the big melanoma specialist centres to get yourself a more definitive diagnosis and some peace of mind. Hoping and praying that a re-read of your pathology by a true melanoma specialist dermatopathologist reveals synchronous primaries…. still bad luck, but nowhere near as serious as the other alternative.
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- August 26, 2016 at 8:53 pm
Hi
I am really sorry that you find yourself in this position. It's a life changer, even though your melanomas are so thin. It's something that will have an impact on your life – hopefully positive (as in, you really do value the happy times so much better after you've been through the 'fire' of a scary diagnosis).
To answer your question, no, I have not had two primaries so close to each other. I have had three separate simultaneous primaries though, which puts both of us into a small and interesting group. Mine were leg, arm and chest – nowhere near each other. There's others here too that have had three or more melanomas, but I've not heard of them being close together except in the case of Bob from Hawaii (not sure if I have this username right) who seemed to be getting 'rashes' of melanoma in a pattern that could have been the extremely rare epidermotropic metastatic melanoma. I'm not sure if that was ever found to be the case for him.
When you say 'deep margin absent', does that mean that one had the base transected so true depth couldn't be established? Or were both fully excised? If one had the base transected so no accurate depth or staging, that's a bit of a worry. Also, in my view, if both pathologists concur that there is a possibility that this could be epidermotropic melanoma, then you need to get to a melanoma specialist as recommended by MPIP or MRF. If for nothing else, to discount that possiblity. Why? Because type 1a – which you are assuming you are – is not metastatic melanoma. An excision is all that you would need. But the possibility of epidermotropic melanoma means the possibility of metastatic melanoma – epidermotropic melanoma is already metastatic disease and this is more serious and requires a different treatment path. From dermnet.nz – I have bolded part of it for you:
"Epidermotropic metastatic melanoma is rare. In this case, the metastases develop more superficially than usual, within the epidermis. Epidermotropic metastatic melanoma is often initially misdiagnosed as primary melanoma. The diagnosis of epidermotropic metastatic melanoma should be considered if multiple lesions arise with similar pathology."
I think you need to get to a melanoma specialist for a definitive diagnosis on this. Pregnancy after stage 1 melanoma would be a different proposition to pregnancy with metastatic disease. Get a definitive diagnosis quickly so you can go ahead with your life plans of becoming a mum. It seems the doctors are leaning towards synchronous primary melanomas – this is the best case scenario. But having put in print the possibility of a more serious metastatic disease, I personally would want to escalate to a true melanoma specialist facility. In particular because epidermotropic melanoma is as rare as hen's teeth, very few physicians would ever have encountered it.
A surgeon specialising in Mohs is not a melanoma specialist – I really hope you can get into one of the big melanoma specialist centres to get yourself a more definitive diagnosis and some peace of mind. Hoping and praying that a re-read of your pathology by a true melanoma specialist dermatopathologist reveals synchronous primaries…. still bad luck, but nowhere near as serious as the other alternative.
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- August 27, 2016 at 12:11 am
Hi,
Thank you for your invaluable input. I picked up the report and read the pathology comment and the word "metastasis" got me worried. Neither the dermatologist nor the surgeon mentioned it or in any way thoroughly discussed the report with me. I'm an audiologist and the inquisitive mind of someone working in health care 8 hrs out of the day made me aware of how one needs to be thorough with anything health related, especially with something of this magnitude.
I Will set up an appointment with a true melanoma specialist, of whom there's 3 in my state, fortunately.
As for your question on the "absence of the deep margin" – I reported the report on here verbatim. I also questioned if "absent" meant there were no margins left or there were none because of the initial shaving for biopsi (I assume none left because this was in regards to the thinnest melanoma. 0.15 mm). However, the report also stated: lymphovascular invasion: absent – which being that they just had a sample of the mole I'm not sure how they can conclude lack of lymphovascular invasion- which makes me think that by "absent" in this report they refer to lack of sample rather than lack of the invasion. So, in short I'm not sure what they mean by absent in this report.
The pathologist that signed off on this report is in fact a dermapathologist. He states that his suspicion is synchronous primaries but also that local epidermotropic metastasis can be a clinical correlation. I'm baffled that both the dermatologist and the surgeon either ignored or failed to give the proper attention to this alternative – especially since it's clearly spelled out in the report.
Thank you again for your detailed and thorough response. You just made me take a new path on this and I can't possibly thank you enough for it. I have immense gratitude.
-
- August 27, 2016 at 12:11 am
Hi,
Thank you for your invaluable input. I picked up the report and read the pathology comment and the word "metastasis" got me worried. Neither the dermatologist nor the surgeon mentioned it or in any way thoroughly discussed the report with me. I'm an audiologist and the inquisitive mind of someone working in health care 8 hrs out of the day made me aware of how one needs to be thorough with anything health related, especially with something of this magnitude.
I Will set up an appointment with a true melanoma specialist, of whom there's 3 in my state, fortunately.
As for your question on the "absence of the deep margin" – I reported the report on here verbatim. I also questioned if "absent" meant there were no margins left or there were none because of the initial shaving for biopsi (I assume none left because this was in regards to the thinnest melanoma. 0.15 mm). However, the report also stated: lymphovascular invasion: absent – which being that they just had a sample of the mole I'm not sure how they can conclude lack of lymphovascular invasion- which makes me think that by "absent" in this report they refer to lack of sample rather than lack of the invasion. So, in short I'm not sure what they mean by absent in this report.
The pathologist that signed off on this report is in fact a dermapathologist. He states that his suspicion is synchronous primaries but also that local epidermotropic metastasis can be a clinical correlation. I'm baffled that both the dermatologist and the surgeon either ignored or failed to give the proper attention to this alternative – especially since it's clearly spelled out in the report.
Thank you again for your detailed and thorough response. You just made me take a new path on this and I can't possibly thank you enough for it. I have immense gratitude.
-
- August 27, 2016 at 12:23 am
P.S. This report is the initial report on the two moles that were first biopsied. I don't have a copy of the report of the wide excision but they called me to ket me know that the margins are clear i.e – the excision of both moles was complete and successful. I'm going back to the surgeon in a 4 days for stitches to be removed. I have a 3.2 inch incision as the surgeon removed the whole chunk of skin around both moles (not individual incision for safer measures). I'm hoping the 2nd pathology report can say more on the diagnosis. But I doubt it. I think the goal of the 2nd pathology is to make sure there was a complete excision of both moles.
Let me know if you have any other input, please. Thank you lots!
-
- August 27, 2016 at 12:23 am
P.S. This report is the initial report on the two moles that were first biopsied. I don't have a copy of the report of the wide excision but they called me to ket me know that the margins are clear i.e – the excision of both moles was complete and successful. I'm going back to the surgeon in a 4 days for stitches to be removed. I have a 3.2 inch incision as the surgeon removed the whole chunk of skin around both moles (not individual incision for safer measures). I'm hoping the 2nd pathology report can say more on the diagnosis. But I doubt it. I think the goal of the 2nd pathology is to make sure there was a complete excision of both moles.
Let me know if you have any other input, please. Thank you lots!
-
- August 27, 2016 at 12:23 am
P.S. This report is the initial report on the two moles that were first biopsied. I don't have a copy of the report of the wide excision but they called me to ket me know that the margins are clear i.e – the excision of both moles was complete and successful. I'm going back to the surgeon in a 4 days for stitches to be removed. I have a 3.2 inch incision as the surgeon removed the whole chunk of skin around both moles (not individual incision for safer measures). I'm hoping the 2nd pathology report can say more on the diagnosis. But I doubt it. I think the goal of the 2nd pathology is to make sure there was a complete excision of both moles.
Let me know if you have any other input, please. Thank you lots!
-
- August 27, 2016 at 7:56 am
Great news that the WLE is all clear. You would expect that – basically the WLE is just chunking out a huge piece of skin 'just in case' the odd melanoma cell managed to fly the coop. I've actually never seen a WLE path report, just like you it seems to be a simple 'all clear' phone call and not much more. I really hope you heal up well and get all this behind you asap. It's great that you work in healthcare, you know the drill, better be safe than sorry and a second opinion does no-one any harm. You can then hopefully get the all clear so you can enjoy your pregnancy and baby in good time. Because both of your melanomas were invasive – anything with a Breslow depth is regarded as invasive – you'll be joining the six-monthly skin check club. Get used to getting (near) naked for your doctor! If you have lots of moles, its probably more reassuring to have these regular checks and get the all clear rather than go without skin checks and worry. In my case, the mental struggle of a melanoma diagnosis is just as bad as the physical. That siad, it's given me a new appreciation for life. Let us know how you get on – yours is a fairly unique situation and what you post here could well help someone in similar situations in future.
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- August 27, 2016 at 7:56 am
Great news that the WLE is all clear. You would expect that – basically the WLE is just chunking out a huge piece of skin 'just in case' the odd melanoma cell managed to fly the coop. I've actually never seen a WLE path report, just like you it seems to be a simple 'all clear' phone call and not much more. I really hope you heal up well and get all this behind you asap. It's great that you work in healthcare, you know the drill, better be safe than sorry and a second opinion does no-one any harm. You can then hopefully get the all clear so you can enjoy your pregnancy and baby in good time. Because both of your melanomas were invasive – anything with a Breslow depth is regarded as invasive – you'll be joining the six-monthly skin check club. Get used to getting (near) naked for your doctor! If you have lots of moles, its probably more reassuring to have these regular checks and get the all clear rather than go without skin checks and worry. In my case, the mental struggle of a melanoma diagnosis is just as bad as the physical. That siad, it's given me a new appreciation for life. Let us know how you get on – yours is a fairly unique situation and what you post here could well help someone in similar situations in future.
-
- August 27, 2016 at 7:56 am
Great news that the WLE is all clear. You would expect that – basically the WLE is just chunking out a huge piece of skin 'just in case' the odd melanoma cell managed to fly the coop. I've actually never seen a WLE path report, just like you it seems to be a simple 'all clear' phone call and not much more. I really hope you heal up well and get all this behind you asap. It's great that you work in healthcare, you know the drill, better be safe than sorry and a second opinion does no-one any harm. You can then hopefully get the all clear so you can enjoy your pregnancy and baby in good time. Because both of your melanomas were invasive – anything with a Breslow depth is regarded as invasive – you'll be joining the six-monthly skin check club. Get used to getting (near) naked for your doctor! If you have lots of moles, its probably more reassuring to have these regular checks and get the all clear rather than go without skin checks and worry. In my case, the mental struggle of a melanoma diagnosis is just as bad as the physical. That siad, it's given me a new appreciation for life. Let us know how you get on – yours is a fairly unique situation and what you post here could well help someone in similar situations in future.
-
- August 27, 2016 at 12:11 am
Hi,
Thank you for your invaluable input. I picked up the report and read the pathology comment and the word "metastasis" got me worried. Neither the dermatologist nor the surgeon mentioned it or in any way thoroughly discussed the report with me. I'm an audiologist and the inquisitive mind of someone working in health care 8 hrs out of the day made me aware of how one needs to be thorough with anything health related, especially with something of this magnitude.
I Will set up an appointment with a true melanoma specialist, of whom there's 3 in my state, fortunately.
As for your question on the "absence of the deep margin" – I reported the report on here verbatim. I also questioned if "absent" meant there were no margins left or there were none because of the initial shaving for biopsi (I assume none left because this was in regards to the thinnest melanoma. 0.15 mm). However, the report also stated: lymphovascular invasion: absent – which being that they just had a sample of the mole I'm not sure how they can conclude lack of lymphovascular invasion- which makes me think that by "absent" in this report they refer to lack of sample rather than lack of the invasion. So, in short I'm not sure what they mean by absent in this report.
The pathologist that signed off on this report is in fact a dermapathologist. He states that his suspicion is synchronous primaries but also that local epidermotropic metastasis can be a clinical correlation. I'm baffled that both the dermatologist and the surgeon either ignored or failed to give the proper attention to this alternative – especially since it's clearly spelled out in the report.
Thank you again for your detailed and thorough response. You just made me take a new path on this and I can't possibly thank you enough for it. I have immense gratitude.
-
- August 26, 2016 at 8:53 pm
Hi
I am really sorry that you find yourself in this position. It's a life changer, even though your melanomas are so thin. It's something that will have an impact on your life – hopefully positive (as in, you really do value the happy times so much better after you've been through the 'fire' of a scary diagnosis).
To answer your question, no, I have not had two primaries so close to each other. I have had three separate simultaneous primaries though, which puts both of us into a small and interesting group. Mine were leg, arm and chest – nowhere near each other. There's others here too that have had three or more melanomas, but I've not heard of them being close together except in the case of Bob from Hawaii (not sure if I have this username right) who seemed to be getting 'rashes' of melanoma in a pattern that could have been the extremely rare epidermotropic metastatic melanoma. I'm not sure if that was ever found to be the case for him.
When you say 'deep margin absent', does that mean that one had the base transected so true depth couldn't be established? Or were both fully excised? If one had the base transected so no accurate depth or staging, that's a bit of a worry. Also, in my view, if both pathologists concur that there is a possibility that this could be epidermotropic melanoma, then you need to get to a melanoma specialist as recommended by MPIP or MRF. If for nothing else, to discount that possiblity. Why? Because type 1a – which you are assuming you are – is not metastatic melanoma. An excision is all that you would need. But the possibility of epidermotropic melanoma means the possibility of metastatic melanoma – epidermotropic melanoma is already metastatic disease and this is more serious and requires a different treatment path. From dermnet.nz – I have bolded part of it for you:
"Epidermotropic metastatic melanoma is rare. In this case, the metastases develop more superficially than usual, within the epidermis. Epidermotropic metastatic melanoma is often initially misdiagnosed as primary melanoma. The diagnosis of epidermotropic metastatic melanoma should be considered if multiple lesions arise with similar pathology."
I think you need to get to a melanoma specialist for a definitive diagnosis on this. Pregnancy after stage 1 melanoma would be a different proposition to pregnancy with metastatic disease. Get a definitive diagnosis quickly so you can go ahead with your life plans of becoming a mum. It seems the doctors are leaning towards synchronous primary melanomas – this is the best case scenario. But having put in print the possibility of a more serious metastatic disease, I personally would want to escalate to a true melanoma specialist facility. In particular because epidermotropic melanoma is as rare as hen's teeth, very few physicians would ever have encountered it.
A surgeon specialising in Mohs is not a melanoma specialist – I really hope you can get into one of the big melanoma specialist centres to get yourself a more definitive diagnosis and some peace of mind. Hoping and praying that a re-read of your pathology by a true melanoma specialist dermatopathologist reveals synchronous primaries…. still bad luck, but nowhere near as serious as the other alternative.
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- August 26, 2016 at 9:09 pm
Hi,
Sorry you are here.Can't say anything about the multiple primary / in transit debate. Sometimes you can never get a clear cut answer…
As regards starting a family- there does seem to be a lively debate on the influence of estrogen. I was prescribed HRT months after initial stage 1 thin diagnosis by 1 doctor- but recurrence came at 20 months later Stage IIB- and was told by another Dr to drop HRT pre surgery – re DVT and also as not happy to prescribe in view of possible melanoma sensitivity.
There is a heap of info on these boards discussing pregnancy and melanoma. This is a reasonable overview
It might be worth asking your primary provider to do blood tests to help work out how big your likely fertility window might be ?
Good luck- whatever you decide. There is no "right" answer..its what you feel comfortable with in the end- after you've gathered as much helpful information as you can.I think that you are doing really well to be thinking with this level of clarity so few days after diagnosis..
Wishing you the best of future health
Deb
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- August 26, 2016 at 9:09 pm
Hi,
Sorry you are here.Can't say anything about the multiple primary / in transit debate. Sometimes you can never get a clear cut answer…
As regards starting a family- there does seem to be a lively debate on the influence of estrogen. I was prescribed HRT months after initial stage 1 thin diagnosis by 1 doctor- but recurrence came at 20 months later Stage IIB- and was told by another Dr to drop HRT pre surgery – re DVT and also as not happy to prescribe in view of possible melanoma sensitivity.
There is a heap of info on these boards discussing pregnancy and melanoma. This is a reasonable overview
It might be worth asking your primary provider to do blood tests to help work out how big your likely fertility window might be ?
Good luck- whatever you decide. There is no "right" answer..its what you feel comfortable with in the end- after you've gathered as much helpful information as you can.I think that you are doing really well to be thinking with this level of clarity so few days after diagnosis..
Wishing you the best of future health
Deb
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- August 26, 2016 at 11:41 pm
Hi Deb,
Thank you very much for your input. I appreciate all the help and the well wishes. I feel like this board is way more helpful and thorough in explaining this insidious disease. And obviously the hope and well wishes are even more helpful and heart-warming. Thank you again, Deb!
-
- August 26, 2016 at 11:41 pm
Hi Deb,
Thank you very much for your input. I appreciate all the help and the well wishes. I feel like this board is way more helpful and thorough in explaining this insidious disease. And obviously the hope and well wishes are even more helpful and heart-warming. Thank you again, Deb!
-
- August 26, 2016 at 11:41 pm
Hi Deb,
Thank you very much for your input. I appreciate all the help and the well wishes. I feel like this board is way more helpful and thorough in explaining this insidious disease. And obviously the hope and well wishes are even more helpful and heart-warming. Thank you again, Deb!
-
- August 26, 2016 at 9:09 pm
Hi,
Sorry you are here.Can't say anything about the multiple primary / in transit debate. Sometimes you can never get a clear cut answer…
As regards starting a family- there does seem to be a lively debate on the influence of estrogen. I was prescribed HRT months after initial stage 1 thin diagnosis by 1 doctor- but recurrence came at 20 months later Stage IIB- and was told by another Dr to drop HRT pre surgery – re DVT and also as not happy to prescribe in view of possible melanoma sensitivity.
There is a heap of info on these boards discussing pregnancy and melanoma. This is a reasonable overview
It might be worth asking your primary provider to do blood tests to help work out how big your likely fertility window might be ?
Good luck- whatever you decide. There is no "right" answer..its what you feel comfortable with in the end- after you've gathered as much helpful information as you can.I think that you are doing really well to be thinking with this level of clarity so few days after diagnosis..
Wishing you the best of future health
Deb
-
- August 28, 2016 at 5:53 pm
Hello.. Sorry you are dealing with this. It may have already been mentioned here… but would advocate for a pet scan… I know they say its unnecessary at certain stages… but wish I had advocated for that with my mom. We trusted a repudable melanoma center. She went from stage 1 to stage 4 in 1.5 years and I cant help but think if she had a PeEt scan versus just the WLE and SNB may have seen something back then, I also wonder if we had gone to another center if they would have suggested that. For sure good to get a second opinion! May be over doing it but would give you some peace of mind perhaps exspecially when considering starting a family!
Wishing you all the best!!!
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- August 28, 2016 at 11:10 pm
Incredibly hard to get insurance to pay for PET scans for stage I without symptoms. You need to remember that PET scans don't pick up microscopic cells, they pick up TUMORS at least 5mm or larger. That's why the SLNB is more accurate than a PET for staging. PET scans have something like 600 times more radiation than a chest x-ray – something also to consider.
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- August 28, 2016 at 11:10 pm
Incredibly hard to get insurance to pay for PET scans for stage I without symptoms. You need to remember that PET scans don't pick up microscopic cells, they pick up TUMORS at least 5mm or larger. That's why the SLNB is more accurate than a PET for staging. PET scans have something like 600 times more radiation than a chest x-ray – something also to consider.
-
- August 28, 2016 at 11:10 pm
Incredibly hard to get insurance to pay for PET scans for stage I without symptoms. You need to remember that PET scans don't pick up microscopic cells, they pick up TUMORS at least 5mm or larger. That's why the SLNB is more accurate than a PET for staging. PET scans have something like 600 times more radiation than a chest x-ray – something also to consider.
-
- August 28, 2016 at 5:53 pm
Hello.. Sorry you are dealing with this. It may have already been mentioned here… but would advocate for a pet scan… I know they say its unnecessary at certain stages… but wish I had advocated for that with my mom. We trusted a repudable melanoma center. She went from stage 1 to stage 4 in 1.5 years and I cant help but think if she had a PeEt scan versus just the WLE and SNB may have seen something back then, I also wonder if we had gone to another center if they would have suggested that. For sure good to get a second opinion! May be over doing it but would give you some peace of mind perhaps exspecially when considering starting a family!
Wishing you all the best!!!
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- August 28, 2016 at 5:53 pm
Hello.. Sorry you are dealing with this. It may have already been mentioned here… but would advocate for a pet scan… I know they say its unnecessary at certain stages… but wish I had advocated for that with my mom. We trusted a repudable melanoma center. She went from stage 1 to stage 4 in 1.5 years and I cant help but think if she had a PeEt scan versus just the WLE and SNB may have seen something back then, I also wonder if we had gone to another center if they would have suggested that. For sure good to get a second opinion! May be over doing it but would give you some peace of mind perhaps exspecially when considering starting a family!
Wishing you all the best!!!
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Tagged: cutaneous melanoma
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