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newly diagnosed pT3b

Forums General Melanoma Community newly diagnosed pT3b

  • Post
    kathycaribe
    Participant

      i haven't told my husband and just found out today.  i live in Mexico and my dermatologist did a 2mm margin excision of a mass on my back.  i had it forever and within the last year family has said to get it checked out.  i cannot see it so i have no idea.  i had a long distance (ironman) triathlon planned so i waited to do that.  the last week the lesion began to itch and weep clear fluid.  Dr. Google reassured me that it could still be an SK so i went with that.

      2 days after the triathlon i had it all excised with 2 mm margins.  after reading this site i now know why the derm would not take larger margins – he was saving a SNB possibility for me.  i even told him to go ahead and go for giant margins but he said that if we did that it would limit me.  SO glad he's a smart cookie.

      so got path report back today.  clark III, Breslow 2.8mm, ulcerated, nodular, but clear margins and only 2 mm2 mitotic rate.  derm asked me to do some blood work (specifically LFTs and LDH, after Dr. Google i now know why) and i'll get that tomorrow.  

      i have contacted an onc in a neighborning town and she says to do the blood work and CT scan before seeing her.

      so i guess i need to tell my husband.  we'll see.  

      questions.  is a melanoma specialist onc all that important at this stage?  my thinking is that they will be looking at the CT and rereading the path and ordering the SNB.  

      is a WME (i think that is right, wide margin excision) necessary if my 2mm margins were clear?

      is my thought process correct?, blood work, CT and SNB?  Is the SNB most important person the pathologist or the surgeon?

       

      thanks!

    Viewing 5 reply threads
    • Replies
        kathycaribe
        Participant
          Cutaneous

          weird – can't edit.  also, i have night sweats like crazy but also day sweats.  seem to wax and wane.  currently on an herbal menopause combination (Estroven).  also submandibular lymph nodes have been enlarged forever.  

           

          any correlation with melanoma with above?  should i stop the Estroven?  thanks!

          kathycaribe
          Participant
            Cutaneous

            weird – can't edit.  also, i have night sweats like crazy but also day sweats.  seem to wax and wane.  currently on an herbal menopause combination (Estroven).  also submandibular lymph nodes have been enlarged forever.  

             

            any correlation with melanoma with above?  should i stop the Estroven?  thanks!

            kathycaribe
            Participant
              Cutaneous

              weird – can't edit.  also, i have night sweats like crazy but also day sweats.  seem to wax and wane.  currently on an herbal menopause combination (Estroven).  also submandibular lymph nodes have been enlarged forever.  

               

              any correlation with melanoma with above?  should i stop the Estroven?  thanks!

              Janner
              Participant

                You want a specialist to do the SNB.  That part is critical.  It is often done for breast cancer patients so you can also go that route to look for a surgeon.  Surgeon who does SNBs a LOT is critical because there is a timing and a technique to finding the correct sentinel node.  Obviously, you want it read by a good pathologist but slides can be sent for a second opinion elsewhere and SNB surgery can only be done once.  The melanoma specialist can come later if you need treatment – but get a good surgeon now.

                WLE – wide local excision.  Yes, for a lesion your size, 2cm margins are recommended.  That's a lot different from 2mm.  IT WILL BE A LARGE SCAR because to remove 2cm of tissue all around, you have to have a minimum of 6cm removed in one direction to close the lesion.   Clear margins are only as good as what the pathologist sees and it is very possible that some cells have already started looking to travel elsewhere.  So surgical removal of large margins is very important.

                Blood work – limited value.  RIght now there really isn't any real specific blood work for melanoma.  CT is typically done after the SNB if it is positive.

                Janner
                Participant

                  You want a specialist to do the SNB.  That part is critical.  It is often done for breast cancer patients so you can also go that route to look for a surgeon.  Surgeon who does SNBs a LOT is critical because there is a timing and a technique to finding the correct sentinel node.  Obviously, you want it read by a good pathologist but slides can be sent for a second opinion elsewhere and SNB surgery can only be done once.  The melanoma specialist can come later if you need treatment – but get a good surgeon now.

                  WLE – wide local excision.  Yes, for a lesion your size, 2cm margins are recommended.  That's a lot different from 2mm.  IT WILL BE A LARGE SCAR because to remove 2cm of tissue all around, you have to have a minimum of 6cm removed in one direction to close the lesion.   Clear margins are only as good as what the pathologist sees and it is very possible that some cells have already started looking to travel elsewhere.  So surgical removal of large margins is very important.

                  Blood work – limited value.  RIght now there really isn't any real specific blood work for melanoma.  CT is typically done after the SNB if it is positive.

                  Janner
                  Participant

                    You want a specialist to do the SNB.  That part is critical.  It is often done for breast cancer patients so you can also go that route to look for a surgeon.  Surgeon who does SNBs a LOT is critical because there is a timing and a technique to finding the correct sentinel node.  Obviously, you want it read by a good pathologist but slides can be sent for a second opinion elsewhere and SNB surgery can only be done once.  The melanoma specialist can come later if you need treatment – but get a good surgeon now.

                    WLE – wide local excision.  Yes, for a lesion your size, 2cm margins are recommended.  That's a lot different from 2mm.  IT WILL BE A LARGE SCAR because to remove 2cm of tissue all around, you have to have a minimum of 6cm removed in one direction to close the lesion.   Clear margins are only as good as what the pathologist sees and it is very possible that some cells have already started looking to travel elsewhere.  So surgical removal of large margins is very important.

                    Blood work – limited value.  RIght now there really isn't any real specific blood work for melanoma.  CT is typically done after the SNB if it is positive.

                      kathycaribe
                      Participant
                        Cutaneous

                        HUGE information.  thank you SO MUCH.  i have a referral to a BC onc so i'll go with him for teh SNA and wait on teh CT. 

                         

                        again, thanks SO MUCH!

                        kathycaribe
                        Participant
                          Cutaneous

                          HUGE information.  thank you SO MUCH.  i have a referral to a BC onc so i'll go with him for teh SNA and wait on teh CT. 

                           

                          again, thanks SO MUCH!

                          kathycaribe
                          Participant
                            Cutaneous

                            HUGE information.  thank you SO MUCH.  i have a referral to a BC onc so i'll go with him for teh SNA and wait on teh CT. 

                             

                            again, thanks SO MUCH!

                      Viewing 5 reply threads
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