Newly Diagnosed – Scared

I am sorry you are going through this. Next step would be a wide exicision and a sentinel node biopsy. Do you have a referral already?

I got my diagnostic (T1b as well) on the 15th of December, and I had my surgeries two weeks later. I had to call and ask and do my best to be seen asap.

Is there anything in particular you would like to know?

I am sorry you are going through this. Next step would be a wide exicision and a sentinel node biopsy. Do you have a referral already?

I got my diagnostic (T1b as well) on the 15th of December, and I had my surgeries two weeks later. I had to call and ask and do my best to be seen asap.

Is there anything in particular you would like to know?

I am sorry you are going through this. Next step would be a wide exicision and a sentinel node biopsy. Do you have a referral already?

I got my diagnostic (T1b as well) on the 15th of December, and I had my surgeries two weeks later. I had to call and ask and do my best to be seen asap.

Is there anything in particular you would like to know?

Hi showmegirl, I am sure someone with more knowledge in staging will post but for now I will help you out with a couple of points to consider. The depth of at least 1.88 is given and they used "at least" because the person who did the biopsy didn't go quite deep enough since the report shows deep margins postive. They can fix that with the wide excesion. The other information will be used by the surgeon and oncologist to help identify the risk factor. They will take into consideration things like Ulceration (which you don't have) good thing and they will consider mitotic rate which is how fast cells are growing along with the thickness of tumor. The surgeon will talk with you about next steps based on the results of pathology report. If you want to learn more I will give you a link where they explain what pathalogists look at. For many people they kind of get freaked out at the beginning so maybe waiting and talking to a medical professional might be the best thing to do at this stage of things. Best Wishes!!!Ed  here is the link https://www.youtube.com/watch?v=2wmeyNjFKQw

Hi showmegirl, I am sure someone with more knowledge in staging will post but for now I will help you out with a couple of points to consider. The depth of at least 1.88 is given and they used "at least" because the person who did the biopsy didn't go quite deep enough since the report shows deep margins postive. They can fix that with the wide excesion. The other information will be used by the surgeon and oncologist to help identify the risk factor. They will take into consideration things like Ulceration (which you don't have) good thing and they will consider mitotic rate which is how fast cells are growing along with the thickness of tumor. The surgeon will talk with you about next steps based on the results of pathology report. If you want to learn more I will give you a link where they explain what pathalogists look at. For many people they kind of get freaked out at the beginning so maybe waiting and talking to a medical professional might be the best thing to do at this stage of things. Best Wishes!!!Ed  here is the link https://www.youtube.com/watch?v=2wmeyNjFKQw

Hi showmegirl, I am sure someone with more knowledge in staging will post but for now I will help you out with a couple of points to consider. The depth of at least 1.88 is given and they used "at least" because the person who did the biopsy didn't go quite deep enough since the report shows deep margins postive. They can fix that with the wide excesion. The other information will be used by the surgeon and oncologist to help identify the risk factor. They will take into consideration things like Ulceration (which you don't have) good thing and they will consider mitotic rate which is how fast cells are growing along with the thickness of tumor. The surgeon will talk with you about next steps based on the results of pathology report. If you want to learn more I will give you a link where they explain what pathalogists look at. For many people they kind of get freaked out at the beginning so maybe waiting and talking to a medical professional might be the best thing to do at this stage of things. Best Wishes!!!Ed  here is the link https://www.youtube.com/watch?v=2wmeyNjFKQw

Hi There Miss Missouri,

Sorry you have joined the club.  The good news is you will be seeing a surgeon right away, and as noted, they will schedule a wide excision (to get clear margins around and below) and do a sentinel lymph node biopsy (SLNB) which will determine whether any mel has spread to lymph nodes.  Until you do this next step, you need to do your best to try not to dwell on it, and stay off the internet as statistics are out of date, and many new treatment options have recently been introduced.  Keep yourself busy with life, and take this one step at a time.  Until the SLNB is done, you don't know what stage you may be, and that will be the crucial point where treatment options occur.

Gary

Hi There Miss Missouri,

Sorry you have joined the club.  The good news is you will be seeing a surgeon right away, and as noted, they will schedule a wide excision (to get clear margins around and below) and do a sentinel lymph node biopsy (SLNB) which will determine whether any mel has spread to lymph nodes.  Until you do this next step, you need to do your best to try not to dwell on it, and stay off the internet as statistics are out of date, and many new treatment options have recently been introduced.  Keep yourself busy with life, and take this one step at a time.  Until the SLNB is done, you don't know what stage you may be, and that will be the crucial point where treatment options occur.

Gary

Hi There Miss Missouri,

Sorry you have joined the club.  The good news is you will be seeing a surgeon right away, and as noted, they will schedule a wide excision (to get clear margins around and below) and do a sentinel lymph node biopsy (SLNB) which will determine whether any mel has spread to lymph nodes.  Until you do this next step, you need to do your best to try not to dwell on it, and stay off the internet as statistics are out of date, and many new treatment options have recently been introduced.  Keep yourself busy with life, and take this one step at a time.  Until the SLNB is done, you don't know what stage you may be, and that will be the crucial point where treatment options occur.

Gary

Sorry to hear you've been diagnosed with melanoma. Where do you have it? I had mine on my lower leg and also had the nodular type. I'm glad to hear your seeing the surgeon this week and push for surgery asap. Are you seeing a Melanoma Specialist? Let us know how things go. 

Sorry to hear you've been diagnosed with melanoma. Where do you have it? I had mine on my lower leg and also had the nodular type. I'm glad to hear your seeing the surgeon this week and push for surgery asap. Are you seeing a Melanoma Specialist? Let us know how things go. 

Sorry to hear you've been diagnosed with melanoma. Where do you have it? I had mine on my lower leg and also had the nodular type. I'm glad to hear your seeing the surgeon this week and push for surgery asap. Are you seeing a Melanoma Specialist? Let us know how things go. 

May I ask what part of Missouri you are in.  I am in Missouri.  I initially went to Columbia but am now being served in Kansas City.  Keep vigilant and keep your chin up.

May I ask what part of Missouri you are in.  I am in Missouri.  I initially went to Columbia but am now being served in Kansas City.  Keep vigilant and keep your chin up.

May I ask what part of Missouri you are in.  I am in Missouri.  I initially went to Columbia but am now being served in Kansas City.  Keep vigilant and keep your chin up.

Sorry you are with us. This stuff is life-changing… or it can be. Maybe some are stoic about things, me – melanoma crosses my mind almost daily…

I think there are kind of three rough categories of diagnosis – the 'I dodged a bullet' in situ or very thin superficial spreading melanomas, the 'bugger, this could go pear shaped' nodular (more aggressive/generally faster growing) or indeterminate depth sort, and the 'all hands on deck, we have a battle' not found til very deep sort.

Yours, to me, is in the middle category – it's nodular (thought to be more aggressive) and it has not been fully excised (at least 1.88) and even at that dept is getting towards the intermediate depth and no longer thin. This means it may have come into contact with lymphatic or vascular pathways… and the little sucker may or may not be on the move.  Then again, it might not – let's hope that is the case.

Did you have an excisional biopsy? Or some shallow shave or something? Just a shame you didn't get a definitive depth/tumor thickness as this is by far the greatest indicator of seriousness. At the depth of at least 1.88mm, you are looking at a 1-2cm Wide Level Excision (cutting 1-2cm of healthy skin from around the site of the biopsy) plus a sentinely lymph node biopsy (to see if any melanoma cells have moved to the lymph nodes). The SLNB will allow you to be staged properly – right now you are 'at least pT1B' – this could stay the same OR it could change depending on the SLNB result.

We could get into the nitty gritty of what each line of your report means but the outcome is the same: a WLE and a SLNB. If you are not offered both, insist on them.

Stay on this board – vent, ask questons, whatever – this is what we are here for. We are all in the same horrible yet oddly life-affirming position of having a melanoma diagnosis.

Sorry you are with us. This stuff is life-changing… or it can be. Maybe some are stoic about things, me – melanoma crosses my mind almost daily…

I think there are kind of three rough categories of diagnosis – the 'I dodged a bullet' in situ or very thin superficial spreading melanomas, the 'bugger, this could go pear shaped' nodular (more aggressive/generally faster growing) or indeterminate depth sort, and the 'all hands on deck, we have a battle' not found til very deep sort.

Yours, to me, is in the middle category – it's nodular (thought to be more aggressive) and it has not been fully excised (at least 1.88) and even at that dept is getting towards the intermediate depth and no longer thin. This means it may have come into contact with lymphatic or vascular pathways… and the little sucker may or may not be on the move.  Then again, it might not – let's hope that is the case.

Did you have an excisional biopsy? Or some shallow shave or something? Just a shame you didn't get a definitive depth/tumor thickness as this is by far the greatest indicator of seriousness. At the depth of at least 1.88mm, you are looking at a 1-2cm Wide Level Excision (cutting 1-2cm of healthy skin from around the site of the biopsy) plus a sentinely lymph node biopsy (to see if any melanoma cells have moved to the lymph nodes). The SLNB will allow you to be staged properly – right now you are 'at least pT1B' – this could stay the same OR it could change depending on the SLNB result.

We could get into the nitty gritty of what each line of your report means but the outcome is the same: a WLE and a SLNB. If you are not offered both, insist on them.

Stay on this board – vent, ask questons, whatever – this is what we are here for. We are all in the same horrible yet oddly life-affirming position of having a melanoma diagnosis.

Sorry you are with us. This stuff is life-changing… or it can be. Maybe some are stoic about things, me – melanoma crosses my mind almost daily…

I think there are kind of three rough categories of diagnosis – the 'I dodged a bullet' in situ or very thin superficial spreading melanomas, the 'bugger, this could go pear shaped' nodular (more aggressive/generally faster growing) or indeterminate depth sort, and the 'all hands on deck, we have a battle' not found til very deep sort.

Yours, to me, is in the middle category – it's nodular (thought to be more aggressive) and it has not been fully excised (at least 1.88) and even at that dept is getting towards the intermediate depth and no longer thin. This means it may have come into contact with lymphatic or vascular pathways… and the little sucker may or may not be on the move.  Then again, it might not – let's hope that is the case.

Did you have an excisional biopsy? Or some shallow shave or something? Just a shame you didn't get a definitive depth/tumor thickness as this is by far the greatest indicator of seriousness. At the depth of at least 1.88mm, you are looking at a 1-2cm Wide Level Excision (cutting 1-2cm of healthy skin from around the site of the biopsy) plus a sentinely lymph node biopsy (to see if any melanoma cells have moved to the lymph nodes). The SLNB will allow you to be staged properly – right now you are 'at least pT1B' – this could stay the same OR it could change depending on the SLNB result.

We could get into the nitty gritty of what each line of your report means but the outcome is the same: a WLE and a SLNB. If you are not offered both, insist on them.

Stay on this board – vent, ask questons, whatever – this is what we are here for. We are all in the same horrible yet oddly life-affirming position of having a melanoma diagnosis.

Hi ShowMe, we have similar path reports and I am little ahead of you in treatment. I had the WLE and SNB done a week ago today. I seen my surgeon yesterday to review healing of the sites. All are healing well. I was worried about the pain for teh skin graph, however, to be honest my donor site was small and did not affect mobility. I was able to stay on Ibuphronin and Tylenol. I took 3 days off work and have resumed this week, though I am working from home. 

I go back in a week and hope to hear teh SNB is  clear.

Heed the advice of staying off the internet and searching you will drive yourself crazy with the what ifs.

Best of luck, stay positive.

Hi ShowMe, we have similar path reports and I am little ahead of you in treatment. I had the WLE and SNB done a week ago today. I seen my surgeon yesterday to review healing of the sites. All are healing well. I was worried about the pain for teh skin graph, however, to be honest my donor site was small and did not affect mobility. I was able to stay on Ibuphronin and Tylenol. I took 3 days off work and have resumed this week, though I am working from home. 

I go back in a week and hope to hear teh SNB is  clear.

Heed the advice of staying off the internet and searching you will drive yourself crazy with the what ifs.

Best of luck, stay positive.

Hi ShowMe, we have similar path reports and I am little ahead of you in treatment. I had the WLE and SNB done a week ago today. I seen my surgeon yesterday to review healing of the sites. All are healing well. I was worried about the pain for teh skin graph, however, to be honest my donor site was small and did not affect mobility. I was able to stay on Ibuphronin and Tylenol. I took 3 days off work and have resumed this week, though I am working from home. 

I go back in a week and hope to hear teh SNB is  clear.

Heed the advice of staying off the internet and searching you will drive yourself crazy with the what ifs.

Best of luck, stay positive.