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Not sure I want to have two full dissections done. Anyone had this done? Will it actually be helpful?
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Not sure I want to have two full dissections done. Anyone had this done? Will it actually be helpful?

› Forums › General Melanoma Community › Not sure I want to have two full dissections done. Anyone had this done? Will it actually be helpful?

  • Post
    • February 23, 2013 at 3:29 am
    johnbil
    Participant

      Hi all

      Diagnosed late in 2012: Back tumor, Breslow 14mm, mitotic 12mm, Clark's IV, ulcerated. Tumor recurred in original excision site (before WLE) in about 4 weeks, at 7mm.

      Hi all

      Diagnosed late in 2012: Back tumor, Breslow 14mm, mitotic 12mm, Clark's IV, ulcerated. Tumor recurred in original excision site (before WLE) in about 4 weeks, at 7mm.

      SNLB showed positive nodes under both arms (1 of 2, and 2 of 5). So doctors are giving me the option of having both full dissections, or not. Chance of morbidity is higher when two dissections are done, they say. At this point, I'm essentially IIIC, with a very active cancer. Is it worth it to have the dissections, and risk a lower quality of life (I'm generally a very active guy, and my work requires me to be), or just accept that it's probably systemic, and just watch and wait?

      Thanks, 

      John

    Viewing 5 reply threads
    • Replies
        • February 23, 2013 at 4:41 am
        washoegal
        Participant

          You need to be looking into clinical trials.  I would not even consider interferon.  Yes, you may want to have at least one CLND done but really at this point you best bet is a clinical trial.

            • February 23, 2013 at 4:54 am
            johnbil
            Participant

              Yeah, I find out on Monday if I'm eligible for Ipi or the BRAF. Problem is, my oncologist isn't sure whether I will need the 2 dissections to be eligible. Definitely pushing for the trials. Already told my onc that I wasn't interested in Interferon…

              • February 23, 2013 at 4:54 am
              johnbil
              Participant

                Yeah, I find out on Monday if I'm eligible for Ipi or the BRAF. Problem is, my oncologist isn't sure whether I will need the 2 dissections to be eligible. Definitely pushing for the trials. Already told my onc that I wasn't interested in Interferon…

                • February 23, 2013 at 4:54 am
                johnbil
                Participant

                  Yeah, I find out on Monday if I'm eligible for Ipi or the BRAF. Problem is, my oncologist isn't sure whether I will need the 2 dissections to be eligible. Definitely pushing for the trials. Already told my onc that I wasn't interested in Interferon…

                • February 23, 2013 at 4:41 am
                washoegal
                Participant

                  You need to be looking into clinical trials.  I would not even consider interferon.  Yes, you may want to have at least one CLND done but really at this point you best bet is a clinical trial.

                  • February 23, 2013 at 4:41 am
                  washoegal
                  Participant

                    You need to be looking into clinical trials.  I would not even consider interferon.  Yes, you may want to have at least one CLND done but really at this point you best bet is a clinical trial.

                    • February 23, 2013 at 5:11 am
                    JerryfromFauq
                    Participant

                      You might be able to push the increased morbidity angle and get Ipi (Yervoy) as for the tumors not being optionally excessional.

                       Another option would be to ask about only having a limited lympectomy done rather than a full one.  In general I am against removal all the lymph nodes in a basin.  Get rid of the cancerous ones and a few clear ones, not a blanket removal of all.    Clinical studies aare being conducted to determine the difference in survival rates between the two methods.

                      A third option would be to convince a Melanoma Onc and surgeon to remove some from one side and to try direct injections of certain chemo agents into the cancerous lymph nodes in the other armpit while you recover from the first operation.  I would not want both sides cut on at the same time. 

                      i have never heard of trying direct injections into cancerous lympn nodes, but this is sometimes tried in other melanoma tumors.  (It work for twelve of Charlie's tumors!  He had to get his NC Onc team to coordinate with Onc's at MDA before they did it.)

                       

                        • February 23, 2013 at 5:17 am
                        johnbil
                        Participant

                          I did indicate that I would submit to one dissection (the "worst" side). Interesting suggestion about the injections on the other side. I will definitely foat that idea. Thanks.

                          • February 26, 2013 at 10:24 pm
                          johnbil
                          Participant

                            For now, they are saying that I would need to get full dissections done on both sides, to join any study, so I am just going to watch and wait. 

                            • February 26, 2013 at 10:24 pm
                            johnbil
                            Participant

                              For now, they are saying that I would need to get full dissections done on both sides, to join any study, so I am just going to watch and wait. 

                              • February 26, 2013 at 10:24 pm
                              johnbil
                              Participant

                                For now, they are saying that I would need to get full dissections done on both sides, to join any study, so I am just going to watch and wait. 

                                • February 23, 2013 at 5:17 am
                                johnbil
                                Participant

                                  I did indicate that I would submit to one dissection (the "worst" side). Interesting suggestion about the injections on the other side. I will definitely foat that idea. Thanks.

                                  • February 23, 2013 at 5:17 am
                                  johnbil
                                  Participant

                                    I did indicate that I would submit to one dissection (the "worst" side). Interesting suggestion about the injections on the other side. I will definitely foat that idea. Thanks.

                                  • February 23, 2013 at 5:11 am
                                  JerryfromFauq
                                  Participant

                                    You might be able to push the increased morbidity angle and get Ipi (Yervoy) as for the tumors not being optionally excessional.

                                     Another option would be to ask about only having a limited lympectomy done rather than a full one.  In general I am against removal all the lymph nodes in a basin.  Get rid of the cancerous ones and a few clear ones, not a blanket removal of all.    Clinical studies aare being conducted to determine the difference in survival rates between the two methods.

                                    A third option would be to convince a Melanoma Onc and surgeon to remove some from one side and to try direct injections of certain chemo agents into the cancerous lymph nodes in the other armpit while you recover from the first operation.  I would not want both sides cut on at the same time. 

                                    i have never heard of trying direct injections into cancerous lympn nodes, but this is sometimes tried in other melanoma tumors.  (It work for twelve of Charlie's tumors!  He had to get his NC Onc team to coordinate with Onc's at MDA before they did it.)

                                     

                                    • February 23, 2013 at 5:11 am
                                    JerryfromFauq
                                    Participant

                                      You might be able to push the increased morbidity angle and get Ipi (Yervoy) as for the tumors not being optionally excessional.

                                       Another option would be to ask about only having a limited lympectomy done rather than a full one.  In general I am against removal all the lymph nodes in a basin.  Get rid of the cancerous ones and a few clear ones, not a blanket removal of all.    Clinical studies aare being conducted to determine the difference in survival rates between the two methods.

                                      A third option would be to convince a Melanoma Onc and surgeon to remove some from one side and to try direct injections of certain chemo agents into the cancerous lymph nodes in the other armpit while you recover from the first operation.  I would not want both sides cut on at the same time. 

                                      i have never heard of trying direct injections into cancerous lympn nodes, but this is sometimes tried in other melanoma tumors.  (It work for twelve of Charlie's tumors!  He had to get his NC Onc team to coordinate with Onc's at MDA before they did it.)

                                       

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