Only isolated cells found in one lymph node, no CLND says onco surgeon

Hi  again,

Got the feeling that  your results genie would be out of the lamp before next week…

Ok – Delighted the toes are staying.

Does your snb say that they detected some single cells of melanoma and they are microscopic.?

Melanoma cells seem to develop into "nests" that are clustered together and grow into tumours. So a nest would be a collection of cells and comes later than isolated cells.

If they have found microscopic traces but only in the sentinel node then I believe you are being advised that CLND complete lymph node dissection – is not needed as they already removed that lymph node with the tiny trace- so the benefit of removal of the others is likely to be far outweighed by the risk of surgery ,lymphoedema etc  So the headline is You are NED- no evidence of disease . 

This spells out the stages so you can draw your own conclusions on staging if you have any more information to add to the picture.

 https://www.melanoma.org/understand-melanoma/diagnosing-melanoma/stages-of-diagnosis

If my assumptions are correct you have strayed the tiniest possible fraction into Stage III territory (sorry ) but have already undergone appropriate surgical treatment.  

Breathe a big sigh of relief and celebrate .

Deb

Hi  again,

Got the feeling that  your results genie would be out of the lamp before next week…

Ok – Delighted the toes are staying.

Does your snb say that they detected some single cells of melanoma and they are microscopic.?

Melanoma cells seem to develop into "nests" that are clustered together and grow into tumours. So a nest would be a collection of cells and comes later than isolated cells.

If they have found microscopic traces but only in the sentinel node then I believe you are being advised that CLND complete lymph node dissection – is not needed as they already removed that lymph node with the tiny trace- so the benefit of removal of the others is likely to be far outweighed by the risk of surgery ,lymphoedema etc  So the headline is You are NED- no evidence of disease . 

This spells out the stages so you can draw your own conclusions on staging if you have any more information to add to the picture.

 https://www.melanoma.org/understand-melanoma/diagnosing-melanoma/stages-of-diagnosis

If my assumptions are correct you have strayed the tiniest possible fraction into Stage III territory (sorry ) but have already undergone appropriate surgical treatment.  

Breathe a big sigh of relief and celebrate .

Deb

Hi  again,

Got the feeling that  your results genie would be out of the lamp before next week…

Ok – Delighted the toes are staying.

Does your snb say that they detected some single cells of melanoma and they are microscopic.?

Melanoma cells seem to develop into "nests" that are clustered together and grow into tumours. So a nest would be a collection of cells and comes later than isolated cells.

If they have found microscopic traces but only in the sentinel node then I believe you are being advised that CLND complete lymph node dissection – is not needed as they already removed that lymph node with the tiny trace- so the benefit of removal of the others is likely to be far outweighed by the risk of surgery ,lymphoedema etc  So the headline is You are NED- no evidence of disease . 

This spells out the stages so you can draw your own conclusions on staging if you have any more information to add to the picture.

 https://www.melanoma.org/understand-melanoma/diagnosing-melanoma/stages-of-diagnosis

If my assumptions are correct you have strayed the tiniest possible fraction into Stage III territory (sorry ) but have already undergone appropriate surgical treatment.  

Breathe a big sigh of relief and celebrate .

Deb

My father also had a microscopic mel in his sentinel node, did also a complete LND and all was clear… However a few years later he progressed to stage IV… so in my opinion, it would be better to stage you at III and give you some immunotherapy (not sure if you qualify if you are stage II)…

nevertheless, you have good results!

take care,

Patrisa

My father also had a microscopic mel in his sentinel node, did also a complete LND and all was clear… However a few years later he progressed to stage IV… so in my opinion, it would be better to stage you at III and give you some immunotherapy (not sure if you qualify if you are stage II)…

nevertheless, you have good results!

take care,

Patrisa

My father also had a microscopic mel in his sentinel node, did also a complete LND and all was clear… However a few years later he progressed to stage IV… so in my opinion, it would be better to stage you at III and give you some immunotherapy (not sure if you qualify if you are stage II)…

nevertheless, you have good results!

take care,

Patrisa

The cells found in my lymph nodes were also microscopic. Still makes me stage 3 but also gave me the ability to start on Ipi for an adjuvant treatment in the hopes to prevent it from coming back.

So, based on what I know, even with one lymph node showing microscopic evidence, that still puts you in the stage 3 category, but just over the hump from 2 and still good news. It also means you should have the option to do adjuvant treatment if you wanted to. 

Your doctor should go over staging and where you fall and all of that with you too, so you better understand your options.

The cells found in my lymph nodes were also microscopic. Still makes me stage 3 but also gave me the ability to start on Ipi for an adjuvant treatment in the hopes to prevent it from coming back.

So, based on what I know, even with one lymph node showing microscopic evidence, that still puts you in the stage 3 category, but just over the hump from 2 and still good news. It also means you should have the option to do adjuvant treatment if you wanted to. 

Your doctor should go over staging and where you fall and all of that with you too, so you better understand your options.

The cells found in my lymph nodes were also microscopic. Still makes me stage 3 but also gave me the ability to start on Ipi for an adjuvant treatment in the hopes to prevent it from coming back.

So, based on what I know, even with one lymph node showing microscopic evidence, that still puts you in the stage 3 category, but just over the hump from 2 and still good news. It also means you should have the option to do adjuvant treatment if you wanted to. 

Your doctor should go over staging and where you fall and all of that with you too, so you better understand your options.

Sounds like good news! Wishing you speedy healing and long health.

I saw an "integrative oncologist" after I decided not to do interferon and I found it helpful. He discussed lifestyle, diet, supplements, etc. to maximize health/immunity in order to decrease likelihood of recurrences and to be in best possible health to face treatment if recurrence does occur. The hard part for me will be, I think, staying motivated to implement his recommendations as my fear fades. 

Blessings, 

Joyce

Sounds like good news! Wishing you speedy healing and long health.

I saw an "integrative oncologist" after I decided not to do interferon and I found it helpful. He discussed lifestyle, diet, supplements, etc. to maximize health/immunity in order to decrease likelihood of recurrences and to be in best possible health to face treatment if recurrence does occur. The hard part for me will be, I think, staying motivated to implement his recommendations as my fear fades. 

Blessings, 

Joyce

Sounds like good news! Wishing you speedy healing and long health.

I saw an "integrative oncologist" after I decided not to do interferon and I found it helpful. He discussed lifestyle, diet, supplements, etc. to maximize health/immunity in order to decrease likelihood of recurrences and to be in best possible health to face treatment if recurrence does occur. The hard part for me will be, I think, staying motivated to implement his recommendations as my fear fades. 

Blessings, 

Joyce

Hello!!!

i just wanted to reply that you and I have almost the identical situation!! I had two isolated tumor cells found in my sentinel node. Mine were very microscopic and had not began to cluster or mat. Unfortunately my oncologist (two oncs actually as I got a second opinion) told me that although they were only microscopic that any trace of melanoma in your node elevates you to a stage 3. However he said that research does show in breast cancer patients that if isolated tumor cells are found in the SLNB they consider the node to be negative and do not elevate the stage. Unfortunately they don't have the same amount of research in melanoma patients at this time so for now they still stage us at a 3. He said that there are a few studies out there right now that are trying to determine the significance of isolated tumor cells in Melanoma patients but those results won't be in for a few years. So here we are in the "limbo" stage. 

Both oncologists I saw gave me the option of immunotherapy. One insisted on the CLND and the other said no way. My second oncologist said that both the risks of immunotherapy and the CLND far outweighed any benefits for a patient like me so I chose the "watch and wait" approach. I get CT scans every 3 months (although now I just graduated to every 4 months) and skin checks every 3 months. I am very comfortable with that decision and things have been going great so far! Just had my one year cancer free scan! Yeah me!

My oncologist feels my chance of recurrence is about 15-20%. I feel the general populations chance of getting cancer is about the same (if not higher) but unlike everyone else, I'm watched VERY closely so if I do progress we will catch it early. I can live with that.

The bottom line is whatever you decide will be your personal decision and what you feel is best for you! I know this stage of the game is the worst part but trust me it does get better!!

Jenna

Hello!!!

i just wanted to reply that you and I have almost the identical situation!! I had two isolated tumor cells found in my sentinel node. Mine were very microscopic and had not began to cluster or mat. Unfortunately my oncologist (two oncs actually as I got a second opinion) told me that although they were only microscopic that any trace of melanoma in your node elevates you to a stage 3. However he said that research does show in breast cancer patients that if isolated tumor cells are found in the SLNB they consider the node to be negative and do not elevate the stage. Unfortunately they don't have the same amount of research in melanoma patients at this time so for now they still stage us at a 3. He said that there are a few studies out there right now that are trying to determine the significance of isolated tumor cells in Melanoma patients but those results won't be in for a few years. So here we are in the "limbo" stage. 

Both oncologists I saw gave me the option of immunotherapy. One insisted on the CLND and the other said no way. My second oncologist said that both the risks of immunotherapy and the CLND far outweighed any benefits for a patient like me so I chose the "watch and wait" approach. I get CT scans every 3 months (although now I just graduated to every 4 months) and skin checks every 3 months. I am very comfortable with that decision and things have been going great so far! Just had my one year cancer free scan! Yeah me!

My oncologist feels my chance of recurrence is about 15-20%. I feel the general populations chance of getting cancer is about the same (if not higher) but unlike everyone else, I'm watched VERY closely so if I do progress we will catch it early. I can live with that.

The bottom line is whatever you decide will be your personal decision and what you feel is best for you! I know this stage of the game is the worst part but trust me it does get better!!

Jenna

Hello!!!

i just wanted to reply that you and I have almost the identical situation!! I had two isolated tumor cells found in my sentinel node. Mine were very microscopic and had not began to cluster or mat. Unfortunately my oncologist (two oncs actually as I got a second opinion) told me that although they were only microscopic that any trace of melanoma in your node elevates you to a stage 3. However he said that research does show in breast cancer patients that if isolated tumor cells are found in the SLNB they consider the node to be negative and do not elevate the stage. Unfortunately they don't have the same amount of research in melanoma patients at this time so for now they still stage us at a 3. He said that there are a few studies out there right now that are trying to determine the significance of isolated tumor cells in Melanoma patients but those results won't be in for a few years. So here we are in the "limbo" stage. 

Both oncologists I saw gave me the option of immunotherapy. One insisted on the CLND and the other said no way. My second oncologist said that both the risks of immunotherapy and the CLND far outweighed any benefits for a patient like me so I chose the "watch and wait" approach. I get CT scans every 3 months (although now I just graduated to every 4 months) and skin checks every 3 months. I am very comfortable with that decision and things have been going great so far! Just had my one year cancer free scan! Yeah me!

My oncologist feels my chance of recurrence is about 15-20%. I feel the general populations chance of getting cancer is about the same (if not higher) but unlike everyone else, I'm watched VERY closely so if I do progress we will catch it early. I can live with that.

The bottom line is whatever you decide will be your personal decision and what you feel is best for you! I know this stage of the game is the worst part but trust me it does get better!!

Jenna