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SNB results – what does it mean?

Forums Cutaneous Melanoma Community SNB results – what does it mean?

  • Post
    Karolina
    Participant

      Sorry for asking, again, silly question, but due to the lack of clarity from the doctor, i am trying to find out as much information as possible from this forum. And as so far, I wasn’t disappointed. Thank you

      Now I am trying to find out whether negative result of SNB means that this cancer COULD NOT spread elsewhere? Or, is it possible that SNB is negative but cells could spread somewhere in the body via different way? Bear in mind that I am still talking about Desmoplastic melanoma, which I understand may behave different to other melanomas…

      Sorry for asking, again, silly question, but due to the lack of clarity from the doctor, i am trying to find out as much information as possible from this forum. And as so far, I wasn’t disappointed. Thank you

      Now I am trying to find out whether negative result of SNB means that this cancer COULD NOT spread elsewhere? Or, is it possible that SNB is negative but cells could spread somewhere in the body via different way? Bear in mind that I am still talking about Desmoplastic melanoma, which I understand may behave different to other melanomas…

      I am a bit concerned as my friend had 3 operations already, at the moment she has an opened wound as the doctor wants to make sure that there are no more cancer cells after last (3rd operation).  However, I wonder whether this cancer could spread elsewhere if, in fact, it is on my friend’s skin for at least last 5 months! If SNB is negative, does it mean that the cancer CAN NOT spread elsewhere by other means? To date my friend had no other treatment done i.e. CT or blood test. Is it also a standard procedure and is not required?

      Please advise

    Viewing 2 reply threads
    • Replies
        lhaley
        Participant

          Karolina,

          I can't give you info about  Desmoplastic melanoma but some of the info is general.  There is no guarantee with a SNB.  My first primary was in 1979 (they hadn't even invented them at the time).  It metasticized deeply under the scar and became stage IV in 2006.   No lymph nodes were involved until 2010!   That year it went to lymph nodes in 3 areas and then recently to the brain.  Like I said, there are no guarantees.   For many an SNB tells you where it is going but sometimes the  cells have also not traveled yet to the lymph nodes.  I've been told that 8% travel go in the blood, not in the nodes.

          Blood work is not usually going to help your friend as part of a standard procedure.  Those who have advanced problems in the areas of liver will give you numbers, otherwise the standard blood tests will not give you information.

          Has your friend have a full body PET scan or other CT scans?  It sounds as if the Dr is being cared by a surgeon. Is an oncologist also involved?

          Linda

          lhaley
          Participant

            Karolina,

            I can't give you info about  Desmoplastic melanoma but some of the info is general.  There is no guarantee with a SNB.  My first primary was in 1979 (they hadn't even invented them at the time).  It metasticized deeply under the scar and became stage IV in 2006.   No lymph nodes were involved until 2010!   That year it went to lymph nodes in 3 areas and then recently to the brain.  Like I said, there are no guarantees.   For many an SNB tells you where it is going but sometimes the  cells have also not traveled yet to the lymph nodes.  I've been told that 8% travel go in the blood, not in the nodes.

            Blood work is not usually going to help your friend as part of a standard procedure.  Those who have advanced problems in the areas of liver will give you numbers, otherwise the standard blood tests will not give you information.

            Has your friend have a full body PET scan or other CT scans?  It sounds as if the Dr is being cared by a surgeon. Is an oncologist also involved?

            Linda

            lhaley
            Participant

              Karolina,

              I can't give you info about  Desmoplastic melanoma but some of the info is general.  There is no guarantee with a SNB.  My first primary was in 1979 (they hadn't even invented them at the time).  It metasticized deeply under the scar and became stage IV in 2006.   No lymph nodes were involved until 2010!   That year it went to lymph nodes in 3 areas and then recently to the brain.  Like I said, there are no guarantees.   For many an SNB tells you where it is going but sometimes the  cells have also not traveled yet to the lymph nodes.  I've been told that 8% travel go in the blood, not in the nodes.

              Blood work is not usually going to help your friend as part of a standard procedure.  Those who have advanced problems in the areas of liver will give you numbers, otherwise the standard blood tests will not give you information.

              Has your friend have a full body PET scan or other CT scans?  It sounds as if the Dr is being cared by a surgeon. Is an oncologist also involved?

              Linda

                Karolina
                Participant

                  Linda,

                   Thank you for your reply. The person who is involved in my friend’s disease is a surgeon who is specialised in cancer’s surgical. He is consulting everything with someone but we don’t know who it is. You have asked whether she had a full body PET scan or other CT scans. NO!!! That’s why I am so  concerned because I don’t know whether she should have it done BUT because of negative SNB he decided not to do OR, apologise for being rude, he is not a competent person. However, I would expect him consulting anything with a competent person.

                   The other thought in my head are, although I hope really that  this is not the case, that he knows already that this cancer went very far and there is not a lot he can do. Please bear in mind that this thought is based on lack or recognition of the cancer in a first place (by this same person), 2 operations which we re unsuccessful and  3rd operation which is not  yet confirmed as successful or not.

                   As so far, unfortunately, I haven’t been given the answer as to what are the standard steps in dealing with this type of cancer. I mean, what should be done and what is not necessary or what is recommended but not necessary. I appreciate that it is very much dependent of the stage of it BUT the problem is that my friend has not been told that as yet. And it is hard to believe that the doctor doesn’t know what.

                   As mentioned before, my friend feels she receives a good service from her consultant hence she doesn’t want to even talk about changing anything or even about asking for a second opinion. I feel t hat something is wrong but no one has said anything and we can’t help my friend at all. The doctor doesn’t even want to talk to her husband as he is not a patient!!!

                   I am so concerned….

                  Karolina
                  Participant

                    Linda,

                     Thank you for your reply. The person who is involved in my friend’s disease is a surgeon who is specialised in cancer’s surgical. He is consulting everything with someone but we don’t know who it is. You have asked whether she had a full body PET scan or other CT scans. NO!!! That’s why I am so  concerned because I don’t know whether she should have it done BUT because of negative SNB he decided not to do OR, apologise for being rude, he is not a competent person. However, I would expect him consulting anything with a competent person.

                     The other thought in my head are, although I hope really that  this is not the case, that he knows already that this cancer went very far and there is not a lot he can do. Please bear in mind that this thought is based on lack or recognition of the cancer in a first place (by this same person), 2 operations which we re unsuccessful and  3rd operation which is not  yet confirmed as successful or not.

                     As so far, unfortunately, I haven’t been given the answer as to what are the standard steps in dealing with this type of cancer. I mean, what should be done and what is not necessary or what is recommended but not necessary. I appreciate that it is very much dependent of the stage of it BUT the problem is that my friend has not been told that as yet. And it is hard to believe that the doctor doesn’t know what.

                     As mentioned before, my friend feels she receives a good service from her consultant hence she doesn’t want to even talk about changing anything or even about asking for a second opinion. I feel t hat something is wrong but no one has said anything and we can’t help my friend at all. The doctor doesn’t even want to talk to her husband as he is not a patient!!!

                     I am so concerned….

                    Karolina
                    Participant

                      Linda,

                       Thank you for your reply. The person who is involved in my friend’s disease is a surgeon who is specialised in cancer’s surgical. He is consulting everything with someone but we don’t know who it is. You have asked whether she had a full body PET scan or other CT scans. NO!!! That’s why I am so  concerned because I don’t know whether she should have it done BUT because of negative SNB he decided not to do OR, apologise for being rude, he is not a competent person. However, I would expect him consulting anything with a competent person.

                       The other thought in my head are, although I hope really that  this is not the case, that he knows already that this cancer went very far and there is not a lot he can do. Please bear in mind that this thought is based on lack or recognition of the cancer in a first place (by this same person), 2 operations which we re unsuccessful and  3rd operation which is not  yet confirmed as successful or not.

                       As so far, unfortunately, I haven’t been given the answer as to what are the standard steps in dealing with this type of cancer. I mean, what should be done and what is not necessary or what is recommended but not necessary. I appreciate that it is very much dependent of the stage of it BUT the problem is that my friend has not been told that as yet. And it is hard to believe that the doctor doesn’t know what.

                       As mentioned before, my friend feels she receives a good service from her consultant hence she doesn’t want to even talk about changing anything or even about asking for a second opinion. I feel t hat something is wrong but no one has said anything and we can’t help my friend at all. The doctor doesn’t even want to talk to her husband as he is not a patient!!!

                       I am so concerned….

                      lhaley
                      Participant

                        Most of us have a "team" of Doctors.  When I went to stage IV I had a surgical oncologist, a plastic surgeon and a oncologist.  Now with my cancer having progressed my team is even larger!   It sounds like your friend needs to expand their medical team.   (THis was in 06 and I was not happy with one of the Doctors and I moved on to a different hospital)

                        Can't even imagine that your husband is not also talked to!   My husband sits in on all appointments and while it's taken him awhile to feel comfortable he now asks important questions, and also talks to the Doctors on the phone. 

                        The hospital that I go to uses a tumor board. My melanoma specialist is the one that leads my particular case but usually the oncology surgeon (he happens to also be a mel specialist)), my urologist oncology (my particular case) and now a radiologist and last time was also the neuro surgeon.  The more imput the better clarification and options that the patient are offered.  

                        Patients go to get 2nd opinions all of the time!  I've now gone to my mel specialist for over 3 years.  When I made the decision with my brain met and had a discussion with my Dr I told him who I had talked to for my second …. and 3rd opinion (actually there were 2 more Doctors I talked to also) and he told me that he would have been upset if I hadn't also talked to others also. 

                        Your friend is the one that needs to make some changes, a second  opinion is the place to start.

                        Linda

                        lhaley
                        Participant

                          Most of us have a "team" of Doctors.  When I went to stage IV I had a surgical oncologist, a plastic surgeon and a oncologist.  Now with my cancer having progressed my team is even larger!   It sounds like your friend needs to expand their medical team.   (THis was in 06 and I was not happy with one of the Doctors and I moved on to a different hospital)

                          Can't even imagine that your husband is not also talked to!   My husband sits in on all appointments and while it's taken him awhile to feel comfortable he now asks important questions, and also talks to the Doctors on the phone. 

                          The hospital that I go to uses a tumor board. My melanoma specialist is the one that leads my particular case but usually the oncology surgeon (he happens to also be a mel specialist)), my urologist oncology (my particular case) and now a radiologist and last time was also the neuro surgeon.  The more imput the better clarification and options that the patient are offered.  

                          Patients go to get 2nd opinions all of the time!  I've now gone to my mel specialist for over 3 years.  When I made the decision with my brain met and had a discussion with my Dr I told him who I had talked to for my second …. and 3rd opinion (actually there were 2 more Doctors I talked to also) and he told me that he would have been upset if I hadn't also talked to others also. 

                          Your friend is the one that needs to make some changes, a second  opinion is the place to start.

                          Linda

                          lhaley
                          Participant

                            Most of us have a "team" of Doctors.  When I went to stage IV I had a surgical oncologist, a plastic surgeon and a oncologist.  Now with my cancer having progressed my team is even larger!   It sounds like your friend needs to expand their medical team.   (THis was in 06 and I was not happy with one of the Doctors and I moved on to a different hospital)

                            Can't even imagine that your husband is not also talked to!   My husband sits in on all appointments and while it's taken him awhile to feel comfortable he now asks important questions, and also talks to the Doctors on the phone. 

                            The hospital that I go to uses a tumor board. My melanoma specialist is the one that leads my particular case but usually the oncology surgeon (he happens to also be a mel specialist)), my urologist oncology (my particular case) and now a radiologist and last time was also the neuro surgeon.  The more imput the better clarification and options that the patient are offered.  

                            Patients go to get 2nd opinions all of the time!  I've now gone to my mel specialist for over 3 years.  When I made the decision with my brain met and had a discussion with my Dr I told him who I had talked to for my second …. and 3rd opinion (actually there were 2 more Doctors I talked to also) and he told me that he would have been upset if I hadn't also talked to others also. 

                            Your friend is the one that needs to make some changes, a second  opinion is the place to start.

                            Linda

                            Karolina
                            Participant

                              Linda,

                              i am sorry that your cancer has progressed. But i understand you are in good hands and I believe you will win with this cancer.

                              As for my friend, I think it will be interesting what this consultant has to say within next 2 weeks as he finally will have to make some judgment. And my friend’s husband talks to him but only in presence of my friend. So when they go to see him to find out the outcome of the 3rd operation, they will ask all questions and will expect answers…

                              Karolina

                              Karolina
                              Participant

                                Linda,

                                i am sorry that your cancer has progressed. But i understand you are in good hands and I believe you will win with this cancer.

                                As for my friend, I think it will be interesting what this consultant has to say within next 2 weeks as he finally will have to make some judgment. And my friend’s husband talks to him but only in presence of my friend. So when they go to see him to find out the outcome of the 3rd operation, they will ask all questions and will expect answers…

                                Karolina

                                Karolina
                                Participant

                                  Linda,

                                  i am sorry that your cancer has progressed. But i understand you are in good hands and I believe you will win with this cancer.

                                  As for my friend, I think it will be interesting what this consultant has to say within next 2 weeks as he finally will have to make some judgment. And my friend’s husband talks to him but only in presence of my friend. So when they go to see him to find out the outcome of the 3rd operation, they will ask all questions and will expect answers…

                                  Karolina

                                  Janner
                                  Participant

                                    If you have a negative SNB, it is not common to have any more scans unless you have symptoms.  The SNB is considered 97% (or something near that) accurate at reading the lymph nodes AT THAT TIME.  However, if cells are left behind locally or if cells are "in transit", the SNB may not reflect the whole story.  But in general, it is considered a very good indication of the current state of disease.  I suspect with desmoplastic melanoma, it's fairly common to have a negative SNB because it is most likely to recur locally!  Lentigo Maligna Melanoma is also a type that recurs locally and it is not uncommon to have several surgeries on a local lesion to get good margins.  So having multiple surgeries doesn't sound out of the realm of possibilitiy to me.  The goal is to get good margins, but not take more than needed.  So that is why surgeries are often staged.  As far as recognizing desmoplastic melanoma, it is quite rare.  There are many dermatologists and other specialists who miss normal melanoma.  So it doesn't seem too unusual for this to happen with a rare type of melanoma.  I am not trying to defend this doctor, just point out that there can be rational explanations for what's going on.  It's hard to know what's happening especially when it's 4th party.  You aren't there with your friend listening to what's happening.  The thing is, if your friend is happy with her care, there's not much you can do about it.   But from my point of view and given what you've told us, while things may be unusual, it could be she is getting very good care.  It's a rare cancer and there may just not be standard "guidelines" specifically for that subtype of melanoma. 

                                    Best wishes,

                                    Janner

                                    Janner
                                    Participant

                                      If you have a negative SNB, it is not common to have any more scans unless you have symptoms.  The SNB is considered 97% (or something near that) accurate at reading the lymph nodes AT THAT TIME.  However, if cells are left behind locally or if cells are "in transit", the SNB may not reflect the whole story.  But in general, it is considered a very good indication of the current state of disease.  I suspect with desmoplastic melanoma, it's fairly common to have a negative SNB because it is most likely to recur locally!  Lentigo Maligna Melanoma is also a type that recurs locally and it is not uncommon to have several surgeries on a local lesion to get good margins.  So having multiple surgeries doesn't sound out of the realm of possibilitiy to me.  The goal is to get good margins, but not take more than needed.  So that is why surgeries are often staged.  As far as recognizing desmoplastic melanoma, it is quite rare.  There are many dermatologists and other specialists who miss normal melanoma.  So it doesn't seem too unusual for this to happen with a rare type of melanoma.  I am not trying to defend this doctor, just point out that there can be rational explanations for what's going on.  It's hard to know what's happening especially when it's 4th party.  You aren't there with your friend listening to what's happening.  The thing is, if your friend is happy with her care, there's not much you can do about it.   But from my point of view and given what you've told us, while things may be unusual, it could be she is getting very good care.  It's a rare cancer and there may just not be standard "guidelines" specifically for that subtype of melanoma. 

                                      Best wishes,

                                      Janner

                                      Janner
                                      Participant

                                        If you have a negative SNB, it is not common to have any more scans unless you have symptoms.  The SNB is considered 97% (or something near that) accurate at reading the lymph nodes AT THAT TIME.  However, if cells are left behind locally or if cells are "in transit", the SNB may not reflect the whole story.  But in general, it is considered a very good indication of the current state of disease.  I suspect with desmoplastic melanoma, it's fairly common to have a negative SNB because it is most likely to recur locally!  Lentigo Maligna Melanoma is also a type that recurs locally and it is not uncommon to have several surgeries on a local lesion to get good margins.  So having multiple surgeries doesn't sound out of the realm of possibilitiy to me.  The goal is to get good margins, but not take more than needed.  So that is why surgeries are often staged.  As far as recognizing desmoplastic melanoma, it is quite rare.  There are many dermatologists and other specialists who miss normal melanoma.  So it doesn't seem too unusual for this to happen with a rare type of melanoma.  I am not trying to defend this doctor, just point out that there can be rational explanations for what's going on.  It's hard to know what's happening especially when it's 4th party.  You aren't there with your friend listening to what's happening.  The thing is, if your friend is happy with her care, there's not much you can do about it.   But from my point of view and given what you've told us, while things may be unusual, it could be she is getting very good care.  It's a rare cancer and there may just not be standard "guidelines" specifically for that subtype of melanoma. 

                                        Best wishes,

                                        Janner

                                        Karolina
                                        Participant
                                          Janner,
                                          thank you for your reply. As you said, maybe my friend is receiving good service com care but the problem we have is that we haven’t been told a lot about medical condition of my friend. She tried to contact him for a last 2days but if never returned a call.

                                          Anyway, two more questions. What symptoms my friend possibly could have if this cancer has spread elsewhere? I appreciate that it may depend on where it went to, but as a general guidance, what symptoms she could have.

                                          Also, what harm could cancer cells do if there were left after each surgery? That’s worries me the most because in fact those cells are on my friends skin since ca.June!! How dangerous it is to leave these cells on the skin? Bear in mind that, as mentioned before, 2 operations has been done and cancer cells have been left and now we are waiting for a result of a third operation.

                                          Thank you for your professional help

                                          k.

                                          Karolina
                                          Participant
                                            Janner,
                                            thank you for your reply. As you said, maybe my friend is receiving good service com care but the problem we have is that we haven’t been told a lot about medical condition of my friend. She tried to contact him for a last 2days but if never returned a call.

                                            Anyway, two more questions. What symptoms my friend possibly could have if this cancer has spread elsewhere? I appreciate that it may depend on where it went to, but as a general guidance, what symptoms she could have.

                                            Also, what harm could cancer cells do if there were left after each surgery? That’s worries me the most because in fact those cells are on my friends skin since ca.June!! How dangerous it is to leave these cells on the skin? Bear in mind that, as mentioned before, 2 operations has been done and cancer cells have been left and now we are waiting for a result of a third operation.

                                            Thank you for your professional help

                                            k.

                                            Karolina
                                            Participant
                                              Janner,
                                              thank you for your reply. As you said, maybe my friend is receiving good service com care but the problem we have is that we haven’t been told a lot about medical condition of my friend. She tried to contact him for a last 2days but if never returned a call.

                                              Anyway, two more questions. What symptoms my friend possibly could have if this cancer has spread elsewhere? I appreciate that it may depend on where it went to, but as a general guidance, what symptoms she could have.

                                              Also, what harm could cancer cells do if there were left after each surgery? That’s worries me the most because in fact those cells are on my friends skin since ca.June!! How dangerous it is to leave these cells on the skin? Bear in mind that, as mentioned before, 2 operations has been done and cancer cells have been left and now we are waiting for a result of a third operation.

                                              Thank you for your professional help

                                              k.

                                              Karolina
                                              Participant
                                                Janner,
                                                thank you for your reply. As you said, maybe my friend is receiving good service com care but the problem we have is that we haven’t been told a lot about medical condition of my friend. She tried to contact him for a last 2days but if never returned a call.

                                                Anyway, two more questions. What symptoms my friend possibly could have if this cancer has spread elsewhere? I appreciate that it may depend on where it went to, but as a general guidance, what symptoms she could have.

                                                Also, what harm could cancer cells do if there were left after each surgery? That’s worries me the most because in fact those cells are on my friends skin since ca.June!! How dangerous it is to leave these cells on the skin? Bear in mind that, as mentioned before, 2 operations has been done and cancer cells have been left and now we are waiting for a result of a third operation.

                                                Thank you for your professional help

                                                k.

                                                Janner
                                                Participant

                                                  I replied earlier this morning but the internet ate my long answer.

                                                  Symptoms:  Not much you can really look for except learning to palpate the lymph node basin where the SNB was located.  That is always considered the most likely area for a recurrence if it spreads.  However, a local recurrence is also higher risk so watching the skin, scar and area under the scar for abnormalities is key. 

                                                  The most important thing for your friend to do is the get appropriate margins.  Hopefully, the third surgery did that, but it's the highest priority.  No need to worry about spread elsewhere until you take care of the primary lesion. 

                                                  Best wishes,

                                                  Janner

                                                  Janner
                                                  Participant

                                                    I replied earlier this morning but the internet ate my long answer.

                                                    Symptoms:  Not much you can really look for except learning to palpate the lymph node basin where the SNB was located.  That is always considered the most likely area for a recurrence if it spreads.  However, a local recurrence is also higher risk so watching the skin, scar and area under the scar for abnormalities is key. 

                                                    The most important thing for your friend to do is the get appropriate margins.  Hopefully, the third surgery did that, but it's the highest priority.  No need to worry about spread elsewhere until you take care of the primary lesion. 

                                                    Best wishes,

                                                    Janner

                                                    Karolina
                                                    Participant

                                                      Hi Janner,

                                                      I understand what you are saying in terms of primary lesion, however I am still confused as to what it primary lesion in my friends case. Was it what was attached to the first lump or anything what was left on my friend’s neck including first and second lump? Are the cells which have been left after second surgery also considered as a primary lesion? If so, again, how harmful those cells can be for the whole body if always have been left with not appropriate margin?

                                                      Is aggressiveness of all cells which have been left on the skin after surgery(s) is this same as if they were not cut out or aggressiveness of those cells is less?

                                                      Karolina

                                                      Karolina
                                                      Participant

                                                        Hi Janner,

                                                        I understand what you are saying in terms of primary lesion, however I am still confused as to what it primary lesion in my friends case. Was it what was attached to the first lump or anything what was left on my friend’s neck including first and second lump? Are the cells which have been left after second surgery also considered as a primary lesion? If so, again, how harmful those cells can be for the whole body if always have been left with not appropriate margin?

                                                        Is aggressiveness of all cells which have been left on the skin after surgery(s) is this same as if they were not cut out or aggressiveness of those cells is less?

                                                        Karolina

                                                        Janner
                                                        Participant

                                                          There is no way to answer your question without seeing the pathology report.  That is really the only way to answer any of your questions.  If your friend won't get them, we really can't help much. 

                                                          As for "aggressiveness", there is also no way to know that.  Since desmoplastic tends to recur locally, I suspect it probably isn't any more aggressive if part of the primary is left behind.  But I could be totally wrong.  Any time you disturb a lesion, the risk exists for it to grow differently than it did before.  Whether that is slower or faster, there is really no way to know.  Again, the most important thing for your friend is to get the primary totally removed and appropriate margins.  Getting copies of the pathology reports for her own records is also a good idea.  Then if she ever has to visit another doctor, she has her records.  But she has to be willing to do that.

                                                          I know you want to know more to help your friend, but we're really handcuffed trying to help you without more specific information.  Sorry.

                                                          Best wishes,

                                                          Janner

                                                          Janner
                                                          Participant

                                                            There is no way to answer your question without seeing the pathology report.  That is really the only way to answer any of your questions.  If your friend won't get them, we really can't help much. 

                                                            As for "aggressiveness", there is also no way to know that.  Since desmoplastic tends to recur locally, I suspect it probably isn't any more aggressive if part of the primary is left behind.  But I could be totally wrong.  Any time you disturb a lesion, the risk exists for it to grow differently than it did before.  Whether that is slower or faster, there is really no way to know.  Again, the most important thing for your friend is to get the primary totally removed and appropriate margins.  Getting copies of the pathology reports for her own records is also a good idea.  Then if she ever has to visit another doctor, she has her records.  But she has to be willing to do that.

                                                            I know you want to know more to help your friend, but we're really handcuffed trying to help you without more specific information.  Sorry.

                                                            Best wishes,

                                                            Janner

                                                            Janner
                                                            Participant

                                                              There is no way to answer your question without seeing the pathology report.  That is really the only way to answer any of your questions.  If your friend won't get them, we really can't help much. 

                                                              As for "aggressiveness", there is also no way to know that.  Since desmoplastic tends to recur locally, I suspect it probably isn't any more aggressive if part of the primary is left behind.  But I could be totally wrong.  Any time you disturb a lesion, the risk exists for it to grow differently than it did before.  Whether that is slower or faster, there is really no way to know.  Again, the most important thing for your friend is to get the primary totally removed and appropriate margins.  Getting copies of the pathology reports for her own records is also a good idea.  Then if she ever has to visit another doctor, she has her records.  But she has to be willing to do that.

                                                              I know you want to know more to help your friend, but we're really handcuffed trying to help you without more specific information.  Sorry.

                                                              Best wishes,

                                                              Janner

                                                              Karolina
                                                              Participant

                                                                Hi Janner,

                                                                I understand what you are saying in terms of primary lesion, however I am still confused as to what it primary lesion in my friends case. Was it what was attached to the first lump or anything what was left on my friend’s neck including first and second lump? Are the cells which have been left after second surgery also considered as a primary lesion? If so, again, how harmful those cells can be for the whole body if always have been left with not appropriate margin?

                                                                Is aggressiveness of all cells which have been left on the skin after surgery(s) is this same as if they were not cut out or aggressiveness of those cells is less?

                                                                Karolina

                                                                Janner
                                                                Participant

                                                                  I replied earlier this morning but the internet ate my long answer.

                                                                  Symptoms:  Not much you can really look for except learning to palpate the lymph node basin where the SNB was located.  That is always considered the most likely area for a recurrence if it spreads.  However, a local recurrence is also higher risk so watching the skin, scar and area under the scar for abnormalities is key. 

                                                                  The most important thing for your friend to do is the get appropriate margins.  Hopefully, the third surgery did that, but it's the highest priority.  No need to worry about spread elsewhere until you take care of the primary lesion. 

                                                                  Best wishes,

                                                                  Janner

                                                                  Karolina
                                                                  Participant
                                                                    Janner,
                                                                    thank you for your reply. As you said, maybe my friend is receiving good service com care but the problem we have is that we haven’t been told a lot about medical condition of my friend. She tried to contact him for a last 2days but if never returned a call.

                                                                    Anyway, two more questions. What symptoms my friend possibly could have if this cancer has spread elsewhere? I appreciate that it may depend on where it went to, but as a general guidance, what symptoms she could have.

                                                                    Also, what harm could cancer cells do if there were left after each surgery? That’s worries me the most because in fact those cells are on my friends skin since ca.June!! How dangerous it is to leave these cells on the skin? Bear in mind that, as mentioned before, 2 operations has been done and cancer cells have been left and now we are waiting for a result of a third operation.

                                                                    Thank you for your professional help

                                                                    k.

                                                                    Karolina
                                                                    Participant
                                                                      Janner,
                                                                      thank you for your reply. As you said, maybe my friend is receiving good service com care but the problem we have is that we haven’t been told a lot about medical condition of my friend. She tried to contact him for a last 2days but if never returned a call.

                                                                      Anyway, two more questions. What symptoms my friend possibly could have if this cancer has spread elsewhere? I appreciate that it may depend on where it went to, but as a general guidance, what symptoms she could have.

                                                                      Also, what harm could cancer cells do if there were left after each surgery? That’s worries me the most because in fact those cells are on my friends skin since ca.June!! How dangerous it is to leave these cells on the skin? Bear in mind that, as mentioned before, 2 operations has been done and cancer cells have been left and now we are waiting for a result of a third operation.

                                                                      Thank you for your professional help

                                                                      k.

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