SNL with micromets; complete dissection?

when I had my SNL they found micromets in one and i opted to have a complete removal. mine where in my neck area so i dont have alot of swelling if an at all in that area. My doctors highly recommended I do the complete removal as well. i choose not to do interfereon for the same reason as i was told it only helps 5% of the time instead im currently on the Ippi vs. Interferon trial getting the 3mg/kg dose of ippi had my third treatment yesterday so far no real side effects fingers crossed it stays that way.

when I had my SNL they found micromets in one and i opted to have a complete removal. mine where in my neck area so i dont have alot of swelling if an at all in that area. My doctors highly recommended I do the complete removal as well. i choose not to do interfereon for the same reason as i was told it only helps 5% of the time instead im currently on the Ippi vs. Interferon trial getting the 3mg/kg dose of ippi had my third treatment yesterday so far no real side effects fingers crossed it stays that way.

when I had my SNL they found micromets in one and i opted to have a complete removal. mine where in my neck area so i dont have alot of swelling if an at all in that area. My doctors highly recommended I do the complete removal as well. i choose not to do interfereon for the same reason as i was told it only helps 5% of the time instead im currently on the Ippi vs. Interferon trial getting the 3mg/kg dose of ippi had my third treatment yesterday so far no real side effects fingers crossed it stays that way.

If you are asking for what is standard protocol, then the lymph node dissection is standard protocol for stage III regardless of the amount of disease.  There have certainly been questions about "is this overkill"  when someone has minimal disease showing as you do.  There are also ongoing clinical trials comparing the LND to no surgery and periodic monitoring with ultrasound.  To date, I don't think there is any finalized data on that.  If you choose not to do the LND, then I would ask about periodic ultrasound monitoring as followup instead.

Radiation would most likely not be a good choice.  Radiation isn't that effective with melanoma.  It is sometimes used for local control say if there is disease found outside a lymph node.  I doubt it would be suggested in your case.  Interferon is the standard for stage III but as you've found out, doesn't have great numbers to back it up.  There may be clinical trials for stage III but you may not qualify given the minimal disease with the exception of the Yervoy vs Interferon one already mentioned.  But it's worth doing a search because trials open/close all the time.  Yes, "monitoring" is a valid option for someone in your position.  There have been many who have chosen that route.  It is very possible that the surgery was curative in you case.  The thing is to pick an option and don't look back.  Do what feels right to you and keep on keeping on!

Best wishes,

Janner

If you are asking for what is standard protocol, then the lymph node dissection is standard protocol for stage III regardless of the amount of disease.  There have certainly been questions about "is this overkill"  when someone has minimal disease showing as you do.  There are also ongoing clinical trials comparing the LND to no surgery and periodic monitoring with ultrasound.  To date, I don't think there is any finalized data on that.  If you choose not to do the LND, then I would ask about periodic ultrasound monitoring as followup instead.

Radiation would most likely not be a good choice.  Radiation isn't that effective with melanoma.  It is sometimes used for local control say if there is disease found outside a lymph node.  I doubt it would be suggested in your case.  Interferon is the standard for stage III but as you've found out, doesn't have great numbers to back it up.  There may be clinical trials for stage III but you may not qualify given the minimal disease with the exception of the Yervoy vs Interferon one already mentioned.  But it's worth doing a search because trials open/close all the time.  Yes, "monitoring" is a valid option for someone in your position.  There have been many who have chosen that route.  It is very possible that the surgery was curative in you case.  The thing is to pick an option and don't look back.  Do what feels right to you and keep on keeping on!

Best wishes,

Janner

If you are asking for what is standard protocol, then the lymph node dissection is standard protocol for stage III regardless of the amount of disease.  There have certainly been questions about "is this overkill"  when someone has minimal disease showing as you do.  There are also ongoing clinical trials comparing the LND to no surgery and periodic monitoring with ultrasound.  To date, I don't think there is any finalized data on that.  If you choose not to do the LND, then I would ask about periodic ultrasound monitoring as followup instead.

Radiation would most likely not be a good choice.  Radiation isn't that effective with melanoma.  It is sometimes used for local control say if there is disease found outside a lymph node.  I doubt it would be suggested in your case.  Interferon is the standard for stage III but as you've found out, doesn't have great numbers to back it up.  There may be clinical trials for stage III but you may not qualify given the minimal disease with the exception of the Yervoy vs Interferon one already mentioned.  But it's worth doing a search because trials open/close all the time.  Yes, "monitoring" is a valid option for someone in your position.  There have been many who have chosen that route.  It is very possible that the surgery was curative in you case.  The thing is to pick an option and don't look back.  Do what feels right to you and keep on keeping on!

Best wishes,

Janner

If you "search" for lymphnode dissection, you will find many many variations about this.   My story (left axillary, eventual total lymph node dissection) can be found in this thread: 

http://www.melanoma.org/community/mpip-melanoma-patients-information-page/new-info-daughter

There is other information on this thread.   As you will see, my saga began years ago.   There are many changes since then, but the basic premise still exists and questions over whether full LND is effective in delaying or averting progression of melanoma.

Some Stage III folks have been offered different options.   You can read and read, but ultimately, the choice is yours, harsh as that may sound.    Doctors will recommend, based on their experiences, or what they reference.    Janner is right.  You ahve to make your choice, remain solid in your conviction, and be vigilant with follow-up care and taking care of yourself in general.   Although, I almost hate that comment—as IF we, who have been inflicted with this crap, wouldn't heed advice and take care of ourselves, right?

Eight years out, I've graduated to a one-year check-up level.   This year I have to transfer my care to another provider.  This is going to be a big deal for me when that, now annual, check-up time comes!!   I'll be sure to let the board know how it goes.

CarolA

StageIII & holding!

If you "search" for lymphnode dissection, you will find many many variations about this.   My story (left axillary, eventual total lymph node dissection) can be found in this thread: 

http://www.melanoma.org/community/mpip-melanoma-patients-information-page/new-info-daughter

There is other information on this thread.   As you will see, my saga began years ago.   There are many changes since then, but the basic premise still exists and questions over whether full LND is effective in delaying or averting progression of melanoma.

Some Stage III folks have been offered different options.   You can read and read, but ultimately, the choice is yours, harsh as that may sound.    Doctors will recommend, based on their experiences, or what they reference.    Janner is right.  You ahve to make your choice, remain solid in your conviction, and be vigilant with follow-up care and taking care of yourself in general.   Although, I almost hate that comment—as IF we, who have been inflicted with this crap, wouldn't heed advice and take care of ourselves, right?

Eight years out, I've graduated to a one-year check-up level.   This year I have to transfer my care to another provider.  This is going to be a big deal for me when that, now annual, check-up time comes!!   I'll be sure to let the board know how it goes.

CarolA

StageIII & holding!

If you "search" for lymphnode dissection, you will find many many variations about this.   My story (left axillary, eventual total lymph node dissection) can be found in this thread: 

http://www.melanoma.org/community/mpip-melanoma-patients-information-page/new-info-daughter

There is other information on this thread.   As you will see, my saga began years ago.   There are many changes since then, but the basic premise still exists and questions over whether full LND is effective in delaying or averting progression of melanoma.

Some Stage III folks have been offered different options.   You can read and read, but ultimately, the choice is yours, harsh as that may sound.    Doctors will recommend, based on their experiences, or what they reference.    Janner is right.  You ahve to make your choice, remain solid in your conviction, and be vigilant with follow-up care and taking care of yourself in general.   Although, I almost hate that comment—as IF we, who have been inflicted with this crap, wouldn't heed advice and take care of ourselves, right?

Eight years out, I've graduated to a one-year check-up level.   This year I have to transfer my care to another provider.  This is going to be a big deal for me when that, now annual, check-up time comes!!   I'll be sure to let the board know how it goes.

CarolA

StageIII & holding!

I had melanoma that was 9mm deep and also in 2 lymph nodes in 11/11. They only took out the 2 lymph nodes and did a wle and then I had radiation treatment for the 9mm  deep melanoma. They did 5 really strong treatments. I am NED since then. I go to UAB in Birmingham. I guess every dr has their own way of doing things, but glad I did not have all of the lymph nodes removed. You just need to listen to your dr and ask questions, why one does this and why someone else does something else and make your own decision. I had no type of chemo or anything either. I am stage 3B.

I just had my CT scan yesterday and ultrasounds the first of Feb and so far so good.

I had melanoma that was 9mm deep and also in 2 lymph nodes in 11/11. They only took out the 2 lymph nodes and did a wle and then I had radiation treatment for the 9mm  deep melanoma. They did 5 really strong treatments. I am NED since then. I go to UAB in Birmingham. I guess every dr has their own way of doing things, but glad I did not have all of the lymph nodes removed. You just need to listen to your dr and ask questions, why one does this and why someone else does something else and make your own decision. I had no type of chemo or anything either. I am stage 3B.

I just had my CT scan yesterday and ultrasounds the first of Feb and so far so good.

I had melanoma that was 9mm deep and also in 2 lymph nodes in 11/11. They only took out the 2 lymph nodes and did a wle and then I had radiation treatment for the 9mm  deep melanoma. They did 5 really strong treatments. I am NED since then. I go to UAB in Birmingham. I guess every dr has their own way of doing things, but glad I did not have all of the lymph nodes removed. You just need to listen to your dr and ask questions, why one does this and why someone else does something else and make your own decision. I had no type of chemo or anything either. I am stage 3B.

I just had my CT scan yesterday and ultrasounds the first of Feb and so far so good.

I think I told you before the list of questions to ask Dr Miner so I won't go over them again regarding the different options.  I don't know if Dr Miner will offer it but one option that might work for you is a partial Lymph Node Dissection.  It is not standard practice, but more doctors are offering it and it leaves some nodes behind. 

The decision making process is difficult.  But the right answer will come to you.  Gather all your options, factor in your lifestyle and your back-up for your kids and you'll be able to find the right answer for you.

Good Luck,

Mary

I think I told you before the list of questions to ask Dr Miner so I won't go over them again regarding the different options.  I don't know if Dr Miner will offer it but one option that might work for you is a partial Lymph Node Dissection.  It is not standard practice, but more doctors are offering it and it leaves some nodes behind. 

The decision making process is difficult.  But the right answer will come to you.  Gather all your options, factor in your lifestyle and your back-up for your kids and you'll be able to find the right answer for you.

Good Luck,

Mary

I think I told you before the list of questions to ask Dr Miner so I won't go over them again regarding the different options.  I don't know if Dr Miner will offer it but one option that might work for you is a partial Lymph Node Dissection.  It is not standard practice, but more doctors are offering it and it leaves some nodes behind. 

The decision making process is difficult.  But the right answer will come to you.  Gather all your options, factor in your lifestyle and your back-up for your kids and you'll be able to find the right answer for you.

Good Luck,

Mary

My daughter is stage IIIb and only had melanoma is one lymph node.  She had all the lymph nodes removed and that is how we know it was only in the one.  She has chosen to do adjuvant biochemotherapy.  I'm sure many people wouldn't do it as she is NED and it is a really difficult treatment.  She is 24 and the chance of recurrence is high and she needs to feel she is doing everything possible to fight this cancer.  Everyone is different though and needs to make their own decision.  I would recommend researching your options as much as possible and then going with your best decision.  There are no guarantees anyway so do what you are comfortable with.

My daughter is stage IIIb and only had melanoma is one lymph node.  She had all the lymph nodes removed and that is how we know it was only in the one.  She has chosen to do adjuvant biochemotherapy.  I'm sure many people wouldn't do it as she is NED and it is a really difficult treatment.  She is 24 and the chance of recurrence is high and she needs to feel she is doing everything possible to fight this cancer.  Everyone is different though and needs to make their own decision.  I would recommend researching your options as much as possible and then going with your best decision.  There are no guarantees anyway so do what you are comfortable with.

My daughter is stage IIIb and only had melanoma is one lymph node.  She had all the lymph nodes removed and that is how we know it was only in the one.  She has chosen to do adjuvant biochemotherapy.  I'm sure many people wouldn't do it as she is NED and it is a really difficult treatment.  She is 24 and the chance of recurrence is high and she needs to feel she is doing everything possible to fight this cancer.  Everyone is different though and needs to make their own decision.  I would recommend researching your options as much as possible and then going with your best decision.  There are no guarantees anyway so do what you are comfortable with.