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SSM T1a 0.6mm – some thoughts
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SSM T1a 0.6mm – some thoughts

› Forums › General Melanoma Community › SSM T1a 0.6mm – some thoughts

  • Post
    • January 6, 2019 at 4:08 pm
    chris0815
    Participant

      Hi,

      I'm Chris from Germany (sorry for my English smiley) and found this forum by random. Unfortunately, they detected a SSM T1a 0.6mm Breslow, Clark III, no regression or ulceration and mitosis <1 on my left shoulder at the beginning of last month. They removed everything and the margins of the cut were clean. The WLE was also clean. The first S100 round showed an 0.116 (lab limit is 0.11), which was mainly due to wrong treatment of the sample (overnight storage without preparation).  They measured S100 again and it was 0.032 (hopefully stable, will be repeated in 4 weeks). In addition they perfomed a node sonography showing only one node in the neck a bit bigger, which was not pathologic and assumed to be bigger/grown/swollen from wound inflammation or a cold or something. The did not a SLNB.

      Now I'm really concerned about the missing SLNB, the swollen node and that they didnt performed any other additional measurement as CT/MRT etc. to complete the staging. So I'm still Nx and Mx and dont know whether there are mets or not. As I learned that early treatment might be the key for survival (what is my prognosis???) I wonder that more precise Nx Mx PET/CT staging is not/will not be performed. So, please tell me what do you think about my situation and maybe you can give advice how I should proceed?

      Is it also possible to improve my survival chances by special nutrition? Sorry If I asked some dumb question, but I'm currently somehow frightened and 'outer space'.

      Thanks in advance and cheers, Chris

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    • Replies
        • January 7, 2019 at 5:53 am
        Janner
        Participant
          In the US, you would not have a SLNB either. The cutoff is usually 0.8mm or stage 1b. You’ve already had more testing than you’d get here. Scans of any type (except possibly a baseline chest xray) are not done for stage 1a. PET scans only identify tumors of a certain size, about 5mm. Since it’s extremely unlikely for someone with your depth to have spread with a large tumor, scans are not really helpful. In fact, scanning early stages often causes more issues because they see some benign barnacle (which are all have) but have to rule out metastasis. So more testing or surgery to show you have no mets.

          Your staging is consistent with most early stagers, you don’t know N and M because statistically the odds are small that they would be positive. My first melanoma was .58mm, 1 mitosis. That was in 1992. I’m still stage 1 all these many years later even though I’ve had 3 primaries.

          As for diet, there is no diet proven to prevent metastasis. Healthy eating is always encouraged so eating healthy is always a good idea. But even the healthiest eaters still get cancer.

            • January 7, 2019 at 4:28 pm
            chris0815
            Participant
              Dear Janner,
              thank you for your response. This means a lot to me. I will meet tomorrow some experts from Berlin’s skin cancer center to define next steps. What do you mean with more surgery and testing?

              Thanks and cheers, Chris0815

              • January 7, 2019 at 5:37 pm
              Janner
              Participant

                I mean – they see something on a scan – and while it doesn't look bad, it might not be completely normal.  So then they have to do repeat scans or even surgery to RULE OUT MELANOMA.  The same scan without a melanoma history would not prompt them to do anything.  At least in the US which doesn't have a socialized medicine system, docs will often do more because 1- they make money and 2- they have less legal liability if they check everything.  "More" isn't always better.

                For someone with your stats, the wide excision is the end of treatment in the US.  You would just be followed up with periodic skin checks.  I always recommend taking pictures of your lesions to watch for change.  And take pictures of all your skin to watch for new lesions.  75% of melanomas arise on new lesions.  While the vast majority of warriors never have a second melanoma primary, your risk of getting one is higher than your risk of a recurrence.  Personal vigilance is good!

                • January 27, 2019 at 1:48 pm
                chris0815
                Participant
                  Maybe I have hundred of moles how do you perform a full body mapping? With a special camera? Can you provide a short ‘how-to’? Sorry dont want to bother you…
                  Im still kind of scared…
                  • February 26, 2019 at 5:03 pm
                  chris0815
                  Participant
                    Hi all,
                    got today new S100 results. 0.164 = mets? I’m so horrified.
                    Cheers, Chris
                  • January 7, 2019 at 9:33 am
                  stars
                  Participant

                    In Australia this would be an everyday thing, a wide level excision only, no SLNB. Kind of… uneventful. Put your mind at ease, go on living and enjoying life, only now with the inconvenience of an annual skin check for a) any new melanoma b) a recurrence at the original site, both of which are very unlikely and now that you will be getting regular checks, would be caught early anyways. Nutrients – just try to stay reasonably healthy, not just for melanoma but for everything! No need to go on a wheat juice fast or anything weird.

                      • January 7, 2019 at 4:31 pm
                      chris0815
                      Participant
                        Thank you. Sounds good. I will do the checks and maybe start personal mole mapping to detect any changes. Maybe Janner can also recommend how to do this.
                        Cheers, Chris0815
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