› Forums › General Melanoma Community › Stage 1 worrier
- This topic has 12 replies, 3 voices, and was last updated 9 years, 12 months ago by
CCJ.
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- March 19, 2016 at 9:33 am
Hi All I'm new to this site but have found it very helpful so far, would appreciate anyone's thoughts or advice on our situation
My husband was diagnosed with Stage 1 at the beginning of Ferbruary. We don't know anything more than that and it's 0.5. We don't know if it's 1A or 1B. I'm slightly frustrated by this and think the consultant should have informed us and given a little more detail. At the time we were in shock and just took the information we were given. It was only once home and researched I realised how much more he could have told us.
He went in for WLE last Wednesday. I was amazed by how much more was taken away! The wound now is approx 5 inches long, about twice the length of the original op. We were told that an extra 1cm margin was to be taken away with the WLE but we feel this was a very generous 1cm!
We are now in the anxious waiting process for the biopsy results. Am I right in thinking that if its stage 1 it would be quite unusual to find anything in the WLE? We were told that the WLE was merely being done as a precaution. Is this true? I find myself doubting what the consultant is telling us.
Also how do they know from the first biopsy if it's not in the lymph nodes? Is that because they make the assumption that because it's just 0.5 then it won't have spread there?
Appreciate anyone's thoughts in this anxious time.
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- March 19, 2016 at 10:30 am
Hi
A stage 1 0.5mm is very thin, very treatable and has an excellent prognosis. A WLE is all that is required, and in general if your first biopsy had clean margins then the WLE will be clean, too. From then on it's just regular (say six monthly) full skin checks – not so much for recurrence (though that is possible) more for a new primary. Please don't be too anxious in your situation – it's a thin, treated melanoma that is most likely gone and gone for good.
Stars
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- March 19, 2016 at 10:30 am
Hi
A stage 1 0.5mm is very thin, very treatable and has an excellent prognosis. A WLE is all that is required, and in general if your first biopsy had clean margins then the WLE will be clean, too. From then on it's just regular (say six monthly) full skin checks – not so much for recurrence (though that is possible) more for a new primary. Please don't be too anxious in your situation – it's a thin, treated melanoma that is most likely gone and gone for good.
Stars
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- March 19, 2016 at 2:55 pm
Thank you so much for taking the time to reply and your reassurance which does help. He has already been told that he'll be having 3 monthly check ups and he's been told that he himself has to be incredibly vigilant. I guess as we don't know if the first biopsy had clean margins that's why we feel a bit anxious. Thanks again and hopefully as you say it'll be gone for good x
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- March 19, 2016 at 2:55 pm
Thank you so much for taking the time to reply and your reassurance which does help. He has already been told that he'll be having 3 monthly check ups and he's been told that he himself has to be incredibly vigilant. I guess as we don't know if the first biopsy had clean margins that's why we feel a bit anxious. Thanks again and hopefully as you say it'll be gone for good x
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- March 19, 2016 at 2:55 pm
Thank you so much for taking the time to reply and your reassurance which does help. He has already been told that he'll be having 3 monthly check ups and he's been told that he himself has to be incredibly vigilant. I guess as we don't know if the first biopsy had clean margins that's why we feel a bit anxious. Thanks again and hopefully as you say it'll be gone for good x
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- March 19, 2016 at 10:30 am
Hi
A stage 1 0.5mm is very thin, very treatable and has an excellent prognosis. A WLE is all that is required, and in general if your first biopsy had clean margins then the WLE will be clean, too. From then on it's just regular (say six monthly) full skin checks – not so much for recurrence (though that is possible) more for a new primary. Please don't be too anxious in your situation – it's a thin, treated melanoma that is most likely gone and gone for good.
Stars
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- March 19, 2016 at 2:10 pm
Ask for a copy of your pathology report. It will give you the additional info (although maybe not in plain English).
The WLE size is pretty standard but does depend on the anatomy. Think about making a 2cm circle in your skin to get 1 cm margins from the center. Now you have to close the wound. Trying to pull the skin together would result in dog ear puckers at each end as well as the likelihood that the stitches would rip. So instead of a circle, they take out an ellipse or eye shaped piece of skin. This allows the skin to be pulled together smoothly (no puckers) and puts less stress on the stitches because it is distributed over a larger area. Depending on the anatomy, the ellipse may be larger if the stress on the area is higher – again to keep the stitches from ripping out.
The WLE is always done so you get those 1 cm margins as a precaution. That is the standard protocol for melanoma. Since melanoma cells like to travel, they are trying to make sure that all cells are removed at the time of surgery by taking extra skin.
They typically don't do the SNB unless the lesion is closer to 1mm. This has been studied over the years and the likelihood of a positive result drops when the lesion size drops. Learn how to palpate the lymph node region and your own skin and lymph node checks.
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- March 19, 2016 at 2:10 pm
Ask for a copy of your pathology report. It will give you the additional info (although maybe not in plain English).
The WLE size is pretty standard but does depend on the anatomy. Think about making a 2cm circle in your skin to get 1 cm margins from the center. Now you have to close the wound. Trying to pull the skin together would result in dog ear puckers at each end as well as the likelihood that the stitches would rip. So instead of a circle, they take out an ellipse or eye shaped piece of skin. This allows the skin to be pulled together smoothly (no puckers) and puts less stress on the stitches because it is distributed over a larger area. Depending on the anatomy, the ellipse may be larger if the stress on the area is higher – again to keep the stitches from ripping out.
The WLE is always done so you get those 1 cm margins as a precaution. That is the standard protocol for melanoma. Since melanoma cells like to travel, they are trying to make sure that all cells are removed at the time of surgery by taking extra skin.
They typically don't do the SNB unless the lesion is closer to 1mm. This has been studied over the years and the likelihood of a positive result drops when the lesion size drops. Learn how to palpate the lymph node region and your own skin and lymph node checks.
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- March 19, 2016 at 3:53 pm
Janner thank you so much for your detailed reply. It makes a huge amount of sense about the wound now. Really appreciate you explaining it as you did.
I will ask for the pathology report when we go back next. I really wish they had offered it to us in the first place.
Thanks too for your explanation about the SNB. That's good to know and I will endeavour to find out how to palpate the lymph nodes.
Thanls so much again Janner
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- March 19, 2016 at 3:53 pm
Janner thank you so much for your detailed reply. It makes a huge amount of sense about the wound now. Really appreciate you explaining it as you did.
I will ask for the pathology report when we go back next. I really wish they had offered it to us in the first place.
Thanks too for your explanation about the SNB. That's good to know and I will endeavour to find out how to palpate the lymph nodes.
Thanls so much again Janner
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- March 19, 2016 at 3:53 pm
Janner thank you so much for your detailed reply. It makes a huge amount of sense about the wound now. Really appreciate you explaining it as you did.
I will ask for the pathology report when we go back next. I really wish they had offered it to us in the first place.
Thanks too for your explanation about the SNB. That's good to know and I will endeavour to find out how to palpate the lymph nodes.
Thanls so much again Janner
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- March 19, 2016 at 2:10 pm
Ask for a copy of your pathology report. It will give you the additional info (although maybe not in plain English).
The WLE size is pretty standard but does depend on the anatomy. Think about making a 2cm circle in your skin to get 1 cm margins from the center. Now you have to close the wound. Trying to pull the skin together would result in dog ear puckers at each end as well as the likelihood that the stitches would rip. So instead of a circle, they take out an ellipse or eye shaped piece of skin. This allows the skin to be pulled together smoothly (no puckers) and puts less stress on the stitches because it is distributed over a larger area. Depending on the anatomy, the ellipse may be larger if the stress on the area is higher – again to keep the stitches from ripping out.
The WLE is always done so you get those 1 cm margins as a precaution. That is the standard protocol for melanoma. Since melanoma cells like to travel, they are trying to make sure that all cells are removed at the time of surgery by taking extra skin.
They typically don't do the SNB unless the lesion is closer to 1mm. This has been studied over the years and the likelihood of a positive result drops when the lesion size drops. Learn how to palpate the lymph node region and your own skin and lymph node checks.
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