stage 4 question
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stage 4 question

› Forums › General Melanoma Community › stage 4 question

  • Post
    • March 13, 2014 at 8:41 am
    hey
    Participant

    I got the call today from the doctor and he stated that I have level 4 melanoma based on my biopsy.  How can this be if I haven't had any ct scans or other test done? Won't these test I'm gonna go through in the very near future determine my real level and the severity of my melanoma?

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  • Replies
      • March 13, 2014 at 10:47 am
      POW
      Participant

      "Level 4" is different from "Stage IV". Level 4 refers to Clark's Level 4 which is an old way of describing how deep the lesion is by looking at how many layers of skin have been penetrated. In recent years, Clark's levels have been replaced by Breslow depth, which is how thick the lesion is in milimeters.

      So you are correct. The pathology report is only the first step. Next will come a wide local excision (WLE) with perhaps a sentinel node biopsy (SNB). Your melanoma stage may be determined at that time or you may need to go on and get CT scans or something to get your final staging. But, no, a biopsy alone can not determine that you have Stage IV melanoma. 

      • March 13, 2014 at 10:47 am
      POW
      Participant

      "Level 4" is different from "Stage IV". Level 4 refers to Clark's Level 4 which is an old way of describing how deep the lesion is by looking at how many layers of skin have been penetrated. In recent years, Clark's levels have been replaced by Breslow depth, which is how thick the lesion is in milimeters.

      So you are correct. The pathology report is only the first step. Next will come a wide local excision (WLE) with perhaps a sentinel node biopsy (SNB). Your melanoma stage may be determined at that time or you may need to go on and get CT scans or something to get your final staging. But, no, a biopsy alone can not determine that you have Stage IV melanoma. 

      • March 13, 2014 at 10:47 am
      POW
      Participant

      "Level 4" is different from "Stage IV". Level 4 refers to Clark's Level 4 which is an old way of describing how deep the lesion is by looking at how many layers of skin have been penetrated. In recent years, Clark's levels have been replaced by Breslow depth, which is how thick the lesion is in milimeters.

      So you are correct. The pathology report is only the first step. Next will come a wide local excision (WLE) with perhaps a sentinel node biopsy (SNB). Your melanoma stage may be determined at that time or you may need to go on and get CT scans or something to get your final staging. But, no, a biopsy alone can not determine that you have Stage IV melanoma. 

        • March 13, 2014 at 2:22 pm
        Brent Morris
        Participant

        Dear Anonymous,

        Sorry you have to deal with this. There is a lot of information and it can be overwhelming.  Anonymous (POW) who posted this response, is right that Clark level is not as important for prognosis as the thickness (Breslow) of the skin lesion. However, what studies need to be done and the need for a wide local excision and/or lymph node biopsy can be a complex decision. Janner's post should give you some direction. Here is a link to staging in melanoma:

        http://www.melanomacenter.org/staging/index.html

        that is useful.  In the end, you consult a dermatologist or surgeon with training and experience in melanoma who can guide you through.

        • March 13, 2014 at 2:22 pm
        Brent Morris
        Participant

        Dear Anonymous,

        Sorry you have to deal with this. There is a lot of information and it can be overwhelming.  Anonymous (POW) who posted this response, is right that Clark level is not as important for prognosis as the thickness (Breslow) of the skin lesion. However, what studies need to be done and the need for a wide local excision and/or lymph node biopsy can be a complex decision. Janner's post should give you some direction. Here is a link to staging in melanoma:

        http://www.melanomacenter.org/staging/index.html

        that is useful.  In the end, you consult a dermatologist or surgeon with training and experience in melanoma who can guide you through.

        • March 13, 2014 at 2:22 pm
        Brent Morris
        Participant

        Dear Anonymous,

        Sorry you have to deal with this. There is a lot of information and it can be overwhelming.  Anonymous (POW) who posted this response, is right that Clark level is not as important for prognosis as the thickness (Breslow) of the skin lesion. However, what studies need to be done and the need for a wide local excision and/or lymph node biopsy can be a complex decision. Janner's post should give you some direction. Here is a link to staging in melanoma:

        http://www.melanomacenter.org/staging/index.html

        that is useful.  In the end, you consult a dermatologist or surgeon with training and experience in melanoma who can guide you through.

      • March 13, 2014 at 12:51 pm
      Tina D
      Participant

      You are correct, the biopsy alone does not determine staging… you have just misunderstood the terminology they used, and the above posts describes this well. When are you going for your follow up scans, etc? 

      Tina

      • March 13, 2014 at 12:51 pm
      Tina D
      Participant

      You are correct, the biopsy alone does not determine staging… you have just misunderstood the terminology they used, and the above posts describes this well. When are you going for your follow up scans, etc? 

      Tina

      • March 13, 2014 at 12:51 pm
      Tina D
      Participant

      You are correct, the biopsy alone does not determine staging… you have just misunderstood the terminology they used, and the above posts describes this well. When are you going for your follow up scans, etc? 

      Tina

      • March 13, 2014 at 1:14 pm
      Janner
      Participant

      Hi, Sorry you have to join us, but the other posters are correct.  I have a more detailed discussion at the bottom of the page here:  http://melanomaresources.info/newlydiagnosed.html  There are also some other links you could explore.

      Take this one step at a time.  The first thing is to get a copy of your pathology report so you can truly understand your situation.  Based on the info found there — that determines the next step.  We're happy to help you answer any questions, but the pathology report would give our answers more substance because we'd know your exact situation.

      Hang in there!

      Janner

      • March 13, 2014 at 1:14 pm
      Janner
      Participant

      Hi, Sorry you have to join us, but the other posters are correct.  I have a more detailed discussion at the bottom of the page here:  http://melanomaresources.info/newlydiagnosed.html  There are also some other links you could explore.

      Take this one step at a time.  The first thing is to get a copy of your pathology report so you can truly understand your situation.  Based on the info found there — that determines the next step.  We're happy to help you answer any questions, but the pathology report would give our answers more substance because we'd know your exact situation.

      Hang in there!

      Janner

      • March 13, 2014 at 1:14 pm
      Janner
      Participant

      Hi, Sorry you have to join us, but the other posters are correct.  I have a more detailed discussion at the bottom of the page here:  http://melanomaresources.info/newlydiagnosed.html  There are also some other links you could explore.

      Take this one step at a time.  The first thing is to get a copy of your pathology report so you can truly understand your situation.  Based on the info found there — that determines the next step.  We're happy to help you answer any questions, but the pathology report would give our answers more substance because we'd know your exact situation.

      Hang in there!

      Janner

      • March 15, 2014 at 10:43 am
      Carole K
      Participant

      HI ,

      Take a deep breath and keep coming to the Board.  Janner is a wealth of knowledge.  She has been very active here far longer than I was. I started here in 1999 and she was already here.  Hang in there.  Sending you positive thoughts and healing hugs.

      Love and Light

      Carole K

      • March 15, 2014 at 10:43 am
      Carole K
      Participant

      HI ,

      Take a deep breath and keep coming to the Board.  Janner is a wealth of knowledge.  She has been very active here far longer than I was. I started here in 1999 and she was already here.  Hang in there.  Sending you positive thoughts and healing hugs.

      Love and Light

      Carole K

      • March 15, 2014 at 10:43 am
      Carole K
      Participant

      HI ,

      Take a deep breath and keep coming to the Board.  Janner is a wealth of knowledge.  She has been very active here far longer than I was. I started here in 1999 and she was already here.  Hang in there.  Sending you positive thoughts and healing hugs.

      Love and Light

      Carole K

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