went for checkup today

I ask a lot of questions, too.  You're right, you need info to make good decisions.  But you explained you were asking about inflammation like that has a huge impact on prognosis – and it doesn't or else it most likely would be including in the staging criteria by now.  It has been studied.  You didn't mention BRAF at all.  That does seem a bit premature, however, with such a high survival rate.  Since the most likely area for mets are lymph nodes (stage III) and BRAF isn't even approved for stage III at this point, you're stretching.  *IF* you ever progress, that is certainly something that can be tested later.  The studies surrounding BRAF/NRAS/MEK and other genetic mutations are very active now and current treatment options may be obsolete in a short period of time.  Why test for a genetic mutation now when the testing may need to be refined for multiple mutations and/or other factors IF the time comes?   I also haven't seen 30% of men with lesions under .5mm having mets represented on this board.  That also isn't reflected in the 92% 10 year survival rate.  How large was the study and were there other factors besides depth that indicated higher risk?

I, too, take an interest in what is going on in terms of research.  But I also understand that everything I research now may have no bearings when and if I advance.  I am also much further out from my diagnosis, however, and melanoma no longer consumes my thoughts as it did once.  Hopefully, you'll get to that point, too.

Best wishes,

Janner

Stage IB since 1992, 3 MM primaries

The idea that these docs studied 884 patients and came up with a "a more effective classification scheme" than the AJCC seems perfectly ridiculous to me. They are using at least two parameters which have not been included in staging in the past — sex and growth phase. I suspect that either of these parameters would be meaningless if they first controlled for the more important factors of location and thickness. Not impressed and the 31% survival they find for one group seems to be an outlier which doesn't compute.

The idea that these docs studied 884 patients and came up with a "a more effective classification scheme" than the AJCC seems perfectly ridiculous to me. They are using at least two parameters which have not been included in staging in the past — sex and growth phase. I suspect that either of these parameters would be meaningless if they first controlled for the more important factors of location and thickness. Not impressed and the 31% survival they find for one group seems to be an outlier which doesn't compute.

The idea that these docs studied 884 patients and came up with a "a more effective classification scheme" than the AJCC seems perfectly ridiculous to me. They are using at least two parameters which have not been included in staging in the past — sex and growth phase. I suspect that either of these parameters would be meaningless if they first controlled for the more important factors of location and thickness. Not impressed and the 31% survival they find for one group seems to be an outlier which doesn't compute.

That except was from 2004 and based on comparing the AJCC 2002 staging.  The AJCC revised their guidelines in late 2009 after consideration of more prognostic factors.  You must look at the numbers  — only 90 men in the study group you indicated.  The new staging guidelines do include mitotic rate.  But sex was not a significant factor otherwise it would have been included as well.  The 2009 staging was based on a population of > 30,000.  And as I said before, I've certainly not seen those kinds of rates for men represented online.

Best wishes,

Janner

That except was from 2004 and based on comparing the AJCC 2002 staging.  The AJCC revised their guidelines in late 2009 after consideration of more prognostic factors.  You must look at the numbers  — only 90 men in the study group you indicated.  The new staging guidelines do include mitotic rate.  But sex was not a significant factor otherwise it would have been included as well.  The 2009 staging was based on a population of > 30,000.  And as I said before, I've certainly not seen those kinds of rates for men represented online.

Best wishes,

Janner

That except was from 2004 and based on comparing the AJCC 2002 staging.  The AJCC revised their guidelines in late 2009 after consideration of more prognostic factors.  You must look at the numbers  — only 90 men in the study group you indicated.  The new staging guidelines do include mitotic rate.  But sex was not a significant factor otherwise it would have been included as well.  The 2009 staging was based on a population of > 30,000.  And as I said before, I've certainly not seen those kinds of rates for men represented online.

Best wishes,

Janner

I ask a lot of questions, too.  You're right, you need info to make good decisions.  But you explained you were asking about inflammation like that has a huge impact on prognosis – and it doesn't or else it most likely would be including in the staging criteria by now.  It has been studied.  You didn't mention BRAF at all.  That does seem a bit premature, however, with such a high survival rate.  Since the most likely area for mets are lymph nodes (stage III) and BRAF isn't even approved for stage III at this point, you're stretching.  *IF* you ever progress, that is certainly something that can be tested later.  The studies surrounding BRAF/NRAS/MEK and other genetic mutations are very active now and current treatment options may be obsolete in a short period of time.  Why test for a genetic mutation now when the testing may need to be refined for multiple mutations and/or other factors IF the time comes?   I also haven't seen 30% of men with lesions under .5mm having mets represented on this board.  That also isn't reflected in the 92% 10 year survival rate.  How large was the study and were there other factors besides depth that indicated higher risk?

I, too, take an interest in what is going on in terms of research.  But I also understand that everything I research now may have no bearings when and if I advance.  I am also much further out from my diagnosis, however, and melanoma no longer consumes my thoughts as it did once.  Hopefully, you'll get to that point, too.

Best wishes,

Janner

Stage IB since 1992, 3 MM primaries

I ask a lot of questions, too.  You're right, you need info to make good decisions.  But you explained you were asking about inflammation like that has a huge impact on prognosis – and it doesn't or else it most likely would be including in the staging criteria by now.  It has been studied.  You didn't mention BRAF at all.  That does seem a bit premature, however, with such a high survival rate.  Since the most likely area for mets are lymph nodes (stage III) and BRAF isn't even approved for stage III at this point, you're stretching.  *IF* you ever progress, that is certainly something that can be tested later.  The studies surrounding BRAF/NRAS/MEK and other genetic mutations are very active now and current treatment options may be obsolete in a short period of time.  Why test for a genetic mutation now when the testing may need to be refined for multiple mutations and/or other factors IF the time comes?   I also haven't seen 30% of men with lesions under .5mm having mets represented on this board.  That also isn't reflected in the 92% 10 year survival rate.  How large was the study and were there other factors besides depth that indicated higher risk?

I, too, take an interest in what is going on in terms of research.  But I also understand that everything I research now may have no bearings when and if I advance.  I am also much further out from my diagnosis, however, and melanoma no longer consumes my thoughts as it did once.  Hopefully, you'll get to that point, too.

Best wishes,

Janner

Stage IB since 1992, 3 MM primaries