AN8

I concur with the above.  You have an atpical mole that is at higher risk for becoming melanoma.  This does NOT mean it will…just a higher risk and the pathologist is recommending a conservative removal to avoid any future issue.  Even though I have had melanoma…I have also had 4 atypical moles fully excised and my 23 year old daughter has had 1 atypical excised.  I am fair, strawberry blonde with a history of burns.  She is brunette, olive complected who tans easily as my husband has indian in his ancestry.  All that does not matter…she still has 50% of her momma's genetics as do you.

The derm may advise you come in for skin checks every 6 months for a while as they did my daughter.  I am still on an every 3 month watch for now.  Find peace that it is not cancer and just be aware that you need to watch yourself for new lesions and changes in existing spots.  Protect yourself from the sun as we  all should anyway.  My daughter's skin is nowhere near as dark as it used to be as she is avoiding too much sun exposure and nixed the tanning bed…but she is still beautiful and most importantly healthy.

Best wishes!

I had my Stage 1b wide excission performed by my dermatologist in her office under local anesthetic.  Location left calf.  Left a hole about the size of an 11" softball.   It could not be stitched so I left with a large gaping hole and had a skin graph a month later. That was under general anesthetic with a plastic surgeon.  

I think removal of early stage melanoma in an office setting under a local is common.  My problem would be "the eyeballing" comment.    There are guidelines  which doctors are supposed to use when calculating the area of removal around the melanoma lesion.  Maybe a second opinion from a derm or surgeon who has more experience with melanoma would be an option that would give you peace of mind.  

For He knows our path and walks with us.  Amen.

Stage 1b here from May 2018.  Sent my 23 yr old daughter to derm in June 2018.  Atypical spitz on shin.  Complete excision. Like you…I feared the diagnosis bc of my experience.  Had path reviewed by my oncologist and he confirmed atypical spitz. My derm and onc said spitz are common in children.  My daughter had this mole for years but bc of my diagnosis they played it safe and ran the biopsy then excised.  You can always send the sample to another pathology dept for a 2nd opinion.  Peace of mind is very important. 

Hello there!  Sorry to have to meet you here but you will find wealth of honest and accurate information here.

1st – congrats on the early catch!  I am a fellow Stage 1b'er and even though having this crappy cancer sucks, we caught it early and our odds of a good outcome are in our favor.  Try to remember that even though I know how hard it is, especially at first diagnosis.   

Your dermatologist made the right call sending you to the cancer center.  Hopefully they have a department/oncologist that specializes in melanoma.   What I expect you to find is that the onc will want to perform a SLNB at the time the lesion is removed to check those lymph nodes.  This is standard proceedure on any lessions deeper than .75mm.   If the lymph node biopsy comes back clear, you will remain a Stage 1b and most likely your follow up treatment will be healing from the removal of the lession and dermatologist skin checks every 3 months for 2-3 years.  My melanoma was cultaneous, yours states nodular, so if anyone else is reading this and had a different avenue of treatment for nodular mel, please advise Bobbie.

If the lymph nodes show evidence of mel,  they will proceed to check literally everything else via CT scans, PET scans, MRI, etc etc.  Depending what that reveals, you will be given a definitive stage which will be a whole other post filled with new questions.

BUT for today you are a Stage 1b, a good place to be.  It is fearful, the testing and waiting for results sucks.  The unknown sucks.  As you go through this journey, keep some things in mind:

-its ok to shut down as long as you get back up.  A melanoma patient has just as much right to feel anxious than anyone else with any type of cancer.  But you have to condition yourself to look at the good of your situation no matter what.  Whether it be an early state diagnosis or the fact that your diagnosis came in a time where wonderful advancement in treatment of melanoma are upon us.

-The anxiety you are feeling today will get better with time, more knowledge, a good medical team and support from family and friends.

-Leave the googling alone.  Only visit reputable sites like this one….and even this one can be tough for early stagers.  Most of what you see online are of individuals who have advanced disease or have the "rare" instances.  They do not accurately represent the outcomes of the general melanoma public.  Early stage mel patients NORMALLY have very good outcomes and live many years never seeing mel again.  Some don't.  No one has a crystal ball and there are things in this world you cannot control (that was a hard one for me).  Live in the moment.  Do not fear what has not yet happened.  Deal with what is on the table today.

-To answer your question…do not be scared.  Be aware.  Arm yourself with knowledge and a good medical support team that you have confidence in and make you feel you are not alone in monitoring your health.  You cannot tend to your overall health if you are scared, anxious, not sleeping or eating correctly.  

You know…I am so long winded…I could go on, but those are some highlights.  Find comfort that you found your lesion early and as you gain knowledge through experience, it only makes you stronger and more apt to find anything else that may  or MAY NOT come your way.  As you keep us updated, we can shed more light on the processes you are going through.  I had a very hard time in the beginning so I have been there.  I finally realized I have to focus on the positive and have some faith that He will walk with me on this path and all with be ok.

Prayers and best wishes you.  Keep in touch.

Ok..that was funny!  Always keep your humor.  I believe it keeps us all sane!  Best wishes to you.

One thing that caught my attention to add to this is when receiving my skin checks, I was concerned about a mole on my arm.  Derm told me it was ok…explained what type mole it was and that they were common AND that for future reference, if there is a hair growing through a mole, it is a good sign.  I had 1 arm hair growing through it.

Now, with that said, I do know if what you have is a "mole" but the waiting game is a very fearful and anxious time.  Wanted to give you a spin that will give you hope all is well.  I too get red bumps on my head…more frequently in the winter…due to dry scalp.  I too have them checked by the derm.   Take a breath, have some faith.  Being upset will not make things better for you and they will not change your situation..be it good or bad.  Let us know how things go.  You can find wonderful advise from people who have been there!

Wishing you the bes!

Hello Ryan,

Stage 1b diagnosis 5/1/18, excission 5/15.  The next three months contained 36 punch biopsies with 6 total excissions, 3 of which were atypical.  Someone asked if my derm was money hungry or cut happy…..no, not at all.  She was dealing with an individual who completely flipped out over her melanoma diagnosis and was striving for a 'clean slate'.  An individual, who unfortunately, has many freckles and moles.  She was giving me peace of mind.  

 Being a bit of a control freak, I had a good 3 months of extreme anxiety and panic attacks (hence the biopsies)  to the surprise of many.  I blew thru an inoperable brain aneurysm diagnosis 3 years ago, so why would I completely loose it over this?? It's the 'c' word.  It's sneaky.  It doesn't play fair.  

Here are some things I did to turn myself around.  #1. Gave it to God removing some of the weight and responsibility off my shoulders which in turn helped me understand that I cannot control this and no one has a crystal ball that contains my future.  Only He knows my path and I have faith in Him no matter what.  #2. Stop googling.  Find one or two trusted websites for solid information and leave the rest alone.  This site should be your one..or one of 2.   The majority of the stories you will find are of individuals or studies of individuals who are unfortunately experiencing the ugliest side of this disease.  Yes, bad things happen with this disease but good things happen more often.  At your stages,there's a 95-97% chance you will not see a recurrence which leads me to #3 Train your mind to focus on the positives.  I know it's hard not to focus on that 3-5% but you have not been given a terminal diagnosis. Your odds of being melanoma free at your stages way out weigh the odds of recurrence.  So focus more on your blessings and fear not what you don't have.  #4. Find doctors that you trust.  Peace of mind is extremely important.  It allows you to sleep at night.  I love my dermatologist group but even when they told me I did not need to be seen by an oncologist for a stage 1b…I asked for the referral anyway.  It made me feel more confident that I was crossing all the t's and dotting all the i's. He is a melanoma specialist and has done wonders for my peace of mind.  He looked me in the eye and said 'even tho odds are vastly in your favor that you will never see melanoma again, I cannot promise that you won't.  But I can promise you "we" will be ready'.  I emphasize the "we".  Find someone that makes you feel you have a partner in this journey.  He follows me every 3 months cking my lymph nodes via ultra sound while my derm cks my skin every 3 months.  #5 find a strong support system outside the Drs office.  My family has been my rock…but yes, they got tired of the crying after 3 months and gave me a swift kick in the ass that I needed.  I have a friend whose husband does have terminal cancer (not melanoma).  She has been amazing in understanding the emotional roller coaster and encouraging me to see my blessings and stop wasting precious time crying and fearing something completely out of my control that may or may not happen.  Your physical health truly suffers when you have an anxious mind.

So do what you need to do to find peace of mind, keep your body healthy, have confidence that you are on top of and prepared for whatever may come your way.  Be your best advocate. Focus on the positives.  It does get better.  Live life.   

Prayers for peace of mind and healing.

Also a 1b here from Memphis area…Hi there neighbor!  I was also going to suggest  the Vanderbilt Center.   I considered that direction until I found my specialist here in Memphis.  Unfortunately, I had a WLE performed by my derm THEN consulted the specialist…the more I read online, the greater the anxiety at first.   My depth was only .44 so I was advised no SLNB.  Which is par for the course except I had focal ulceration.  The specialist I consulted would have advised a SLNB had he done the WLE due to the ulceration….just his opinion there are many who would still lean on the depth as the deciding factor. So he has my lymph nodes behind my knee and groin area ckd via ultra sound every 3 months and will for 3 yrs.

The anxiety and fear of the unknown is very very hard.  It took me out for about 3 months.  Then I decided that I cannot control this.  It is what it is.  Just have to give it to God, fight whatever battle may come my way and have some faith.   He may very well remain a 1b forever.   I had a very close friend ask me when I was going thru my darkest days when first diagnosed…"Has anyone told you that you have terminal cancer?"   My answer was no.  She said, "then you focus on the blessings you do have and not the fear of what you don't."   Get it???  She should know.  Her husband is stage IV esophageal cancer and he lives his life every day. 

Many prayers to you and your husband.  If you need a Memphis connection, send me a message. 

My 22 yr old daughter just had a junctional spitzoid biopsied with WLE.  Since my diagnosis of Stage 1b in May, they will be more inclined to remove anything "funny" from her due to genetics.  Please know that not all atypical moles become melanoma.  Yes, they carry a higher risk, but put it in perspective.  If the general poplulation carries a 2.6% lifetime risk of developing melanoma and an atypical mole  increases that risk by 3x's, you are looking at an increased risk of approximately 7.8%.  Its VERY hard when looking at the data on the internet to not think instant doom and gloom.  Especially when you are dealing with your child.  For the 1st three months after my diagnosis, then her atypical lesion…I was A HOT MESS.  Being a stage 1b my odds are around 92-95% of not seeing this ugly monster again…did I appreciate that…NO.  I concentrated on the 8-5% because it can happen.  I can get hit by a bus tomorrow too.

Per my oncologist who is on the national board that writes the protocol for melanoma diagnosing and treatment, atypicals/spitz can be hard to assess.  Our derm states she sees spitz in younger kids quite often.  To give you some peace of mind, get a 2nd opinion on the path report from an oncologist that is a melanoma specialist.  I can tell you I had my oncologist look at my daughter's..no shame at all.  The onc specialist can also give his opinion about a WLE and lymph nodes.  You must remember, per the current pathology, this is NOT cancer.  Its not even pre cancer…its a funky mole that might, maybe, could turn into something one day.  No one is going to approve a SLBN for an atypical non cancerous lesion.  No insurance company will cover it either….however, being your kid, I am sure you would pay out of pocket like I would if need be.  The procedure is invasive and painful and I feel your derm may be correct in stating what you saw on the internet may have been a misdiagnosis from the beginning.  The only thing I can offer in terms of "doing something" to ck those lymph nodes is to see if your dr will perform ultra sounds.  My oncologist does an ultra sound every 3 months of my lymph nodes at my groin and behind my knee (lesion was left calf).  He will do so for 3 yrs, then drop to every 6 months for the next 2 yrs.  BUT I had melanoma and the lesion was ulcerated so no problem getting the order and having insurance cover it.  Maybe you can check into that.  Its pain free, non-invasive and my oncologist said its a great alternative to the SLNB.   At minimum it will give you peace of mind.  Also, tell your derm you want skin cks every 6 months.  They will also ck those lymph nodes via physical examination.

I know this is very scary.  But take a breath and find comfort in the fact that this is not melanoma and odds are way in your favor that it will never be.  You have to find peace of mind to enjoy life with your child.  Have faith that you are in a good place and all can and will be ok.  Wishing you the best. 

Hello, fellow Stage 1(1b to be exact due to focal ulceration).  Derm removed my melanoma stating no SLNB needed due to thin lesion (.44mm).  Due to my anxiety, I consulted an oncologist.  I just happened to be lucky enough to have my appointment with a member of the national board that sets the criteria for melanoma testing and treatment.  Talk about a blessing!  He explained, like Janner stated, .75mm is the standard used to determine the use of a SLNB.  EXCEPT when ulceration is involved.  The opinion then splits 50/50 and he sides with those that would perform a SLNB regardless of thin depth.  Therefore, he checks my lymph nodes behind my knee and in my groin every 3 months and he will do so for the next 3 years.  It gave me peace of mind to speak to someone who understood my anxieties and the unpredictability of melanoma.  I also felt like I was doing something to check the inside of my body and not just my skin.   My insurance covers the ultra sounds and it is a non invasive test. Why not??

 Do what brings you peace of mind and confidence that if ..IF..it does return you will be on top of it.  If you did not have ulceration, I do feel that a SLNB would be an invasive procedure for your depth.  Most drs won't do it and most insurances won't cover it.   Be your own advocate.  Best wishes to you!

I have been told the same thing by my derm, but I recall another post recently where someone said their derm does not support that theory??  I am asking mine again because its good to know small things like that. 

You can NEVER go wrong getting something checked so make that appt if you have not done so!

Well, nect derm visit I am going to ask again about the "hair thing".  Not sure if scalp and arm would be different.  

I completely understand the "thinking the worse" – Tyoe 2 Diabetic with an inoperable(at this time – too small) brain aneurysm.  Its like saying "next" with every new diagnosis.

Please let me know what the doctor says.  Continued prayers.

100% on point Janner.  Spend more time counting your blessings than fearing something you don't have and may never have.

I understand completely your concern.  My melanoma developed in an existing mole so my mind went haywire thinking others had changed and I hadn't noticed.  Or are others new and I have not noticed because I have so many.  Did my many biopsies the 4 months following my diagnosis scientifically benefit me in any way?  5 of the 6 atypicals/funky lesions which were completely excised were found within the first 12 biopsies.   Even some would say atypicals don't need removal unless change is noticed.  So the others were…a waste??  Yes, but for some reason in my head, it's what I needed at the time.  Striving for that clean slate.  Did I accomplish that?  No..I have way too many freckles/moles!! Am I recommending you go have numerous biopsies?  Absolutely not. I am not the norm by far.  But if you do see something you are uncomfortable with, show it to your doctor..even if you think they have seen it and passed it by.  They can explain to you why they think it's ok.  It's all about peace of mind and having confidence in yourself that you are on top of this.  

Remember, you caught the first one early that led to the other lesion being caught extremely early.  Due to your experience, you are now armed with more knowledge about melanoma.  You are more prepared today than you were before to find anything suspicious.  Find comfort in that.