@bob-b
Forum Replies Created
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- May 16, 2013 at 3:26 pm
Most well intentioned people believe sun exposure "causes" melanoma. Many believe in the Easter Bunny and Santa, too
Most dermatologists and the $B sun screen industry afraid of losing their 'smoking gun' believe in The Bogeyman (the Sun). Just as plenty of urologists continue to believe in PSA tests for all men.
I won't rant, promise. But I am VERY tired of the medical profession repeating the same tired old shiboleth. As long as the world focuses on The Bogeyman, the REAL causes of Melanoma will remain obscured.
MRF, you are among the biggest infractors. Please, wake up!
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- May 16, 2013 at 3:26 pm
Most well intentioned people believe sun exposure "causes" melanoma. Many believe in the Easter Bunny and Santa, too
Most dermatologists and the $B sun screen industry afraid of losing their 'smoking gun' believe in The Bogeyman (the Sun). Just as plenty of urologists continue to believe in PSA tests for all men.
I won't rant, promise. But I am VERY tired of the medical profession repeating the same tired old shiboleth. As long as the world focuses on The Bogeyman, the REAL causes of Melanoma will remain obscured.
MRF, you are among the biggest infractors. Please, wake up!
-
- May 16, 2013 at 3:26 pm
Most well intentioned people believe sun exposure "causes" melanoma. Many believe in the Easter Bunny and Santa, too
Most dermatologists and the $B sun screen industry afraid of losing their 'smoking gun' believe in The Bogeyman (the Sun). Just as plenty of urologists continue to believe in PSA tests for all men.
I won't rant, promise. But I am VERY tired of the medical profession repeating the same tired old shiboleth. As long as the world focuses on The Bogeyman, the REAL causes of Melanoma will remain obscured.
MRF, you are among the biggest infractors. Please, wake up!
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- July 16, 2012 at 3:50 pm
Janner,
Do we attract that which we think? An example or two…. If we are fearful, bad things are more likely happen. If confrontational, we generate confrontations. And, as you are aware I am more concerned with 'overtreatment' than most, it looks like overtreatment is what I get, as well.
I was successful in my wish to avoid biopsies and go directly to Wide Lesion Excisions (WLE) with Primary #1 (LMM, 2 1/2 years ago) and Primary #2 (SSM, 4 months ago after tracking its growth 8 months, excised twice). However, with Primary #3 (SSM, 2 months ago after tracking its growth 2 1/2 years)- best practice, standard health insurance protocols, the health industry, etc wore me down. It all combined to coerce me into a shave biopsy I did not want of a lesion that, for the third time in a row, turned out as expected: Melanoma.
After waiting two weeks, what I found to be an ambivalent, rudimentary pathology report claimed diseased tissue "at the margin". According to the also delayed "addendum", the shave had presumably "transected the lesion" at .94mm depth. Obviously there was no way to know how deeply the lesion had gone. (Maybe "1.5mm?", one doctor speculated, imagined…). Due to the depth (over .75/recent staging) and our lack of knowledge of "actual depth", a SLNB was strongly encouraged. I again declined- as I had with Primary #1 and Primary #2.
Here is maybe where it gets interesting re: "overtreatment"? See what you think….
Post-WLE pathology showed absolutely no residual disease! Hey, what about the "transected lesion" biopsy? What about diseased tissue "at the margin"? This time, the pathologist who had signed the biopsy pathology simply avoided me. After weeks of persistence, the pathologist who signed the post-WLE report with which I had no problem, talked it over. The credibility of his opinion seems key:
According to him, it is quite common for a WLE to be "clear" after the shave biopsy showed disease "at the margin". the question, of course: IS this true? Of course doctors, pathologists, friends, family… everyone asks, "Why, aren't you content to learn the thing was completely excised?"
Sorry, I am NOT content. A WLE under general anesthetic was performed that came up 100% healthy, based on (it would appear) potentially spurious biopsy results.
What about a "transected" biopsy that turns out to have completely removed the lesion- PRIOR to a WLE? Would much appreciate your opinion.
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- July 16, 2012 at 3:50 pm
Janner,
Do we attract that which we think? An example or two…. If we are fearful, bad things are more likely happen. If confrontational, we generate confrontations. And, as you are aware I am more concerned with 'overtreatment' than most, it looks like overtreatment is what I get, as well.
I was successful in my wish to avoid biopsies and go directly to Wide Lesion Excisions (WLE) with Primary #1 (LMM, 2 1/2 years ago) and Primary #2 (SSM, 4 months ago after tracking its growth 8 months, excised twice). However, with Primary #3 (SSM, 2 months ago after tracking its growth 2 1/2 years)- best practice, standard health insurance protocols, the health industry, etc wore me down. It all combined to coerce me into a shave biopsy I did not want of a lesion that, for the third time in a row, turned out as expected: Melanoma.
After waiting two weeks, what I found to be an ambivalent, rudimentary pathology report claimed diseased tissue "at the margin". According to the also delayed "addendum", the shave had presumably "transected the lesion" at .94mm depth. Obviously there was no way to know how deeply the lesion had gone. (Maybe "1.5mm?", one doctor speculated, imagined…). Due to the depth (over .75/recent staging) and our lack of knowledge of "actual depth", a SLNB was strongly encouraged. I again declined- as I had with Primary #1 and Primary #2.
Here is maybe where it gets interesting re: "overtreatment"? See what you think….
Post-WLE pathology showed absolutely no residual disease! Hey, what about the "transected lesion" biopsy? What about diseased tissue "at the margin"? This time, the pathologist who had signed the biopsy pathology simply avoided me. After weeks of persistence, the pathologist who signed the post-WLE report with which I had no problem, talked it over. The credibility of his opinion seems key:
According to him, it is quite common for a WLE to be "clear" after the shave biopsy showed disease "at the margin". the question, of course: IS this true? Of course doctors, pathologists, friends, family… everyone asks, "Why, aren't you content to learn the thing was completely excised?"
Sorry, I am NOT content. A WLE under general anesthetic was performed that came up 100% healthy, based on (it would appear) potentially spurious biopsy results.
What about a "transected" biopsy that turns out to have completely removed the lesion- PRIOR to a WLE? Would much appreciate your opinion.
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- July 16, 2012 at 3:50 pm
Janner,
Do we attract that which we think? An example or two…. If we are fearful, bad things are more likely happen. If confrontational, we generate confrontations. And, as you are aware I am more concerned with 'overtreatment' than most, it looks like overtreatment is what I get, as well.
I was successful in my wish to avoid biopsies and go directly to Wide Lesion Excisions (WLE) with Primary #1 (LMM, 2 1/2 years ago) and Primary #2 (SSM, 4 months ago after tracking its growth 8 months, excised twice). However, with Primary #3 (SSM, 2 months ago after tracking its growth 2 1/2 years)- best practice, standard health insurance protocols, the health industry, etc wore me down. It all combined to coerce me into a shave biopsy I did not want of a lesion that, for the third time in a row, turned out as expected: Melanoma.
After waiting two weeks, what I found to be an ambivalent, rudimentary pathology report claimed diseased tissue "at the margin". According to the also delayed "addendum", the shave had presumably "transected the lesion" at .94mm depth. Obviously there was no way to know how deeply the lesion had gone. (Maybe "1.5mm?", one doctor speculated, imagined…). Due to the depth (over .75/recent staging) and our lack of knowledge of "actual depth", a SLNB was strongly encouraged. I again declined- as I had with Primary #1 and Primary #2.
Here is maybe where it gets interesting re: "overtreatment"? See what you think….
Post-WLE pathology showed absolutely no residual disease! Hey, what about the "transected lesion" biopsy? What about diseased tissue "at the margin"? This time, the pathologist who had signed the biopsy pathology simply avoided me. After weeks of persistence, the pathologist who signed the post-WLE report with which I had no problem, talked it over. The credibility of his opinion seems key:
According to him, it is quite common for a WLE to be "clear" after the shave biopsy showed disease "at the margin". the question, of course: IS this true? Of course doctors, pathologists, friends, family… everyone asks, "Why, aren't you content to learn the thing was completely excised?"
Sorry, I am NOT content. A WLE under general anesthetic was performed that came up 100% healthy, based on (it would appear) potentially spurious biopsy results.
What about a "transected" biopsy that turns out to have completely removed the lesion- PRIOR to a WLE? Would much appreciate your opinion.
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- June 10, 2012 at 1:49 pm
Nor could I. But the abstract of the EM-link research does appear on the left side of the page.
Here's another, from "dissident" dermatologists who don't keep pointing at the sun like the sunblock industry, AMA, derms in general:
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- June 10, 2012 at 1:49 pm
Nor could I. But the abstract of the EM-link research does appear on the left side of the page.
Here's another, from "dissident" dermatologists who don't keep pointing at the sun like the sunblock industry, AMA, derms in general:
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- June 10, 2012 at 1:49 pm
Nor could I. But the abstract of the EM-link research does appear on the left side of the page.
Here's another, from "dissident" dermatologists who don't keep pointing at the sun like the sunblock industry, AMA, derms in general:
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- June 10, 2012 at 6:45 am
All of us have heard much the same reasons you give for doing a SLNB. I have also heard them from oncologists, dermatologists and well-meaning friends- who all counsel "making sure", "sleeping better at night", etc. We can dispute your argument- logically. But we there is no way we can dispute it- emotionally. As Janner and others have said, it is a decision we must all make based largely on our own particular state of mind.
I was offered an SLNB two years ago for a Breslow .67 and .8 (second opinion). I declined. There has been no recurrence- maybe I was lucky. We'll never know…. Recently I've been offered an SLNB again- for a third primary, shave biopsy .94 transected. We of course cannot know how deep it goes until a WLE is performed.
I will decline an SLNB again. Bad decision? Got lucky once, foolishly hope to get lucky again? Maybe. But here's the point: We try to make our decisions based on statistics, common sense, logic. But the BIG issue is- as far as I am concerned- can we live with the uncertainty that we also know is an integral part of life? Can we bear the 3 or 5 or 10% risk we are told we run by declining an SLNB? It's strictly individual It's emotional, with a link, dubious at best, to objective reality .
Others must take their own chances, I will take mine. And remind family, friends and doctors they cannot make our decisions for us. We are all unique individuals and must make our own.
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- June 10, 2012 at 6:45 am
All of us have heard much the same reasons you give for doing a SLNB. I have also heard them from oncologists, dermatologists and well-meaning friends- who all counsel "making sure", "sleeping better at night", etc. We can dispute your argument- logically. But we there is no way we can dispute it- emotionally. As Janner and others have said, it is a decision we must all make based largely on our own particular state of mind.
I was offered an SLNB two years ago for a Breslow .67 and .8 (second opinion). I declined. There has been no recurrence- maybe I was lucky. We'll never know…. Recently I've been offered an SLNB again- for a third primary, shave biopsy .94 transected. We of course cannot know how deep it goes until a WLE is performed.
I will decline an SLNB again. Bad decision? Got lucky once, foolishly hope to get lucky again? Maybe. But here's the point: We try to make our decisions based on statistics, common sense, logic. But the BIG issue is- as far as I am concerned- can we live with the uncertainty that we also know is an integral part of life? Can we bear the 3 or 5 or 10% risk we are told we run by declining an SLNB? It's strictly individual It's emotional, with a link, dubious at best, to objective reality .
Others must take their own chances, I will take mine. And remind family, friends and doctors they cannot make our decisions for us. We are all unique individuals and must make our own.
-
- June 10, 2012 at 6:45 am
All of us have heard much the same reasons you give for doing a SLNB. I have also heard them from oncologists, dermatologists and well-meaning friends- who all counsel "making sure", "sleeping better at night", etc. We can dispute your argument- logically. But we there is no way we can dispute it- emotionally. As Janner and others have said, it is a decision we must all make based largely on our own particular state of mind.
I was offered an SLNB two years ago for a Breslow .67 and .8 (second opinion). I declined. There has been no recurrence- maybe I was lucky. We'll never know…. Recently I've been offered an SLNB again- for a third primary, shave biopsy .94 transected. We of course cannot know how deep it goes until a WLE is performed.
I will decline an SLNB again. Bad decision? Got lucky once, foolishly hope to get lucky again? Maybe. But here's the point: We try to make our decisions based on statistics, common sense, logic. But the BIG issue is- as far as I am concerned- can we live with the uncertainty that we also know is an integral part of life? Can we bear the 3 or 5 or 10% risk we are told we run by declining an SLNB? It's strictly individual It's emotional, with a link, dubious at best, to objective reality .
Others must take their own chances, I will take mine. And remind family, friends and doctors they cannot make our decisions for us. We are all unique individuals and must make our own.
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- June 10, 2012 at 6:10 am
May I ask a dumb question? How did you know "at least one node had mel because of the dye test BEFORE the SNB"? Isn't the die strictly to determine the sentinel node to which it likely flows from the lesion- but the dye cannot indicate the presence of melanoma in the node(s)?
Detection of melanoma is possible only AFTER the SNB. Not before.
Or have I misunderstood? Thanks much.
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- June 10, 2012 at 6:10 am
May I ask a dumb question? How did you know "at least one node had mel because of the dye test BEFORE the SNB"? Isn't the die strictly to determine the sentinel node to which it likely flows from the lesion- but the dye cannot indicate the presence of melanoma in the node(s)?
Detection of melanoma is possible only AFTER the SNB. Not before.
Or have I misunderstood? Thanks much.
-
- June 10, 2012 at 6:10 am
May I ask a dumb question? How did you know "at least one node had mel because of the dye test BEFORE the SNB"? Isn't the die strictly to determine the sentinel node to which it likely flows from the lesion- but the dye cannot indicate the presence of melanoma in the node(s)?
Detection of melanoma is possible only AFTER the SNB. Not before.
Or have I misunderstood? Thanks much.
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