Debbiem

Thank you for posting this! I’ve gained so much weight since starting Opdivo and tried to manage it with exercise and diet but it doesn’t help. So far the doctors have no medical reason for it except for possibly inflammation. I would love to hear any ways to counter this side effect.

Hi Karen

I’m sorry about your melanoma diagnosis. Hearing it for the first time is the hardest.

Over the past 11 months I’ve had over 40 surgeries for many melanomas – on my arms, legs, face, etc.

My dermatologist gives me the option to remove more than 1 at a time which I always do. I’ve had to have skin grafts and she did 2 of them at the same time. It can be a lot but I prefer to just do it. Also since I’ve had so many, she sometimes “stages” them and doesn’t close the excisions (since I’ve had several re-excisions due to positive margins). It helps preserve healthy skin and sometimes we just let them heal this way instead of stitching.

I would recommend a dermatologist who specializes in melanoma if possible. They will take the minimal margins to see if they are clear. Regarding a skin graft it really depends on location and if they can close the excision.

I just started Immunotherapy this week so there are great systemic treatments for melanoma now. It’s encouraging to see how much progress is being made in treating melanoma.

I pray your surgeries go well,
Debbie

It is scary to get that first call and hear you or your spouse has cancer. Sorry to hear about your husband.
Many doctors refer out to plastic surgeons as they have more experience.
I would recommend going to a dermatologist who has experience with melanoma and an Oncologist who specializes in melanoma if there’s one in your area.

My first melanoma diagnosis was in 2005 and I wish I would have done these two things. I was rediagnosed last year but my previous dermatologist missed several melanomas for years. She was not a melanoma dermatologist.

Regarding the lab report, melanoma in Situ is the top layer of skin which requires surgery for removal. They take about 1/2” around the tumor to get clear margins. They are checking a lymph node to make sure it hasn’t spread. This is a conservative (good) approach. Breslow depth is the thickness of it. Clark’s level is rating its invaseness.
If the staging stays 1b, they can completely remove the cancer by surgery which is good.

There are some great people on this site who have articles with more info so hopefully others will respond.

I want to encourage you as I’ve had over 40 surgeries in 10 months for many melanomas. My case is extremely rare though. The medical community has been advancing melanoma treatment since my first diagnosis in 2005 and it’s pretty awesome to see how far treatment has come.

I pray your husband’s surgery goes well.
Debbie

Awesome news about the clear nodes! I’ve had a few that had to be re-excised several times but eventually came back clear. I pray your surgeon gets it all on the next go around.
Cheering for you and your healing!

Are you getting care at a cancer center?

With your history, it seems like there would be benefit in going to a cancer center if possible.

Hang in there!
Debbie

Hi Karen

I think as long as there’s someone on your medical team with melanoma expertise that’s great. I am blessed with a great team who have been thorough and advocate for me.

On another note, they thought all of my melanomas could be primary tumors but it’s unusual to experience multiple primaries. So they looked at epidermitropic Metastatic melanoma which is extremely rare. This is likely my case due to the number of melanomas and that they spread to other areas of my skin.

Thank you for praying. It’s good that we don’t have to be on the journey alone.

Praying and cheering for you!
Debbie

I understand the worrying part. My husband had stage 4 cancer in 2006 and I worried a lot until I prayed and finally had peace about it. He’s 13 years clear and going strong. 🙂

Regarding the lab report, it looks like the 1b melanoma came out of the melanoma in Situ. I don’t know if they gave you the detailed lab report. Sometimes it helps bring clarity to what is going on. They give as much detail as possible so the doctors know how to treat it. The summary you shared seems to indicate that there was a melanoma in Situ (top layer of skin) that ended up going into the next layer of skin. The good news is that Monday is almost here. Hang in there!

I hope his appointment goes well tomorrow and that surgery will take care of it.

Blessings,
Debbie

I understand the worrying part. My husband had stage 4 cancer in 2006 and I worried a lot until I prayed and finally had peace about it. He’s 13 years clear and going strong. 🙂

Regarding the lab report, it looks like the 1b melanoma came out of the melanoma in Situ. I don’t know if they gave you the detailed lab report. Sometimes it helps bring clarity to what is going on. They give as much detail as possible so the doctors know how to treat it. The summary you shared seems to indicate that there was a melanoma in Situ (top layer of skin) that ended up going into the next layer of skin. The good news is that Monday is almost here. Hang in there!

I hope his appointment goes well tomorrow and that surgery will take care of it.

Blessings,
Debbie