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- April 6, 2019 at 7:39 pm
Regression is a bit of a mixed bag in my experience; the good news is that is shows your body is successfully defending against the melanoma, partially destroying it. The downside is that it makes it difficult to acutally estimate the correct depth of the melanoma at its maximum.
Out of an abundance of caution, my surgeon took the approach that the melanom was full depth, to the extent of the estimated depth including the regressed amount, sizing the WLE accordingly.
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- April 6, 2019 at 1:31 pm
I've had SLNB and multiple WLE procedures at Sinai Hospital in Baltimore; the quality of the surgery was superb, both in terms of scarring and retention of function in the affected area (large excision at right elbow).
Recommend their surgical oncology group without qualification.
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- March 11, 2019 at 5:48 pm
In the absence of regression, you have the benefit of knowing what you are dealing with depth-wise. The mitotic rate, presence of ulceration and other factors may indeed support a sentinel lymph node biopsy in conjunction with the WLE you mention. Out of an abundance of caution, you may want to do this anyway (only real difference in my experience is general versus local anesthesia, although either should take place in an ER for WLE).
I’m not sure days matter, or even weeks, from a medical perspective; psychologically, however, I know it is a great burden.
I’m not familiar with “Zoom”, but the name itself does not inspire confidence. Keep pressing for a referral to a surgical oncologist who specializes in melanoma.
There are great people on this site, at all stages of the disease; your family is not alone .
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- April 7, 2019 at 11:31 am
Out of an abundance of caution, which is appropriate with melanoma, yes; the two measurements combined would be a rough indication of the maximum depth of the melanoma. Wonderful that your body is destroying it so effectively, but your surgeon may elect to treat based upon total depth since regressed areas are more difficult to measure accurately, My personal motto is "Cut frequently…and often too !". I've had multiple "false alarm" biopsies, but also several that came back with severe atypia. Do your ABCDE self exams, keep an eye out for the "ugly ducklings", and schedule follow ups at least every 6 months until you are five (5) years clean. Vigilance is key and wonderful that you caught it at stage 1.
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- March 23, 2019 at 11:08 am
You ar.e your own best advocate, so be aggressive in your follow up; dermatologist every six months and surgical oncologist who performed SLND every six months. If you can arrange it, schedule these visits so that do not overlap, i.e., so that see someone every three months or so. The standard protocol is to do this until you are clear for 5 years. This said, no one knows your body as well as you do, so stay on your ABCDE self-checks, keeping an eye out for the "ugly duckling" which seems different to you than other moles, keep an eye on these, and point them out during your periodic visits. The foregoing may result in biopsies with negative results but, as those on this board will attest, it beats the alternative. Best of success to you !
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- March 12, 2019 at 7:30 pm
No sedation as it's not needed; the anesthesiologist is present and you may require additional local at any time (the worst you will feel is a stinging sensation).
This said, I would have someone else drive you as any surgery is a shock to the body and the amount of local you may receive can be significant.
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- March 11, 2019 at 9:13 pm
PS –
On the SLNB, the only real difference (since WLE should be in an OR anyway) is general versus local anesthetic. If your doctor is willing, have it done and get the peace of mind you may be looking for.
I have NO medical training whatsoever, but firmly believe that, once melanoma is in you, it is "in you" (some recent research suggests the possibility of dermal "migration" above and beyond genetic predisposition, etc.).
To my mind, there is no "win", "beating it", etc., but, rather, success (call it "peaceful coexistence") by staying ahead of it through vigilance and aggressive treatment of anything which, reasonably, causes you concern.
My team punch-biopsies anything they believe to be suspect.
90% of the time, it's just a Band Aid with no follow through needed; this said, it makes me feel a lot better and you may as well. Once in a while, we cut, and I am grateful as I know you are too.
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- March 11, 2019 at 8:57 pm
Punch biopsies are actually quite good due to the depth of the sample.
Although I have begun to look a bit like a baseball, my motto is "Cut often…frequently too !"
Have the surgeries required and stay on it like a hawk; get a dermatologist specializing in melanoma (my "Botox and acne" original dermatologist though I might have some sort of basal cell). Assuming the SLNB is negative (fingers crossed) have your husband see that person every six months for five years and the surgical oncologist at a similar interval, I schedule mine so that I am basically seeing someone every 3-4 months.
Keep everyone posted !
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