jeffjohn78

Hi Matt,

Wow that is a long wait!  I can recommend Dr. Fairies at the John Wayne Cancer Institute @ St. Johns Health Center in Santa Monica.  I refently had surgery by him on 9/3.  He is a great doctor and my surgery was scheduled 1 week after the decision was made that surgery was necessary, so they do not mess around.  Good luck!

Jeff

Hi Matt,

Wow that is a long wait!  I can recommend Dr. Fairies at the John Wayne Cancer Institute @ St. Johns Health Center in Santa Monica.  I refently had surgery by him on 9/3.  He is a great doctor and my surgery was scheduled 1 week after the decision was made that surgery was necessary, so they do not mess around.  Good luck!

Jeff

Hi Matt,

Wow that is a long wait!  I can recommend Dr. Fairies at the John Wayne Cancer Institute @ St. Johns Health Center in Santa Monica.  I refently had surgery by him on 9/3.  He is a great doctor and my surgery was scheduled 1 week after the decision was made that surgery was necessary, so they do not mess around.  Good luck!

Jeff

Hi!

In Situ carries a 95% cure rate so lets hope that is the case.  Either way the advice is the same:

1. find a melanoma specialist, not just an oncologist, all cancers aren't the same.

2. Be vilagent in protecting your skin from sun damage going forward and do'nt skip any of your 3 month checkups.

I wish you the best!

Jeff

Hi!

In Situ carries a 95% cure rate so lets hope that is the case.  Either way the advice is the same:

1. find a melanoma specialist, not just an oncologist, all cancers aren't the same.

2. Be vilagent in protecting your skin from sun damage going forward and do'nt skip any of your 3 month checkups.

I wish you the best!

Jeff

Hi!

In Situ carries a 95% cure rate so lets hope that is the case.  Either way the advice is the same:

1. find a melanoma specialist, not just an oncologist, all cancers aren't the same.

2. Be vilagent in protecting your skin from sun damage going forward and do'nt skip any of your 3 month checkups.

I wish you the best!

Jeff

Hi Leaf,

1. I am assuming we are talking about PPO insurance.  Your doctor should have got pre-approval from the insurance company for this procedure.  When I get my scans, I always get something in the mail before the date of my scan stating it has been approved as been medically necessary.  You might want to confirm that your Dr. is doing this.

2. You have the right to appeal any decision made by your insurance company.  You wuld need to call your insurance company and state you would like to make an appeal of a claim denial and ask to speak to a "greivance" representative. I have done this myself in the past and sucessfully won my appeal.  

Hope this helps!

Jeff

Hi Leaf,

1. I am assuming we are talking about PPO insurance.  Your doctor should have got pre-approval from the insurance company for this procedure.  When I get my scans, I always get something in the mail before the date of my scan stating it has been approved as been medically necessary.  You might want to confirm that your Dr. is doing this.

2. You have the right to appeal any decision made by your insurance company.  You wuld need to call your insurance company and state you would like to make an appeal of a claim denial and ask to speak to a "greivance" representative. I have done this myself in the past and sucessfully won my appeal.  

Hope this helps!

Jeff

Hi Leaf,

1. I am assuming we are talking about PPO insurance.  Your doctor should have got pre-approval from the insurance company for this procedure.  When I get my scans, I always get something in the mail before the date of my scan stating it has been approved as been medically necessary.  You might want to confirm that your Dr. is doing this.

2. You have the right to appeal any decision made by your insurance company.  You wuld need to call your insurance company and state you would like to make an appeal of a claim denial and ask to speak to a "greivance" representative. I have done this myself in the past and sucessfully won my appeal.  

Hope this helps!

Jeff

Hi There!

While no melanoma diagnosis is a good diagnosis, your husbands's would definitly be considered low risk.  He is at Stage 1b.

I will do my best to answer your questions.

1.  All you have to do is ask.  You have the right to know all information regardding your health.

2. first appointment should consist of a complete check of his body for any other melanoma on the skin.  Also will be given full labs including blood test and likely will be scheduled for full body PET/CT scan and MRI of the brain.  Doctor should also explain the procedure necessary to remove the tumor.  For stage 1 it will be a wide margin excision.  This would be where they remove the actual tumor and a margin of skin surronding the tumor, in order to remove any floating cancerous cells around the tumor.  The margin they remove depends on the size of the tumor.  It sounds like your husbands is small fortunetly.  For stage 1 they do not always do a sentinal node biopsy.  But being that you dr has already mentioned the lymph nodes I am guessing that they will.  This is where they shoot a dye in the area of the tumor and see which lymph node drains the dye.  This most likely the node that would have drained the tumor and therefore most likely the node to contain cancerous cells.  Sometime it is more then 1 node.  They remove this node and test it for the presence of cancerous cells.  If it comes back positive then additional treatment is done, if not, being that it is only at stage 1, there would most likely be no further treatment other then close monitoring of the skin periodically to ensure no other melanoma's are showing up.  This sentinal node biopsy is done at the same time as the wide margin excision, so ther will be one operation done.  Please note each doctor is different so what I have described is both based on what I have went through and research, but you doctor could be different. 

3. I would ask anything you need to ask to feel as comfortable as possible about your situation going forward.  This your health and so do not be shy.  If you are not already, I would ask to be reffered to a melanoma specialist, as not al cancers are the same.  This is very important.  There are cutting edge treatments available to melanoma patients who have progressed to stage 3 or 4 that a non melanoma specialist may not be aware of.  I hope your husband won't ever have to worry about those type of treatments but it is best to be in place where they are available if need be.

Also, if you Dr. does not mention the sentinal node biopsy procedure you might want to ask about that.  

4. Yes if it has spread to a lymph node, it automatically becomes at least stage 3. Assuming the scans come back clear (cancerous nodes do not always show up positive on scans I believe), you would know on your follow up appointment after the surgery.  This assuming he has the sentinal node biopsy done of course.  

I hope this helps and my best advice would be not to worry about the lymph nodes until you are told there is something there.  No need to worry until you have something to worry about.  And even then there are treatments available now that as soon as 5 years ago were not available, they are making amazing progress in treatment of melanoma.

Jeff

Hi There!

While no melanoma diagnosis is a good diagnosis, your husbands's would definitly be considered low risk.  He is at Stage 1b.

I will do my best to answer your questions.

1.  All you have to do is ask.  You have the right to know all information regardding your health.

2. first appointment should consist of a complete check of his body for any other melanoma on the skin.  Also will be given full labs including blood test and likely will be scheduled for full body PET/CT scan and MRI of the brain.  Doctor should also explain the procedure necessary to remove the tumor.  For stage 1 it will be a wide margin excision.  This would be where they remove the actual tumor and a margin of skin surronding the tumor, in order to remove any floating cancerous cells around the tumor.  The margin they remove depends on the size of the tumor.  It sounds like your husbands is small fortunetly.  For stage 1 they do not always do a sentinal node biopsy.  But being that you dr has already mentioned the lymph nodes I am guessing that they will.  This is where they shoot a dye in the area of the tumor and see which lymph node drains the dye.  This most likely the node that would have drained the tumor and therefore most likely the node to contain cancerous cells.  Sometime it is more then 1 node.  They remove this node and test it for the presence of cancerous cells.  If it comes back positive then additional treatment is done, if not, being that it is only at stage 1, there would most likely be no further treatment other then close monitoring of the skin periodically to ensure no other melanoma's are showing up.  This sentinal node biopsy is done at the same time as the wide margin excision, so ther will be one operation done.  Please note each doctor is different so what I have described is both based on what I have went through and research, but you doctor could be different. 

3. I would ask anything you need to ask to feel as comfortable as possible about your situation going forward.  This your health and so do not be shy.  If you are not already, I would ask to be reffered to a melanoma specialist, as not al cancers are the same.  This is very important.  There are cutting edge treatments available to melanoma patients who have progressed to stage 3 or 4 that a non melanoma specialist may not be aware of.  I hope your husband won't ever have to worry about those type of treatments but it is best to be in place where they are available if need be.

Also, if you Dr. does not mention the sentinal node biopsy procedure you might want to ask about that.  

4. Yes if it has spread to a lymph node, it automatically becomes at least stage 3. Assuming the scans come back clear (cancerous nodes do not always show up positive on scans I believe), you would know on your follow up appointment after the surgery.  This assuming he has the sentinal node biopsy done of course.  

I hope this helps and my best advice would be not to worry about the lymph nodes until you are told there is something there.  No need to worry until you have something to worry about.  And even then there are treatments available now that as soon as 5 years ago were not available, they are making amazing progress in treatment of melanoma.

Jeff

Hi There!

While no melanoma diagnosis is a good diagnosis, your husbands's would definitly be considered low risk.  He is at Stage 1b.

I will do my best to answer your questions.

1.  All you have to do is ask.  You have the right to know all information regardding your health.

2. first appointment should consist of a complete check of his body for any other melanoma on the skin.  Also will be given full labs including blood test and likely will be scheduled for full body PET/CT scan and MRI of the brain.  Doctor should also explain the procedure necessary to remove the tumor.  For stage 1 it will be a wide margin excision.  This would be where they remove the actual tumor and a margin of skin surronding the tumor, in order to remove any floating cancerous cells around the tumor.  The margin they remove depends on the size of the tumor.  It sounds like your husbands is small fortunetly.  For stage 1 they do not always do a sentinal node biopsy.  But being that you dr has already mentioned the lymph nodes I am guessing that they will.  This is where they shoot a dye in the area of the tumor and see which lymph node drains the dye.  This most likely the node that would have drained the tumor and therefore most likely the node to contain cancerous cells.  Sometime it is more then 1 node.  They remove this node and test it for the presence of cancerous cells.  If it comes back positive then additional treatment is done, if not, being that it is only at stage 1, there would most likely be no further treatment other then close monitoring of the skin periodically to ensure no other melanoma's are showing up.  This sentinal node biopsy is done at the same time as the wide margin excision, so ther will be one operation done.  Please note each doctor is different so what I have described is both based on what I have went through and research, but you doctor could be different. 

3. I would ask anything you need to ask to feel as comfortable as possible about your situation going forward.  This your health and so do not be shy.  If you are not already, I would ask to be reffered to a melanoma specialist, as not al cancers are the same.  This is very important.  There are cutting edge treatments available to melanoma patients who have progressed to stage 3 or 4 that a non melanoma specialist may not be aware of.  I hope your husband won't ever have to worry about those type of treatments but it is best to be in place where they are available if need be.

Also, if you Dr. does not mention the sentinal node biopsy procedure you might want to ask about that.  

4. Yes if it has spread to a lymph node, it automatically becomes at least stage 3. Assuming the scans come back clear (cancerous nodes do not always show up positive on scans I believe), you would know on your follow up appointment after the surgery.  This assuming he has the sentinal node biopsy done of course.  

I hope this helps and my best advice would be not to worry about the lymph nodes until you are told there is something there.  No need to worry until you have something to worry about.  And even then there are treatments available now that as soon as 5 years ago were not available, they are making amazing progress in treatment of melanoma.

Jeff

Hi Kevin,

I had a small bowel resection in Sep 2013.  I had a mass in my small bowel that was days away from causing a blockage as well another mass in my mesintary above my spleen.  I had both removed in Sep.  I am currently NED status with 2 clear scans in a row.  The actuall surgery was not a big deal at all.  I was in the hospital for about 5 days.  You can not gog home until you can have complete bowel movement and eat full meals, which takes time as when you have suregry on your intestines they in effect shut down as defense mechanism and takes a few days for them to start up again.  

The pain was very minimal and scar is also minimal.  The recovery time was about two weeks and I was back in bowing league 3 weeks after my surgery.  So this type of surgery is not crippling in any way and you can resume full activity after a couple weeks, so no need to worry about that.  Just got to make sure you keep active and walking as soon as you can after the surgery as that is wjhat get the bowels working again as well as preventing you scar form tightening up after the surgery.  I was taking wals around the hospital floor I was on two days after the surgery.  Just wanted to let you know the bowel resection surgery isa not the end of the world!

Jeff

Hi Kevin,

I had a small bowel resection in Sep 2013.  I had a mass in my small bowel that was days away from causing a blockage as well another mass in my mesintary above my spleen.  I had both removed in Sep.  I am currently NED status with 2 clear scans in a row.  The actuall surgery was not a big deal at all.  I was in the hospital for about 5 days.  You can not gog home until you can have complete bowel movement and eat full meals, which takes time as when you have suregry on your intestines they in effect shut down as defense mechanism and takes a few days for them to start up again.  

The pain was very minimal and scar is also minimal.  The recovery time was about two weeks and I was back in bowing league 3 weeks after my surgery.  So this type of surgery is not crippling in any way and you can resume full activity after a couple weeks, so no need to worry about that.  Just got to make sure you keep active and walking as soon as you can after the surgery as that is wjhat get the bowels working again as well as preventing you scar form tightening up after the surgery.  I was taking wals around the hospital floor I was on two days after the surgery.  Just wanted to let you know the bowel resection surgery isa not the end of the world!

Jeff

Hi Kevin,

I had a small bowel resection in Sep 2013.  I had a mass in my small bowel that was days away from causing a blockage as well another mass in my mesintary above my spleen.  I had both removed in Sep.  I am currently NED status with 2 clear scans in a row.  The actuall surgery was not a big deal at all.  I was in the hospital for about 5 days.  You can not gog home until you can have complete bowel movement and eat full meals, which takes time as when you have suregry on your intestines they in effect shut down as defense mechanism and takes a few days for them to start up again.  

The pain was very minimal and scar is also minimal.  The recovery time was about two weeks and I was back in bowing league 3 weeks after my surgery.  So this type of surgery is not crippling in any way and you can resume full activity after a couple weeks, so no need to worry about that.  Just got to make sure you keep active and walking as soon as you can after the surgery as that is wjhat get the bowels working again as well as preventing you scar form tightening up after the surgery.  I was taking wals around the hospital floor I was on two days after the surgery.  Just wanted to let you know the bowel resection surgery isa not the end of the world!

Jeff