Roxanne218

THANK YOU to all who have responded. Really some excellent information here – much appreciated!

Forgot to mention that I'm a 67 yr. old senior. Things are tougher at this age, and if there's an easier method – I'll take it!

I actually think since SLNB isn't as accurate as we'd like, that it should be replaced with a genetic test on the excised tumor. So far this type of test has shown to be quite accurate, and I feel insurance companies should recognize this instead of SLNB. A friend had their tumor tested this way at Castle Biosciences, and it came back "high risk" which should tell everyone he would be the right candidate for adjuvant therapy. The way it is now – whether the patient wants to or not, he/she is pretty much obligated to get SLNB in order for ins. to pay for treatments (if results are positive). If they just have the genetic test done, it's much easier on the patient too, since the excised tumor is immediately sent to the company for testing – that's all. I'm hoping in the near future that SLNB won't be standard procedure any more for newly diagnosed mel patients. (This is good: They are shying away from complete node dissections now.) Just my 2 cents.

Good advice, Celeste. However, if someone is only a Stage 1, don't doctors recommend NOT having the SLNB for this stage since it's very curable with excision only? I am a Stage 2A (as far as I know), and SLNB was recommended to me but I had opted out. My oncologist offered adjuvant treatment to me as a Stage 2 patient, and that is when I decided to "watch and wait" for a while. So, I got the impression Stage 2 patients can opt for adjuvant therapy with no problem. Is this correct?

You're welcome. By the way, I have not started any treatment yet, and am watching and waiting for the time being. Best wishes to you and everyone here.

Brian, I've done lots of research and the reasons I opted out of SLNB are:

1) It is not any kind of treatment.

2) It can't make any difference on patient survival.

3) Melanoma can travel past the sentinel node and into another node that may be missed during SLNB.

4) Melanoma can travel via bloodstream only and miss nodes entirely.

5) Having a positive SLNB result does not mean the melanoma has actually spread to distant organs or that it ever will. It only shows that the melanoma has the ability to spread, hence Stage 3 diagnosis. 

6) Finally, having either a positive or negative SLNB result can give sort of an answer right after surgery, but there still is no guarantee to know what the melanoma will or won't do after that.

For me, I didn't think having this done was going to give me any answers except info on more precise staging. 

Roxanne

Update: I did the PET scan with weird results but my onc doesn't think they are melanoma related. One was a benign-appearing 6mm nodule on my thyroid. The other a 7mm focal point with slightly increased activity on my right breast, 2.6 max SUV. I went on to do more tests for the breast – a mammogram and ultrasound. Absolutely nothing found on both! Now they are recommending a Breast MRI for me. I wonder how much I should worry about this possibly being the start of breast cancer. I've read online articles with differing opinions. Has anyone else had this kind of situation?

I know that adjuvant treatment would probably be available to me ONLY if I do the PET scan and end up having positive results, which of course would change my stage to a 3 or 4. Not sure I want to have the PET scan at this point because of the amt. of radiation, which can actually cause cancer in some people! So hard to decide… I'm seeing an oncologist or two before deciding on the scan.

Thank you Janner. I'll post what I end up doing. Best wishes to all!

Thank you Raco. I wish you the best also. March on and keep strong.

Beth, Thank you for your info. I read on here of someone who later had the SLNB after their WLE, where the WLE had not affected the path at all. My derm who performed my WLE said I could still have it done even though it wouldn't be in the correct order. Will be seeing him again next week to find out more. I do wish there was another way besides that invasive surgery to check the nodes. But, I guess there just isn't any other procedure as accurate.

Depth was 2.6 mm with no ulceration. Mitotic rate 3.

I actually tried there and they aren't accepting any new patients re: melanoma.  Couldn't believe it!