Confusion on diagnosis.....new to site and melanoma

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4/14/2011 3:23pm
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Replies: 4

In August of 2010 I found out I had melanoma and was a month pregnant one day apart so needless to say its been a CRAZY 9 months as it is for anyone facing this diagnosis!!  My thoughts and prayers first off to everyone on here fighting this ugly disease!!!  I've loved reading all the positive attitudes and stories though, its very uplifting!!!! :)  

To get to my questions......my first dermatologist whom I've since left due to feelings of discomfort on my part.....called and told me my results over the phone while I was on vacation.  Upon returning from vacation I immediately had an appointment in which he told me that he got everything with the punch biopsy but felt it necessary to take a wide excision (1cm all the way around).  He also told me the melanoma was .5mm (I'm assuming he meant depth but not sure) and was a Stage1 with a great prognosis and extremely low chances of recurrence....all great news considering the diagnosis at hand.  He only wanted to see me every six months and wasn't very thorough with the full body check and privacy was an issue in his office (at least for me).  So I sought out a clinic that seemed to better suit my needs/wants that said he did the right thing with the wide excision that they would have handled it the same way so that was comforting.  However they will see me every three months along with yearly liver function tests, lung x-rays and eye exams!!  

Upon them receiving my records from the first dermatologist I asked for more specifics on my diagnosis such as mitosis, ulceration, etc. as I know these things have an effect on prognosis.....so she showed me the report in black and white and it plainly said the melanoma was in situ, unulcerated, and 0 mitosis....which I know are all wonderful news....but I'm just confused by whats written in black and white and what my first dermatologist told me....why the difference in diagnosis????  Just made me wonder...not sure if its anything to be concerned about or not so any input would be appreciated.

Thanks A

I just had a thought cross through my head while reading your post.  Is it possible that your doc might have said something about 5mm margins instead of depth?  The standard for a melanoma in situ diagnosis only requires 5mm margins, not 1cm margins.  Some will take more - just in case.  My Mom just had the same diagnosis 2 weeks ago and the doctor did say to her that 5mm margins were all that were required, but he would be taking 1cm margins.  I'm wondering if in situ was mentioned, didn't really ring a bell with you,  and then you heard 5mm.  Could be totally off base here, but I figure it was worth mentioning.  Then again, maybe he just mixed you up with someone else.

Sorry you had to join the melanoma crowd, but in situ is where you want to be.

Best wishes,

Janner

Sorry to have heard you've joined the Melanoma club :(

I doubt very much your melanoma was ulcerated considering it was in situ and not very deep at all.   Deep tumours are more likely to be ulcerated then thin ones. 

I agree with Janner - they may want to take out more to be sure - 5mm margins.  I also agree with him that in situ is where you want to be.  I'm Stage 3c and wish I had known that the bump on my back was melanoma.

Off topic here, but I started to grow the bump on my back a few months after I gave birth to my daughter. I have also read about other woman who were diagnosed with melanoma while pregnant or after birth.  Could there be some kind of hormonal thing that happens? All I know is when I was pregnant, the moles on my body changed - got darker, changed shape, etc.

 

All the best

Lisa

Many impossible things have been accomplished for those who refuse to quit

I'd be interested too, thanks Lisa, for asking.  Mine didn't start to change until I was well into menopause.  I'd never had any problem with my mole for 30-some years, other than comments about how it would give me trouble one day.  Which it did, but not until those hormonal changes.  Good question.  I hope someone knows!

Thanks for all the responses.......and @ Janner you could be very right about him confusing me with another patient, the disorganization and his failure to remember my case was problematic for me considering the diagnosis.   So that's probably a good guess, but I know they took out 1 cm margins which is more than necessary, but I don't mind if that's what he thought best and my current dermatologist agreed it was a good decision and only improves my prognosis by lowering the chances of recurrence!!  @ Lisa, not sure on the hormonal thing either I would love to hear some answers regarding that, from what I've read it should have no impact on prognosis, recurrence etc, especially when caught early.....thanks for all the replies I really appreciate the feedback!!! :)   Best wishes all around to everyone!!!