What can expect from the surgical removal?

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11/12/2010 4:52pm
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I posted earlier this week that I had not got my pathology reports back yet from the doctor and was afraid of the unknown.  Well I got the phone call today at work that I do have Melanoma.  They want to schedule for me to have surgery to remove the area on my back, and to have tests done to assure that it hasn't spread.  I am going to go to a different doctor, I called them today and they said once they recieve the pathology from my current doctor then they will call me next week to schedule my surgery.  I still don't know the depth or anything, my doctors office didn't even know.  The pathologist called them and told them that it is Melanoma so that they could call me and let me know before the weekend.  Any advice on how to get through this from here would be great.  I am trying not to worry and hoping that it hasn't spread but every time I look at other moles that have changed recently I just worry more.  The current doctor said I need to have a chest x-ray is this standard procedure after being diagnosed?

Hi Kellie.  If they have confirmed it is melanoma, then my best advice to you is to seek out a melanoma specialist.  You really want to work with someone that specializes in this type of skin cancer. You are scared, and rightfully so, which is why you are noticing changes in your moles that you might not have other wise noticed. Remember, melanoma, when caught early, is very curable so try not to let anxiety overtake you until you understand what exactly you are dealing with. I can tell you from my experience, and that of friends that have also been diagnosed that yes, a chest x ray is standard procedure.

We Got This!

I was recently diagnosed with Melanoma as well (November 2nd 2010). My tumour was 0.39mm and I had a small piece of skin removed from the middle of my back on November 4th. I did not need a chest x-ray or any other tests done because the depth of invasion was extremely minimal. I am not sure why anyone on this board would tell you that chest xrays are standard procedure unless they are medical doctors and they have your pathology report. My advice to you...try not to worry too much about it...Melanoma is not a death sentence and it is curable...even at Stage 2 or 3. If you need to talk, speak to your family or a close friend. I scared myself silly for a whole week by researching melanoma online and reading the posts on this forum. Try not to do that. It doesn't help.

The only real wisdom is knowing you know nothing -Socrates

Kellie,

There are no standard procedures, that's one of the issues that we all have. There have been many times that the board has had discussions on scans at stage 3 (this is not initial diagnosis but for check ups). Some Doctors do scans, others do not except for when there are symptoms.  When at stage 4 - some Doctors do brain mri's as part of the standard protocal, some do it only if there are symptoms.  If the depth of your mole is very thin then there is a good chance the Dr. won't do anything, if it is thicker than they will want to check things out.  Remember when they give you the information, don't mix up levels and stages. Your stressed and need to have someone with you when everything is explained. If you can't take someone with you then take notes and read them back to the Dr. so you know that you have everything straight!  My Dr. takes notes for us, he says he wants our attention on what he is saying. He gives us the notes before we leave.

What tests they would do now depends on the depth. Since your Doctors office didn't know that info they were probably just trying to assure you that everything would be looked into. They had made you wait so long for the results that at least they felt some urgency getting the info to you!

Are you changing Doctors because of the amount of time it took?  That could have been the labs fault and not the Dr. When going to a new Doctor don't be shocked if they send it off for another read to a different lab, especially if you'll be going to a major cancer center. 

Take the weekend and treat yourself to something special. There is nothing you can do until you go to the Doctor. You will definitely have a wide excision done. Some dermatologists do those themselves, depending on their area of expertise and the depth. Some will send you on to a surgeon.  I've had both done.  Reading about melanoma will only get you upset since you don't have enough information yet.

I wish you had gotten better news but we're here for you,

linda

dealing with mel since 1979 and still here to talk about it!!

Linda,

I am switching doctors for a couple reasons.  First, after my first round of biopsies came back abnormal they suggested a full body scan.  I went in the following week for that and the PA did NOT check my whole body.  At that time I didn't know any different, I didn't know that she should have checked my scalp, she didn't measure any of them and for the amount of moles I have they certainly didn't take any pictures.  I also had on a gown and my undergarments and if there was an area covered by clothing she didnt really check it.  And while I am glad they did call and tell me the news before the weekend so I didn't have to continue to wait I do not like how they did it.  I was in our copy room at work when I got the phone call, the nurse asked if it was me I said yes, she identified herself and then immediately said "I am sorry to have to tell you that you have Melanoma."  I was in a busy area around alot of people and just started crying which I normally do not do in front of people.  She started telling me what needs to be done from here and blah blah blah....no time to process anything.  Also I have a friend that used to be a nurse at this dermatologist office and she said that his bedside manner is pretty bad and he can be pretty inconsiderate of his patients.  The other thing is that since it is pretty likely I have Dysplastic Nevi Syndrome the Cancer Genetists I am working with suggested I see a doctor who deals with that often.

I am not looking forward to the surgery, but I am hoping to get a complete body check and to know exactly where I stand in all of this.

Kellie

Jessicajoy is right - a melanoma caught in the eary stage is very curable; you just need to know the depth and what that means.  Knowledge is power!  As everyone has stressed before, get yourself to a melanoma specialist.  After my initial biopsy at a dermatologist's office, I went to MD Anderson where they did do a chest x-ray prior to the excision.  I'm not a doctor, but it does appear to be standard - it's a common site for metastisis, so it's really just a precaution.  Keep asking questions and talk to others and do whatever works for you best to relieve anxiety.  It's a normal feeling.  Wishing you the best outcome possible!!

Dear Kellie - I am so sorry you got the news (and now they leave with you the weekend to ponder) but please try not to freak out.  Easier said then done I know. 

The "usual" process is - surgery to remove the mole (wide excision) and sentinel node biospy (if your breslow is over 1mm), if the node biopsy is positive then further tests like PET/CT scans, if those are clean then they do another surgery to remove all of the lymph nodes.  I encourage you to get your path reports sent to you right away.  This will give you the info you need to know about your mitotic rate and breslow depth, ulceration, etc.

I wanted to say that my husband's snetinel node pathology results took a very long time - like what you experienced - and this might mean they had a hard time determining if it was melanoma.  Because his first path report was so iffy, we sent it to UC San Francisco for a second opinion.  After 3 months long months they decided to agree with the first report and error on the side caution. 

Either way, it is best that you have surgery.  My husband's surgery on his back was quite easy and I hope you dont worry too much about that. You can see a pic of his surgery on our website if that type of thing doesnt freak you out - it looked much worse than it really felt.  The scar isnt that noticeable a year later and it healed very quickly due to the drainage tube - which is gross but actually helps prevent infection.  The amount they take out is based on the depth and size of the melanoma.  

My best to you!

Emily - wife of Mike, stage 3a

www.emandmichael.com

Our experience with melanoma: http://emandmichael.wordpress.com/

Is a chest x-ray standard procedure?  I suspect that is is just an option for the Doctors to try to stay aheaad of the melanoma.  The lungs is the most common organ for melanoma to go to.  If melanoma travels thru the lymph channels it will be found in a set of the lymph nodes, if a melanoma is deep, it may get into the blood stream.  I would not worry about the suggestion that the lungs (chest) be checked to help verify the presence or absence of current spread.  Odds are nothing will be found there, but if it were to be found, the earlier the better.  Wish they had found mine a few years ealier!

    Dependant on the size/depth of the tumor found, they well may want to take a larger clearance around the original site, this is common.  They will often look at the lymph nodes in the chain to see if any melanoma cells have ben trapped in the "sentinel lymph node") the first one in the path.  As noted above, the depth of the primary usually determins if the sentinel bide is removed.  Removal of just the sentinel node is a fairly minor operation, if done..

I'm me, not a statistic. Praying to not be one for years yet.

Hi Kellie, my name is Dave and I was also diagnosed with melanoma yesterday after having a mole on chest removed. The Dr. is sending me to a surgeon Thu for a consultation where they will do surgery to take a larger area around the mole and test lymph nodes. The Dr. told me I had stage 4 melanoma, I hope that he meant the depth was level 4, since can the stage be determined just from biopsy of the mole???  The Dr. did not know much and I will call MOnday to get my biopsy report. Thanks to all for responding!

Live life to the fullest and enjoy each day!

Dave,

I hope to that your doctor made an error on your stage.  I think I am glad my doctors office had no other information for me rather than for them to give me incorrect information, or information to just freak me out more over the weekend.  I am also going to get my pathology reports Monday, and I should be hearing from the other doctors office I am going to.  They said they would call me to discuss surgery and stuff on Monday.

I hope you are making it through the weekend ok....I know for myself I had to use some retail therapy! 

Kellie

Hello Kelli,

One piece of advice...always request copies of ALL tests...xrays, lab, path reports, PET scans, etc.  For me, this has been a great tool.  I tend to go blank after I hear confirming news regarding my melanoma...really I do, so having the paper copy of the results allow me to be more informed.  So sorry to hear about your diagnosis.  Stay informed and get all reports sent to you...You paid for them!

My best to you and your,

Suzan AB

Stage IV

Presently...One Day At A Time.