Melanoma in situ - what questions should I ask

Posted By
9/17/2012 12:53pm
Replies: 9

I was recently diagnosed with melanoma in situ.  I want to ask the MD the right questions.  What things should I be asking?

Anonymous - (9/17/2012 - 1:02pm)

maybe if you should get a 2nd opinion on pathology, just to confirm and make sure

Really not a lot to ask with melanoma in situ.  It is basically cured after it has been removed.  I think the question I would want to know most is if the pathologist who read the slides was a dermatopathologist who reads melanoma regularly.  Basically, you want to know that the diagnosis is correct so you need to know the credentials of the doctor who reads the pathology.  A general pathologist reads all types of tissue slides but a dermatopathologist reads only skin slides.  That's what I'd want to see. 

Other than that, watch for any moles that change.  They don't have to be melanoma, but those are the "suspicious" ones.  Practice sun safety and just be more "aware".

Anonymous - (8/7/2014 - 6:58am)

I disagree that the person who reads the slide has to be a dermatopathologist.  I know some people in both the fields of pathology and dermatopathology and melanoma in-situ is not a particularly difficult diagnosis to make.

This will more than likely create some discussion, as it always does, but In Situ is NOT, and I repeat is NOT melanoma.

I say this as a fact that has been explained to me over and over over many years by not only pathologists, but dermapathology people not only in a private setting, but explained and presented at at a MRF symposium. .  In-Situ is NOT melanoma.

Please do not buy in to the hype of pre-melanoma; that is like being pre-pregnant.............either you are or are not.

Now, for some real life tools after understanding that............ask for a second opinion from a DERMAPATH to be sure it is indeed in-situ.  This would be the logical next step.  You should find little difficulty from your insurance provider for that  as a next step; and either with or without insurance, it is still a logical next step.

You do NOT have melanoma at this point in your diagnosis; what you want is to be certain, and I get that.

So request a dermapath reading to be sure.  Once you have that, you will have more knowledge to develop a plan forward.

Hope this helps.

Charlie S

Anonymous - (9/18/2012 - 8:26am)

why is in situ not melanoma?  has to be invasive to be considered mel?  so there is no stage 0, officially starts at stage I?    i guess my question would be then how to explain cases such as yoopergirl who started as stage 0 but then progressed

In Situ is considered by some oncologists as not being melanoma, and other oncologists believe that it is. In my case I had in situ removed with large clear margins...but 4 years later it returned and wasn't considered in situ anymore! Amazing that all the lymph nodes had come back clear and I was told nothing to worry about ( they took out 5 sentinal lymph nodes from my neck)..More amazing was in 2009 I was stage 4 and the 6.8 cent melanoma was pressing against my superior vena cava- kissing my heart. I stand with the oncologists who believe in situ IS melanoma...because it IS!

Advocate for your own treatment.. Stage 4 Melanoma NED Surgery,Radiation, Temodar 300Mg July 2009-March 2010, then "Phase I Study of Anti-PD-1 Human Monoclonal Antibody MDX-1106 and Vaccine Therapy"

Hello!  I,too, was just diagnosed with Melanoma in situ based on a small sample that my PCP took. I have a Surgery Consult and Oncology appointment next week.

I was wondering how everything worked out for you and if you had any advice you can share.

Also, maybe you know the answer to my question. My biopsy report inidcated that the Melanoma Cells covered the full tissue sample, which is why I need further surgery, can this diagnosis change? Is there a chance that the cells go deeper than the sample showed?

Thanks in advance for anyones opinion/advice/experience!