Metastasies Clarification

Posted By
Dale from PA
8/12/2010 12:28am
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Replies: 5

Hello All:

I was diagnosed with melanoma on my lower left back in early January, 2010.  I immediately had that little sucker cut right out.  The surgeon oncologist said that I was Stage I.  Great!  Eight months later I go to my dermatologist for my quarterly checkup and she is sure I have another tumor on my upper right shoulder.  She took a biopsy today but, of course, I will have to wait until Monday to get the results.  My question is, is this normal?  It seems inconsistant that a Stage I could spread that far, that fast.  Has anyone else had such a situation occur?  Am I facing surgery every eight months for the rest of my life?  Unfortunately, when they did the original surgery, they could not biopsy the lymph nodes since they were located deep in the belly and not accessable by  needle.  They would have had to do major abdominal surgery to get to them.  It has me worried that I may really be a Stage III.  Any thoughts from the experts?


Janner - (8/12/2010 - 12:49am)

Well, the first obvious question is does the derm think this is a metastasis or a new primary melanoma?  A new melanoma primary doesn't change your staging unless it is worse than the first one.  New primaries are totally separate occurrences that have nothing to do with previous primaries.  That is probably the most likely scenario.  However, if the derm thinks it is a metastasis, that is a different beast entirely.

Do you know more information than "stage I" concerning your original melanoma?  If you knew your depth and other characteristics, that gives us a better feel for your situation. 

Hang in there and try not to stress too much.  It doesn't necessarily have to be bad news. 

Best wishes,


(Stage I since 1992 with 3 melanoma primaries)


     Thanks for the reply.  My original melanoma was Level IV, Stage I.  I was not smart enough to ask the question of whether this was a metastises or new primary.  Anyway, my derm is a Physician's Assistant in whom I have great confidence (she diagnosed me originally when I went in for an unrelated minor hand problem) but she may not be willing to give that kind of an opinion.  It is, however, an important question I should ask her when she calls with the biopsy results.  I guess I should hope it is a new primary.  I am concerned that it was not visible when I was checked four months ago and now the derm is concerned even though it is only the size of one-quarter of a pencil eraser.  Thanks again,


Janner - (8/12/2010 - 10:34am)


I suggest you start asking for copies of your pathology reports for your own files.  Clark's Level IV isn't too specific.  The Breslow depth - depth in millimeters is the most important prognostic factor.  It's best to keep your own copies of these reports - create your own medical history file.  Then you don't have to rely on doctors for this information.  If you change doctors or a different specialist needs this information, you have it!

As for primary vs. metastasis - the pathology would have to determine that as well.  But given the distance away and the size of the lesion, I still would lean towards a new primary as opposed to metastasis.  Hang in there - even new lesions don't have to be melanoma. 


yep, yep, I second the notion to get copies of everything, most places dont make you pay but it might cost 5 or 10 bucks here and there, pay it, make a binder and or file's. I just had a CT scan this past Monday and had a copy of it in hand today when I seen my oncologist and surgeon....very handy. Then you can also sit and google every word you want till your head explodes  . I think I've lost my mind a couple times just this past week.....keep your sense of humor  love ya, Sharon in Reno, Stage IV

To Thy Own Self Be True & Move Fast When You "Know" You Have To!!


     Thanks for your reply, made me laugh, something I needed this week.  Since January I have been spending a lot of time on the internet doing research which, of course, is how I found this site.  Hope your brain scan showed you had one.  As Janner suggested, I will make copies of everything.  Good idea.