Decisions and help
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Decisions and help

› Forums › General Melanoma Community › Decisions and help

  • Post
    • January 27, 2018 at 1:51 pm
    Tjvcc
    Participant

      Hi I am stage 3b, 30yr old male.

      I had my surgery in December, 

      my lesion was on my knee it is a spitz/spitz Melanoma. I have had 4 path reports most saying treat as melanoma. I have two nodes positive with only 3 cells in each, not developed just tiny individual cells spread out. Pets came clean

      Here is my issue, prior to my biopsy I fell on my knee. So badly that I compressed the tumor multiple times between my knee and the ground, it filled with a liquid and popped. The biopsy was taken 2 days later.

      i have learned that a fall like this will destroy a path reading, raising moronic rates, creating ulceration, crating atypical cells, especially if it is biopsies quickly after and a spitz can stain and look like melanoma as it is. I also learned this fall could have lead to draining of those cells into my nodea. I have confirmed this with pathologist and read reports/case studies online.

      Most of the labs do not know I fell and one did not think it was melanoma. I have to make a decision on treatment next week and I can’t figure out what to do. My gut is telling me the fall created these bad markers. I also had a mutations test done that was negative. I can’t wrap my head around this I feel like no labs will take me serious when I say I fell, or they don’t want the liability if it wasn’t from the fall.

       

      any advice would be great, I am also thinking of taking opdivo

       

       

       

       

       

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    • Replies
        • January 27, 2018 at 2:14 pm
        ed williams
        Participant

          You might want to give us the pathology report in more detail, not much to go on with what you have given!!!Ed

          • January 27, 2018 at 3:13 pm
          Bubbles
          Participant

            Sorry you are dealing with this, TJ.  Ed makes a good point.  While discriminating cells in a stain can be tricky, I don't think a fall would change the results of your cutaneous lesions very much and certainly would not affect findings in a lymph node.  If there is concensus that the lymph nodes were positive for micro mets of melanoma…that is probably the bottom line. There are many threads here that talk about opdivo (an anti-PD-1 immunotherapy…also called Nivolumab or nivo for short) in the adjuvant setting and otherwise. Just use the search bubble.  Ask more questions as you need.

            I wish you well.  Celeste

            • January 27, 2018 at 3:53 pm
            Janner
            Participant

              Which markers did you have tested?  Was that the FSH test?  That is often done to determine if a Spitz nevi is really melanoma.  Was that negative for melanoma? 

              I think you are grasping at straws a bit for the trauma induced spread.  If you want to go that way, watch and wait is certainly an option for stage 3.  But I think you have to admit to yourself the possibility exists this is melanoma spread to lymph nodes.  No pathologist is going to consider a fall/trauma in their diagnosis.  They are only going to report what they see right in front of them on the slides.  That's their business.  If they see cells in a lymph node, then they are there.  How they got there is a moot point to a pathologist – that's not their job to determine.  Pathologists report on what they see.  They don't stage melanoma because they can only see their tiny slides and not the rest of your body or situation.  That's where your oncologist comes in – they evaluate the entire scope of the person and the disease.  If you and your doc decide that trauma is a contributing factor, then that's where you decide what treatment option makes sense based on your personal history.  But don't expect a pathologist to do anything other than report exactly what they see.

              • January 29, 2018 at 3:17 am
              Becky
              Participant

                I am sure as heck no expert but when researching my sons unusual melanoma dx I did read that benign spitz nevus can sometimes spread to lymph nodes.They recommend treat as melanoma…which is what we did..but I dont feel like you are grasping at straws. My son had 3 path reports…two said melanoma and one was baiscally melanoma cannot be ruled out but maybe a spitz type nevus that spread to lymph nodes but not necessariy melanoma…just severely atypical cells…but since melanoma cannot be ruled out, treat as melanoma. I know how confusing it can be!

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