Dissection Surgery – Second Opinion

In my opinion, if you know for a fact that this is Melanima, get it out! Any other treatment necessary can wait until you get a Melanoma specialist. No matter what other decisions get made, the important thing is to get that crap out as soon as possible.

In my opinion, if you know for a fact that this is Melanima, get it out! Any other treatment necessary can wait until you get a Melanoma specialist. No matter what other decisions get made, the important thing is to get that crap out as soon as possible.

In my opinion, if you know for a fact that this is Melanima, get it out! Any other treatment necessary can wait until you get a Melanoma specialist. No matter what other decisions get made, the important thing is to get that crap out as soon as possible.

BuckyTom: the lymph node dissection is a fairly standard protocol given your diagnosis. I myself have had two neck dissections in the past year. It never hurts to get a second opinion, but I suspect most oncologists/surgeons would recommend the same thing. Depending on the extent, location and number of nodes removed, the procedure can often be completed in under an hour, almost certainly under a general anaesthetic. Preferrably, you will want this done by an experienced surgical oncologist or ENT surgeon familiar with melanoma and in coordination with your oncologist.

Ideally, the surgery will remove the melanoma and your follow-up scans will be clear. If they are not clear and there is evidence the melanoma has spread, you will want to begin having discussions with your oncologist regarding other therapies, most likely targeted gene therapies such as Zelboraf or Yervoy. Both of these drug therapies are discussed widely on this board and many patients are reporting favorable results.

The initial diagnosis is a real shocker of course, but the best thing you can do in my opinion is avoid the statistics, educate yourself on the growing number of drug therapies available, adjust your diet to help fortify your body with the good stuff and find a qualified melanoma oncologist/clinic that you can work with.  Stay strong and I sincerely wish you all the best. Jonathan

BuckyTom: the lymph node dissection is a fairly standard protocol given your diagnosis. I myself have had two neck dissections in the past year. It never hurts to get a second opinion, but I suspect most oncologists/surgeons would recommend the same thing. Depending on the extent, location and number of nodes removed, the procedure can often be completed in under an hour, almost certainly under a general anaesthetic. Preferrably, you will want this done by an experienced surgical oncologist or ENT surgeon familiar with melanoma and in coordination with your oncologist.

Ideally, the surgery will remove the melanoma and your follow-up scans will be clear. If they are not clear and there is evidence the melanoma has spread, you will want to begin having discussions with your oncologist regarding other therapies, most likely targeted gene therapies such as Zelboraf or Yervoy. Both of these drug therapies are discussed widely on this board and many patients are reporting favorable results.

The initial diagnosis is a real shocker of course, but the best thing you can do in my opinion is avoid the statistics, educate yourself on the growing number of drug therapies available, adjust your diet to help fortify your body with the good stuff and find a qualified melanoma oncologist/clinic that you can work with.  Stay strong and I sincerely wish you all the best. Jonathan

BuckyTom: the lymph node dissection is a fairly standard protocol given your diagnosis. I myself have had two neck dissections in the past year. It never hurts to get a second opinion, but I suspect most oncologists/surgeons would recommend the same thing. Depending on the extent, location and number of nodes removed, the procedure can often be completed in under an hour, almost certainly under a general anaesthetic. Preferrably, you will want this done by an experienced surgical oncologist or ENT surgeon familiar with melanoma and in coordination with your oncologist.

Ideally, the surgery will remove the melanoma and your follow-up scans will be clear. If they are not clear and there is evidence the melanoma has spread, you will want to begin having discussions with your oncologist regarding other therapies, most likely targeted gene therapies such as Zelboraf or Yervoy. Both of these drug therapies are discussed widely on this board and many patients are reporting favorable results.

The initial diagnosis is a real shocker of course, but the best thing you can do in my opinion is avoid the statistics, educate yourself on the growing number of drug therapies available, adjust your diet to help fortify your body with the good stuff and find a qualified melanoma oncologist/clinic that you can work with.  Stay strong and I sincerely wish you all the best. Jonathan

I would have the dissection done.  Why?  You have at least one other node with MM, and it is big enough to light up the PET.  This could mean there are other, smaller affected nodes (micro disease).  So it makes sense to try to get them out.  Also, knowing the number of impacted nodes has a prognostic value, and may help you and your Drs. plan your future treatment.

For what it's worth, I had a radical neck dissection in 1997 and I'm still around to bother my family to no end.  Please make sure the surgeon is a head and neck specialist who has done plenty of these procedures.

Best wishes,

Harry

I would have the dissection done.  Why?  You have at least one other node with MM, and it is big enough to light up the PET.  This could mean there are other, smaller affected nodes (micro disease).  So it makes sense to try to get them out.  Also, knowing the number of impacted nodes has a prognostic value, and may help you and your Drs. plan your future treatment.

For what it's worth, I had a radical neck dissection in 1997 and I'm still around to bother my family to no end.  Please make sure the surgeon is a head and neck specialist who has done plenty of these procedures.

Best wishes,

Harry

I would have the dissection done.  Why?  You have at least one other node with MM, and it is big enough to light up the PET.  This could mean there are other, smaller affected nodes (micro disease).  So it makes sense to try to get them out.  Also, knowing the number of impacted nodes has a prognostic value, and may help you and your Drs. plan your future treatment.

For what it's worth, I had a radical neck dissection in 1997 and I'm still around to bother my family to no end.  Please make sure the surgeon is a head and neck specialist who has done plenty of these procedures.

Best wishes,

Harry

I agree with Harry in Fair Oaks, "…you will want this done by an experienced surgical oncologist or ENT surgeon familiar with melanoma…" There are many, many lymph nodes around the head and neck and many, many delicate nerves. The better this surgery is done, the better your chances of getting all of the (potenitally) affected lymph nodes and the fewer side effects you will experience from the surgery (like nerve damage or lymphedema). I would rather delay the surgery for a week or two while I found a really good head-and-neck surgeon experienced with melanoma than rush to the first surgeon that was recommended to me. If you can, get to a melanoma specialty center. If you can't get to one, call the closest one and ask for a recommendation to a head-and-neck surgeon. You don't want needless delay, but you shouldn't panic, either. Melanoma treatment is much, much better than it was even 2 or 3 years ago. 

I agree with Harry in Fair Oaks, "…you will want this done by an experienced surgical oncologist or ENT surgeon familiar with melanoma…" There are many, many lymph nodes around the head and neck and many, many delicate nerves. The better this surgery is done, the better your chances of getting all of the (potenitally) affected lymph nodes and the fewer side effects you will experience from the surgery (like nerve damage or lymphedema). I would rather delay the surgery for a week or two while I found a really good head-and-neck surgeon experienced with melanoma than rush to the first surgeon that was recommended to me. If you can, get to a melanoma specialty center. If you can't get to one, call the closest one and ask for a recommendation to a head-and-neck surgeon. You don't want needless delay, but you shouldn't panic, either. Melanoma treatment is much, much better than it was even 2 or 3 years ago. 

I agree with Harry in Fair Oaks, "…you will want this done by an experienced surgical oncologist or ENT surgeon familiar with melanoma…" There are many, many lymph nodes around the head and neck and many, many delicate nerves. The better this surgery is done, the better your chances of getting all of the (potenitally) affected lymph nodes and the fewer side effects you will experience from the surgery (like nerve damage or lymphedema). I would rather delay the surgery for a week or two while I found a really good head-and-neck surgeon experienced with melanoma than rush to the first surgeon that was recommended to me. If you can, get to a melanoma specialty center. If you can't get to one, call the closest one and ask for a recommendation to a head-and-neck surgeon. You don't want needless delay, but you shouldn't panic, either. Melanoma treatment is much, much better than it was even 2 or 3 years ago. 

I agree with most on here. Go ahead with the dissection. I did and although there were no positive nodes, I'm glad I did it because what if I didn't and there was one with melanoma? It's standard of care for your situation.

In an ideal situation, find the best head and neck surgeon who is experienced in removing lymph nodes with melanoma and get it done tomorrow. Being that is not possible, you have to decide between getting it done monday or waiting to get a surgeon experienced with melanoma. It's a tough call as on one hand you want "the best" to do the surgery and on the other hand, you want it done as soon as possible. Maybe putting all of this together helps you decide.

In the meantime do yourself a favor and avoid sugar and simple carbs (white flour based food) at least until the surgery is over.

I agree with most on here. Go ahead with the dissection. I did and although there were no positive nodes, I'm glad I did it because what if I didn't and there was one with melanoma? It's standard of care for your situation.

In an ideal situation, find the best head and neck surgeon who is experienced in removing lymph nodes with melanoma and get it done tomorrow. Being that is not possible, you have to decide between getting it done monday or waiting to get a surgeon experienced with melanoma. It's a tough call as on one hand you want "the best" to do the surgery and on the other hand, you want it done as soon as possible. Maybe putting all of this together helps you decide.

In the meantime do yourself a favor and avoid sugar and simple carbs (white flour based food) at least until the surgery is over.

I agree with most on here. Go ahead with the dissection. I did and although there were no positive nodes, I'm glad I did it because what if I didn't and there was one with melanoma? It's standard of care for your situation.

In an ideal situation, find the best head and neck surgeon who is experienced in removing lymph nodes with melanoma and get it done tomorrow. Being that is not possible, you have to decide between getting it done monday or waiting to get a surgeon experienced with melanoma. It's a tough call as on one hand you want "the best" to do the surgery and on the other hand, you want it done as soon as possible. Maybe putting all of this together helps you decide.

In the meantime do yourself a favor and avoid sugar and simple carbs (white flour based food) at least until the surgery is over.

Is your local surgeon talking about a one node removal, a partial lymph node basin removal are a radical complete node basin removal?  There are studies underway that question if the radical approach is better than removal of all nodes that have melanoma in them plus a few that are clear.  Personally, I tend to favor leaving some clear nodes in to help limit a spread if more cells are in the lymph channel.  Prefer a second lymph node removal rather than going to stage IV.  .  My great Oncological melanoma specialist surgeon spend 7 hours cutting and sending the groin lymph basins tissue to the pathologist without actually removing every node he could find. That was in Jan 2007 after my local GP and then the local general surgeon screwed things up for me .  I would not be against a short delay. 

   It sounds likely that you have been diagnosed as stage 3.  Another question is what other treatments will be available out side of "wait and watch".  Stage III treatments are very limited.

Be sure you have copies of all the available paperwork on hand to go for the second opinion with the specialists.  They  will want copies of the scans, radiology reports, surgical reports, pathology reports, and if possible your local oncologist patient notes.  They may also want to review the slides of the tissue removed for the previous pathology reports, be sure you know where they are located (both slides and the paraffin block of tissue).

   Could you also start a profile so that we knowmore about your situation for our advice.

Is your local surgeon talking about a one node removal, a partial lymph node basin removal are a radical complete node basin removal?  There are studies underway that question if the radical approach is better than removal of all nodes that have melanoma in them plus a few that are clear.  Personally, I tend to favor leaving some clear nodes in to help limit a spread if more cells are in the lymph channel.  Prefer a second lymph node removal rather than going to stage IV.  .  My great Oncological melanoma specialist surgeon spend 7 hours cutting and sending the groin lymph basins tissue to the pathologist without actually removing every node he could find. That was in Jan 2007 after my local GP and then the local general surgeon screwed things up for me .  I would not be against a short delay. 

   It sounds likely that you have been diagnosed as stage 3.  Another question is what other treatments will be available out side of "wait and watch".  Stage III treatments are very limited.

Be sure you have copies of all the available paperwork on hand to go for the second opinion with the specialists.  They  will want copies of the scans, radiology reports, surgical reports, pathology reports, and if possible your local oncologist patient notes.  They may also want to review the slides of the tissue removed for the previous pathology reports, be sure you know where they are located (both slides and the paraffin block of tissue).

   Could you also start a profile so that we knowmore about your situation for our advice.

Is your local surgeon talking about a one node removal, a partial lymph node basin removal are a radical complete node basin removal?  There are studies underway that question if the radical approach is better than removal of all nodes that have melanoma in them plus a few that are clear.  Personally, I tend to favor leaving some clear nodes in to help limit a spread if more cells are in the lymph channel.  Prefer a second lymph node removal rather than going to stage IV.  .  My great Oncological melanoma specialist surgeon spend 7 hours cutting and sending the groin lymph basins tissue to the pathologist without actually removing every node he could find. That was in Jan 2007 after my local GP and then the local general surgeon screwed things up for me .  I would not be against a short delay. 

   It sounds likely that you have been diagnosed as stage 3.  Another question is what other treatments will be available out side of "wait and watch".  Stage III treatments are very limited.

Be sure you have copies of all the available paperwork on hand to go for the second opinion with the specialists.  They  will want copies of the scans, radiology reports, surgical reports, pathology reports, and if possible your local oncologist patient notes.  They may also want to review the slides of the tissue removed for the previous pathology reports, be sure you know where they are located (both slides and the paraffin block of tissue).

   Could you also start a profile so that we knowmore about your situation for our advice.