HELP WITH MY TREATMENT TO TAKE THE BEST DECISION

This topic has 42 replies, 8 voices, and was last updated 12 years, 8 months ago by _Paul_.

Post

- August 12, 2012 at 5:40 pm
- Quote
DanielM
Participant
               On August 03 the melanoma was removed of my skin (back). Based on the pathologist report, on August 10, the oncologist determined that it was on stage two, almost three. He suggested treatment like stage 3 with interferon. I will look for a second opinion in Houston, Tx( MD Anderson). But I am really scared of the secondary effects of the medicines available: interferon,http://skincancer.about.com/od/livingwithskincancer/a/interferon-side-effects.htm, Yervoy, Zelboraf, etc.

There are so many organic effects, including brain damages (of short duration…suppose). Actually, besides this cancer problem my overall health is good. I have metabolic syndrome (Diabetes, HBP, and triglycerides and cholesterol problems), but all those issues are in control with the parameters in good range. I made extensive research for these problems and together with my doctor with medicine, exercise and supplements I am in good health condition. Otherwise, these medicines for melanoma are a nightmare for anybody. The oncologist told us about that the interferon may provoque sucidal issues, and I researched that also affects your reasoning skills.

What I love more for my daily life and my work, as Mathematics teacher, is my capacity to teach Math to my students and teach them decision taking skills. I need to collect the most information available to deal with this new huge problem in my life,

Thanks and never give up to your life,

DanielM

Viewing 14 reply threads

Replies

- - August 12, 2012 at 6:53 pm
  - Quote
  Janner
  Participant
  I'm not sure how you can be "almost stage III". Stage II is based on depth. If you had a deep stage II lesion, that is concerning. But that doesn't mean you are stage III and it doesn't mean you qualify for all treatments listed. Stage III is whether or not you have melanoma in the lymph nodes. You either do or don't, so I don't get "almost". As for adjuvant treatments for stage II, Interferon is likely to be your only bet. Yervoy is not approved for stage III let alone stage II. Zelboraf is used when you typically have a lot of disease and stage IV and this requires testing for the BRAF mutation. They never give it as an adjuvant treatment. There are some stage III folks who have done bio-chemo as an adjuvant therapy, but again that is stage III not II. I think I saw someone mention recently a clinical trial for stage II, and that might be your other choice. Unfortunately, there aren't really any good adjuvant treatment choices right now, and recent breakthroughs have been for treating stage IV active disease, not prevention.
  - August 13, 2012 at 2:35 am
    
    Quote
    lunchlady
    Participant
    
    I enjoy reading your responses as you obviously are very knowledgeable about melanoma. However, my husband is stage IIIC and did not have any positive nodes. 7 of his nodes were clustered but they were negative for melanoma. According to the AJCC's updated staging (2010) chart, a patient is considered stage III if they have intransit metastasis/satellites without metastatic nodes (N2c). I agree that there is no "almost" when it comes to staging.
  - August 13, 2012 at 2:35 am
    
    Quote
    lunchlady
    Participant
    
    I enjoy reading your responses as you obviously are very knowledgeable about melanoma. However, my husband is stage IIIC and did not have any positive nodes. 7 of his nodes were clustered but they were negative for melanoma. According to the AJCC's updated staging (2010) chart, a patient is considered stage III if they have intransit metastasis/satellites without metastatic nodes (N2c). I agree that there is no "almost" when it comes to staging.
  - August 13, 2012 at 4:28 am
    
    Quote
    Janner
    Participant
    
    I understand that, my father has intransits at the moment although his might make him stage IV instead of III (debatable if they are considered distant intransits). But the original poster does not list intransits. When I reread, I did see a mention of a satellite (gray area in staging) at the end of the path report and it may be that that is the reason for the "almost stage III" comment. The original poster has a very deep lesion which can carry a higher risk of recurrence than stage IIIa. The pathology report only gives us a basis for staging but we can't see the whole picture (size, distance from primary, etc. of possible satellites) which is why docs stage, not pathology reports. Some things are judgement calls and it's possible that the possibility of a satellite falls into that category and IS almost stage III. I guess I stand corrected from my original posting because as I analyze further, I can see how that statement could be made with regards to satellites.
    
    As for your husband, I've heard of clustered lymph nodes because that can be their normal condition. Often times they are found in clusters. So I'm not sure about the "clustered and benign" comment because that sounds like the nature of some lymph nodes and not anything related to disease. I'm curious, what were you told about the clustered nodes? (I'm always willing to learn).
    
    For the original poster, check out "Carver" in the profiles. Her lesion was deeper than yours although she did have one positive node, I believe. However, she's over 5 years NED. She did no other treatment than surgery. I wish there were great options for adjuvant therapies for melanoma, but at this time – it's pretty bleak. Getting a second opinion from a major melanoma center is a great idea given your higher risk lesion. It never hurts to have more options/opinions.
    
    Best wishes,
    
    Janner
  - August 13, 2012 at 4:28 am
    
    Quote
    Janner
    Participant
    
    I understand that, my father has intransits at the moment although his might make him stage IV instead of III (debatable if they are considered distant intransits). But the original poster does not list intransits. When I reread, I did see a mention of a satellite (gray area in staging) at the end of the path report and it may be that that is the reason for the "almost stage III" comment. The original poster has a very deep lesion which can carry a higher risk of recurrence than stage IIIa. The pathology report only gives us a basis for staging but we can't see the whole picture (size, distance from primary, etc. of possible satellites) which is why docs stage, not pathology reports. Some things are judgement calls and it's possible that the possibility of a satellite falls into that category and IS almost stage III. I guess I stand corrected from my original posting because as I analyze further, I can see how that statement could be made with regards to satellites.
    
    As for your husband, I've heard of clustered lymph nodes because that can be their normal condition. Often times they are found in clusters. So I'm not sure about the "clustered and benign" comment because that sounds like the nature of some lymph nodes and not anything related to disease. I'm curious, what were you told about the clustered nodes? (I'm always willing to learn).
    
    For the original poster, check out "Carver" in the profiles. Her lesion was deeper than yours although she did have one positive node, I believe. However, she's over 5 years NED. She did no other treatment than surgery. I wish there were great options for adjuvant therapies for melanoma, but at this time – it's pretty bleak. Getting a second opinion from a major melanoma center is a great idea given your higher risk lesion. It never hurts to have more options/opinions.
    
    Best wishes,
    
    Janner
  - August 13, 2012 at 4:28 am
    
    Quote
    Janner
    Participant
    
    I understand that, my father has intransits at the moment although his might make him stage IV instead of III (debatable if they are considered distant intransits). But the original poster does not list intransits. When I reread, I did see a mention of a satellite (gray area in staging) at the end of the path report and it may be that that is the reason for the "almost stage III" comment. The original poster has a very deep lesion which can carry a higher risk of recurrence than stage IIIa. The pathology report only gives us a basis for staging but we can't see the whole picture (size, distance from primary, etc. of possible satellites) which is why docs stage, not pathology reports. Some things are judgement calls and it's possible that the possibility of a satellite falls into that category and IS almost stage III. I guess I stand corrected from my original posting because as I analyze further, I can see how that statement could be made with regards to satellites.
    
    As for your husband, I've heard of clustered lymph nodes because that can be their normal condition. Often times they are found in clusters. So I'm not sure about the "clustered and benign" comment because that sounds like the nature of some lymph nodes and not anything related to disease. I'm curious, what were you told about the clustered nodes? (I'm always willing to learn).
    
    For the original poster, check out "Carver" in the profiles. Her lesion was deeper than yours although she did have one positive node, I believe. However, she's over 5 years NED. She did no other treatment than surgery. I wish there were great options for adjuvant therapies for melanoma, but at this time – it's pretty bleak. Getting a second opinion from a major melanoma center is a great idea given your higher risk lesion. It never hurts to have more options/opinions.
    
    Best wishes,
    
    Janner
  - August 13, 2012 at 10:33 am
    
    Quote
    lunchlady
    Participant
    
    I apologize if I offended you by not making myself clear. I was only referring to your statement regarding stage III is when the nodes are positive for melanoma. As far as my mentioning the clustered nodes (matted), I should not have as it does not pertain to my husbands staging. Although it is listed on the ACJJ staging chart as a consideration (N3) when nodes are positive.
  - August 13, 2012 at 10:33 am
    
    Quote
    lunchlady
    Participant
    
    I apologize if I offended you by not making myself clear. I was only referring to your statement regarding stage III is when the nodes are positive for melanoma. As far as my mentioning the clustered nodes (matted), I should not have as it does not pertain to my husbands staging. Although it is listed on the ACJJ staging chart as a consideration (N3) when nodes are positive.
  - August 13, 2012 at 10:33 am
    
    Quote
    lunchlady
    Participant
    
    I apologize if I offended you by not making myself clear. I was only referring to your statement regarding stage III is when the nodes are positive for melanoma. As far as my mentioning the clustered nodes (matted), I should not have as it does not pertain to my husbands staging. Although it is listed on the ACJJ staging chart as a consideration (N3) when nodes are positive.
  - August 13, 2012 at 12:31 pm
    
    Quote
    Janner
    Participant
    
    No, you didn't offend me, you brought up a good point! – and made me rethink my previous answer. In general, most of us think of stage III as node positive only, but that isn't always the case. Intransits do affect staging and you can be stage III without positive nodes. As for the clustered nodes, comment I understand. They are used in staging, but I think that the "cluster" effect refers to them being attached by involved melanoma, not just normal tissue. 😉 Have a good one!
    
    Janner
  - August 13, 2012 at 12:31 pm
    
    Quote
    Janner
    Participant
    
    No, you didn't offend me, you brought up a good point! – and made me rethink my previous answer. In general, most of us think of stage III as node positive only, but that isn't always the case. Intransits do affect staging and you can be stage III without positive nodes. As for the clustered nodes, comment I understand. They are used in staging, but I think that the "cluster" effect refers to them being attached by involved melanoma, not just normal tissue. 😉 Have a good one!
    
    Janner
  - August 13, 2012 at 12:31 pm
    
    Quote
    Janner
    Participant
    
    No, you didn't offend me, you brought up a good point! – and made me rethink my previous answer. In general, most of us think of stage III as node positive only, but that isn't always the case. Intransits do affect staging and you can be stage III without positive nodes. As for the clustered nodes, comment I understand. They are used in staging, but I think that the "cluster" effect refers to them being attached by involved melanoma, not just normal tissue. 😉 Have a good one!
    
    Janner
  - August 13, 2012 at 10:40 am
    
    Quote
    lunchlady
    Participant
    
    I apologize if I offended you by not making myself clear. I was only referring to your statement regarding stage III is when the nodes are positive for melanoma. As far as my mentioning the clustered nodes (matted), I should not have as it does not pertain to my husbands staging. Although it is listed on the ACJJ staging chart as a consideration (N3) when nodes are positive.
  - August 13, 2012 at 10:40 am
    
    Quote
    lunchlady
    Participant
    
    I apologize if I offended you by not making myself clear. I was only referring to your statement regarding stage III is when the nodes are positive for melanoma. As far as my mentioning the clustered nodes (matted), I should not have as it does not pertain to my husbands staging. Although it is listed on the ACJJ staging chart as a consideration (N3) when nodes are positive.
  - August 13, 2012 at 10:40 am
    
    Quote
    lunchlady
    Participant
    
    I apologize if I offended you by not making myself clear. I was only referring to your statement regarding stage III is when the nodes are positive for melanoma. As far as my mentioning the clustered nodes (matted), I should not have as it does not pertain to my husbands staging. Although it is listed on the ACJJ staging chart as a consideration (N3) when nodes are positive.
  - August 13, 2012 at 2:35 am
    
    Quote
    lunchlady
    Participant
    
    I enjoy reading your responses as you obviously are very knowledgeable about melanoma. However, my husband is stage IIIC and did not have any positive nodes. 7 of his nodes were clustered but they were negative for melanoma. According to the AJCC's updated staging (2010) chart, a patient is considered stage III if they have intransit metastasis/satellites without metastatic nodes (N2c). I agree that there is no "almost" when it comes to staging.
- - August 12, 2012 at 6:53 pm
  - Quote
  Janner
  Participant
  I'm not sure how you can be "almost stage III". Stage II is based on depth. If you had a deep stage II lesion, that is concerning. But that doesn't mean you are stage III and it doesn't mean you qualify for all treatments listed. Stage III is whether or not you have melanoma in the lymph nodes. You either do or don't, so I don't get "almost". As for adjuvant treatments for stage II, Interferon is likely to be your only bet. Yervoy is not approved for stage III let alone stage II. Zelboraf is used when you typically have a lot of disease and stage IV and this requires testing for the BRAF mutation. They never give it as an adjuvant treatment. There are some stage III folks who have done bio-chemo as an adjuvant therapy, but again that is stage III not II. I think I saw someone mention recently a clinical trial for stage II, and that might be your other choice. Unfortunately, there aren't really any good adjuvant treatment choices right now, and recent breakthroughs have been for treating stage IV active disease, not prevention.
- - August 12, 2012 at 6:53 pm
  - Quote
  Janner
  Participant
  I'm not sure how you can be "almost stage III". Stage II is based on depth. If you had a deep stage II lesion, that is concerning. But that doesn't mean you are stage III and it doesn't mean you qualify for all treatments listed. Stage III is whether or not you have melanoma in the lymph nodes. You either do or don't, so I don't get "almost". As for adjuvant treatments for stage II, Interferon is likely to be your only bet. Yervoy is not approved for stage III let alone stage II. Zelboraf is used when you typically have a lot of disease and stage IV and this requires testing for the BRAF mutation. They never give it as an adjuvant treatment. There are some stage III folks who have done bio-chemo as an adjuvant therapy, but again that is stage III not II. I think I saw someone mention recently a clinical trial for stage II, and that might be your other choice. Unfortunately, there aren't really any good adjuvant treatment choices right now, and recent breakthroughs have been for treating stage IV active disease, not prevention.
- - August 12, 2012 at 7:36 pm
  - Quote
  MichaelFL
  Participant
  Your melanom depth is listed in your profile as over 4mm. Have you discussed or had what is called a SNB-sentinel node biopsy with your doc? If this is the case, and one or more of your nodes are positive for melanoma, interferon may be an option.
  
  Not sure what you mean by almost stage three. There is no almost. It is based on your lymph nodes being positive for melanoma. Do you think the doc meant Clarks Level 2 (II), and due to the level on invasion of the skin they meant it may have been almost Clarks level three (III)? Clarks level III and melanoma stage III are not the same.
  
  Take a deep breath and then do more research into where you are wiith this.
  
  You may wish to start by getting a copy of your pathology report and post it here.
  - August 12, 2012 at 8:29 pm
    
    Quote
    DanielM
    Participant
    
    this was the diagnosis:
    
    a) skin back area, initial excision malignant melanoma, nodular, invasive to a depth of 6.5 mm
    
    1. breslow tumor thickness is 6.5 mm
    
    2. there is a focal microsatellite melanoma cells just beneath the deep table of the tumor
    
    3. the level of invasion extends to the reticular dermis( clark's level IV)
    
    4. mitotic activity = greater than 4/mm2
    
    5. no epidermal ulceration
    
    6. no lymphovascular invasion
    
    7. no perineural space involvement
    
    8. no tumor cells infiltrated by lymphocytes(absent lymphocytic infiltrate of tumor cells)
    
    9. the melanoma is 18 mm away from the deep inked resection margin
    
    10. the melanoma is less than 2 mm away from the superior margin and 2 mm away from the inferior margin.
    
    b) skin, back area, wider excision:
    
    no melanoma cells in this wide excision.
    
    the wide excision shows a cuff of normal skin at the previous surgical biopsy cavity site( at least 1 cm cuff of normal skin around the previous excisional cavity site)
    
    c) designated as satellite lessions to back:
    
    no melanoma cells seen,
    
    thanks,
    
    DanielM
  - August 12, 2012 at 9:23 pm
    
    Quote
    Gene_S
    Participant
    
    Hi Daniel,
    
    Welcome to the forum that no ones wants to be at!
    
    Do a search on Gene_S and you will the get results of my hundreds of
    
    hours on this disease (my opinions of course).
    
    He is a great video for you and your students. see:
    
    http://www.youtube.com/watch?v=D1R-jKKp3NA
    
    Best wishes,
    
    Gene
  - August 12, 2012 at 9:29 pm
    
    Quote
    Gene_S
    Participant
    
    corrected version… sorry!
    
    Welcome to the forum that no ones wants to be at!
    
    Do a search on Gene_S and you will get the results of my hundreds of
    
    hours on this disease (my opinions of course).
    
    He is a great video for you and your students. see:
    
    http://www.youtube.com/watch?v=D1R-jKKp3NA
    
    Best wishes,
    
    Gene
  - August 12, 2012 at 9:29 pm
    
    Quote
    Gene_S
    Participant
    
    corrected version… sorry!
    
    Welcome to the forum that no ones wants to be at!
    
    Do a search on Gene_S and you will get the results of my hundreds of
    
    hours on this disease (my opinions of course).
    
    He is a great video for you and your students. see:
    
    http://www.youtube.com/watch?v=D1R-jKKp3NA
    
    Best wishes,
    
    Gene
  - August 12, 2012 at 9:29 pm
    
    Quote
    Gene_S
    Participant
    
    corrected version… sorry!
    
    Welcome to the forum that no ones wants to be at!
    
    Do a search on Gene_S and you will get the results of my hundreds of
    
    hours on this disease (my opinions of course).
    
    He is a great video for you and your students. see:
    
    http://www.youtube.com/watch?v=D1R-jKKp3NA
    
    Best wishes,
    
    Gene
  - August 12, 2012 at 9:23 pm
    
    Quote
    Gene_S
    Participant
    
    Hi Daniel,
    
    Welcome to the forum that no ones wants to be at!
    
    Do a search on Gene_S and you will the get results of my hundreds of
    
    hours on this disease (my opinions of course).
    
    He is a great video for you and your students. see:
    
    http://www.youtube.com/watch?v=D1R-jKKp3NA
    
    Best wishes,
    
    Gene
  - August 12, 2012 at 9:23 pm
    
    Quote
    Gene_S
    Participant
    
    Hi Daniel,
    
    Welcome to the forum that no ones wants to be at!
    
    Do a search on Gene_S and you will the get results of my hundreds of
    
    hours on this disease (my opinions of course).
    
    He is a great video for you and your students. see:
    
    http://www.youtube.com/watch?v=D1R-jKKp3NA
    
    Best wishes,
    
    Gene
  - August 12, 2012 at 9:36 pm
    
    Quote
    MichaelFL
    Participant
    
    Has a SNB or sentinel node biopsy been done? Based on your Breslow depth (and other factors) it should have.
    
    If so, what were the results?
  - August 12, 2012 at 9:36 pm
    
    Quote
    MichaelFL
    Participant
    
    Has a SNB or sentinel node biopsy been done? Based on your Breslow depth (and other factors) it should have.
    
    If so, what were the results?
  - August 12, 2012 at 9:36 pm
    
    Quote
    MichaelFL
    Participant
    
    Has a SNB or sentinel node biopsy been done? Based on your Breslow depth (and other factors) it should have.
    
    If so, what were the results?
  - August 12, 2012 at 8:29 pm
    
    Quote
    DanielM
    Participant
    
    this was the diagnosis:
    
    a) skin back area, initial excision malignant melanoma, nodular, invasive to a depth of 6.5 mm
    
    1. breslow tumor thickness is 6.5 mm
    
    2. there is a focal microsatellite melanoma cells just beneath the deep table of the tumor
    
    3. the level of invasion extends to the reticular dermis( clark's level IV)
    
    4. mitotic activity = greater than 4/mm2
    
    5. no epidermal ulceration
    
    6. no lymphovascular invasion
    
    7. no perineural space involvement
    
    8. no tumor cells infiltrated by lymphocytes(absent lymphocytic infiltrate of tumor cells)
    
    9. the melanoma is 18 mm away from the deep inked resection margin
    
    10. the melanoma is less than 2 mm away from the superior margin and 2 mm away from the inferior margin.
    
    b) skin, back area, wider excision:
    
    no melanoma cells in this wide excision.
    
    the wide excision shows a cuff of normal skin at the previous surgical biopsy cavity site( at least 1 cm cuff of normal skin around the previous excisional cavity site)
    
    c) designated as satellite lessions to back:
    
    no melanoma cells seen,
    
    thanks,
    
    DanielM
  - August 12, 2012 at 8:29 pm
    
    Quote
    DanielM
    Participant
    
    this was the diagnosis:
    
    a) skin back area, initial excision malignant melanoma, nodular, invasive to a depth of 6.5 mm
    
    1. breslow tumor thickness is 6.5 mm
    
    2. there is a focal microsatellite melanoma cells just beneath the deep table of the tumor
    
    3. the level of invasion extends to the reticular dermis( clark's level IV)
    
    4. mitotic activity = greater than 4/mm2
    
    5. no epidermal ulceration
    
    6. no lymphovascular invasion
    
    7. no perineural space involvement
    
    8. no tumor cells infiltrated by lymphocytes(absent lymphocytic infiltrate of tumor cells)
    
    9. the melanoma is 18 mm away from the deep inked resection margin
    
    10. the melanoma is less than 2 mm away from the superior margin and 2 mm away from the inferior margin.
    
    b) skin, back area, wider excision:
    
    no melanoma cells in this wide excision.
    
    the wide excision shows a cuff of normal skin at the previous surgical biopsy cavity site( at least 1 cm cuff of normal skin around the previous excisional cavity site)
    
    c) designated as satellite lessions to back:
    
    no melanoma cells seen,
    
    thanks,
    
    DanielM
- - August 12, 2012 at 7:36 pm
  - Quote
  MichaelFL
  Participant
  Your melanom depth is listed in your profile as over 4mm. Have you discussed or had what is called a SNB-sentinel node biopsy with your doc? If this is the case, and one or more of your nodes are positive for melanoma, interferon may be an option.
  
  Not sure what you mean by almost stage three. There is no almost. It is based on your lymph nodes being positive for melanoma. Do you think the doc meant Clarks Level 2 (II), and due to the level on invasion of the skin they meant it may have been almost Clarks level three (III)? Clarks level III and melanoma stage III are not the same.
  
  Take a deep breath and then do more research into where you are wiith this.
  
  You may wish to start by getting a copy of your pathology report and post it here.
- - August 12, 2012 at 7:36 pm
  - Quote
  MichaelFL
  Participant
  Your melanom depth is listed in your profile as over 4mm. Have you discussed or had what is called a SNB-sentinel node biopsy with your doc? If this is the case, and one or more of your nodes are positive for melanoma, interferon may be an option.
  
  Not sure what you mean by almost stage three. There is no almost. It is based on your lymph nodes being positive for melanoma. Do you think the doc meant Clarks Level 2 (II), and due to the level on invasion of the skin they meant it may have been almost Clarks level three (III)? Clarks level III and melanoma stage III are not the same.
  
  Take a deep breath and then do more research into where you are wiith this.
  
  You may wish to start by getting a copy of your pathology report and post it here.
- - August 13, 2012 at 3:52 pm
  - Quote
  washoegal
  Participant
  Wow Daniel, you really did have a deep one! So sorry about that. I hope being a math teacher you at least know logically not to dwell too much on statistics…since each individual person is different.
  
  Now, On to the subject at hand.
  
  Yes, definitely get yourself to MD Anderson ASAP! It's one of the top places to be. If it hasn't been done already, the first thing that will be done is a Sentinel Lymph Node Biopsy. The doc will remove 2-4 Lymph Nodes the are in the first line of "attack" to see if the cancer has spread there. This web site has more information on the surgery. I found the surgery very easy.
  
  Based on the results from this you will then decide if you need further surgery/and or treatment. But let's get to that stage if and when you need to.
  
  I am stage 3 (2 lymph nodes positive) and decided not to do interferon, it is a very personal choice. So far I am cancer free almost 2.5 years!
  
  Good Luck
  
  Mary
- - August 13, 2012 at 3:52 pm
  - Quote
  washoegal
  Participant
  Wow Daniel, you really did have a deep one! So sorry about that. I hope being a math teacher you at least know logically not to dwell too much on statistics…since each individual person is different.
  
  Now, On to the subject at hand.
  
  Yes, definitely get yourself to MD Anderson ASAP! It's one of the top places to be. If it hasn't been done already, the first thing that will be done is a Sentinel Lymph Node Biopsy. The doc will remove 2-4 Lymph Nodes the are in the first line of "attack" to see if the cancer has spread there. This web site has more information on the surgery. I found the surgery very easy.
  
  Based on the results from this you will then decide if you need further surgery/and or treatment. But let's get to that stage if and when you need to.
  
  I am stage 3 (2 lymph nodes positive) and decided not to do interferon, it is a very personal choice. So far I am cancer free almost 2.5 years!
  
  Good Luck
  
  Mary
- - August 13, 2012 at 3:52 pm
  - Quote
  washoegal
  Participant
  Wow Daniel, you really did have a deep one! So sorry about that. I hope being a math teacher you at least know logically not to dwell too much on statistics…since each individual person is different.
  
  Now, On to the subject at hand.
  
  Yes, definitely get yourself to MD Anderson ASAP! It's one of the top places to be. If it hasn't been done already, the first thing that will be done is a Sentinel Lymph Node Biopsy. The doc will remove 2-4 Lymph Nodes the are in the first line of "attack" to see if the cancer has spread there. This web site has more information on the surgery. I found the surgery very easy.
  
  Based on the results from this you will then decide if you need further surgery/and or treatment. But let's get to that stage if and when you need to.
  
  I am stage 3 (2 lymph nodes positive) and decided not to do interferon, it is a very personal choice. So far I am cancer free almost 2.5 years!
  
  Good Luck
  
  Mary
- - August 13, 2012 at 9:59 pm
  - Quote
  MikeWI
  Participant
  Wow, now I understand what I was like a year ago when my cancer was found. It scared the crap out of me.
  
  1. I would recomend going for the second opinion at MD Anderson. It never hurts to have too much information.
  
  2. From your information listed in this post, you are likely stage 2b. Stage 2c has ulceration, and is above 4mm in size. Your report stated it was 6 mm and not ulcerated. I am not a doctor, but that is my thoughts
  
  3. Interferon. I am stage 2c, 7mm with ulceration on my right leg. I had a wide area incision and sentinel node removal. Both surgeries came back negative for melanoma cells. I am current doing interferon, I have about 3 weeks of treatment left in the self injection phase. It has not been easy, for my son to have a father I would do it again in a heart beat. Maybe the interferon helped, or maybe it did nothing. I did try something
  
  4. Statistics. Be careful with them as you don't know what variables were used to calculate them. Also remember that you are a person not a statistic. You may have different results. According to the american cancer society web site it is very unlikely that stage 4 patients will survive five years. And yet on this board I have met stage 4 survivors with ten years of survival and longer.
  
  Good luck and remember that daily we are learning a lot about this cancer. Several trials going on now are looking promising. It is my hope that we find a cure for this cancer.
  
  Thanks,
  
  MIkeWI
  
  stage 2c, currently NED
- - August 13, 2012 at 9:59 pm
  - Quote
  MikeWI
  Participant
  Wow, now I understand what I was like a year ago when my cancer was found. It scared the crap out of me.
  
  1. I would recomend going for the second opinion at MD Anderson. It never hurts to have too much information.
  
  2. From your information listed in this post, you are likely stage 2b. Stage 2c has ulceration, and is above 4mm in size. Your report stated it was 6 mm and not ulcerated. I am not a doctor, but that is my thoughts
  
  3. Interferon. I am stage 2c, 7mm with ulceration on my right leg. I had a wide area incision and sentinel node removal. Both surgeries came back negative for melanoma cells. I am current doing interferon, I have about 3 weeks of treatment left in the self injection phase. It has not been easy, for my son to have a father I would do it again in a heart beat. Maybe the interferon helped, or maybe it did nothing. I did try something
  
  4. Statistics. Be careful with them as you don't know what variables were used to calculate them. Also remember that you are a person not a statistic. You may have different results. According to the american cancer society web site it is very unlikely that stage 4 patients will survive five years. And yet on this board I have met stage 4 survivors with ten years of survival and longer.
  
  Good luck and remember that daily we are learning a lot about this cancer. Several trials going on now are looking promising. It is my hope that we find a cure for this cancer.
  
  Thanks,
  
  MIkeWI
  
  stage 2c, currently NED
- - August 13, 2012 at 9:59 pm
  - Quote
  MikeWI
  Participant
  Wow, now I understand what I was like a year ago when my cancer was found. It scared the crap out of me.
  
  1. I would recomend going for the second opinion at MD Anderson. It never hurts to have too much information.
  
  2. From your information listed in this post, you are likely stage 2b. Stage 2c has ulceration, and is above 4mm in size. Your report stated it was 6 mm and not ulcerated. I am not a doctor, but that is my thoughts
  
  3. Interferon. I am stage 2c, 7mm with ulceration on my right leg. I had a wide area incision and sentinel node removal. Both surgeries came back negative for melanoma cells. I am current doing interferon, I have about 3 weeks of treatment left in the self injection phase. It has not been easy, for my son to have a father I would do it again in a heart beat. Maybe the interferon helped, or maybe it did nothing. I did try something
  
  4. Statistics. Be careful with them as you don't know what variables were used to calculate them. Also remember that you are a person not a statistic. You may have different results. According to the american cancer society web site it is very unlikely that stage 4 patients will survive five years. And yet on this board I have met stage 4 survivors with ten years of survival and longer.
  
  Good luck and remember that daily we are learning a lot about this cancer. Several trials going on now are looking promising. It is my hope that we find a cure for this cancer.
  
  Thanks,
  
  MIkeWI
  
  stage 2c, currently NED
- - September 30, 2012 at 6:59 pm
  - Quote
  _Paul_
  Participant
  Hi Daniel,
  
  I would definitely look into receiving a sentinel node biopsy (SNB). There is some debate if doing so actually improves the survivability, but it is important to know the stage, since treatment options depend on it. I had a 1.3mm Breslow removed from my scalp, but it was a Clark's Level 4 since the skin is so thin there. I had a SNB and it revealed a micro-metastasis in one lymph node so that made me a stage IIIa.
  
  Not many Dr.'s recommend Interferon, another reason to seek a second opinion. My understanding is that Interferon reduces the chance of recurrence by only 10% and after 20 years only increases survivability by 3%. IMHO not very good payback for something with the potential to significantly reduce one's quality of life for a year.
  
  Have you looked into clinical trials? While they offer hope, there is risk and some of them have serious side effects. But not all. Johns Hopkins has a GVX trial that I am trying to get into that appears to have mild side effects compare to others.
  
  – Paul.
- - September 30, 2012 at 6:59 pm
  - Quote
  _Paul_
  Participant
  Hi Daniel,
  
  I would definitely look into receiving a sentinel node biopsy (SNB). There is some debate if doing so actually improves the survivability, but it is important to know the stage, since treatment options depend on it. I had a 1.3mm Breslow removed from my scalp, but it was a Clark's Level 4 since the skin is so thin there. I had a SNB and it revealed a micro-metastasis in one lymph node so that made me a stage IIIa.
  
  Not many Dr.'s recommend Interferon, another reason to seek a second opinion. My understanding is that Interferon reduces the chance of recurrence by only 10% and after 20 years only increases survivability by 3%. IMHO not very good payback for something with the potential to significantly reduce one's quality of life for a year.
  
  Have you looked into clinical trials? While they offer hope, there is risk and some of them have serious side effects. But not all. Johns Hopkins has a GVX trial that I am trying to get into that appears to have mild side effects compare to others.
  
  – Paul.
- - September 30, 2012 at 6:59 pm
  - Quote
  _Paul_
  Participant
  Hi Daniel,
  
  I would definitely look into receiving a sentinel node biopsy (SNB). There is some debate if doing so actually improves the survivability, but it is important to know the stage, since treatment options depend on it. I had a 1.3mm Breslow removed from my scalp, but it was a Clark's Level 4 since the skin is so thin there. I had a SNB and it revealed a micro-metastasis in one lymph node so that made me a stage IIIa.
  
  Not many Dr.'s recommend Interferon, another reason to seek a second opinion. My understanding is that Interferon reduces the chance of recurrence by only 10% and after 20 years only increases survivability by 3%. IMHO not very good payback for something with the potential to significantly reduce one's quality of life for a year.
  
  Have you looked into clinical trials? While they offer hope, there is risk and some of them have serious side effects. But not all. Johns Hopkins has a GVX trial that I am trying to get into that appears to have mild side effects compare to others.
  
  – Paul.