› Forums › General Melanoma Community › Likelihood of a 2nd primary 2 months after 1st one?
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- November 19, 2015 at 11:55 pm
I had a stage 1a melanoma removed in September. Breslow level .5, 0 mitosis, no regression, no ulceration, Clark level III. Clear margins after WLE. No sentinel lymph node biopsy was done. I feel very lucky that it seems to have been found early (by my gynecologist by the way). I have lots of funky looking moles and haven't been entirely happy with my dermatologist as she seems too rushed and rather scattered at times (not knowing the reason I'm there for an appointment for example).
Anyway, since September I've had total body photography and my derm did a full body skin check. Even though I have lots of moles she didn't think I need to worry about another melanoma at this point. Just check myself monthly for changes and go in every 3-4 months for her to check my skin and lymph nodes.
I made an appointment with a new dermatologist to see if I might want to switch to someone else who would be a little more aggressive. The day before the appointment (a week ago last Monday) I went on a 3-4 mile hike. That night I noticed a mole under my arm (armpit area), looked inflamed. There was redness around the base and the mole itself was darker. Totally freaked me out and after looking at my pictures knew it looked different from just a month earlier when I had the pictures taken.
The next day I saw the new dermatologist who checked me over and thought the mole under my arm was probably just inflamed from hiking but had his nurse do a biopsy of it and another mole I didn't like the looks of on my stomach. He called today and said the mole on my stomach was fine. He read me the report on the other mole and the pathologist called it a benign neoplasm but he wasn't able to 100% rule out melanoma because the sample was small and there was blood around the base (I had noticed that it didn't look like a lot had been taken from this biopsy. Normally there's quite a hole left but this was really small and looked like she just took off the very top) . He said the pathologist had done extra stains but to be on the safe side recommended an excision. The doctor told me not to lose any sleep over it. Of course, now that I've already had one melanoma this is scaring me a bit. Someone is supposed to call me to set up an appointment for the excision next week.
Any thoughts?
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- November 20, 2015 at 3:04 am
About 10% of the melanoma population have more than 1 primary. But honestly, the wording you used sounds more like CYA than a real worry about melanoma. (I've read a lot of path reports over the years). Do the excision if you want but if it were me, I wouldn't lose much sleep over this one. Do what makes YOU feel comfortable!
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- November 20, 2015 at 3:04 am
About 10% of the melanoma population have more than 1 primary. But honestly, the wording you used sounds more like CYA than a real worry about melanoma. (I've read a lot of path reports over the years). Do the excision if you want but if it were me, I wouldn't lose much sleep over this one. Do what makes YOU feel comfortable!
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- November 20, 2015 at 3:04 am
About 10% of the melanoma population have more than 1 primary. But honestly, the wording you used sounds more like CYA than a real worry about melanoma. (I've read a lot of path reports over the years). Do the excision if you want but if it were me, I wouldn't lose much sleep over this one. Do what makes YOU feel comfortable!
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- November 20, 2015 at 2:32 pm
Thank you so much Janner. That thought went through my head too. I'm going to have the excision to ease my mind as the pathologist recommended it and the doctor agrees. I'm guessing the doctor didn't see it as super urgent since he said someone would call me next week to schedule.
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- November 20, 2015 at 2:32 pm
Thank you so much Janner. That thought went through my head too. I'm going to have the excision to ease my mind as the pathologist recommended it and the doctor agrees. I'm guessing the doctor didn't see it as super urgent since he said someone would call me next week to schedule.
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- November 20, 2015 at 2:32 pm
Thank you so much Janner. That thought went through my head too. I'm going to have the excision to ease my mind as the pathologist recommended it and the doctor agrees. I'm guessing the doctor didn't see it as super urgent since he said someone would call me next week to schedule.
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- November 21, 2015 at 4:45 am
It's certainly possible to have a second primary within a short amount of time, or even at the same time. In my case, I would have had all three primaries all at once, but they were excised separately (6 months apart).
I went to a skin cancer clinic (run by doctors, not dermatologists) for a full skin check. One small BCC was removed, and one mole imaged for future checking. After three months it was re-imaged and had changed, so was excised. This was a melanoma in situ. After three months I returned for a checkup and kind of pressured the dr to excise two other freckly type things that weren't new, weren't noticed by the dr earlier as suspicious, but I didn't like the look of after having the experienc of melanoma.
One immediately came back as stage 1 melanoma 0.33mm stage 1A (or B, can't remember). The other first came back as a dysplastic nevus with a recommendation for 2mm excision (only a punch biopsy had been done). When the 2mm excision was done, it actually came back as another stage 1 melanoma – fortunately very thin 0.15mm.
So if I were you I would get the second excision done, because as my story shows:
– you can have more than one primary at the same time – it's called simultaneous primaries
– something that is incompletely excised and first comes back as innocent can, on full excision, turn out to be melanoma
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- November 21, 2015 at 4:45 am
It's certainly possible to have a second primary within a short amount of time, or even at the same time. In my case, I would have had all three primaries all at once, but they were excised separately (6 months apart).
I went to a skin cancer clinic (run by doctors, not dermatologists) for a full skin check. One small BCC was removed, and one mole imaged for future checking. After three months it was re-imaged and had changed, so was excised. This was a melanoma in situ. After three months I returned for a checkup and kind of pressured the dr to excise two other freckly type things that weren't new, weren't noticed by the dr earlier as suspicious, but I didn't like the look of after having the experienc of melanoma.
One immediately came back as stage 1 melanoma 0.33mm stage 1A (or B, can't remember). The other first came back as a dysplastic nevus with a recommendation for 2mm excision (only a punch biopsy had been done). When the 2mm excision was done, it actually came back as another stage 1 melanoma – fortunately very thin 0.15mm.
So if I were you I would get the second excision done, because as my story shows:
– you can have more than one primary at the same time – it's called simultaneous primaries
– something that is incompletely excised and first comes back as innocent can, on full excision, turn out to be melanoma
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- November 21, 2015 at 4:45 am
It's certainly possible to have a second primary within a short amount of time, or even at the same time. In my case, I would have had all three primaries all at once, but they were excised separately (6 months apart).
I went to a skin cancer clinic (run by doctors, not dermatologists) for a full skin check. One small BCC was removed, and one mole imaged for future checking. After three months it was re-imaged and had changed, so was excised. This was a melanoma in situ. After three months I returned for a checkup and kind of pressured the dr to excise two other freckly type things that weren't new, weren't noticed by the dr earlier as suspicious, but I didn't like the look of after having the experienc of melanoma.
One immediately came back as stage 1 melanoma 0.33mm stage 1A (or B, can't remember). The other first came back as a dysplastic nevus with a recommendation for 2mm excision (only a punch biopsy had been done). When the 2mm excision was done, it actually came back as another stage 1 melanoma – fortunately very thin 0.15mm.
So if I were you I would get the second excision done, because as my story shows:
– you can have more than one primary at the same time – it's called simultaneous primaries
– something that is incompletely excised and first comes back as innocent can, on full excision, turn out to be melanoma
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Tagged: cutaneous melanoma
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