need some advice, new dx

HI daddysdaughter34,

There are others on this board that may be more familiar with the VA. I’ll let them chime in with their advice. But in reading this path report it says that your father has melanoma and that the surgical margins at its deepest point was positive for melanoma– so they did not get all of it.

If I were in your shoes, I would pester the VA in all the ways possible for an appointment with an oncologist with melanoma experience (or one willing to work with one). Waiting a couple of weeks probably isnt’ going to change anything and waiting this long isn’t uncommon, but of course the sooner your dad can get this looked at the better.

After you dad sees an oncologist he’ll probably be referred for a PET scan to see if there’s cancer anywhere else. If it’s no where else, he’ll be referred to a Surgeon for a Sentinal Node Biopsy (SNB). This SNB needs to be done BEFORE the next Wide Local Exicsion (WLE). Most of the time they are done at the same time.

Sounds like your dad has a wonderfully loving advocate on his side! I’m hoping that more folks with VA experience chime in here, but if you have more questions, just ask. There’s good folk here.

Shalom!
Julie in SoCal

Hi. No, your dad isn’t really staged yet. He is at least Stage 2, based on the depth of the melanoma. As Julie said, he will need the SNLB and the WLE. The SNLB will determine if the melanoma has spread to the lymph nodes. If so, then your father would be Stage 3. If not, he will remain at Stage 2. If it has spread to the lymph nodes, your father definitely needs to be seen by a melanoma specialist, and I assume that would be a referral outside the VA system.

I have had horror stories for 16 years with the VA. But when my stage 2b melanoma went to stage 4 melanoma in a year the VA did everything treating me perfect. I am being seen at Audie Murphy hospital in San Antonio. Them being perfect I think has a direct relationship to 2 things. One, after 3 surgeries on the stage 2b spot the dr decided in surgery not to do a LNB so a year later while drying off after a shower I felt a lump in my upper shoulder, my primary was on my head next to my crown. When the same dr removed the lump, melanoma and pet scan had 7 more in my lungs I really think he felt guilty for not doing the LNB a year earlier and could have been treated then. Second, this was the summer of 2016 and the ipi/nivo combo had not been approved that long, I was the first veteran at this hospital whose overall health was good enough to risk all the side effects. The cost for the drugs was $800,000 and had to be approved by the hospital’s financial board. As you and I both know I was thinking months before all this happened. To my surprise from the surgery to remove the lump in my shoulder to my first combo treatment was about 2 weeks. During that time I had pet scans, mri of my brain, port implanted, all chemo nurses trained on the combo and got my first combo. At 13 months I was NED and did 1 year of maintenance for a total of 57 doses over 26 months. August was 2 years NED and still have several side effects, some ok and some I fight everyday. Through all this I still worked full time. Where is he being treated at?

I meant SNB, not LNB.