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NEW – need guidance – Is this a reoccurrence or a new melanoma
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NEW – need guidance – Is this a reoccurrence or a new melanoma

› Forums › Cutaneous Melanoma Community › NEW – need guidance – Is this a reoccurrence or a new melanoma

  • Post
    • November 17, 2018 at 2:08 pm
    NYChris
    Participant

      My hubby was diagnosed 2/2017 with melanoma stage 2B (1.4mm thick and ulcerated) on his right upper arm which was excised and sentinel node was clear.  He has been going every 3-4 months for checkups and last month an atypical mole was found and excised and we were told its melanoma in situ. He is scheduled for wider margin surgery on 11/30. Yesterday I received the path report and it seems it read that they can't determine if this is a recoccurence or a new melaonma.  We meet with the oncologist on Monday.  I also noticed on the original path report that he is BRAF Negative NRAS Negative.  

      I have just started researching to try and help him and can't figure out the first line treatment for his type of melaoma. We live in NY and were hoping to find someone who is doing research with his type of cancer.  

      How do we know what other genetic mutations are in his melanoma? Any help to navigate this would be greatly appreciated.  We are no strangers to cancer having a daughter with high risk leukemia who was treated with 4 years of chemo but so thankful she is here!!! 

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        • November 17, 2018 at 6:26 pm
        Mat.in.Brooklyn
        Participant

          Hi. I'm sorry your husband has to deal with this. I live in NYC and am currently being treated for Stage IV melanoma under Dr. Jeffrey Weber at Perlmutter Cancer Center NYU Langone. They have an excellent melanoma research and treatment program. Dr. Weber is one of the big dogs when it comes to melanoma treatment. Dr. Pavlak and Dr. Wilson are also excellent and treat there as well. The main thing is to see a melanoma specialist who can guide you and stop this in it's tracks! I wish you bot the best, Mat.

          • November 17, 2018 at 8:17 pm
          ed williams
          Participant

            Hi NY Chris, I might be wrong but something coming back and you catch it insitu would be the best possible news. Janner is much better in this department, maybe put out a post with her name on it to get her attention. Again, my first thought is catching melanoma early is always a good thing and insitu usually means just getting good margins. There is no treatment offered for insitu other than having a good dermatologist and regular visit. Some hospitals are offering trials for high risk stage 2 patients but I am not sure if they would offer it almost 2 years later. Getting a good second opinion might be a good thing at this point. One question I would ask about would be is the oncology team offering scans to check for any chance of progression. Best Wishes!!!Ed

              • November 17, 2018 at 9:14 pm
              NYChris
              Participant

                Thank you so much for your reply and insight.  Yes the insitu is good news but if it is from the original melanoma this is the ? As far as scans he had one after the frist surgery in 2017. As far as surveillance do most doctors suggest them yearly and is it a PET scan ?  Does it include the head too? Sorry for all the ?s just trying to get up to speed.  So happy for the help offered here.  Thanks again!!

                 

                • November 17, 2018 at 9:53 pm
                ed williams
                Participant

                  I would ask for ct-scan of chest abdomen and blood work up. It is hard to get a brain MRI scan approved if there is no other sign of melanoma spreading. Might be hard to get a pet-ct approved for stage 2 but they might go for ct-scan based on ulceration of original tumor and having another melanoma pop up. It might be asking for the moon but if you don't ask you probably won't get. Best Wishes!!!Ed 

                • November 18, 2018 at 2:34 pm
                Rcollins1863
                Participant

                  I’m new to the group.  I have a  ? And not sure how to start a new discussion. Please advise 

                  • November 18, 2018 at 2:34 pm
                  Rcollins1863
                  Participant

                    I’m new to the group.  I have a  ? And not sure how to start a new discussion. Please advise 

                      • November 18, 2018 at 4:02 pm
                      Janner
                      Participant

                        At the top of the list of postings, look for the green help button.  Then look to the right of that.  There are two pencil icons.  Choose "Create a New Topic".

                        • November 20, 2018 at 3:16 am
                        MelanomaMike
                        Participant

                          first go back to main "Bulletin Board" wich will say {Go Back To Bulletin Board} then search for {"Create New Topic"} at very top of board, press those buttons and write away!..see ya soon..

                        • November 18, 2018 at 3:55 pm
                        Janner
                        Participant

                          It is always more helpful to post the entire report rather than just paraphrasing as there may be info that is important that you might miss – or info you think is important that really isn't.  Where was this mole located?

                          It's unlikely just an "in situ" would be considered a metastatic lesion.  The reason is in situ is confined to the epidermis where there are no blood or lymph vessels.  Melanoma uses lymph or blood vessels to travel and these vessels are located deeper within the skin in the lower dermis.  In the most simplest terms, new primaries grow from the top down and metastatic lesions grow from the bottom (where the vessels are) up.  If they are finding a lesion with only epidermal growth and nothing below, it's growing from the top down and is a new primary.  But seeing the whole report helps because things like regression can put different twists on how this is read.  If this is a new primary, nothing changes in his staging.  They remove it with surgery and it's done.  He's still stage 2B.

                          I'm unsure why you are asking about treatment at this date?  Are you thinking that this is a metastatic lesion?  I think it is better to wait and talk to the oncologist before you continue the research.  Then you can understand better what you are really dealing with – new primary versus metastasis.  The paths are so completely different that you really need that input to proceed.

                          • November 20, 2018 at 3:01 am
                          MelanomaMike
                          Participant

                            Hay NYChris, {my wife was born and raised in Queens till about 1975 then moved here to Calif.} anyways, wow, ya thats a "tricky" one, is it a New Breed of Melanoma or is it of the Same Family as his prior lesion {i believe thats your question/Topic correct?.  If so, i had a tumor removed last year {June 2017} it was tested and it came back "Not" related to all my tumors in my prior 9 years that iv had surgery for {6 tumors in total}, in a Nut Shell, Different DNA, He wasnt my daddy haha..Ive learned here its considered my "New Primary"  dated 2017…Well, here nor there, were behind him & you, in front of him & you and to the sides of him & you through all this, we offer up good prayers/vibes and some good much needed "Words" via MRF"s platforum {kinda like platform, i made that up just now}…Continue taking good care of him ok? he needs  you, your doing "good works"…

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