Newly Diagnosed with Upcoming SLNB & WLE

Hello Kelly. With the caveat that I’m not an expect, I’m pretty sure that neither PET nor CT are sensitive to detect trace cancer cells, which are still important for determining spread at this stage. Also, don’t think that the couple of lymph nodes they take for SLNB have much effect on your health (although, of course, surgery always entails some risk).

Sorry you are dealing with this, Kelly, but Gopher’s advice is sound. Docs and researchers have tried other methods – from radiography to ultrasound – to evaluate and monitor nodes . However, when the difference in treatment (and risk for progression) comes down to cells in a node, those methods are just not sensitive enough. When I speak of treatment, I mean that should your SLNB be positive , that would put you into the category of a stage III melanoma patient – making you in need of and eligible for – systemic treatment. The risk of lymphedema is real. However, the risk is far greater with a complete lymph node dissection (which we have learned is NOT beneficial even if there are positive nodes) and simultaneously much reduced when only the sentinel node(s) is being removed.

It is true that melanoma can be aggressive and is something to take extremely seriously. However, the time frame in which you are getting your surgery done is acceptable. I am going to keep all fingers and toes crossed that your nodes are negative and apart from close monitoring, your will be done with melanoma.

There are many, many, many articles regarding SLNB on my blog if you are interested. Just type ‘slnb’ into the search box. Here is one on the lack of benefit in using ultrasound to assess nodes: https://chaoticallypreciselifeloveandmelanoma.blogspot.com/2019/07/pre-operative-ultrasound-of-lymph-nodes.html

I wish you my best. Celeste

I had the exact same scenario as you a mere 8-9 months ago. Ditto what was said about melanoma cells, a few cells are different from a lump. They did a radioactive nuclear scan to find cancerous lymph nodes. It is different scan from a PET or CAT scan. this describes it pretty well.
https://www.cancer.gov/about-cancer/diagnosis-staging/staging/sentinel-node-biopsy-fact-sheet

I was always slightly confused and my onc surgeon even sat me down and discussed CLNB vs. SLNB . At that time I understood next to nothing.. I had to make a decision before i knew much of anything. I was very concerned about lymphedema. So given that i understood next to nothing about he procedure i opted for minimalist SLNB.
Even today, as they removed 4 axillary lymph nodes, i am not sure if they found the SLNB, removed it, studied it, found cancer, and moved on to next LN, or they simply removed a cluster. I don’t know and didn’t know to ask, so honestly it was your post that got me to think about that question.

its kind of irrelevant now because i have been doing Opvido 2x monthly, 240mg, and am NED. So if they didn’t remove all melanotic LN’s, those didn’t metastize in last 6 months.

heh Keely. i am working off memory but i think i was told i had 4 involved LN in armpit,(axially) after the nucellar scan. the discussion of CLNB vs SLNB took place before i knew how many LN involved. which if you stop and think about it was wrong. i was asked to decide on a course of action before the facts were know. .At this point i am talking to my Oncological Surgeon only , who has a different brief from the Oncologists. They didn’t confer much, if at all. . in fact i didn’t see a oncologist till after i had SLNB.

anywho, a nuclear scan revealed 4 axiallary LN involved and they were removed.

i cannot honestly say any swelling , real or imagine, resulted from the 4 nodes being removed. in the long run i have shown no symptoms of lymphedema

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however i understand melanoma in the lower body goes to the LN’s in the groin first. i think that is a whole nother magilla.

good luck and ask me anything

tim