Possible 2nd primary?
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Possible 2nd primary?

› Forums › General Melanoma Community › Possible 2nd primary?

  • Post
    • February 21, 2013 at 3:48 pm
    [email protected]
    Participant
      Hello again everyone!
      I have more questions as always:-) I had a crazy spot removed in August that was melanoma. My scar looks great and I have not had any bumps or things they told me to look for. That’s my good news! I noticed a few nights ago that I have a spot that looks just as ugly and discolored as the first spot growing about four inches above my scar line. I am scheduled to see my dermatologist tomorrow. My questions is if it is melanoma then it would be a second primary, right? If I understand right then that is not as bad as it would be if it was the first one coming back??? So then would it change my stage? I am currently a stage 1 because my first one was only .25mm but if in fact this is another one does that increase my chances that it would be in my lymph nodes:-(? I did not have them biopsied in August since my primary was so small. As always any information you can give me I thank you for in advance;-)!
      Beth
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    • Replies
        • February 21, 2013 at 5:35 pm
        Janner
        Participant

          If it were to be a new primary, it is evaluated independently from your first.  Primaries are not related to each other so they are handled as if they were the first and only one.  Depth of a new primary would determine if it needed a SNB.   Staging would only change if this is a primary and by itself it had a worse stage.  You are basically the stage of your worst primary.  Again, the risk for it being in the lymph nodes is totally related to depth of the second one if it is truly a new primary.

          • February 21, 2013 at 5:35 pm
          Janner
          Participant

            If it were to be a new primary, it is evaluated independently from your first.  Primaries are not related to each other so they are handled as if they were the first and only one.  Depth of a new primary would determine if it needed a SNB.   Staging would only change if this is a primary and by itself it had a worse stage.  You are basically the stage of your worst primary.  Again, the risk for it being in the lymph nodes is totally related to depth of the second one if it is truly a new primary.

            • February 21, 2013 at 5:35 pm
            Janner
            Participant

              If it were to be a new primary, it is evaluated independently from your first.  Primaries are not related to each other so they are handled as if they were the first and only one.  Depth of a new primary would determine if it needed a SNB.   Staging would only change if this is a primary and by itself it had a worse stage.  You are basically the stage of your worst primary.  Again, the risk for it being in the lymph nodes is totally related to depth of the second one if it is truly a new primary.

                • February 21, 2013 at 6:37 pm
                [email protected]
                Participant
                  Okay so if it is a new primary and better or same depth then that is good news (if melanoma had good news), right? How can they tell if it is a primary or the same one coming back (they are in the same region, right shoulder, but pretty far apart)? If it is the same one returning will the depth still determine if pet scan is needed or is that something that really depends on the doctor? And at what point do they test for BRAF? I know I’m getting way ahead of myself but I hate not having total control of something to do with my own body and since I was never a sun worshipper and am the first in my long line of red head Irish family to get melanoma I’m a little pissed off;-) Thank you so much for taking time to answer my questions. You can never know how much this means.
                  • February 21, 2013 at 6:37 pm
                  [email protected]
                  Participant
                    Okay so if it is a new primary and better or same depth then that is good news (if melanoma had good news), right? How can they tell if it is a primary or the same one coming back (they are in the same region, right shoulder, but pretty far apart)? If it is the same one returning will the depth still determine if pet scan is needed or is that something that really depends on the doctor? And at what point do they test for BRAF? I know I’m getting way ahead of myself but I hate not having total control of something to do with my own body and since I was never a sun worshipper and am the first in my long line of red head Irish family to get melanoma I’m a little pissed off;-) Thank you so much for taking time to answer my questions. You can never know how much this means.
                    • February 21, 2013 at 6:37 pm
                    [email protected]
                    Participant
                      Okay so if it is a new primary and better or same depth then that is good news (if melanoma had good news), right? How can they tell if it is a primary or the same one coming back (they are in the same region, right shoulder, but pretty far apart)? If it is the same one returning will the depth still determine if pet scan is needed or is that something that really depends on the doctor? And at what point do they test for BRAF? I know I’m getting way ahead of myself but I hate not having total control of something to do with my own body and since I was never a sun worshipper and am the first in my long line of red head Irish family to get melanoma I’m a little pissed off;-) Thank you so much for taking time to answer my questions. You can never know how much this means.
                      • February 21, 2013 at 7:08 pm
                      Janner
                      Participant

                        You are getting way ahead of yourself.  I'll answer the pertinent questions now. 

                        When they do the biopsy, they will know you have a history of melanoma.  They will look at the lesion.  In the simplest of terms, they look for growth patterns to determine if this is a new primary or if it is a metastasis.  In general, new primaries grow from the top down (epidermis down toward the dermis) and metastases grow from the bottom up (lymph vessels up through the layers of skin).  Depth means nothing if this were a recurrence.

                        PET Scans, BRAF testing and all the rest are not appropriate at this time.  First you need to determine if this is even melanoma.  If it is melanoma, then is it a primary or a recurrence.  You have to know that before you go anywhere else because at that point, treatment options diverge.  Don't get ahead of yourself – you'll only cause yourself more worry and "pre-worry" never helped anyone.  Take care of business and get the biopsy.  Wait for the results then go from there.  I'll be happy to help you with any question that are appropriate when you get to that point.

                        Janner

                        • February 21, 2013 at 7:08 pm
                        Janner
                        Participant

                          You are getting way ahead of yourself.  I'll answer the pertinent questions now. 

                          When they do the biopsy, they will know you have a history of melanoma.  They will look at the lesion.  In the simplest of terms, they look for growth patterns to determine if this is a new primary or if it is a metastasis.  In general, new primaries grow from the top down (epidermis down toward the dermis) and metastases grow from the bottom up (lymph vessels up through the layers of skin).  Depth means nothing if this were a recurrence.

                          PET Scans, BRAF testing and all the rest are not appropriate at this time.  First you need to determine if this is even melanoma.  If it is melanoma, then is it a primary or a recurrence.  You have to know that before you go anywhere else because at that point, treatment options diverge.  Don't get ahead of yourself – you'll only cause yourself more worry and "pre-worry" never helped anyone.  Take care of business and get the biopsy.  Wait for the results then go from there.  I'll be happy to help you with any question that are appropriate when you get to that point.

                          Janner

                          • February 21, 2013 at 7:08 pm
                          Janner
                          Participant

                            You are getting way ahead of yourself.  I'll answer the pertinent questions now. 

                            When they do the biopsy, they will know you have a history of melanoma.  They will look at the lesion.  In the simplest of terms, they look for growth patterns to determine if this is a new primary or if it is a metastasis.  In general, new primaries grow from the top down (epidermis down toward the dermis) and metastases grow from the bottom up (lymph vessels up through the layers of skin).  Depth means nothing if this were a recurrence.

                            PET Scans, BRAF testing and all the rest are not appropriate at this time.  First you need to determine if this is even melanoma.  If it is melanoma, then is it a primary or a recurrence.  You have to know that before you go anywhere else because at that point, treatment options diverge.  Don't get ahead of yourself – you'll only cause yourself more worry and "pre-worry" never helped anyone.  Take care of business and get the biopsy.  Wait for the results then go from there.  I'll be happy to help you with any question that are appropriate when you get to that point.

                            Janner

                            • February 21, 2013 at 8:28 pm
                            [email protected]
                            Participant
                              Got it;-). Thank you so much!!
                              • February 21, 2013 at 8:28 pm
                              [email protected]
                              Participant
                                Got it;-). Thank you so much!!
                                • February 21, 2013 at 8:28 pm
                                [email protected]
                                Participant
                                  Got it;-). Thank you so much!!
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