Stage 2 Melanoma – Questions
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Stage 2 Melanoma – Questions

› Forums › General Melanoma Community › Stage 2 Melanoma – Questions

  • Post
    • December 7, 2015 at 9:01 pm
    Kare83
    Participant

      Hi, I'm Kare. I had a stage 2 melanoma removed a few weeks ago, followed by a wide-margin excision last week.

      My doctor told me it was stage 2 – the mole was on my upper right back (on my shoulder blade).

      I know melanoma can always come back. I am concerned as everything I have read tells me that stage 2 melanoma usually has a growth of 2mm+

      Yet on one of the cancer info sites (might be this one, I can't even remember where I read it now) it says a melanoma only needs to be 1mm to have entered the bloodstream?

      So I'm not sure what this means? Is there anything more I need to have done?

      I have been put on 3 monthly checks now.. as melanoma also runs in the immediate family.

      Also, what is the difference between Stage 2 and Level 2? I have read some people talking about level 2 and not sure if it the same as Stage 2 or not?

      Just want to make sure I have all bases covered. I am getting frustrated with people around me at the moment.. They think it is all over yet I am on edge and feel like it can be discovered elsewhere any day :( I know stage 2 is still early to have .. I don't feel I have the right to really even talk about having melanoma, considering what everyone else is going through.. I just want to make sure I understand everything I can about it.

    Viewing 2 reply threads
    • Replies
        • December 7, 2015 at 11:54 pm
        Janner
        Participant

          Did you have a sentinel node biopsy?  Level 2 and stage 2 are totally different things.  Staging is based on depth and other factors.  Clark's  Level is the skin anatomy and not used in staging anymore.  If you didn't have a sentinel node biopsy, I'm thinking your lesion might be level 2 and not stage 2  – probably stage 1.  Get a copy of your pathology report and it will give you all the pertinent information.

          • December 7, 2015 at 11:54 pm
          Janner
          Participant

            Did you have a sentinel node biopsy?  Level 2 and stage 2 are totally different things.  Staging is based on depth and other factors.  Clark's  Level is the skin anatomy and not used in staging anymore.  If you didn't have a sentinel node biopsy, I'm thinking your lesion might be level 2 and not stage 2  – probably stage 1.  Get a copy of your pathology report and it will give you all the pertinent information.

              • December 8, 2015 at 12:59 am
              Kare83
              Participant

                I haven't had any other procedure done, no. I just had the mole removed, then a WME a week later.

                He said I am high risk now as it runs in the family and checks are now every 3 months. I am covered in moles though and am really nervous.

                I have read of others having stage 2 melanoma's removed from their upper backs and having the doctor wave them away.. only to find the cancer return later on because they didn't have any other procedure done.. Should I be concerned?

                I haven't got a copy of the path report, though I go back in on Wednesday to have stiches removed so I will ask for a copy. I am in Australia too, so I'm not sure if things are treated or classed differently here either.

                • December 8, 2015 at 12:59 am
                Kare83
                Participant

                  I haven't had any other procedure done, no. I just had the mole removed, then a WME a week later.

                  He said I am high risk now as it runs in the family and checks are now every 3 months. I am covered in moles though and am really nervous.

                  I have read of others having stage 2 melanoma's removed from their upper backs and having the doctor wave them away.. only to find the cancer return later on because they didn't have any other procedure done.. Should I be concerned?

                  I haven't got a copy of the path report, though I go back in on Wednesday to have stiches removed so I will ask for a copy. I am in Australia too, so I'm not sure if things are treated or classed differently here either.

                  • December 8, 2015 at 12:59 am
                  Kare83
                  Participant

                    I haven't had any other procedure done, no. I just had the mole removed, then a WME a week later.

                    He said I am high risk now as it runs in the family and checks are now every 3 months. I am covered in moles though and am really nervous.

                    I have read of others having stage 2 melanoma's removed from their upper backs and having the doctor wave them away.. only to find the cancer return later on because they didn't have any other procedure done.. Should I be concerned?

                    I haven't got a copy of the path report, though I go back in on Wednesday to have stiches removed so I will ask for a copy. I am in Australia too, so I'm not sure if things are treated or classed differently here either.

                    • December 8, 2015 at 1:11 am
                    Janner
                    Participant

                      It is likely you are stage 1 as 1mm is generally the cutoff for the SLNB in Australia.  ASK because those terms are often confused and it irritates me when docs don't make sure their patients know the difference.

                      • December 8, 2015 at 1:11 am
                      Janner
                      Participant

                        It is likely you are stage 1 as 1mm is generally the cutoff for the SLNB in Australia.  ASK because those terms are often confused and it irritates me when docs don't make sure their patients know the difference.

                        • December 8, 2015 at 1:11 am
                        Janner
                        Participant

                          It is likely you are stage 1 as 1mm is generally the cutoff for the SLNB in Australia.  ASK because those terms are often confused and it irritates me when docs don't make sure their patients know the difference.

                          • December 8, 2015 at 5:29 am
                          Kare83
                          Participant

                            Yes, it's very confusing!! I asked him if it was stage 0 or stage 1 (as I originally thought it may be either of these based on what he said over the phone) and he said "It's actually a stage 2"

                            Kind of annoyed I didn't get the path report offered to me either but I'll be sure to ask him for a copy.

                            Melanoma took my grandfathers life and my brother has also had one removed a few years ago. 

                            • December 8, 2015 at 5:29 am
                            Kare83
                            Participant

                              Yes, it's very confusing!! I asked him if it was stage 0 or stage 1 (as I originally thought it may be either of these based on what he said over the phone) and he said "It's actually a stage 2"

                              Kind of annoyed I didn't get the path report offered to me either but I'll be sure to ask him for a copy.

                              Melanoma took my grandfathers life and my brother has also had one removed a few years ago. 

                              • December 8, 2015 at 5:29 am
                              Kare83
                              Participant

                                Yes, it's very confusing!! I asked him if it was stage 0 or stage 1 (as I originally thought it may be either of these based on what he said over the phone) and he said "It's actually a stage 2"

                                Kind of annoyed I didn't get the path report offered to me either but I'll be sure to ask him for a copy.

                                Melanoma took my grandfathers life and my brother has also had one removed a few years ago. 

                                • December 8, 2015 at 2:08 pm
                                ed williams
                                Participant

                                  Hi Kare, could I make a suggestion to you since you said you are from Australia. I have been following on facebook a man named "Jay Allen" they call him " The Melanoma Man". He works for the Melanoma Institute of Australia and is 7 years out from being stage 3 Melanoma on his leg with complete lymph node removal in groin. He was the guy behind getting suntan beds banned in Australia and New Zealand. He has helped many melanoma patients in Australia and maybe some one you could reach out to for advice and support. I know they run melanoma support groups in Australia. Wishing you the best!!! Ed

                                  • December 8, 2015 at 2:08 pm
                                  ed williams
                                  Participant

                                    Hi Kare, could I make a suggestion to you since you said you are from Australia. I have been following on facebook a man named "Jay Allen" they call him " The Melanoma Man". He works for the Melanoma Institute of Australia and is 7 years out from being stage 3 Melanoma on his leg with complete lymph node removal in groin. He was the guy behind getting suntan beds banned in Australia and New Zealand. He has helped many melanoma patients in Australia and maybe some one you could reach out to for advice and support. I know they run melanoma support groups in Australia. Wishing you the best!!! Ed

                                    • December 8, 2015 at 2:08 pm
                                    ed williams
                                    Participant

                                      Hi Kare, could I make a suggestion to you since you said you are from Australia. I have been following on facebook a man named "Jay Allen" they call him " The Melanoma Man". He works for the Melanoma Institute of Australia and is 7 years out from being stage 3 Melanoma on his leg with complete lymph node removal in groin. He was the guy behind getting suntan beds banned in Australia and New Zealand. He has helped many melanoma patients in Australia and maybe some one you could reach out to for advice and support. I know they run melanoma support groups in Australia. Wishing you the best!!! Ed

                                      • December 8, 2015 at 7:35 pm
                                      Kare83
                                      Participant
                                        Thanks Ed! Just followed him now. 🙂
                                        • December 8, 2015 at 7:35 pm
                                        Kare83
                                        Participant
                                          Thanks Ed! Just followed him now. 🙂
                                          • December 8, 2015 at 7:35 pm
                                          Kare83
                                          Participant
                                            Thanks Ed! Just followed him now. 🙂
                                            • December 8, 2015 at 11:55 pm
                                            Kare83
                                            Participant

                                              Hi Janner!

                                              I got a copy of the pathology report today. I am feeling much calmer and understanding a little bit more now though just a few questions, if you, or anyone can shed some light.

                                              The melanoma was Clark Level 2, with a Breslow thickness of 0.4mm (which I am told this is really good).

                                              There was a moderate lymphocytic imflammatory infiltrate, consistent with a component of regression (not sure what this means)

                                              There is no evidence or ulceration, perineural invasion or vascular invasion.

                                              Clear margins and excision appears complete.

                                              So it looks like we caught it still in the early stages which I am relieved about. I am a little confused about Clark Level 2.. No where in my report does it say what Stage that is.

                                              He explained that he will check all areas of lymph nodes at each of my 3 monthly checks from now on to make sure there is nothing there as well. 

                                               

                                              Thanks so much for your time answering my questions!! I just want to know as much as I possibly can so I can feel comfortable in my skin again.

                                              • December 8, 2015 at 11:55 pm
                                              Kare83
                                              Participant

                                                Hi Janner!

                                                I got a copy of the pathology report today. I am feeling much calmer and understanding a little bit more now though just a few questions, if you, or anyone can shed some light.

                                                The melanoma was Clark Level 2, with a Breslow thickness of 0.4mm (which I am told this is really good).

                                                There was a moderate lymphocytic imflammatory infiltrate, consistent with a component of regression (not sure what this means)

                                                There is no evidence or ulceration, perineural invasion or vascular invasion.

                                                Clear margins and excision appears complete.

                                                So it looks like we caught it still in the early stages which I am relieved about. I am a little confused about Clark Level 2.. No where in my report does it say what Stage that is.

                                                He explained that he will check all areas of lymph nodes at each of my 3 monthly checks from now on to make sure there is nothing there as well. 

                                                 

                                                Thanks so much for your time answering my questions!! I just want to know as much as I possibly can so I can feel comfortable in my skin again.

                                                • December 8, 2015 at 11:55 pm
                                                Kare83
                                                Participant

                                                  Hi Janner!

                                                  I got a copy of the pathology report today. I am feeling much calmer and understanding a little bit more now though just a few questions, if you, or anyone can shed some light.

                                                  The melanoma was Clark Level 2, with a Breslow thickness of 0.4mm (which I am told this is really good).

                                                  There was a moderate lymphocytic imflammatory infiltrate, consistent with a component of regression (not sure what this means)

                                                  There is no evidence or ulceration, perineural invasion or vascular invasion.

                                                  Clear margins and excision appears complete.

                                                  So it looks like we caught it still in the early stages which I am relieved about. I am a little confused about Clark Level 2.. No where in my report does it say what Stage that is.

                                                  He explained that he will check all areas of lymph nodes at each of my 3 monthly checks from now on to make sure there is nothing there as well. 

                                                   

                                                  Thanks so much for your time answering my questions!! I just want to know as much as I possibly can so I can feel comfortable in my skin again.

                                                  • December 9, 2015 at 1:51 am
                                                  Janner
                                                  Participant

                                                    Staging is rarely mentioned in a pathology report because staging is "systemic" and pathology only looks at one tiny piece of skin.  Staging is usually done by the doctor because he has the complete picture.

                                                    Clarks Level II and Breslow of 0.4mm is very good.  You are still missing one piece of information that will stage you – mitosis.  If it is <1, then you are stage 1a.  If it is 1 or more, you are stage Ib. 

                                                    All the factors are good except regression which is mixed.  Regression means the body recognizes the lesion as bad and tries to destroy it.  This is good.  However, you can't always determine how deep a lesion was prior to the regression.  This can confuse the issue a little.  Often a pathologist can determine the depth of the regression based on the "infiltrare" left behind.  Since the description doesn't say extensive regression, you can probably assume this is a minor issue and changes nothing in your prognosis.

                                                    Less than 10% of the melanoma population every have more than one primary.  You are obviously at higher risk, but that's the reality.  If you have lots of moles, I'd investigate taking photos of your moles and monitor them for change.  Remove those changing moles or that one ugly duckling.  Changing moles don't have to be melanoma but they are higher risk.  I only biopsy things that change (stage IB since 1992 with 3 melanoma primaries). 

                                                    The first year is the hardest – hard to reconcile the diagnosis and feel comfortable.  But you are definitely in a good place.

                                                    • December 9, 2015 at 1:51 am
                                                    Janner
                                                    Participant

                                                      Staging is rarely mentioned in a pathology report because staging is "systemic" and pathology only looks at one tiny piece of skin.  Staging is usually done by the doctor because he has the complete picture.

                                                      Clarks Level II and Breslow of 0.4mm is very good.  You are still missing one piece of information that will stage you – mitosis.  If it is <1, then you are stage 1a.  If it is 1 or more, you are stage Ib. 

                                                      All the factors are good except regression which is mixed.  Regression means the body recognizes the lesion as bad and tries to destroy it.  This is good.  However, you can't always determine how deep a lesion was prior to the regression.  This can confuse the issue a little.  Often a pathologist can determine the depth of the regression based on the "infiltrare" left behind.  Since the description doesn't say extensive regression, you can probably assume this is a minor issue and changes nothing in your prognosis.

                                                      Less than 10% of the melanoma population every have more than one primary.  You are obviously at higher risk, but that's the reality.  If you have lots of moles, I'd investigate taking photos of your moles and monitor them for change.  Remove those changing moles or that one ugly duckling.  Changing moles don't have to be melanoma but they are higher risk.  I only biopsy things that change (stage IB since 1992 with 3 melanoma primaries). 

                                                      The first year is the hardest – hard to reconcile the diagnosis and feel comfortable.  But you are definitely in a good place.

                                                      • December 9, 2015 at 1:51 am
                                                      Janner
                                                      Participant

                                                        Staging is rarely mentioned in a pathology report because staging is "systemic" and pathology only looks at one tiny piece of skin.  Staging is usually done by the doctor because he has the complete picture.

                                                        Clarks Level II and Breslow of 0.4mm is very good.  You are still missing one piece of information that will stage you – mitosis.  If it is <1, then you are stage 1a.  If it is 1 or more, you are stage Ib. 

                                                        All the factors are good except regression which is mixed.  Regression means the body recognizes the lesion as bad and tries to destroy it.  This is good.  However, you can't always determine how deep a lesion was prior to the regression.  This can confuse the issue a little.  Often a pathologist can determine the depth of the regression based on the "infiltrare" left behind.  Since the description doesn't say extensive regression, you can probably assume this is a minor issue and changes nothing in your prognosis.

                                                        Less than 10% of the melanoma population every have more than one primary.  You are obviously at higher risk, but that's the reality.  If you have lots of moles, I'd investigate taking photos of your moles and monitor them for change.  Remove those changing moles or that one ugly duckling.  Changing moles don't have to be melanoma but they are higher risk.  I only biopsy things that change (stage IB since 1992 with 3 melanoma primaries). 

                                                        The first year is the hardest – hard to reconcile the diagnosis and feel comfortable.  But you are definitely in a good place.

                                                        • December 9, 2015 at 3:06 am
                                                        Kare83
                                                        Participant

                                                          No dermal mitoses can be identified. So that would be Stage 1a, right? 🙂   and….. What is mitoses? 

                                                          I feel very blessed. I know there are a lot of people here fighting and the stories are heart breaking. Even though it is in my family and I have always been aware, I am going to urge everyone I know to keep up with their skin checks, no matter how annoying I become in doing so.

                                                          I feel like my doctor has acted very fast on my case, even though it was very early stage. It gives me a lot of relief knowing he is being so active with everthing. 

                                                          • December 9, 2015 at 3:06 am
                                                          Kare83
                                                          Participant

                                                            No dermal mitoses can be identified. So that would be Stage 1a, right? 🙂   and….. What is mitoses? 

                                                            I feel very blessed. I know there are a lot of people here fighting and the stories are heart breaking. Even though it is in my family and I have always been aware, I am going to urge everyone I know to keep up with their skin checks, no matter how annoying I become in doing so.

                                                            I feel like my doctor has acted very fast on my case, even though it was very early stage. It gives me a lot of relief knowing he is being so active with everthing. 

                                                            • December 9, 2015 at 3:06 am
                                                            Kare83
                                                            Participant

                                                              No dermal mitoses can be identified. So that would be Stage 1a, right? 🙂   and….. What is mitoses? 

                                                              I feel very blessed. I know there are a lot of people here fighting and the stories are heart breaking. Even though it is in my family and I have always been aware, I am going to urge everyone I know to keep up with their skin checks, no matter how annoying I become in doing so.

                                                              I feel like my doctor has acted very fast on my case, even though it was very early stage. It gives me a lot of relief knowing he is being so active with everthing. 

                                                              • December 9, 2015 at 4:10 am
                                                              Janner
                                                              Participant

                                                                Mitosis is cell division.  So none identified means probably not growing fast and yes, stage 1a.

                                                                • December 9, 2015 at 4:10 am
                                                                Janner
                                                                Participant

                                                                  Mitosis is cell division.  So none identified means probably not growing fast and yes, stage 1a.

                                                                  • December 9, 2015 at 4:10 am
                                                                  Janner
                                                                  Participant

                                                                    Mitosis is cell division.  So none identified means probably not growing fast and yes, stage 1a.

                                                                    • December 9, 2015 at 10:10 pm
                                                                    Kare83
                                                                    Participant

                                                                      I cannot thank you enough!! Thank you Janner!! smiley

                                                                      • December 9, 2015 at 10:10 pm
                                                                      Kare83
                                                                      Participant

                                                                        I cannot thank you enough!! Thank you Janner!! smiley

                                                                        • December 9, 2015 at 10:10 pm
                                                                        Kare83
                                                                        Participant

                                                                          I cannot thank you enough!! Thank you Janner!! smiley

                                                                        • December 7, 2015 at 11:54 pm
                                                                        Janner
                                                                        Participant

                                                                          Did you have a sentinel node biopsy?  Level 2 and stage 2 are totally different things.  Staging is based on depth and other factors.  Clark's  Level is the skin anatomy and not used in staging anymore.  If you didn't have a sentinel node biopsy, I'm thinking your lesion might be level 2 and not stage 2  – probably stage 1.  Get a copy of your pathology report and it will give you all the pertinent information.

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