› Forums › General Melanoma Community › What can I expect from my first surgical onocologist appointment?
- This topic has 8 replies, 6 voices, and was last updated 7 years ago by
BethPendley.
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- April 29, 2018 at 6:17 pm
Hello, I wanted to see what I may expect from my first appointment at the James Center in Columbus Ohio? I have already been diagnosed of having melanoma by my dermatologist, but due to the shave biopsy I don’t know what stage, etc. Basically any info would be appreciated as to what will take place at my first visit, maybe what I should ask? Im sorry if I seem repetitive, but as many of you have read my previous posts, I’m very scared and full of anxiety. Thank you for letting this forum be a source of comfort.
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- April 30, 2018 at 12:50 am
My first biopsy involved a follow-up with a plastic surgeon where they removed the skin around with a 1cm margin. This is standard procedure which removes all melanoma in the overwhelming majority of cases.
If your melanoma is "thin" (<1mm, essentially doesn't "pierce" your skin) then there is a high chance it is isolated, and generally you should not have too much to worry about if you haven't had other melanomas in the past. Be aware of your family history, as some melanoma is hereditary.
Stay positive! There is probably nothing to worry about, just stay aware!
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- April 30, 2018 at 7:28 pm
I just finished treatment for malignant melanoma. I had a mole on my flank above my beltline that I have had for awhile change color and develop a scaly appearance. I went to the dermatologist expecting it to be nothing but after he examined it he decided it looked suspect enough to biopsy it. As I said it turned out to be melanoma. Luckily it was diagonsed as "thin" and in Stage I, just slightly over 1mm in depth with no ulceration. My dematologist took about a 1cm biopsy and the report came back with good surgical margins meaning no visible cancer spreading beyond the borders of the original biopsy site. Because of the vertical depth of the cancer, it was noted in the pathology report to have spread into the second layer of dermis and not just confined to the upper layer of the epidermis. Based on the pathology report they recommeded a wider excsion to remove more healthy tissue around the original lesion site and a Sentinal Lymphnode Biopsey to check if cancer cells where pasing into the lymphatic system. This is the primary means (its thought) that if melanoma is going to spread it will travel. Anyway, if the tumor is > 1mm deep the current guidelines recommend Sentinal Lymphnode Biopsy. So I was referred to a surgical oncologist and had the proceedure (WE + SNLB) performed about 10 days ago at University Hospital in Tucson AZ. You mentioned that you have had a shave biopsy that told you that you have Melanoma, unfortunately they cannot tell you what stage it is from that nor recommend a treatment plan unti they know how deep into the skin it reaches. Unlike other types of skin cancer at a minimum you can probably expect the surgeon or dematologist to want to do an excisional biopsy of at least 1cm to determine how deep into the skin the melanoma is.
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- April 30, 2018 at 10:53 am
Filled out lots and lots of forms, met the surgeon who explained procedure & examined area. (“Your skin is nice and loose. That’s good “ … um thanks I think?) Nurse explained after care and follow up. Scheduled surgery and follow up appt. and answered any questions. That was about it for 1st appt.
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- April 30, 2018 at 2:50 pm
Probably very unlikely that they would do surgery that day. With a surgical oncologist, they may be looking at WLE and SLNB, which is a general anesthesia procedure. They did my wife's outpatient, but it was most of the day from prep to nuclear med to surgery to recovery.
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- May 1, 2018 at 2:18 am
Hi – I wish you all the best of luck! We just had my dad's first surgical oncology visit last Thursday. He had his sentinel lymph node removed when his primary was shave biopsied originally due to the swelling of the lymph node being original cause of that visit/biopsy. In the interim from diagnosis to surgical oncology we had clear PET and CT scan (other than known sites). During surgical consult, they reviewed all procedures, ordered a brain MRI and required him to get cardio clearance due to a prior heart issue. They also ordered some bloodwork we had drawn that day. In and out in less than 2 hours and the scheduler called next day to set up surgery in 4 weeks. Not excited about the long wait, but we are with Moffitt and trusting that the drs there are the best and worth the wait. We have already done the brain MRI Friday and visited cardio today to get clearance. Praying for a scheduling change that allows us to get in surgery earlier. I would say to not expect same day, but I have also spoken to many people who were scheduled for less than the 4 week wait that we currently have. Make sure you have a list with any questions you have because the consult will seem to go very fast and you don't want to wish you had remembered to ask something!
For us, we already knew because of the level of cancer in the sentinel lymph node and depth based on shave biopsy that the modified lymph dissection would be required, but if you don't yet know those things then asking about the procedure overall and what type of info they can get from the pathology report you already have on staging would be good questions.
Best wishes!
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