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why do they make you wait?!
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why do they make you wait?!

› Forums › General Melanoma Community › why do they make you wait?!

  • Post
    • April 27, 2018 at 2:16 pm
    Ohio mom
    Participant

      Ive been diagnosed with melanoma and I will be seeing a reknown cancers care center physician specializing in melanoma-but this is  after knowing I have had this diagnosis for 2 weeks and then I find out it is just for a consultation?!!!   Why can’t they even do an excision on that day if they know the shave biopsy was malignant?!  They say I am a minimum of stage 1a, but really it’s anyones guess how deep it may go because of the initial way of the biopsy-shaved.  Does anyone have any idea how I could manage to get them to excise the area?  I am losing my mind.  I go next week and I can’t imagine waiting to just have another scheduled appointment!!!  I am trying to stay calm, but my anxiety is through the roof.  I cry all the time.  Could I “demand” an excisional biopsy without being tossed out?  Any suggestions would be helpful!!

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        • April 27, 2018 at 2:50 pm
        Janner
        Participant

          You are getting the cart before the horse.  You DON'T want an excisional biopsy.  If you were the poster from down below (similar situation), you may be asking for a sentinel node biopsy.  That requires anesthesia in a hospital type setting.  And that HAS to be done prior to the wide excision.  Usually they are done in the same setting but the SNB is done first.  The sentinel node biopsy requires them to inject a tracer and they follow that to the first lymph node in the drainage chain.  If you have the wide excision done first, that may compromise the drainage paths.  So if you are considering the SNB, do not let them take more tissue out first.  Your wait is fairly typical, just so you know.  Most of us have been there.

          • April 27, 2018 at 3:15 pm
          iskitwo
          Participant

            The waiting is the hardest part but as Janner said most of us have sat through that waiting period.  I would be pushing for the SNB since they did a shave and you don't know the true depth. The doctor will be able to give you much more info on this. Try not to google to much and find things to do that get your mind away from it. Take a deep breath and take this one doctors appt at a time. Also if I will the wait time is extra long I will ask the office to call if there is a cancelation. Hang in there!!

             

              • April 27, 2018 at 4:13 pm
              Ohio mom
              Participant

                Thank u!  Your right, I will stop googling.  It’s very dire.

                I could use all the experienced info here other than what I’ve read.

                I will for sure ask for the SNLB, but does anyone have a guesstimate to what the average depth is after a shaved biopsy?  Do they add that to the previous number?

                • April 27, 2018 at 7:23 pm
                iskitwo
                Participant

                  Someone with more experience might chime in but I don't think you will ever know the true depth. Mine was a shave biopsy which didn't have clear margins. They did the excision  but they don't put them together to give you a total depth. This is why my surgeon went ahead with the SNLB. 

                  • April 28, 2018 at 6:25 pm
                  Ohio mom
                  Participant

                    So good to know.  Thank you for sharing your situation.

                    best wishes to u!

                    • April 27, 2018 at 8:16 pm
                    Janner
                    Participant

                      They can't "add".  Think about it.  They take a chunk of skin and slice it so they can look at it on microscope slides.  Then they come back and take an additional chunk of skin.  There is no way to match the first bit with how it fits out of the 2nd excision.  All they can say is you have "at least" a .5mm lesion.  If they find more in the remaining depth, you could say you have XX residual.  They may be able to see a section that has the full depth of skin on the second excision, but that is no longer the center (and most likely the deepest area).  Shaves just compromise depth if they bisect a lesion and you lose this important information. 

                      • April 28, 2018 at 6:24 pm
                      Ohio mom
                      Participant

                        I get what your saying.  I guess when you are scared and looking for answers.

                        i know that not everything may look like “melanoma” but why do dermatologist do shave biopsy if the possibility is even there?  Who wouldn’t rather have a scar over a compromised diagnosis of the Breslow depth.  I at least feel in my case, I basically said this is not normal, it was dark red, as big as a pencil eraser and I stated that I would like the area tested.  Not being a doctor if I would have known…I would have demanded to cut as deep and wide as possible or let me go to someone who will. But I can only go forward.  But to me, anything that doesn’t look healthy, don’t shave biopsy!!

                        • April 28, 2018 at 6:51 pm
                        bjeans
                        Participant

                          Or do a punch biopsy at least. Shaves are faster/easier for the doctor, which doesn't excuse doing them when there's even a chance it's melanoma. My husband's large mole was completely removed with clear margins by the regular dematologist's surgeon, though of course they were widened when he had a WLE. 

                          But your other point is also well taken – why would a patient know who didn't already know?! We just lucked out – it was that we had any knowledge – until after the fact. The dermatologist thought it might be squamous cell. I was skeptical, though that's just my natural talent of pessimism. 

                          • May 8, 2018 at 5:53 pm
                          almostalice
                          Participant
                            In constrast I’ve had 12 moles removed so far 3 have been positive. The rest looked suspect and I’m sure in my case could have been nice homes for some melanoctye frat partying … But none the less I have scars I didn’t need.
                          • May 8, 2018 at 5:50 pm
                          almostalice
                          Participant
                            Waiting is almost certainly the worst part of all this. Healthy distractions can help, obsessing is much less helpful than calmer reflection.

                            Information is power and a curse too. If it’s SSM (superficial sideways growing) this is often a better situation and you’re in luck because most Melanomas progress sideways and not downwards.

                            1a is still close to in-situ you’re at a good place in staging. I often talk myself down from anxiety by convincing myself it’s growing sideways.

                            It’s a trick of the mind to go negative and unrealtsic. That poster is right too, I was refused node biopsy because they obtained clear margins.

                            You have good signals in your case so breathe and take care of your nerves.

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