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WLE & SLNB Follow up….. now what?

Forums General Melanoma Community WLE & SLNB Follow up….. now what?

  • Post
    upsidedown16
    Participant

      Hi Everyone, 

      I had my post-surgery follow up today. I was diagnosed via shave biopsy which initially revealed the depth to be at least .67 mm with a mitosis rate of 3/mm2, non ulcerated, and lymph/vascular involvement not identified.

      Wide Excision revealed:

      -maximum tumor thickness to be 2.15mm (invades recticular dermis)

      -macroscopic satellite nodules not identified

      -ulceration not identified 

      -regression not identified 

      Margins: 

      -Peripheral Margins: uninvolved by invasive melanoma distance of invasive melanoma from closest peripheral margin: 8mm

      -Deep Margin: uninvolved by invasive melanoma distance of invasive melanoma from closest deep margin: 16mm 

      -mitotic index: 2/mm2

      -lymph/vascular involvement: not identified

      -perineural invasion: not identified 

      -tumor infiltrating lymphocytes:present, brisk. 

      -tumor regression: not identified 

      2 lymph nodes were removed and those revealed no metastasis….. fantastic news but why do I feel worried and scared?? 

      Based on the overall results I am Stage IIa

      I am very alamared by the depth melanoma based on the WLE…… I know the depth of the shave and wide excision cannot be combined, so what does this mean? The uncertainty bothers me. 

      Secondly, what's next? My surgical onocologist said it would most likely be monitoring and follow ups with derm but that he would consult with the tumor board and see if any additional therapies are warranted. I asked about routine CT/PET scans and he said these are only needed if there are symptoms…. is this true?? I  feel like it would be best to schedule them routinely along with the derm follow ups. 

      For those of you who are or have been Stage IIa…. what's next now? Monthly skin checks, follow ups with derm, follow ups with primary….? I just want to make sure I'm not missing anything. Thank you for taking the time to read this post! I've learned so much about melanoma through this website and I am very thankful to have the this as a resource especially during this roller coaster 

       

    Viewing 2 reply threads
    • Replies
        Treadlightly
        Participant

          Congratulations on having no lymph node involvement.That is the best news you could have hoped for under the circumstances.

          As I mentioned in a previous posting, my melanoma diagnosis was also stage 2A. 

          I was also troubled by the depth of my melanoma…which was 3.7 mm…quite a bit deeper than yours. This just shows how much variability there can be from one case to another. Ultimately…every case is unique and can have a completely different presentation, diagnosis, and prognosis.

          After my initial treatment (WLE & SLNB), I had check ups with my Melanoma specialist every 3 months for the first 3 years, followed by check ups twice per year with my Dermatologist. At all of these visits, my doctors checked my lymph nodes by palpating and feeling for swelling. They also look me over very thoroughly and ask if I have noticed anything new pop up. I am told that I will need to continue these check ups twice per year for the rest of my life.

          As for CT or PET scans…doctors generally will not order them for you routinely. However, if you ever present with symptoms they will perform them for you. In my case, I began having a persistent headache a couple of years after my initial treatment, which lasted more than a month. At my next 3-month appointment, they ordered a CT scan of my brain. Thankfully it was negative. The final diagnosis was that my eyesight was slipping (due to normal aging) and I needed to get prescription eye glasses. The headaches were believed to be due to eye fatigue.

          At this point, the best you can do is to be vigilant in looking for any signs of new or spreading melanoma, along with avoiding all of the risk factors for skin cancer (limit sun exposure and no tanning beds, use sunscreen, take Vitamin B supplements, etc.). 

          In addition to the above, I also take an herbal supplement called Turmeric (500 mg capsule). Turmeric is touted as a way to fight cancer by supporting a healthy inflammatory response and providing a powerful antioxidant.

          https://draxe.com/turmeric-benefits/

          Please let us know if your doctors do prescribe any further treatments.

          Best of luck to you!!!

          Mark

          Treadlightly
          Participant

            Congratulations on having no lymph node involvement.That is the best news you could have hoped for under the circumstances.

            As I mentioned in a previous posting, my melanoma diagnosis was also stage 2A. 

            I was also troubled by the depth of my melanoma…which was 3.7 mm…quite a bit deeper than yours. This just shows how much variability there can be from one case to another. Ultimately…every case is unique and can have a completely different presentation, diagnosis, and prognosis.

            After my initial treatment (WLE & SLNB), I had check ups with my Melanoma specialist every 3 months for the first 3 years, followed by check ups twice per year with my Dermatologist. At all of these visits, my doctors checked my lymph nodes by palpating and feeling for swelling. They also look me over very thoroughly and ask if I have noticed anything new pop up. I am told that I will need to continue these check ups twice per year for the rest of my life.

            As for CT or PET scans…doctors generally will not order them for you routinely. However, if you ever present with symptoms they will perform them for you. In my case, I began having a persistent headache a couple of years after my initial treatment, which lasted more than a month. At my next 3-month appointment, they ordered a CT scan of my brain. Thankfully it was negative. The final diagnosis was that my eyesight was slipping (due to normal aging) and I needed to get prescription eye glasses. The headaches were believed to be due to eye fatigue.

            At this point, the best you can do is to be vigilant in looking for any signs of new or spreading melanoma, along with avoiding all of the risk factors for skin cancer (limit sun exposure and no tanning beds, use sunscreen, take Vitamin B supplements, etc.). 

            In addition to the above, I also take an herbal supplement called Turmeric (500 mg capsule). Turmeric is touted as a way to fight cancer by supporting a healthy inflammatory response and providing a powerful antioxidant.

            https://draxe.com/turmeric-benefits/

            Please let us know if your doctors do prescribe any further treatments.

            Best of luck to you!!!

            Mark

            Treadlightly
            Participant

              Congratulations on having no lymph node involvement.That is the best news you could have hoped for under the circumstances.

              As I mentioned in a previous posting, my melanoma diagnosis was also stage 2A. 

              I was also troubled by the depth of my melanoma…which was 3.7 mm…quite a bit deeper than yours. This just shows how much variability there can be from one case to another. Ultimately…every case is unique and can have a completely different presentation, diagnosis, and prognosis.

              After my initial treatment (WLE & SLNB), I had check ups with my Melanoma specialist every 3 months for the first 3 years, followed by check ups twice per year with my Dermatologist. At all of these visits, my doctors checked my lymph nodes by palpating and feeling for swelling. They also look me over very thoroughly and ask if I have noticed anything new pop up. I am told that I will need to continue these check ups twice per year for the rest of my life.

              As for CT or PET scans…doctors generally will not order them for you routinely. However, if you ever present with symptoms they will perform them for you. In my case, I began having a persistent headache a couple of years after my initial treatment, which lasted more than a month. At my next 3-month appointment, they ordered a CT scan of my brain. Thankfully it was negative. The final diagnosis was that my eyesight was slipping (due to normal aging) and I needed to get prescription eye glasses. The headaches were believed to be due to eye fatigue.

              At this point, the best you can do is to be vigilant in looking for any signs of new or spreading melanoma, along with avoiding all of the risk factors for skin cancer (limit sun exposure and no tanning beds, use sunscreen, take Vitamin B supplements, etc.). 

              In addition to the above, I also take an herbal supplement called Turmeric (500 mg capsule). Turmeric is touted as a way to fight cancer by supporting a healthy inflammatory response and providing a powerful antioxidant.

              https://draxe.com/turmeric-benefits/

              Please let us know if your doctors do prescribe any further treatments.

              Best of luck to you!!!

              Mark

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