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  • #21410
    cohanja
    Participant

    very scary article to read, but now I understand why some doctors order annual chest xray even for patients who had a thin “low risk” lesion

    http://www.sciencecodex.com/surgeons_report_melanoma_recurs_after_10_years_in_more_than_6_percent_of_patients-114849

    #61557
    Catherine Poole
    Keymaster

    I will run this by our Scientific Board. A chest xray is only going to show later stage disease so isn’t a good tool for finding an early spread. I think you may have found an a study that further proves we should all live in the moment!

    #61558
    cohanja
    Participant

    i’m beginning to think whatever they think is known about this disease may not really be known at all

    “compared with the early-recurrence group, patients with a late recurrence tended to have had an original melanoma with characteristics indicating a more favorable disease outcome. Specifically, their original tumor was more likely to have been thin and nonulcerated”

    how valid then are these “characteristics” they use for prognosis? they say nonulcerated and thin are good indicators, but yet they are more likely to recur?

    #61559
    Catherine Poole
    Keymaster

    Here is what one of our Scientific Advisory Board members says and he is a top melanoma specialist at premiere melanoma center: “Late recurrence of early stage melanoma is a well-recognized phenomenon. This is a nice study that accurately characterizes that risk as around 3-7%. The study is made possible by the very powerful JWCI clinical database.

    Other than patient awareness, it is unclear how a reminder of this phenomenon should affect patient care, especially after treatment of low-risk primary melanoma. It is unclear who found the recurrences (patient or physician), and if by the physician, how they were found (physical exam, blood test, imaging).”

    More importantly, it is not completely clear how many patients diagnosed and treated >10 years earlier were lost to follow-up, and how many patients diagnosed >10 years earlier returned to JWCI only to be treated for their recurrence. This selection bias would substantially inflate the percentage of late recurrences. The bias would be eliminated if the authors had stated how many patients treated at JWCI >10 years earlier were lost to follow-up, and of those who were not lost to follow-up, what the recurrence rate was among patients treated at JWCI >10 years earlier who were still participating in a structured program of follow-up at the time of their recurrence. I expect that this would help to reduce the reported rate of late recurrence.

    ________________________________________

    #61560
    cohanja
    Participant

    what does “lost to follow up” mean? they weren’t getting medical care any longer?

    #61561
    HoolieB
    Participant

    Catherine Poole wrote:

    I will run this by our Scientific Board. A chest xray is only going to show later stage disease so isn’t a good tool for finding an early spread. I think you may have found an a study that further proves we should all live in the moment!

    I’ve often wondered if a yearly chest xray does more harm than good. It seems to me that limiting radiation exposure outweighs the uncertain benefits of the test, at least for lower-risk patients like myself.

    Instead of obsessing about the 6.9% of patients who have had a recurrence > 10 years later, I’m all for celebrating the 93.1% who are still NED.

    #61562
    Catherine Poole
    Keymaster

    I quit my annual chest xray early on as my doctor said it was not a useful tool to find early disease. It just made me anxious! And yes, good to concentrate on how great a low risk lesion can be rather than the tiny (less than 6% most likely) % of those who might recur.

    #61563
    cohanja
    Participant

    as far as the radiation from scans, does anyone buy “hormesis effect?”

    #61564
    Worrywart
    Participant

    Isn’t this typical for all cancers? The less aggressive ones tend to recur later….IF they ever recur?

    This doesn’t seem like anything new, it just seems like the same information. Am I missing something?

    #61565
    7spider
    Participant

    My Dermatologist recommends the yearly chest x-ray, however my surgeon did not. So I did a compromise and had the one last year after surgery for a baseline. I will do skin exams every 6 mos. and have a chest x-ray every three years. In the mean time I just bought my first boat. Gonna put a biminy top on it, so I can get out of that strong sun. Got a good panama hat, some of that good sunscreen ” Columbia ” sportswear, good 100 sunblock and a new fishing rod. Now if the fish cooperate I should be fine, and if they don’t, well I guess deep breaths and meditation or possibly something for high blood pressure.

    #61566
    7spider
    Participant

    If ya want to see my fish go to the FB thing. I do however try to educate as many people I can about Melanoma and being careful in the sun.

    #61567
    linlore
    Participant

    I had stage 1 diagnosis 3 years ago. After clear margins, my dermatologist recommended in addition to 6 month skin checks, annual blood work and chest x-ray (both were also normal). Subsequent 2 years I also had blood work and chest x-ray. On my most recent annual physical, however, my primary doctor and subsequently also my dermatologist, both said chest x-rays are not necessary. So I will forego an annual x-ray. Is there a recommended time frame to have a chest x-ray? Same as non-melanoma patients?

    #61568
    Catherine Poole
    Keymaster

    Chest xrays are sometimes used for pneumonia or other diagnosis of lung issues. But only as needed. They aren’t a regular thing for prevention anymore that I know of.

    #61569
    Lisa P
    Participant

    Can someone tell me what recurrence is? Is it that a new melanoma appears at the site of one that was previously excised? Does it mean they didn’t really clear the margins the first time around? Alternatively, does it mean that there’s some metastatic thing happening? Yikes.

Viewing 14 posts - 1 through 14 (of 14 total)
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