Home Forums Melanoma Diagnosis: Stages I &II Biopsy to surgery times

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  • #20539
    cut52
    Participant

    Had a mole removed by excision on July 03, 2012, and results came back on July 17 as melanoma developing in a nevus. Depth of 2.3 cm, mitotic index is eight mitosis per one mm. Saw an oncologist on Aug. 03, and further surgery for excision and Sentinel lymph node biopsy set for Sept. 10, 2012. My question is would this be considered an acceptable time frame?

    #55819
    Catherine Poole
    Keymaster

    That seems like a long delay to me, two months. Are you going to a place of melanoma expertise? This would be considered a fairly high risk melanoma (probably nevus (mole) turning to melanoma rather than the other way around) and they would want to get these procedures done in a timely fashion.

    #55820
    cut52
    Participant

    Hello Catherine, Thank you for the timely response. I am being seen by an Oncologist at Princess Margaret Hospital in Toronto, Ontario, Canada. I do consider this to be one of the best hospitals available to me, as it is a cancer treating hospital. I am attaching my biopsy report for you to look at if you may. Thanks, Dale[attachment=0]Scan.tif[/attachment]

    #55821
    krissy424
    Participant

    Forgive me for sticking my nose in, but i could not view your attached file. try this, works for me.

    http://forum.melanomainternational.org/mif/download/file.php?id=1%22%20alt=%22Scan.tif

    ==

    #55822
    Worrywart
    Participant

    It seems normal for any Universal Healthcare system in which the Doctors work for the Government rather than the patient. Here in US, the Dr’s work for us, and if they aren’t prompt we’ll seek care elsewhere. I had my biopsy on a Thursday, was called to say it was melanoma on Monday, and had WLE 2 days later.

    #55823
    Catherine Poole
    Keymaster

    Worrywart has her universal care opinions that I don’t necessarily agree with. Yes, care can be slower in Canada and it can be here in the U.S. too. There is no perfect system, but I do believe there should be a system where everyone has access to healthcare whether or not they can afford it. But back to the point, I’m sorry this has been so delayed for you. I wonder if you can lobby for a quicker surgery, or switch to another center that is less tied up. Please look at our list of Global Centers for Canadian centers that have melanoma specialists. Let us know how you are doing.

    #55824
    marti
    Participant

    3,5 years ago I was seen in a famous cancer hospital in The Netherlands, I was unfortunate to meet an oncology head/neck surgeon who told me bluntly waiting 6 weeks for SNB was normal, and he used the words “What do you expect, Everybody has cancer here ”

    I picked up the phone the same day and asked in a second melanoma center how long the waiting time for SNB would be, maybe the secretary understood my feelings and I was connected to the professor himself, and he told my that the waiting time was acceptable since the visible part of the melanoma was removed ; and this would mean that ” the head engine” of the melanoma was removed.After asking, he could see me the same day (!) himself, and after consulting him I decided to stay with this fantastic, understanding doctor, the head/surgeon in the field of melanoma.

    Despite these facts, the SNB was done within 10 days.

    The base-line: pick up the phone and start asking around, as I did. Maybe other Canadians can share their experiences, and advise you where there are possibilities to avoid this gruesome waiting-period for an SNB/WLE.

    I wish you a fast timeframe for your WLE/ SNB procedure with good results,

    marti

    #55825
    cut52
    Participant

    Thanks for the info everyone. Called the Mayo Clinic and The Cleveland Clinic and looks like the best I could move up surgery is maybe two weeks, that is a big maybe. I am still looking at other options, and thanks for responding Marti, I was told the “big engine” was already removed, so maybe another month is not that bad??

    #55826
    itom
    Participant

    I was in a similar situation as yours just recently. The physician excised my melanoma on May 8, I got the biopsy results on May 15. Mine was at least .65mm deep with a mitosis of 2 /mm2 and not ulcerated with the peripheral margins showing melanoma in situ and invasive melanoma. I had the surgical consult on June 6 where I talked to a general surgeon doing the WLE and SLNB and a dermatologist discussing my results. My surgery and WLE were done on July 6, which is about 2 months from the original biopsy. I’m also in Canada in Edmonton Alberta. Even though waiting for results is very hard because you don’t know your prognosis, I wouldn’t of minded waiting for the surgery if my margins were clear since the melanoma would have been removed with the WLE taking care of any melanoma in situ left behind. Thankfully my WLE was clear but it did have a depth but it was smaller than .65mm and my lymph node was clear and I hope that you will have good results as well. But I definitely agree with the previous poster in phoning to get in earlier just because anything with a mitosis higher then 6 is considered high and with your depth being an intermediate risk I would definitely try to get in earlier. If you didn’t need the SLNB and just WLE you probably could get in earlier just because any dermatologist can do the WLE but for the SLNB you need a surgeon which are always busy and they would want to do them at the same time so the lymphatic drainage pattern won’t be altered by the WLE. Now, it could also take longer just because right now it is summer and I was told by my dermatologist that during the summer the Government shuts down a lot of the operating rooms and a lot of surgeons will go on holidays during this time. But I would at least talk to your oncologist about your concern of waiting so long and see what he says.

    John

    #55827
    Worrywart
    Participant

    It was fully removed so don’t worry yourself about the wait time – if there were margins involved I’d worry, but since there are not it is probably already gone. However, with a cancer diagnosis it is very anxiety provoking to not be able to move fwd with treatment, and not healthy to have the added stress/anxiety of having to wait.

    I do have my opinions on Universal Healthcare, but I also agree that everyone does deserve healthcare. My brother was dx with cancer and he had no insurance and no means to pay. Here in Colorado he was eligible for free healthcare and his surgery and all his treatments, scans, etc have been paid in full. All states should have such a program – I just don’t agree that Universal Healthcare (run by Govrt) is the answer.

    #55828
    cut52
    Participant

    Just an update.Surgery was moved up to today, twelve days sooner than original so happy about that. WLE and SLNB done. Results of pathology to follow. Second reading of original pathology was better, mole depth 1.98 and mitotic rate of 6, not great but better. Any good recommendations on good treatments if path report positive??

    #55829
    Lisa P
    Participant

    Glad your surgery was moved up and hope you’re doing well. Please keep us posted about your pathology results but, in the meantime, take care and enjoy some time with supportive friends and family. Sending good thoughts your way, Lisa

    #55830
    Catherine Poole
    Keymaster

    There aren’t a lot of choices for stage 3 adjuvant therapy, we just discussed this in our webinar last week. The MageA3 is a good trial to get into, not sure what is available in Canada. Also, the Yervoy vs. Interferon is recruiting in many areas, but many drop out when they get the interferon. Watch and wait is perfectly acceptable and a choice many make. Careful vigilance of your body and taking care of any changes promptly seems a good avenue, and perfectly aggressive too. Be sure to discuss with your doctor. Happy your surgery is over and you can start to heal.

    #55831
    cut52
    Participant

    I will add to the redone original biopsy. Peripheral Margins: Uninvolved by invasive melanoma. Distance if invasive melanoma from closest peripheral margin: 0.45mm. Uninvolved by melanoma in situ. Distance of melanoma in situ from closest peripheral margin: 0.23mm. Deep Margins: Uninvolved by invasive melanoma. Distance of invasive melanoma from deep margin: 0.38mm. Does this look like the original biopsy might have got it all?

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