follow up?
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wpatterson4 , wasn’t your lesion almost identical to mine? 0.3mm, mitotic rate <1/mm2? If it has ruined your life, have you overestimated the risk you have?
NO!!!! Mine was .34 (similar) with extensiveregression, a trait that some physicians associate strongly with the reaper. Multiple studies have shown this to be an adverse prognostic indicator. Ever since mitotic rate took its place in melanoma staging, extensive regression has fallen out of vogue. However, there have been too many studies demonstrating that it’s a bad sign, including one published in 2011 that involved the go-to expert (Guerry) for MIF forums. However, partial or focal regression is said to have no prognostic significance.
Plus, I haven’t had a sentinel node biopsy. That’s the most important thing. It takes some of that dreaded uncertainty out of it.
http://journals.lww.com/ajsp/Abstract/2011/02000/High_Lymphatic_Vessel_Density_and_Lymphatic.8.aspx As far as the negative SLNB result, of course I’m glad it was negative; but, I don’t put a lot of faith in that in terms of predicting recurrance. It’s a diagnostic tool, but a negative result doesn’t mean it didn’t spread through blood or to another node or hadn’t reached the node yet, etc…. I’m saying that I understand your concerns, but that your SNB should have given you some reassurance, peace of mind. Ok, so maybe I just don’t know & am not aware of the stats around this. What is the % of SLNB negatives that go on to develop metastatic disease? wpatterson4, I did have papillary dermal fibrosis and a dermal mitotic figure was identified as well as dermal nests. So, I do have some negative prognostic indicators, even though regression was partial focal and not extensive. Not sure. To be honest, I don’t have any hard numbers on that, but I believe it depends on the stage of the primary. I do think, though, that you are far less likely to go stage 3 or 4 than the average 1A patient. Remember, SNB is a staging tool. If melanoma patients who had negative SNB’s went on to develop mets at the same rate as those who never had the procedure done, it wouldn’t be of much use. “I did have papillary dermal fibrosis and….” ….a sentinel lymph node biopsy.
There are no guarantees, but they wouldn’t perform these tests if they didn’t reveal useful information OFTEN. It’s a prognostication tool, not a therapy, even though 3a patients who’ve had the procedure done tend to have better odds than those who show up at the clinic with a golf ball in their groin/armpit.
Personally I find all of this futile and exhausting. Instead of helping you move forward, I feel you Cohanja are starting to drag me backwards. So in the interest of keeping on the positive track I have been on for quite some time, I will be taking a much needed break for a bit. A shame really as I sincerely wish to help others on this forum who come looking for information and reassurance. Cohan, maybe you should start a blog. I would also suggest prank calling to alleviate your stress, but that just isn’t as easy these days as when I was a kid. The authorities frown upon it. I’m sorry, Casey188, that you feel I’m dragging you backwards. I suspect that these forums are filled with positive stories, not so positive stories, cases that make people scared, cases that give people hope, questions, answers, thoughts, etc. .everything. And, those who come to read and post and ask/answer questions are going to be exposed to everything – the good, the bad and the ugly. I think that is part of being able to participate – it won’t only be the positive stuff that one comes across, but I think that is reality. Cohanja, I think you just need to accept the fact that YES, you were diagnosed with melanoma and YES it can be deadly. Accept it..plain and simple. I was dx with melanoma at same time as a friend from high school that was also 34. He recently passed from the melanoma and the day before his memorial her son was diagnosed with cancer. Yet she remains positive. She looks for silver lining and believes that it will all be okay, no matter what. Focus your energy on others, rather than yourself, you seem VERY self-involved. I understand you are scared, BUT you cannot control this and just have to accept that you were diagnosed with a dangerous disease but it was caught early. It may come back someday, it may not, but right now, you are wasting your time worrying. In a way, our thoughts and attitude affect our future. Negative thoughts bring negative consequences.
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