Home Forums Melanoma: Newly Diagnosed – Stages I & II Melanoma Stage 1A / Living Away From Home

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  • #21562
    LifeisLove
    Participant

    Hello,

    First off I’m glad I found this site.

    Unfortunately, my younger brother at age 25 was diagnosed with final stage metastatic melanoma in the brain without finding the primary cancerous mole or mark. He passed away April of this year.

    We’re both covered in moles and have very fair skin.

    I have recently taken off a few moles to be safe – one has just come back positive for superficially invasive meligant, stage 1A (I think) as far as my Pathology report goes – It’s located on my right back by the shoulder blade..

    tumor thickness is 0.5 mm deep, gross tumor size 4mm, Automatic clark level 2, lymphovascular invasion not identified, focally present / non-brisk…all others seem to be ok.

    I’m very worried and anxious, I’m currently working in Hongkong so away from the westcoast – this seems like a nightmare after what just happened this year with my brother leaving us.

    I feel like there’s a lot of other moles on me that also need to be taken off and I’m very worried they’re positive too.

    I’ve been told I need to get some 2nd stage surgery 1 cm area diameter at least to make sure it didn’t spread.

    One surgeon here said he could do it right away.

    The other surgeon said he could he wouldn’t do it without consultation first and needed PET scan done to see if I had some other diseases first ?? he was not happy I asked him to get it done even though I had the pathology reports and I don’t know why, is he right ??

    I think I’m going to the surgeon tomorrow recommended by the dermatologist here to get it as fast as possible, any suggestions ??

    Any advice would be great !! I hope someone can reply soon

    #62418
    Catherine Poole
    Keymaster

    For a .5 depth melanoma, you would go back for a the wide excision. You would not need pet scans. I would make sure your original slides are sent to an expert also, try http://www.drmihm.com, Dr. Mihm is a world renowned dermatopathologist. I can understand your anxiety and so sorry for your loss. I think you’ve stayed on top of things so you’ve found this early and low risk. I do think you should have whole body photography when you return to the states, look at http://www.dermatrak.com for this idea of keeping track of your skin. Our memories aren’t as good as photos! Take good care and let us know how you are doing.

    #62419
    LifeisLove
    Participant

    Hello Catherine,

    Thanks for your fast reply.

    When you say slides, do you mean I should get the biopsy samples from the (surgeon/dermatologist) who does the wide cut and send them myself to Dr Mihm ? Or do you mean send the photos ?

    When I’m not working in Asia I live in British Columbia, Canada very close to Vancouver. Do you happen to know any facilities there for screening moles using advanced tech photography etc ?

    Since the call this morning, I’m now looking at all my moles and feeling some look very suspicious..do you have any recommendations for Hong Kong in terms of Dermatologists to see who specialize in this ?

    Thank you

    #62420
    Worrywart
    Participant

    I am sorry for the loss of your brother. I am sure that does add to the anxiety. I agree with Catherine about photography. Have you had a full body check? Start paying close attention to your skin now, watch for change and get to know your skin. What Catherine means about 2nd opinion is that you should call the Dermatologist that removed your cancerous mole and request he/she send slides (your biopsy specimen) to Dr. Mihm for a second opinion on pathology. If not Dr Mihm, a dermatopathologist that specializes in melanoma – most universities have good dermatopaths. I am not sure why that particular Dr said you needed a PET scan, that seems very odd to me. THat is not recommended in states for low risk lesions. .5 is a low risk melanoma that was caught early.

    #62421
    Catherine Poole
    Keymaster

    Thanks for clarifying Worrywart. You do want your slides of your original lesion sent for another opinion. I don’t know of any Hong Kong experts as melanoma is pretty rare over there. I am checking on Vancouver BC docs/centres for you as well.

    Dr Jason Rivers is tops in Vancouver. He also has one of the few

    body photography pieces of equipment in Canada. His number is 604-682-7546

    #62422
    krissy424
    Participant

    Hi LIL, I was diagnosed June 15, 2012.

    Superficial spreading, radial growth phase

    Clark ll, Breslow .55, upper right side of back.

    I believe that our reports are nearly the same.

    I saw the derm 48 hrs after I first saw the lesion.

    The biopsy was done in his office immediately.

    Then 17 days later I had wide excision done .

    That is all I needed. I have skin checks regularly

    and need No other treatment. I know the fear those

    first months when I understood very little about melanoma.

    This forum helped so much. Ask any questions and we

    Will do our best answering them .

    Krissy

    #62423
    Icegurl470
    Participant

    My pathology was also very similar. Depth was .5 right shoulder blade. I had the WLE and the only other addition test I had was an axillary lymph node biopsy because subsequent tests detected mitosis, which is a late stage of cell division, suggesting it may have begun to spread. However, this is not the norm for thin melanomas such as ours, because odds are very slim cancer has metastasized, and, not surprisingly, my tests came back clear. The shoulder blade can be a tricky place to excise, they ended up making a football shaped excision for me, which ended up taking a little more than a centimeter of surrounding tissue, but it made the wound easier to close up. I couldn’t bend or reach with that arm for two to four weeks without the risk of popping stitches, but I haven’t had any issues since.

    #62424
    LifeisLove
    Participant

    Hi Everyone,

    Thanks so much for the replies, I’ve been going through a lot these past few days.

    I found a dermatologist in HK ( Dr. Henry Yeung) who did a wide excision of about 1cm around the original removal. I’m now waiting for the results which could be back as early as mid week ! The doctor also does mole mapping (photo wise)..I have so many moles he said it would take around 3-4 hours so I’m scheduled to go back there on the 19th.

    At the same time he spotted another large mole on my top right inner leg (groin area) which he removed as well..waiting to that result too.

    As Catherine noted I should send back to North America for a 2nd opinion but at the moment the lab is saying it’s too difficult to send over and may not be possible..

    I’m a little worried that because Melanoma is so rare here that something maybe over looked ? Or am I just paranoid..at the same time if the doctors are qualified they should know what to look for..I assume.

    Very nervous/anxious right now

    #62425
    LifeisLove
    Participant

    Icegurl470 wrote:

    My pathology was also very similar. Depth was .5 right shoulder blade. I had the WLE and the only other addition test I had was an axillary lymph node biopsy because subsequent tests detected mitosis, which is a late stage of cell division, suggesting it may have begun to spread. However, this is not the norm for thin melanomas such as ours, because odds are very slim cancer has metastasized, and, not surprisingly, my tests came back clear. The shoulder blade can be a tricky place to excise, they ended up making a football shaped excision for me, which ended up taking a little more than a centimeter of surrounding tissue, but it made the wound easier to close up. I couldn’t bend or reach with that arm for two to four weeks without the risk of popping stitches, but I haven’t had any issues since.

    Hi Icegurl40,

    Thanks for sharing.

    I’m now wondering if I should have done an axillary lymph node biopsy but no one said it was necessary..did it suggest it was spreading from your original pathology ?

    Catherine, do you know if I should have had an axillary lymph node biopsy done too ? My pathology said no dermal mitoses identified.

    #62426
    LifeisLove
    Participant

    krissy424 wrote:

    Hi LIL, I was diagnosed June 15, 2012.

    Superficial spreading, radial growth phase

    Clark ll, Breslow .55, upper right side of back.

    I believe that our reports are nearly the same.

    I saw the derm 48 hrs after I first saw the lesion.

    The biopsy was done in his office immediately.

    Then 17 days later I had wide excision done .

    That is all I needed. I have skin checks regularly

    and need No other treatment. I know the fear those

    first months when I understood very little about melanoma.

    This forum helped so much. Ask any questions and we

    Will do our best answering them .

    Krissy

    Thank you so much Krissy !

    I really appreciated the support more than words can express !

    #62427
    LifeisLove
    Participant

    Catherine Poole wrote:

    Thanks for clarifying Worrywart. You do want your slides of your original lesion sent for another opinion. I don’t know of any Hong Kong experts as melanoma is pretty rare over there. I am checking on Vancouver BC docs/centres for you as well.

    Dr Jason Rivers is tops in Vancouver. He also has one of the few

    body photography pieces of equipment in Canada. His number is 604-682-7546

    Hi Catherine,

    I see, I was mixed up.

    I thought the you meant my wide excision should be sent for a 2nd opinion.

    My orginal mole was removed by a Doctor on the West Coast of Canada and sent to the BC cancer agency in Vancouver, it was not removed here in Hongkong where I’m working now.

    #62428
    LifeisLove
    Participant

    RESULTS ARE BACK:

    My results for my wide excision have come back all.

    The doctor called me tonight and said there looked to be no evident spreading melanoma but that there was a ‘residual atypical melanocytic proliferation in the edge of the original scar ! He said nothing further needs to be done and that I shouldn’t worry because everything has been taken out.

    The pathology report states that the melanocytic proliferation is not diagnosed as melanoma by itself but given my history it’s compatibale with residual melanoma..the residual tumor was .3mm deep and 4.5 mm from the inked marked margin.

    Dear Catherin, can I get some feedback on this ?

    It was done at St. Pauls Hospital in HongKong by in the pathology department.

    Anything would help.

    #62429
    Catherine Poole
    Keymaster

    I would just follow up and get second opinions on all slides to be reassured. All sounds low risk.

    #62430
    Icegurl470
    Participant

    [/quote]I’m now wondering if I should have done an axillary lymph node biopsy but no one said it was necessary..did it suggest it was spreading from your original pathology ?

    Catherine, do you know if I should have had an axillary lymph node biopsy done too ? My pathology said no dermal mitoses identified.[/quote]

    No, my original pathology did not detect mitoses. The game plan was to just to WLE, but I got a call from the surgeon about a week after the initial appointment and he said the they had done their own tests on the biopsy and detected mitoses, so this put me in the stage IB category and qualified me for an optional LNB. I ended up going for the LNB, but even my surgeon said there was little chance it had spread that far, it was mostly a precautionary measure. The way my health insurance works, it would have cost me the same either way.

    #62431
    Catherine Poole
    Keymaster

    I would be suspicious of a surgeon who “did his own tests” and found mitosis. I also think you need a second opinion from an expert dermatopathologist (and nothing less!) to see if there was any mitosis. This just doesn’t sound kosher to me.

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