Nodular melanoma
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When researching- I know nodular melanoma is one of the worst to have- but once it’s taken out and it’s confirmed that it’s not in my lymph nodes- which I know isn’t always accurate, but I’m praying it is- is the likelihood for recurrence the same as with other stage 1b’s- or is mine higher since it’s nodular….. I know there are no “for sures”- but I’m just trying to understand. So I guess my real question is is modular the worst “forever” or is it just because it can spread quickly, but once it’s out- it has the same likelihood as other tumors in my same stage category? Thanks for your input and wisdom! Happy Girl: I have nodular melanoma and I am a stage 1b as well. I’ve also wondered if there is a better chance of recurrence with nodular melanoma. I look forward to hearing from Catherine or another expert here regarding your question.
Nodular melanoma gets its bad reputation from skipping the usual biological progression that superficial spreading melanomas do. They tend to grow down, vertical growth and skip the radial growth phase. But they arise from moles, and usually occur from UV exposure just like superficial spreading. They are less common, 10% of melanomas are nodular and more common in men. I do think they warrant more vigilance but it sounds like both of you are on top of this! That’s important and therefore you are not necessarily dealing with the worst case scenario. So the majority of the threat is more because it can develop quickly when found- not necessarily a worse prognosis stage- wise….like my stage 1b is worse than a superficial melanoma stage 1b. I do understand that there are no guarantees- but it sounds like the playing field is evened out so to speak once stages are given. Am I understanding this correct- like I said though- i understand there are no guarantees.
That’s how I understand it too, HappyGirl – that the increased risk is mainly in the fact that they grow faster and therefore are often deeper when “caught” that superficial spreading M’s. Good question though!
~Wendy
Yes, that is true with all of these different types of melanoma, it depends on when they are caught and not what type they are. I had a modular melanoma diagnosed in 2009. It was 1.05mm and Clark level 4. I spent a lot of time reading blogs and forums and worrying myself rigid. I had nodular, the worst type. I had Clark level 4 , nearly the deepest! Always seeking someone who had had similar to me, seeking a good outcome and good news. Unfortunately those who have good outcomes don’t tend to post on forums and blogs. So it just led to me reading endless stories of surgery, tests, poor outcomes and worse. And my reason for posting now is that after 5 years I have been discharged and no more check ups needed. Just have to stay vigilant and take sun precautions. It is good to read about good outcomes so I am posting this now. If you are newly diagnosed and worried be reassured that there are many good outcome stories, just not to be found on these melanoma websites and blogs. You will think about it every minute of every day to start with, it fades away and after a few months you will think about it less and less. Then as check ups draw near you might get anxious, but time heals and confidence grows. So get off the websites, live life, enjoy life , don’t put things off , do what you want and try not to think negatively. Stay strong, eat good food and stay out of the sun ! Hopefully you will have a good news story too….
Thank you Karenjane for your story. You make several excellent points, the best one being that you are an example of a positive outcome. 
Thank you so much for your post. I’m coming up on my first post surgery appointment with my surgeon and am feeling anxious already. Thanks for the positive reminders. I can’t tell you how thankful I am for survivors like you sharing with scared newbies like me (although I’m sure you already know because you have been here too.). I pray things continue to go well for you! I’m 2B, Nodular melanoma, Breslow was 4.5. It’s been 1.5 years since the surgery. The info I got from my oncologist was slightly different than what has been posted. He recommended interferon (which I declined) because of the depth “and” what he said was the tendancy of nodular to spread because of their aggressiveness. Spread at the sight and spread (from cells that have already travelled) thru the body.
Yes, my lymph nodes and margins were clear, however, as well all know, it’s a lot of wait and see and if it does come back, it’ll be because some rogue cells will plant themselves somewhere and cause havoc.
I’m sure different oncologists have different opinions on the nodular aspect.
hi Ive been told the same as you -nodular is aggressive for recurrence. I am 3yrs NED but did Interferon. I know it wont increase overall survival but was told it will delay recurrence: my nodular was almost 4mm deep breslow, with mitosis 15 and complete ulceration, so it makes u wonder if interferon maybe helps delay recurrence after all.
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