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December 26, 2013 at 11:18 pm #21722
I was hoping you may have some advice please.
My wife is 28 years old, had a malignant melanoma removed from her neck 3 years ago. 1mm in depth, Clarks level 3, was in the vertical growth phase and had a high mitotic rate of 11/mm2. She had a negative sentinel node biopsy and was deemed stage 1b.
We go back and forth to a hospital in Tennessee each year as we trust the surgical oncologist there.
Anyway, his assistant/nurse practitioner who gives my wife the physical each year told us there is a 50% lifetime risk chance of recurrence due to the high mitotic rate.
Does such a high percentage sound right for a lesion of only 1mm in depth?
We had thought and hoped my wife may be more in the 15 to 20% range for a risk of recurrence.
Also, does your percentage risk go down as the years progress? My wife is now 3 years out.
Also, my understanding is mitotic rate tells us how fast the tumor was growing? If this is the case, why is mitotic rate still deemed so important if the melanoma was caught quickly before it could grow to a more substantial depth?
Finally, based on the features of the melanoma above, would it be deemed a huge risk for my wife to try and start a family and have a kid/get pregnant?
Thanks for everything
JohnDecember 27, 2013 at 12:11 am #63264Catherine PooleKeymaster
I would ask the nurse practitioner where she saw that statistic. I’ve not seen it in relationship to mitotic rate, I also would want another pathologist to look at the slides, but that may be too late. Where do you go in Tennesee? Nashville has two excellent places if that isn’t too far, Vanderbilt and Sarah Cannon. I’ve seen the 50% chance for recur with a stage III melanoma and positive node but not in relation to mitosis.
So having a baby should not impact the recurrence rate. There is no proven hormonal connection in getting melanoma. You just don’t want a recur when you are pregnant. I think you should get another opinion and/or wait just a bit longer. Two years is the average time for recurrence and your wife has surpassed that. But I don’t think you are getting her check ups at a place of melanoma excellence, unless it is one of the above I mentioned.
So tell us a little more..December 27, 2013 at 12:30 am #63265
We go to Vanderbilt. We felt really comfortable with the surgical oncologist there who worked on my wife but now we don’t see him as we now just get to see his assistant for the yearly check up.
Any tips or advice on this?
For a yearly check up, do you feel we should be seeing someone else?
We still do derm appointments every 3 months too with our local derm.
JohnDecember 27, 2013 at 12:41 pm #63266Catherine PooleKeymaster
I would contact the surgical oncologist and get his/her opinion on what the nurse told you. And I would ask the opinion on pregnancy and whether you should wait or go forward. Talk to your local derm too. I think you are on the upside of this diagnosis, but there are never any guarantees unfortunately. Let us know what you find out.December 27, 2013 at 6:27 pm #63267 Ok thanks Catherine
We shall do this
JohnDecember 29, 2013 at 1:03 pm #63268WorrywartParticipant
I remember you, has it already been 3 years?? Wow, time flies. I am glad your wife has been well.
I agree that you should call the oncologist and ask his opinion on recurrence stats due to the high mitotic rate, and to ask if pregnancy could potentially increase risks of recurrence. I know I’ve read over and over again on his forum that pregnancy/hormones and melanoma are not related – however I developed my melanoma during a pregnancy and I know several others did too. I also grew new nevi at a rapid rate during pregnancy. Please let us know what the oncologist says and I wish you both a Happy Healthy New Year!
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