Home Forums Melanoma Diagnosis: Stages I &II scalp wide excision

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  • #20426
    kstoesz
    Participant

    I have been diagnosed with Stage IIb – 1.82 mm (at least) depth, Clarke Level IV, Breslow depth at least 1.82. Biopsy results say “Metastatic Melanoma” and my Dr. calls it a satelite recurrence from a past Insitu (which was removed 2 years ago). It is on my scalp. Are there any of you out there that have gone thru this. I am scheduled for my surgical consult on Friday the 6th and Wide Excision and Sentinel Node Biopsy is hopefully the following week. Anxious about as we wait on final result….any words of advice? I am worried.

    Thank you,

    Kris

    Colorado

    #55214
    Catherine Poole
    Keymaster

    I would recommend you get treatment at a melanoma center of excellence, and you have a plastic surgeon consultation. This is a tricky area for surgery. I’m sure this is a scary time for you and if you can, try doing some relaxation exercises, and meditation. I think Worrywart is from Colorado and possibly can suggest a good treatment center, the University of Colorado comes to mind. Let us know how you are doing.

    #55215
    Worrywart
    Participant

    A satellite from an in situ? What happened? Was it a recurrence that you didn’t notice? Where was your in situ? Who read your first pathology? Sorry for all questions, but whenever I hear in situ that advances I am curious.

    I went here for a couple years, but now I see someone locally, in Colorado Springs.

    http://www.uch.edu/conditions/cancer/melanoma/

    #55216
    kstoesz
    Participant

    It has been 2 weeks since my surgery on my scalp. (Wide excision with skin graft) I also had a SLN removal and it was negative for melanoma. I met with the oncologist 7/30/12 (University of Colorado – Anshutz Cancer) and since this is a recurrence (surgeon says “in-transit) he did not want to STAGE. I am confused about that…and as to why. Everything I read on informative websites says I am at a Stage IIIB. My pathology report says

    “nodule of melanoma (0.6 cm), consistent with metastatic melanoma, present within dermis and subcutaneous tissue. In formalin designated “scalp melanoma,” is a 4.1 x 3.9 x .6 cm scalp tissue with 0.6 x 0.6 cm pink-white nodule elevated less than 0.1 cm above the scalp surface.”

    The oncologist is ordering a PET scan and more blood work in a few weeks. He did educate me about Interferon and did NOT recommend it. I was told that Yervoy would not be an option at this point unless another nodule appears. (since the melanoma was not in my lymph node) He is also sending my pathology of my scalp to have molecular targeting tested to see if the BRAF (V600) gene is present. Dr. R. also gave me a percentage 15% that melanoma could return.

    With all this information, it is still confusing. I am at the “watch and wait” stage and it is not fun.

    @worrywort – Yes it was a satellite from an insitu. I have been going for derm checks every 6 months. The new nodule showed up only about 3 months ago. I have been at teh UCH since my first diagnoses in 2010 with Dr. Robinson. I don’t have my insitu path handy, but I could find it if you want that name.

    Thank you all for your support.

    KStoesz

    Colorado

    #55217
    barb3246
    Participant

    Kris,

    I’m really sorry that you had this recurrance, but I’m so happy that your SNB was negative.

    Hopefully you will never deal with this again!!

    I have had 2 in-situs, so your story is particularly scary to me. Was there anything on your original path that would explain how you could get an in-transit recurrance from an in-situ lesion? How large a margin did they take for the original in-situ WLE?

    Barb

    #55218
    Worrywart
    Participant

    Hello fellow Coloradan –

    Congrats on your clean SNB! I am glad you are done w/ surgery and can start moving fwd, planning next steps.

    What did your satellite look like? I’m always on lookout for recurrence. Was your melanoma narrowly excised due to location? I am curious about your first path report, but don’t worry about digging it up if it’s too much trouble – you have enough to deal with!

    Blessings!

    #55219
    kstoesz
    Participant

    The more I read on this board, the more information I learn. My question to you all is at what point does the cancer get staged? I have my original pathology report as well as the post surgical report. My doctor does not want to “Stage” me as he says that is not as common of a practice anymore. When I compare my original pathology report to what is on the internet and my results of my SLN removal I am at a IIIb. If I put my pathology reports on this forum, will I get some help? I am confused…and worried.

    Thank you,

    Kris

    #55220
    Catherine Poole
    Keymaster

    Go to our resource page to find the link for staging: http://www.melanomainternational.org/melanoma_info/coping.html

    I agree with your doctor, that staging isn’t that important with a clean SLNB. Take care.

    #55221
    Worrywart
    Participant

    Yes, if you post your path report there are many of us that might be able to answer your questions.

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