Home Forums Melanoma: Newly Diagnosed – Stages I & II The Waiting Is The Hardest Part

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  • #22345
    winterlong
    Participant

    Hello everyone,

    I’m new, and unstaged as yet.

    I’ve been in to our cancer hospital in Melbourne Australia called Peter Mac (Macallum)

    I had a referral from a skin cancer clinic here.

    The doctor there said I needed to have the lesion removed in hospital.

    The dermatologists (started with one, ended up with a small posse..:-D) all think it is melanoma.

    They tried to squeeze me in for an excision today, but time ran out.

    Either this Thursday or next they said,

    and then the long wait for pathology report.

    I’m hoping it’s only on the surface.

    I asked the medical photographer if you can tell by looking, and he said no.

    Do any of you think you can tell?

    My lesion is on my upper back, and looks like a turtle. It has all the classic signs you look for, and most of it is raised up and very dark. it’s just on one centimeter, but that’s not thickness or anything, just the surface.

    I’ll keep you all posted, and have been reading your stories the last week or so.

    So sorry you all have this diagnosis.

    winterlong.

    #66266
    Catherine Poole
    Keymaster

    Welcome Winterlong,

    Hey, you are enjoying summer there, correct? You can’t tell a lesion’s depth until it is excised and looked at under a microscope. So that is what the photographer is telling you. Over 1.0, they may want to do a sentinel node biopsy. But yes, the waiting is really hard, we’ve all been through it. We are here to support you!

    #66267
    winterlong
    Participant

    Thankyou so much Catherine.

    You are an inspiration.

    It was a comfort to know I can come here and share with others if I need to.

    #66268
    winterlong
    Participant

    Just checking in this morning here. :)

    My lesion, (I’ve decided to call it the dark Prince Turtle…) is as yet untouched, and

    I am waiting for excision of it.

    On the positive side,

    my house is now super clean. :D :D

    #66269
    Catherine Poole
    Keymaster

    Cleaning can give you that sense of calm, I guess.. I do it when I’m mad! Sorry this is such a long wait for you. Can you be a squeaky wheel and get it pushed up?

    #66270
    winterlong
    Participant

    Funny you should say that Catherine..

    The surgeon who did some breast reconstruction for me there (Peter Mac, and yeah..that’s a story for another day. ;) )_

    Is also a melanoma surgeon in the onco surgical dept.

    I emailed my concerns to him, and he said he’ll try and get me in this week.

    Here’s hoping.

    It feels great that he cares enough to try. Not great that so many are waiting like me. I feel for everyone going through this.

    #66271
    Catherine Poole
    Keymaster

    Any news?

    #66272
    winterlong
    Participant

    No news unfortunately Catherine.

    I did not hear back from the surgeon.

    I did not want to push, but sent a quick ‘any news’ text on Thurs 12th, but no reply.

    Oh well..I’m booked in for Mon 23rd here, so I guess that is it.

    Thanks for asking. :)

    #66273
    winterlong
    Participant

    Prince the dark turtle was finally excised today.

    Interestingly,

    the young registrar excising it said,

    hmmm..

    it has some characteristics of melanoma..

    the asymmetry, and blue veil

    but, it is raised, and not as large as you might expect from an ssm

    Goodness, maybe it won’t be malignant after all?

    I thought ssm’s could be raised though??

    makes me think they should not tell you what they think it is, or look at you like it’s a bad situation. 😆

    I’m sure I’m not the 1st person who’s been told different things about their lesion eh? :)

    I asked if it was not melanoma, what else did he think it could be.

    He said..maybe intradermal nevus.

    Well, I don’t feel quite so worried now. it might be nothing!

    #66274
    winterlong
    Participant

    Hmmm,

    I just google intradermal nevus, and looked at images..

    My lesion looks nothing like those pictures.

    Right, time to get stuck in to some fun projects for a week or so. :)

    #66275
    Catherine Poole
    Keymaster

    NO ONE can tell what a lesion is until it is looked at under the microscope by a pathologist (preferably a dermatopathologist) so this person should not be throwing out guesses. When do you get the pathology report?

    #66276
    winterlong
    Participant

    About a week to wait Catherine.

    Stitches out in 12 days, but nurse said someone will call me as soon as results are in.

    #66277
    winterlong
    Participant

    Update.

    Just spoke with skin cancer nurse at Peter Mac.

    She says it is melanoma, but they’ve caught it early.

    I will need wider margins around the wound she says, but they will discuss this on Friday when I get my stitches removed.

    I think I am very lucky, and glad I acted when I did. :)

    #66278
    Catherine Poole
    Keymaster

    Good news! Be sure to get a copy of the pathology report and we can go over it if you like. Hope you are feeling relieved.

    #66279
    winterlong
    Participant

    Hi all,

    Catherine, thank you so much for holding my hand through all of this.

    I saw the dermatologist, and one of the Chiefs of melanoma unit at the hospital today.

    The Chief looked at the wound, which is still healing. and assured me that after a further 5mm margin is removed around the original lesion site, I’ll be good to go. :)

    The Dermatologist told me he was so glad I got it removed when I did, and so am I.

    I’ve read my share of Path reports for Breast cancer, but i am new to melanoma, and happy for any shared comments.

    What I do know, is that this looks to be the best cancer dx I ever had!!! :D :D

    In Situ! phew.

    I’m not sure what my dad had originally, but I reckon it might have been at least a Stage 1 or 2, and probably not enough follow through checks after. I’ll try to find out.

    HISTOPATHOLOGY REPORT

    REQUEST DETAILS

    E/O lesion midline upper back stitch superior.

    MACROSCOPIC DESCRIPTION

    “Midline upper back stitch superior”. A skin ellipse 25x14x8mm with a suture in one apex designated 12 0’clock. There is a flat tan variegated lesion with ill-defined borders, 9x8mm, 2mm from the 9 0’clock margin. Margins marked, 3 0’clock blue, 9 0’clock black. 1.1: 12 0’clock margin LSx1 and adjacent TSx2, 1.2: 6 0’clock margin LSx1 and adjacent TSx2. P2. (lesion in toto). (rf/ms)

    MICROSCOPIC DESCRIPTION

    Sections show mild to moderately damaged skin with subcutis. There is an asymmetric proliferation of melanocytes with junctional and dermal components. The junctional melanocytes show some nucleomegaly, angulated nuclear contours and hyperchromasia. They form nests at the end of elongated rete. They also show confluent lentigenous spread and multifocal suprabasal spread. Suprabasal spread is not associated with features of irritation. This is consistent with in situ melanoma. The dermal component is composed of nests of small maturing melanocytes in the papillary dermis. Mitoses are not seen. There is an associated infiltrate of small lymphocytes and melanophages. SOX 10 immunostains confirms the extent of both melanocytic components. HMB45 is negative in the dermal component which has a Ki67 index of <5%. In situ melanoma is 1.5mm from the (nearest) peripheral margin. The dermal component is clear of the margins. There is no evidence of invasive malignancy in 3 levels.

    DIAGNOSIS

    Midline upper back – In situ melanoma (superficial spreading type, Clark level 1) 1.5mm from nearest peripheral margin, arising in a dysplastic compound naevus.

    So, with my basic knowledge, it seems,

    it is all contained with good margins, but if left unchecked would have migrated?

    mitosis not seen….so it is not in the process of proliferation? (awesome!)

    thin, thin, thin ..clark level 1? :)

    They also show confluent lentigenous spread and multifocal suprabasal spread. Suprabasal spread is not associated with features of irritation.

    say what now?? :D

    A question, and honest answer please..

    Have you know anyone to recur from an insitu dx?

    The dermatologist said that’s why they recheck the area every few months for awhile.

    I find it confusing that they say you’ll be cured…but just in case! (hmmmm)

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