Malignant melanoma: need to scan?

Tough call for me, because your dermatologist is making the call every six months. My first thought is a second opinion from another doctor. Give that some thought and don't be concerned about the reaction of your dermatologist when you do. He's accustomed to being reviewed when a patient gets anxious about a condition.

Welcome @texas7777.
I'm going to bring @lynnkay1956 and @cynaburst into this conversation. They both have had melanoma (different stages) and may be able to give some insight on follow-up tests and second opinions.

In the meantime, here is some information about follow-up from the American Cancer Society http://www.cancer.org/cancer/skincancer-melanoma/detailedguide/melanoma-skin-cancer-after-follow-up which states "A typical follow-up schedule for people with early-stage melanomas that were removed completely generally calls for physical exams every 6 to 12 months for several years. If these exams are normal, the time between your doctor visits may be extended. Your doctor may recommend more frequent exams if you have many moles or atypical moles. ... Imaging tests such as chest x-rays or CT scans might be done as well, especially for people who had more advanced stage disease."

Texas, do you also do regular self-exams to check for any new lumps, moles or changes to your skin?

You don't say what stage your original melanoma was. Did you have a wide excision, or did your initial biopsy state the margins were clear? I have had two early melanomas - Stage 0, which is considered in situ, and Stage 1A. With both of them I had biopsies and later wide excisions, and with the Stage 1A I also had a sentinel node biopsy, though I know that was only because my oncologist was nervous and not because the depth of my lesion warranted it.

As for follow up I now see my dermatologist every 3 months, but after 1 I saw her every 6 months. She does a visual inspection as well, but we take pictures once a year and they have a computer program at her office that compares the images and looks for changes in any of my moles. The key is to spot any moles that have changed or which look different from the others. I am also supposed to see my surgical oncologist yearly (I did for the first couple of years but an a year or so behind now). He does a chest x-ray and looks over any lesions I am concerned about, and that is it. I think CT scans are for those who had more advanced disease. My first melanoma was on my arm below my left shoulder and the second one was on the middle of my back.

There are some internet communities out there for people with melanoma that are helpful, although many are for those with more advanced melanoma, and they can be pretty scary for someone who had early melanoma which is treatable only by excision.

http://www.MPIP.org is a very good site I have found to be helpful.

I hope that helps you somewhat. Feel free to ask more questions.

I guess it was stage 1. He removed a small mole on my right flank and had it analyzed. I then went back & he removed about a 2" long chunk. Injections on your flank are not fun! Was then told "margins clear", not much else. He said to come back yearly, but I go back every 6 months.

I think I may try to find a more thorough dermatologist. I have wondered, but not talked to him, about taking pictures in his office each time for comparison; I like that idea of using a computer program to do the comparison. I also like the idea of dermatoscopy; something more than just a "look-over." To many stories of folks who had caught melanoma's early, only to find out a few yr later that it's spread/gone deep. I just don't want my life to rely on 1 man.

Just today, I visited my general pract. about other issues (on another discussion board); PVC's, light headedness (really affecting my driving), tired (on top of stress with toddlers, remodel, & wk), ringing in my ears, shortness of breath, etc... and we discussed a CT of the brain and chest. He warned me against that much radiation at once. I may decide to do a brain CT, but I'll wait till I see a neurologist. Fun stuff... You know the worst thing about getting old... Getting old!
Thanks for your time.
Travis

I also had a brain tumor several years ago, and I have to have follow up scans every so often. Having just been through this process, I know that MRIs are much more likely to find something like that in the head, and they avoid radiation. Why wouldn't you have an MRI of the brain and not a CT?

@texas7777, just on the point about having head and chest CT, my urologist wanted me to have a CT around my kidney, and when I asked about the radiation, he promptly changed to an MRI. That did the trick, although My MRI shop would not do a general abdominal MRI including my bladder and prostate, so I had to have a second MRI -- this one at another facility. They wouldn't do an abdominal either, just pelvis (including my prostate). No biggie; two MRIs are only inconvenient for me in that I had to drive 35 miles round trip to get them. Would you consider an MRI?

Due to my ignorance of all of this (I'm learning fast now!), I suggested a CT because I didn't know any better. He didn't persuade me into an MRI though. Just warned me about the neg. effects of a CT. From only a few minutes of research today, its said that CT is better to detect cancer (if needed later, maybe use that on my chest area?) and an MRI is better for tumors.

I was thinking that my PVC's are causing all of my symptoms, but my general prac. thinks otherwise. Might be an underlying cause due to the light-headedness, ringing in my ears, reduction in eyesight (in my good eye!), 40% energy some days, etc... He referred me to a neurologist here in San Angelo. I guess I'll wait to see what he says but may go ahead and travel to Mayo to get everything checked out.

What were your symptoms with your brain tumor? I don't have any bad headaches, but have other issues as stated. My mom passed away at 49 with a brain aneurysm; bad headaches for 6 months and then it just happened all at once.

Can't believe I'm telling all this to strangers, but this is a great discussion group. REALLY helps as I press forward & try to find the right people to put together the right game plan.

I had a tumor in auditory canal called Acoustic Neuroma. I lost most of my hearing in one ear, had terrible ringing and fullness in the ear, and horrible headaches.

I would highly recommend a trip to Mayo to get all checked out if you can do it. I went to Mayo for a heart condition that I have as well and it is an amazing place. They are terrific there. And it seems like your doc is sort of shooting in the dark if you are the one giving him suggestions for testing.

I think I will go ahead & head to a Mayo clinic unless I can find specialists that I need in Dallas or San Antonio (I have places to stay in both cities & can drive there). My general Dr. is mainly used as a hub and a place to get referrals! Pretty much goes for any general I've ever had. I'm guessing Mayo could do multiple back-to-back office visits while there? I'll call and start the conversation. I'd have a dermotol. check out moles, neurologist run an MIR of brain (or I'd get that done beforehand), and a electophysiol. go through all the tests I've already had for my PVC's, etc... Even if it was a 3-4 day trip, it would be worth it for a piece of mind.

Texan777 Here are the contact numbers for Mayo Clinic at all 3 campuses: Minnesota, Florida and Arizona http://mayocl.in/1mtmR63 They will help plan your visit to make it as efficient as possible with testing and doctor consults.