Malignant melanoma

Posted by joe0818 @joe0818, Mon, Sep 9 5:27am

Hello all, I was recently diagnosed with malignant melanoma. I had 3 moles removed, 2 from my upper right chest, and one from middle lower back. The 2 on my chest are cancer, one is melanoma, and the other has pre cancerous cells. I am having surgery on Sept 20th to remove more skin around the 2 moles on my chest, and the description on the Mayo portal says Excision split thickness skin graft lower extremity, excision full thickness skin graft lower extremity, and flap closure skin/soft tissue defect. I have been looking those descriptions up but reading different answers. I was just curious if anyone else has had these procedures done and what I can expect. I am very nervous about the whole thing.

Hi Joe, welcome to Connect.
This page on Mayo's website describes Mohs Surgery to remove the melanoma https://www.mayoclinic.org/tests-procedures/mohs-surgery/about/pac-20385222
It goes on to explain:
"After all of the cancer has been removed, you and your surgeon can decide on how to repair the wound. Depending on the extent of the operation, this might include:
– Letting the wound heal on its own (healing by second intention)
– Using stitches to close the wound (primary closure)
– Shifting skin from an adjacent area (skin flap) to cover the wound
– Using a skin graft from another part of the body, such as behind the ear, to cover the wound
If the surgical area is extensive or complex, your surgeon may temporarily close your wound and then refer you to another surgeon for reconstructive surgery to repair the wound.

So one of your areas can be repaired using a skin flap and the other 2 require skin grafts. Exactly where they take the skin graft from and the extent of the wound will be something you discuss with your surgeon.

But that's enough from me. Allow me to bring others into the conversation who have had melanoma, like @gingerw @bdpp @rucyrious @grandmar @gaybinator and @danielad. They can speak from first-hand experience.

Joe, keep your questions coming. Did you receive information about what to expect with the surgery?

REPLY

Hi @joe0818 I am Scott and I am sorry to read of your health journey. Recently I had this surgery done on my face. It involved my nose in several places and two locations on my cheek.

It turned out to be a bit more involved than they had first hoped, but that is why they did frozen sections during the surgery to determine how deep to go, how far out, and to go into my cheek as well. I was pleased they did it this way and were able to continue with the additional work all at one time, even if more extensive than first hoped. The follow up pathology reports confirmed the frozen findings.

On my cheek they were able to flap the adjacent skin over the incisions. On my nose they needed to borrow a bit of skin from elsewhere. The only complication (if you can call it that) I had was trouble stopping the post-op bleeding since I am on very large daily of aspirin due to a recent stroke.

Now I'm using a daily smear of a silicon gel to try and keep the scaring as small as possible. But as a GOF (grizzled old f*rt) I am beyond caring a lot about my looks, which weren't all that great to begin with 🙂

Wishing you all good outcomes!

REPLY

Hi @joe0818 Thank you @colleenyoung for tagging me into this conversation. I had malignant melanoma on my right forearm, halfway between wrist and elbow. I had a skin flap surgery because of the large but fairly shallow area, but was never given the option, as the surgeon wouldn't know until he went in and did the actual surgery. It was a MOHS procedure, also. I sport a 32 stitch scar in roughly a horseshoe shape; many people think it is a dogbite scar. The skinflap was uncomfortable, being it was on my arm and there was no excess skin there. The skin had to "stretch" over the course of a month.

It sounds like your doctor did biopsies on both spots on your chest. A few things to discuss with your doctor. Will they also want to consider lymph node surgery with the melanoma? If he wants your thoughts, turn the question back to him and ask, "what would you advise your favorite cousin to do?" Ask what procedure they will be doing, how much of an area are they planning at this point, to involve? Will you be given a local sedation, or complete sedation? [I was given a light sedation, but being a lightweight I went to sleep and started snoring ;))!]

I am glad you went to your doctor and they caught it in time. You will probably be advised to have a skin check every 6 months for the rest of your life. My surgery was December 2008.

Please come back with any more questions/concerns you might have, okay?
Ginger

REPLY
@colleenyoung

Hi Joe, welcome to Connect.
This page on Mayo's website describes Mohs Surgery to remove the melanoma https://www.mayoclinic.org/tests-procedures/mohs-surgery/about/pac-20385222
It goes on to explain:
"After all of the cancer has been removed, you and your surgeon can decide on how to repair the wound. Depending on the extent of the operation, this might include:
– Letting the wound heal on its own (healing by second intention)
– Using stitches to close the wound (primary closure)
– Shifting skin from an adjacent area (skin flap) to cover the wound
– Using a skin graft from another part of the body, such as behind the ear, to cover the wound
If the surgical area is extensive or complex, your surgeon may temporarily close your wound and then refer you to another surgeon for reconstructive surgery to repair the wound.

So one of your areas can be repaired using a skin flap and the other 2 require skin grafts. Exactly where they take the skin graft from and the extent of the wound will be something you discuss with your surgeon.

But that's enough from me. Allow me to bring others into the conversation who have had melanoma, like @gingerw @bdpp @rucyrious @grandmar @gaybinator and @danielad. They can speak from first-hand experience.

Joe, keep your questions coming. Did you receive information about what to expect with the surgery?

Jump to this post

Thank you!!

REPLY
@gingerw

Hi @joe0818 Thank you @colleenyoung for tagging me into this conversation. I had malignant melanoma on my right forearm, halfway between wrist and elbow. I had a skin flap surgery because of the large but fairly shallow area, but was never given the option, as the surgeon wouldn't know until he went in and did the actual surgery. It was a MOHS procedure, also. I sport a 32 stitch scar in roughly a horseshoe shape; many people think it is a dogbite scar. The skinflap was uncomfortable, being it was on my arm and there was no excess skin there. The skin had to "stretch" over the course of a month.

It sounds like your doctor did biopsies on both spots on your chest. A few things to discuss with your doctor. Will they also want to consider lymph node surgery with the melanoma? If he wants your thoughts, turn the question back to him and ask, "what would you advise your favorite cousin to do?" Ask what procedure they will be doing, how much of an area are they planning at this point, to involve? Will you be given a local sedation, or complete sedation? [I was given a light sedation, but being a lightweight I went to sleep and started snoring ;))!]

I am glad you went to your doctor and they caught it in time. You will probably be advised to have a skin check every 6 months for the rest of your life. My surgery was December 2008.

Please come back with any more questions/concerns you might have, okay?
Ginger

Jump to this post

They are doing a sentinel node injection test the day before surgery to see if it has spread to any lymph nodes close to the area the 2 moles were taken from. They said the surgery will be general surgery.

REPLY
@joe0818

They are doing a sentinel node injection test the day before surgery to see if it has spread to any lymph nodes close to the area the 2 moles were taken from. They said the surgery will be general surgery.

Jump to this post

@joe0818 Good for them doing the sentinel node injection. I am sure your dr will discuss this with you prior to the surgery. Did they tell you what stage the biopsied same was?
Ginger

REPLY
@gingerw

@joe0818 Good for them doing the sentinel node injection. I am sure your dr will discuss this with you prior to the surgery. Did they tell you what stage the biopsied same was?
Ginger

Jump to this post

That's why they are doing the surgery, to see how deep it is, then they will know what stage it is. Just from the mole they sliced off, they said it's at least 2.8mm thick. It will. be good to know about the nodes before. And I am having a full body check this Friday, they only did the waist up before. And I will be going to see the dermatologist every 3 months for the rest of my life.

REPLY

@joe0818
Hi Joe!
Welcome! I am sorry to hear about the health issues you are having.
It was suggested I reach out to you about my journey.
My melanoma is not as large as the one you have.
During a pedicure, I found a teeny, tiny dot on my toe.
It was not discolored, raised or oddly shaped.
However, when I showed the doctor, she said that someone my age (60s), does not get new moles on my feet, so, so it was removed.
The surgeon went deep and wide to make sure he got everything.
He gave me a couple of stitches to close the wound.
My brother, on the other hand, had his melanoma on his back.
His surgeon, too, decided to stitch the wound which was quite long and deep..
Now this was many years ago so methods might have changed.
Wishing you the best of luck!
Ronnie (GRANDMAr)

REPLY
@grandmar

@joe0818
Hi Joe!
Welcome! I am sorry to hear about the health issues you are having.
It was suggested I reach out to you about my journey.
My melanoma is not as large as the one you have.
During a pedicure, I found a teeny, tiny dot on my toe.
It was not discolored, raised or oddly shaped.
However, when I showed the doctor, she said that someone my age (60s), does not get new moles on my feet, so, so it was removed.
The surgeon went deep and wide to make sure he got everything.
He gave me a couple of stitches to close the wound.
My brother, on the other hand, had his melanoma on his back.
His surgeon, too, decided to stitch the wound which was quite long and deep..
Now this was many years ago so methods might have changed.
Wishing you the best of luck!
Ronnie (GRANDMAr)

Jump to this post

Thank you for your reply, sorry to hear about your struggles too. I hope you are well. Did you go in the sun a lot with sandals or flip flops, or use tanning beds? My wife is 54 and thinks she's to old to get it.

REPLY
@joe0818

Thank you for your reply, sorry to hear about your struggles too. I hope you are well. Did you go in the sun a lot with sandals or flip flops, or use tanning beds? My wife is 54 and thinks she's to old to get it.

Jump to this post

@joe0818
Thank you!
I go for regular check ups and I am obsessed with checking my own body for anything that is unusual.
My problem is I am full of freckles and all sorts of marks.
Much of the damage comes from when we were children, not what we are doing today.
As a kid, I used to sit in the sun all summer long.
I used baby oil to 'burn', a sun visor and anything else that would help.
No such thing as sunblock or tanning beds those days.
I NEVER went in a tanning bed but I always wore flip flops and sandals in warm weather…..I live in Florida and still do, ALL wear long!
You are NEVER too young or old to get any kind of skin cancer!
I hope your wife gets a body check each year.
I was also told by the surgeon that all areas need to be checked, even the 'unseen, private parts'.
I also have my dentist do a thorough exam and well as my gyn and eye doctor.

Ronnie

REPLY

Once again, I've given too much information, but I offer it as a testament to NEVER GIVE UP:

My husband has Squamous Cell Carcinoma of the Spindle variety. This is just as aggressive as melanoma. He had a kidney transplant in 2012 and the cancer appeared in summer of 2014. SCC is associated with transplants (because of immuno-suppression) and particularly with kidney transplant (they don't know why kidney more than others).

In summer of 2014, he had a small lesion on top of his head and went to the regular dermatologist who scraped it and froze it. This went on for 2-3 months before the doctor sent him to a Mohs surgeon. In the meanwhile, new tumors had appeared in other places on his head. The first trip to the Mohs surgeon was a doozy. When finished, the doctor had me come into the room and stationed a nurse to stand behind me in case I passed out. There were 6-7 separate excisions – the smallest were the size of a quarter and the largest was about 2 1/2 inches in diameter. The dressing was to apply mupirocin and wadded Xeroform, covered by Telfa pads. The incisions required no stitches or grafts. They healed from the outside toward the center.
The tumors continued to come and my husband was having 2-3 removed by Mohs each week. After about 2 months the doctor recognized that it could not be controlled and he arranged a referral to Mayo Jacksonville.

On July 29, 2015 a surgery was done to resect a large portion of his scalp – approx. 5” by 7”. This was accomplished via regular surgery rather than Mohs. It is called a “free flap.” A section of left mid-back tissue was taken for the graft. This was topped with skin shaved from his left thigh which turned out to be the most painful of all. It looked and felt like a road rash, so we jokingly told the story of him wiping out on his Harley on the way to Sturgis. Immediately after the surgery to install the flap, he underwent 8 weeks of radiation. This has left the flap tissue subject to erosions which continue to this day. If he had not had the radiation, the flap would have indeed been a beautiful illustration of the skill of the plastic surgeons at Mayo. But radiation is the gift that keeps on giving, and giving, and giving. He wears a doo-rag in public.

He had one 1 ½” diameter surgery done by a local ENT where a graft was used. It healed well, but since there was nothing to replace the tissue which was taken, there is a depression in that spot.

The cancer spread to major organs, but thankfully in June of 2016 his local doctors met as a tumor board and decided to try Keytruda. As of May of this year, the PET scan was completely clear. It truly is a miracle.

REPLY
@gaybinator

Once again, I've given too much information, but I offer it as a testament to NEVER GIVE UP:

My husband has Squamous Cell Carcinoma of the Spindle variety. This is just as aggressive as melanoma. He had a kidney transplant in 2012 and the cancer appeared in summer of 2014. SCC is associated with transplants (because of immuno-suppression) and particularly with kidney transplant (they don't know why kidney more than others).

In summer of 2014, he had a small lesion on top of his head and went to the regular dermatologist who scraped it and froze it. This went on for 2-3 months before the doctor sent him to a Mohs surgeon. In the meanwhile, new tumors had appeared in other places on his head. The first trip to the Mohs surgeon was a doozy. When finished, the doctor had me come into the room and stationed a nurse to stand behind me in case I passed out. There were 6-7 separate excisions – the smallest were the size of a quarter and the largest was about 2 1/2 inches in diameter. The dressing was to apply mupirocin and wadded Xeroform, covered by Telfa pads. The incisions required no stitches or grafts. They healed from the outside toward the center.
The tumors continued to come and my husband was having 2-3 removed by Mohs each week. After about 2 months the doctor recognized that it could not be controlled and he arranged a referral to Mayo Jacksonville.

On July 29, 2015 a surgery was done to resect a large portion of his scalp – approx. 5” by 7”. This was accomplished via regular surgery rather than Mohs. It is called a “free flap.” A section of left mid-back tissue was taken for the graft. This was topped with skin shaved from his left thigh which turned out to be the most painful of all. It looked and felt like a road rash, so we jokingly told the story of him wiping out on his Harley on the way to Sturgis. Immediately after the surgery to install the flap, he underwent 8 weeks of radiation. This has left the flap tissue subject to erosions which continue to this day. If he had not had the radiation, the flap would have indeed been a beautiful illustration of the skill of the plastic surgeons at Mayo. But radiation is the gift that keeps on giving, and giving, and giving. He wears a doo-rag in public.

He had one 1 ½” diameter surgery done by a local ENT where a graft was used. It healed well, but since there was nothing to replace the tissue which was taken, there is a depression in that spot.

The cancer spread to major organs, but thankfully in June of 2016 his local doctors met as a tumor board and decided to try Keytruda. As of May of this year, the PET scan was completely clear. It truly is a miracle.

Jump to this post

Hi Joe.
Welcome to the group, glad you found us.
Good that others can assist in your questions as my journey starts with primary unknown. No indication on the skin of where it was, suspect the couple of blistering sunburns I had in the 70’s.

An aggressively growing lump in my breast was Melanoma. Mastectomy on September 2018. After the mass was removed (6cm) and identified, started Opdivo. Additional metastases (Mets) presented, Opdivo considered a fail for me. Moved to a Chemo+Keytruda combo, and had good results. My first clear scan came off chemo, remained on Keytruda. Second PET scan, body is clear, but they found 3 brain mets. Meet with neurosurgeon on Tuesday.

Be diligent, it is a nasty cancer!!

Good luck… Barb

REPLY
@bdpp

Hi Joe.
Welcome to the group, glad you found us.
Good that others can assist in your questions as my journey starts with primary unknown. No indication on the skin of where it was, suspect the couple of blistering sunburns I had in the 70’s.

An aggressively growing lump in my breast was Melanoma. Mastectomy on September 2018. After the mass was removed (6cm) and identified, started Opdivo. Additional metastases (Mets) presented, Opdivo considered a fail for me. Moved to a Chemo+Keytruda combo, and had good results. My first clear scan came off chemo, remained on Keytruda. Second PET scan, body is clear, but they found 3 brain mets. Meet with neurosurgeon on Tuesday.

Be diligent, it is a nasty cancer!!

Good luck… Barb

Jump to this post

Hi Barb,
So sorry about your Mets.
Yes, it is nasty!
My brother in law was what Sloan Kettering called a chronic cancer patient.
He began with a Melanoma on his leg.
It was large.
Soon after that he had another.
The surgeon explained that the cancer was a jumping bean.
Once open, it jumps to another site.
In all, he had 5 surgeries.
2 on the leg, 2 on the brain and 1 in the groin.
Sadly, they could not get it due to all the veins, muscles, etc.
Now this was over. 40 years ago.
He went to the Bahamas which was using immunotherapy with success.
He was too far gone.
Now they do have treatments, which the US did not have then.
Prayers…
Ronnie (GRANDMAr)

REPLY

Surgery went well, they said the dermatologist got it all when she first removed the mole. I had about a 6"×2" excision that they were able to stitch shut, so no grafts. They also removed 2 nodes from my armpit to check them for cancer, all the tests came back negative. I go back to the dermatologist in November for my next full body check. Thanks for all the comments and stories, it is greatly appreciated!!!

REPLY
@joe0818

Surgery went well, they said the dermatologist got it all when she first removed the mole. I had about a 6"×2" excision that they were able to stitch shut, so no grafts. They also removed 2 nodes from my armpit to check them for cancer, all the tests came back negative. I go back to the dermatologist in November for my next full body check. Thanks for all the comments and stories, it is greatly appreciated!!!

Jump to this post

@joe0818 Glad to hear the surgery went well for you! There are several remedies to help the scar heal nicely, one that several people suggested to me was Vitamin E. Break open a capsule and use the oil inside on the stitch line to help. It worked for me, not sure if you want to try it? I also used arnica montana, a homeopathic remedy, to assist with any bruising.
Ginger

REPLY
Please login or register to post a reply.