New Melanoma diagnosis: next test to see if spread to lymph nodes

Posted by birdman518 @birdman518, May 26 5:36am

I just was told yesterday that my biopsy showed that I have stage 2B melanoma on my scalp. I will be calling today to set up an appointment at Moffitt Cancer center in Tampa (which is only about 45 minutes from me).

I was told that they will do a "dye" test (?) that will attempt to determine if it has moved into my lymph nodes or not. The biopsy showed (somehow) that the cells were actively dividing, thus indicating some urgency. If it has not, the site will be excised and some type of followups will be ordered. Not clear yet exactly, as all is a little hard to absorb.

I appreciate these forums and the people who share their stories!

MItch

@birdman518, sorry to hear that you now have a new diagnosis to add to neuropathy and related issues. I'm bringing in members like @grandmar @sherilewis @gingerw who can share their melanoma experiences with you. @mlenney167 also just joined the forum and is caring for someone with melanoma.

It sounds like you're going to have a sentinel node biopsy. This article from Mayo Clinic includes a video that helps explain how it works
https://www.mayoclinic.org/tests-procedures/sentinel-node-biopsy/multimedia/sentinel-node-biopsy/vid-20084727
It is a lot to absorb. Keep asking questions: here and to your medical team. How was the melanoma on your scalp detected?

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@colleenyoung

@birdman518, sorry to hear that you now have a new diagnosis to add to neuropathy and related issues. I'm bringing in members like @grandmar @sherilewis @gingerw who can share their melanoma experiences with you. @mlenney167 also just joined the forum and is caring for someone with melanoma.

It sounds like you're going to have a sentinel node biopsy. This article from Mayo Clinic includes a video that helps explain how it works
https://www.mayoclinic.org/tests-procedures/sentinel-node-biopsy/multimedia/sentinel-node-biopsy/vid-20084727
It is a lot to absorb. Keep asking questions: here and to your medical team. How was the melanoma on your scalp detected?

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Thank you! I got the diagnosis Tues at 1pm and had my neuro tests done the same day at 3pm. I have not had time to digest the latter.

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Hi Mitch,
I am so sorry for your diagnosis. You picked a great hospital to get treatment!
I live in Florida and went to Moffitt when I was diagnosed with lung cancer.
I was so impressed with my treatment, that I also decided to go there for the dermatologist.
I was diagnosed with melanoma several years ago, on my big toe.
I found a teeny, tiny spot on my big toe during a pedicure.
I pointed out during my yearly skin check.
I was told that when you reach a certain age, new spots in certain areas was not normal.
The doctor took a biopsy and it came back positive for melanoma.
She sent me to a doctor at Advent in Orlando for the surgery.
They got it all.
Other than getting check every 4 months for the first couple of years and now every 6 months, no other treatment has been needed.

I also hear you have neuropathy. Me too!
I have spine issues and nerve damage probably because I waited so long to have the issues surgically taken care of.
I have no feeling or movement in one toe (coincidentally the toe that had the Melanoma) and all my toes on both feet are starting to get numb.
In addition, my right ankle has become difficult to flex.
I spoke with my neurosurgeon the last time I saw him and he suggested I see the neurologist.
I don't like the one I previously used so I am looking for a new one.
I did find one near my home who has fantastic reviews and credentials, but I HATE the place he is associated with.
But I think I will give it a try anyway.

If I can be of any help, please let me know!
Ronnie
(grandmaR)

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I had a similar finding on. my scalp…after a number of conflicting opinions on the biopsy they determined it was a stage 1a melanoma however it seemed to be slow growing with no ulceration…moffit did not plan to do a sentinel lymph node test, but due to the fact i previously had another mole(biopsy was benign) in that area they wanted to do a fairly large excision with sufficient margins…what I learned however was that moffit surgeons will typically do a wide excision that requires a skin graft to close….leaving an indentation…I did some extensive additional research, consulting with some other doctors with recognized expertise in melanoma who felt they could do a wide excision with appropriate margins that could be closed with stitches…their consensus was that the moffit approach(they are a surgical center) was very conservative, and in my case possibly not necessary…..the key apparently is to be able to get the acceptable margins to be sure tissue is clear of any remaining cancer cells. its was a tough decision because for sure moffit has a very high reputation in this field..but my doctor was confident they could achieve the necessary margins without the need to graft my scalp. has been three years with no additional issues…I go to the dermatologist ever three months for a full body check up…good luck and I hope it works out for you

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We met the surgeon today at Moffitt and did all of the pre-op things. Surgery is scheduled for June 18th. We indicated that we would be ready sooner if a slot came up. We take it that they are very busy but we can't say enough about the efficiency and kindness of all the people we've met.

On the day of the surgery, before the surgery, the "dye" will be injected at the site of the tumor, in the nuclear medicine suite. The surgeon will then take out a piece about the sized of a half-dollar around the tumor and then any lymph nodes that are indicated by the trail of "dye". If we are lucky, there will be none. Any that are extracted will be sent to the pathology lab and we will get the results in about a week.

They really didn't want to talk about anything beyond this immediate process. No other treatments were mentioned (chemo, radiation, drugs) at this time, just lifelong check-ups every 3-4 months. No "next steps" until we know what "this step" is was their message today.

Thanks to all for sharing their stories. I feel like I am lucky to be able to go to Moffitt, and to be only about 45 minutes away.

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@herbert1

I had a similar finding on. my scalp…after a number of conflicting opinions on the biopsy they determined it was a stage 1a melanoma however it seemed to be slow growing with no ulceration…moffit did not plan to do a sentinel lymph node test, but due to the fact i previously had another mole(biopsy was benign) in that area they wanted to do a fairly large excision with sufficient margins…what I learned however was that moffit surgeons will typically do a wide excision that requires a skin graft to close….leaving an indentation…I did some extensive additional research, consulting with some other doctors with recognized expertise in melanoma who felt they could do a wide excision with appropriate margins that could be closed with stitches…their consensus was that the moffit approach(they are a surgical center) was very conservative, and in my case possibly not necessary…..the key apparently is to be able to get the acceptable margins to be sure tissue is clear of any remaining cancer cells. its was a tough decision because for sure moffit has a very high reputation in this field..but my doctor was confident they could achieve the necessary margins without the need to graft my scalp. has been three years with no additional issues…I go to the dermatologist ever three months for a full body check up…good luck and I hope it works out for you

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I was told that a skin graft would only be done if necessary and that the 1st choice is to not do one. So at this point I feel like I have to trust my surgeon.

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did they indicate to you how they will close the incision…..skin graft or stitches?

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@birdman518

I was told that a skin graft would only be done if necessary and that the 1st choice is to not do one. So at this point I feel like I have to trust my surgeon.

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they are one of the most respected institutions in the country….so if they can, am sure they will try the least impact approach…..good luck and hopefully it's just regular derm visits going forward..

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@herbert1

did they indicate to you how they will close the incision…..skin graft or stitches?

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1st choice is stitches ("glue")… 2nd is skin graft

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@birdman518 Mitch, I had melanoma surgery on my right forearm on 12/31/2008. It was amelanotic, meaning non-colored, and 3 different medical professionals discounted it as "nothing to worry about" before I was able to get it biopsied. By then it was 4"x2", and required 32 stitches to close, in a horseshoe pattern! My surgeon asked me about sentinel node procedure. I asked him what he would advise his sister/aunt if they were in the same situation. I had no follow-up, no chemo/radiation. All these years later there is still a full-body check every six months. I have had subsequent squamous cell and anodular basal cell cancer surgeries also.

I wish you every good outcome!
Ginger

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@gingerw

@birdman518 Mitch, I had melanoma surgery on my right forearm on 12/31/2008. It was amelanotic, meaning non-colored, and 3 different medical professionals discounted it as "nothing to worry about" before I was able to get it biopsied. By then it was 4"x2", and required 32 stitches to close, in a horseshoe pattern! My surgeon asked me about sentinel node procedure. I asked him what he would advise his sister/aunt if they were in the same situation. I had no follow-up, no chemo/radiation. All these years later there is still a full-body check every six months. I have had subsequent squamous cell and anodular basal cell cancer surgeries also.

I wish you every good outcome!
Ginger

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Thank you, Ginger! FWIW mine is already listed as stage 2b melanoma. The total area to be cut out is about the size of a quarter, but since it is on my scalp, there is not a lot of skin to work with. It sounds weird but I feel more bummed out about having to deal with the surgical wound than the melanoma!

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@birdman518

Thank you, Ginger! FWIW mine is already listed as stage 2b melanoma. The total area to be cut out is about the size of a quarter, but since it is on my scalp, there is not a lot of skin to work with. It sounds weird but I feel more bummed out about having to deal with the surgical wound than the melanoma!

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@birdman518 They might use a cadaver skin transplant. Ask them! If the wound is in a place where you cannot see it easily yourself, ask a family member or good friend to help you. You need to be sureit is taken care of! Since mine was on my right forearm, I was lucky to be left-handed. But still needed help to change things out. I was single and lived alone, but had a good friend to assist me. p.s. Mine was stage 2b, also.
Ginger

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