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Bron
New User
Joined: 28 Sep 2009
Posts: 4
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 Posted: Mon Sep 28, 2009 3:46 pm Post subject: New to the forum |
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Hi,
I was diagnosed with Melanoma Stage II ? a few weeks back. Since, I have had it removed from the back of my head which included 14 staples and a few days of rest. I was hoping someone can clear something up for me. I have an appt tomorrow to for the results of my blood check and chest xray and am feeling pretty confident since what I found on the internet today. I was told that the cancer was .4 mm in depth but was also told by the nurse that it was in stage II. From what I understood today it would have to be a 1.0 mm in depth to be considered a stage II. Can someone please clear this up for me. |
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brainman
Site Admin
Joined: 13 Oct 2005
Posts: 5972
Location: Tennessee
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HaoleBoy
Senior User
Joined: 19 Aug 2008
Posts: 130
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| Posted: Mon Sep 28, 2009 11:56 pm Post subject: Re: New to the forum |
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Bron, Stage is determined by a combination of the tumor's penentration into the skin (i.e. Breslow depth), whether ulceration is present or not, the status of the regional lymph nodes (which has a variety of sub-criteria), and whether or not there is "distant metastatic spread" beyond the regional lymph nodes to an organ, distant lymph nodes, or distant areas of the skin -- the latter is not to be confused with a 2nd occurrence of melanoma as in a 2nd primary tumor...You will see this expressed on a melanoma staging chart as TNM where T = tumor thickness (as expressed in Breslow depth), N = status of the regional lymph nodes; M = metastasis
If your tumor was .4mm thick (Breslow), then the T = 1 ( .99mm and less)... You likely did not have a Sentinel Lymph Node given that your tumor was thin (a good thing)....and I presume there was no clinical evidence (upon palpation) of any regional lymph node metastasis so N = 0 (almost assuredly).....You didn't mention if your primary tumor was ulcerated or not (this would be on the initial biopsy report)... If it was ulcerated, then you are Stage IB, which is still a good place to be...
I believe someone is confusing Clark's Level with Stage -- a common occurrence.... Clark's Level was a standard grading criteria invented by Dr Clark in the early 70s which attempted to set universal criteria for grading and classifying melanoma tumors based on whether the tumor was confined to the epidermis (Clark's Level 1); penetrated to the epidermal/reticular dermis junction (Clark's Level 2), the upper reticular dermis (Clark's Level 3), or the lower reticular dermis (Clark's Level 4), or the subcutaneous fatty/muscle layer (Clark's Level 5)..... the deeper the tumor penetrated (especially Clark's Level 4 and 5), the greater the possibility that the tumor had metastasized due to the existence of the lymphatic and vascular networks in the lower reticular and subcutaneous regions ....
In any event, Clark's Level is not used much these days except for differentiating "thin" melanomas less than 1mm in thickness for staging classification between Stage IA and IB. The forthcoming American Joint Cancer Committee's new Staging Guidelines for Melanoma, due out in early 2010, will throw it out completely as a differential is staging "thin" melanomas, and will use the mitotic rate (the measurement of mitosis/mitoses) -- rate of malignant cell division -- in classifying Stage IA (no mitosis observed), or Stage IB (1 mitosis or more per power of magnification present as seen under a microscope)....
Bottom line is that you are NOT Stage II.... You are most likely Stage IB under the current staging system, and if no mitoses were present in your tumor, you may be "demoted" to Stage IA (which is GREAT) in the forthcoming Staging Classification system.... Again, this assumes that your primary tumor was NOT ulcerated.... If it was ulcerated, then you are Stage IB regardless of which staging system (current versus the next one)....
You have a VERY GOOD prognosis in any event.... localized, potentially curable melanoma and the recurrence risk for you at Stage IB within the next 10 years is less than 20%... and it gets better for you the further out in time you go from your initial diagnosis without a recurrence ....
CONGRATS, 
Haole Boy (aka Hawaii Bob)
Stage IIA |
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Bron
New User
Joined: 28 Sep 2009
Posts: 4
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| Posted: Tue Sep 29, 2009 7:16 am Post subject: Re: New to the forum |
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It is nonulcerated and has not been found in any of my lymph nodes. They did not do a biopsy on them however. He just felt the ones in my neck, armpits, and groin area. He said they felt fine and there was no need to do a biopsy. The mole that it was found in was about the size of a nickel. But the cancer was just a about 1/3 of that. They did not inform me of the clark level.
Thank you for the repsonse, I found out today the final details of the extent of the cancer. I will keep you guys informed. |
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Bron
New User
Joined: 28 Sep 2009
Posts: 4
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| Posted: Wed Sep 30, 2009 10:05 am Post subject: Re: New to the forum |
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| Results came back and I am free of cancer. This is wonderful news. I just wanted to keep you guys updated. |
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brainman
Site Admin
Joined: 13 Oct 2005
Posts: 5972
Location: Tennessee
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