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Thread: Recent Surgery for Melanoma

  1. #1
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    Recent Surgery for Melanoma

    Hello,

    My name is Vince and I had been looking for support forums for melanoma. I had a mole that was biopsied last November and that came back positive for melanoma. I had surgery last month (in December) to remove a margin around the site as well a sentinel lymph node removal using a radioactive dye. The pathology on the lymph node came back negative which was a big relief.

    The melanoma was located in my groin which I can pretty much guarantee has never been exposed to any sun, but admittedly I have not protected the rest of my body and had more burning sunburns than I can remember. I can also remember always having a birthmark at that location and in my teen years it started changing into something that looks more like what we would consider a mole. Over the years since then (I'm 56 now), it continued to change. I had it looked at during a physical in 2005 but my doctor at the time thought it was just a large skin tag. During my physical this past year, my wife was pretty insistent that I get it looked at again, and as fate would have it she actually works for my personal physician and she made sure he checked it. He became rather alarmed by what he saw and referred me to a dermatologist who did the biopsy. When it tested positive, they referred me to a local hospital and the surgical oncology group who did the procedure. I also had to had some reconstructive work done as I had quite a noticeable section of that area removed.

    So in discussing what to expect in the future, my surgeon mentioned I will have an increased risk of a recurrence so I will continue seeing him every 3 months. My dermatologist also will be seeing me every 3 months as well. I am not fair skinned or fair haired (I'm of Italian descent) but when it comes to moles, I must have over 100 of them all over. I can see the need for frequent visits to the dermatologist now.

    I'm glad I found these forums because I know very little about cancer in general and even less about skin cancer. I had initially thought that I would have the surgery, and if it the pathology was good, that would be the end of it. I see now that isn't exactly the case and I feel like it's important for me now to learn more about this type of cancer.

    Thanks for listening!
    Vince

  2. #2
    Administrator Top User Kermica's Avatar
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    Hi Vince, and welcome to the place no one wants to be but many come to value. I am glad to hear that your melanoma was removed with clean margins. Do you happen to know how many millimeters deep that had to go to accomplish that?

    I am not sure why you would need to see the surgeon every three months if you are seeing a qualified dermatologist on the same schedule. I have had two skin cancers (though not Mel) and see my guy every six months at this point (used to be more frequently but schedules relax a bit as time goes by). If I have a suspicious lesion, he removes it for pathological exam or freezes it off if less suspicious. I am sure he would refer me to a surgeon if one was needed by circumstance.

    We see plenty of doctors along this journey but I am not sure why you would need to see two of them for the same preventive activity. Ask your GP his opinion about the necessity of the current plan. Good luck with everything.

    Good health,

    kermica
    When the world says, "Give up," Hope whispers, "Try it one more time."
    ~Author Unknown

    Age 67
    Follicular lymphoma diagnosed August 08, Stage 1
    2 cycles (20 treatments each) localized radiation to tumor sites. Remission confirmed July 09
    Restaged to Stage 3 May 2010
    Recurrence confirmed May 2010 - Watch and Wait commenced - multiple scans with minimal progression.
    Cutaneous Squamous Cell Carcinoma diagnosed September 2012. Mohs surgical excision 09/2012. Successful, clean edges all around.
    Significant progression detected in PET scan - December 2012
    Biopsy to check for transformation 1/18/2013 - negative for that but full of lymphoma, of course.
    July 2013 - Rescan due to progression shows one tumor (among many) very suspect for transformation, another biopsy 8/12/13.
    August 2013 - No evidence of transformation, 6 courses of B+R commence 8/29 due to "extensive, systemic disease".
    February 2014 - Diagnostic PET scan states: Negative PET scan. Previous noted hypermetabolic cervical, axillary, iliac and inguinal lymphadenopathy has resolved. Doctor confirms full remission.
    June 2014 - started 2 year maintenance Rituxan, 1 infusion every 3 months. Doctor confirms lump under right arm are "suspicious" for recurrent disease, deferring scans for now.
    February 2015 - Doc and I agreed to stop R maintenance as it is depressing my immune system too much.
    June 2015 - Confirm that the beast is back by physical exam, will scan in August after esophageal issues settle down so we can get a clear view.
    August 2015 - physical exam in error, PET/CT shows no evidence of disease. Remission continues well into second year!
    December 2015 - Cardiologist tells me I have plaque buildup growing at an alarming rate. Stent or bypass down the road but not yet...
    March 2016 - new tumor below the jaw so remission is over. Back to active surveillance until treatment is needed.
    June 2016 - C/T scan indicates presence of multiple lesions in iliac chain.
    August 2016 - PET/CT shows multiple areas of lymphoma as expected plus new areas of concern in bowel.
    January 2017 - C/T scan shows significant progression in cervical and inguinal lymph chains, largest tumor is impacting hearing, measures 2.1x4.6 cm. 4 to 8 cycles of R-CVP, 1x3weeks to commence 2/6/17.
    April 2017 - Mid treatment scan shows about 1/3 reduction in multiple tumors. Also shows abdominal aortic aneurysm with peripheral thrombus. Cardiologist changed meds, spoke of need for surgical repair down the road.
    September 2017 - finished 10 rounds of R-CP, V was stopped due to neuropathy in feet. No further treatment planned at this time, at least 10 tumors can be felt which seem to be growing again.
    December 2017 - Biopsy of external iliac node with SUV of 13.1 shows no transformation! However, the FL grade is now 3A instead of Gr 1-2. Will start indefinite protocol using Copanlisib, one of the new targeted therapies. I remain hopeful.
    March 2018 - Copanlisib failed, treatment stopped 3/28. New plan is to go to Dana Farber on 4/16 for case review and treatment recommendation.

    May 2018 - did not qualify for clinical trials at Dana Farber. Tumors need to get larger to be considered. On consultation w/Dr. Armand at DF and my onc, have decided to take a break from cancer treatments. Will have a biopsy of the mass in my sinus discovered in scan at DF and to get the aneurysm repaired as it has developed a potentially catastrophic penetrating ulcer. Surgery scheduled for 7/12.

    September 2018 - biopsy of mass in nose shows transformed DLBCL throughout. Assessing options for this negative development.

    October 2018 - started 6 to 8 cycles of R-CHOP. Goal is to get to full remission to open up other options.

    February/March 2019 - PET shows four hot spots following R-CHOP. referred to Dana Farber for stem cell transplant. Pre testing all good, accepted for Auto Transplant. Will begin inpatient process about April 1.

  3. #3
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    Thanks for the welcome Kermica.

    Unfortunately, I don't know the measurement of how deep they went to remove the margin. I check my online medical records and the surgical report isn't in there. They do have the pathologists report and he described six different sections that were removed and indicated the size of each section. Not sure if that is the same thing you were asking about.

    When I discussed the treatment plan with the surgeon, I did feel pretty comfortable with coming back to see him every 90 days as a precaution for things that a dermatologist wouldn't check for. I do have to go see my primary care doctor next week and I will discuss it with him.

    That is quite a battle you've been fighting in your signature block. I am quite humbled at what that take and I'll pray that you continue to fight back as strong as you have been. Again thank you for taking the time to respond!

    Best wishes
    Vince

 

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