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Thread: Melanoma removed: Are all Skin clinics money gougers?

  1. #1

    Melanoma removed: Are all Skin clinics money gougers?

    I had a Melanoma removed last week. It was a freckle on the back of my neck that I had noticed had gone dark black in appearance two weeks ago. You could tell it was clearly a Melanoma just by looking at it. I went to a Skin Cancer clinic here in Brisbane and had it removed last week.

    Problem is, the Doctor called me the other day confirming it was stage 1 Melanoma, and that I had to come in for more surgery. They said when they removed the Melanoma originally they only took 1mm of the surrounding tissue because they were not certain it was a Melanoma. They said the industry guidelines for Melanoma are to take 5mm of surrounding tissue. So therefore I must come back to take the extra tissue to be on the safe side.

    As you might expect, considering this is all happening on the back of my neck, and will be visible unless I wear a collard shirt, I am extremely frustrated about what I see as nothing more than a money grab. Why did the doctor not remove the 5mm the first time, especially as it is located on such a sensitive area of the body, not only to prevent complications involved with future surgery, but also to reduce the scarring.

    Now I have to go back in and have a healing wound cut open again, have the whole thing made much larger, and risk infection and god knows what else, when all this could have been avoided by the doctor taking that tiny extra bit of tissue the first time!

    I am so upset at what I see as just a pure money gouge with no care at all about the patient. I have heard from others that this is a common thing with skin cancer clinics, to cut and cut, simply for profit.

    I have decided I will go in tomorrow simply because I am also having another Melanoma cut off from my torso, and I couldn't be bothered arguing with the guy that is going to be performing surgery on me, for safety reasons, so will just go along with the whole sham and suffer in silence and once the stitches are out in a week or so make sure next time if I have one to ask for the 5mm to be taken away the first time. This whole ordeal has been so frustrating, it has me wanting to move to Briton or somewhere with no sun.

    I need a second opinion regarding the safety of cutting into a healing wound, anyone happy to share their thoughts? I don't want to get an infection and end up even worse off. It was quite a large Melanoma, about the size of my index fingernail, and what I am looking at on my neck now is a mangled mess, and I can't even begin to imagine what it is going to look like after more cutting.

  2. #2
    Super Moderator Top User po18guy's Avatar
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    Sorry to hear this. Sadly, it sounds like they are covering their nether regions regarding the margins. Nevertheless, I would rather have some temporary discomfort and even a scar if I could know with assurance that the entire growth was removed. The back of the neck is not that far from several lymph nodes and you certainly do not want it in your lymphatic system! You have the right to demand an explanation as to why such a small margin was taken, and to know the results of any pathological examination from the first surgery, as well as the additional tissue removed.
    07/08 Age 56 DX 1) Peripheral T-Cell Lymphoma-Not Otherwise Specified. Stage IV-B, >50 ("innumerable") tumors, bone marrow involvement.
    08/08-12/08 Four cycles CHOEP14 + four cycles GND (Cyclofosfamide, Doxorubicin, Vincristine, Etoposide, Prednisone & Gemcitabine, Navelbine, Doxil)
    02/09 2) Relapse.
    03/09-06/13 Clinical trial of Romidepsin > long-term study. NED for 64 twenty-eight day cycles, dose tapered.
    07/13 3) Relapse, 4) Suspected Mutation.
    08/13-02/14 Romidepsin increased, stopped for lack of response. Watch & Wait.
    09/14 Relapse/Progression. Visible cervical nodes appear within 4 days of being checked clear.
    10/06/14 One cycle Belinostat. Discontinued to enter second clinical trial.
    10/25/14 Clinical trial of Alisertib/Failed - Progression.
    01/12/15 Belinostat resumed/Failed - Progression. 02/23/15
    02/24/15 Pralatrexate/Failed - Progression. 04/17/15
    04/15 Genomic profiling reveals mutation into PTCL-NOS + AngioImmunoblastic T-Cell Lymphoma. Stage IV-B a second time. Two dozen tumors + small intestine (Ileum) involvement.
    04/22/15 TREC (Bendamustine, Etoposide, Carboplatin). Full response in two cycles. PET/CT both clear. Third cycle followed.
    06/15-07/15 Transplant preparation (X-rays, spinal taps, BMB, blood test, MUGA scan, lung function, CMV screening, C-Diff testing etc. etc. etc.) Intrathecal Methotrexate during spinal tap.
    BMB reveals 5) 26% blast cells of 20q Deletion Myelodysplastic Syndrome MDS), a bone marrow cancer.
    07/11-12/15 Cyclofosfamide + Fludarabine conditioning regimen.
    07/16/15 Total Body Irradiation.
    07/17/15 Moderate intensity Haploidentical Allogeneic Stem Cell Transplant receiving my son's peripheral blood stem cells.
    07/21-22/15 Triple dose Cyclofosfamide + Mesna, followed by immunosuppressants Tacrolimus and Mycophenolate Mofetil.
    07/23-08/03/15 Marrow producing zero blood cells. Fever. Hospitalized two weeks.
    08/04/15 Engraftment occurs, and blood cells are measureable - released from hospital.
    08/13/15 Day 26 - Marrow is 100% donor cells. Platelets climbing steadily, red cells follow.
    09/21/15 Acute skin Graft versus Host Disease arrives.
    DEXA scan reveals Osteoporosis.
    09/26/-11/03/15 Prednisone to control skin GvHD.
    11/2015 Acute GvHD re-classified to Chronic Graft versus Host Disease.
    05/2016 Tacrolimus stopped. Prednisone from 30-90mg daily tried. Sirolimus begun.
    09/16/16 Three skin punch biopsies.
    11/04/16 GvHD clinical trial of Ofatumumab (Arzerra) + Prednisone + Methylprednisolone begun.
    12/16 Type II Diabetes, Hypertension - both treatment-related.
    05/17 Extracorporeal Photopheresis (ECP) begun in attempt to control chronic Graft-versus-Host-Disease (cGvHD.
    06/17 Trying various antibiotics in a search for tolerable prophylaxis.
    08/17 Bone marrow biopsy reveals the presence of 2% cells with 20q Deletion Myelodysplastic Syndrome, considered to be Minimum Residual Disease. Active surveillance is the course of choice.
    To date: 18 chemotherapeutic drugs in 9 regimens (4 of them at least twice), 5 salvage regimens, 3 clinical trials, 4 post-transplant immuno-suppressant drugs, the equivalent of 1,000 years of background radiation from scanning from 45+ CT series scans and about 24 PET scans. Two lymphoid malignancies plus a myeloid malignancy lend a certain symmetry to the journey.

    Believing in the redemptive value of suffering makes all the difference.

  3. #3
    Ok. Thanks for reply. My original post has disappeared! I didn't know about the lymph nodes in the neck. I will go along with the surgery just to be safe, but as it was only stage 1, there is nothing below the surface skin level, that is what makes the whole thing so frustrating. Especially when it was black and looked exactly like the melanoma in the pictures on doctor surgery walls. I just find the whole explanation hard to believe. Why only remove 1mm when you could remove 5mm the first time. I am interested to know if others have gone through something similar?

    Here is my original post below:

    I had a Melanoma removed last week. It was a freckle on the back of my neck that I had noticed had gone dark black in appearance two weeks ago. You could tell it was clearly a Melanoma just by looking at it. I went to a Skin Cancer clinic here in Brisbane and had it removed last week.

    Problem is, the Doctor called me the other day confirming it was stage 1 Melanoma, and that I had to come in for more surgery. They said when they removed the Melanoma originally they only took 1mm of the surrounding tissue, when the industry guidelines for Melanoma are to take 5mm.

    As you might expect, considering this is all happening on the back of my neck, and will be visible unless I wear a collard shirt, I am extremely frustrated about what I see as nothing more than a money grab. Why did the doctor not remove the 5mm the first time, especially as it is located on such a sensitive area of the body, not only to prevent complications involved with future surgery, but also to reduce the scarring.

    Now I have to go back in and have a healing wound cut open again, have the whole thing made much larger, and risk infection and god knows what else, when all this could have been avoided by the doctor taking that tiny extra bit of tissue the first time!

    I am so upset at what I see as just a pure money gouge with no care at all about the patient. I have heard from others that this is a common thing with skin cancer clinics, to cut and cut, simply for profit.

    I have decided I will go in tomorrow simply because I am also having another Melanoma cut off from my torso, and I couldn't be bothered arguing with the guy that is going to be performing surgery on me, for safety reasons, so will just go along with the whole sham and suffer in silence and once the stitches are out in a week or so make sure next time if I have one to ask for the 5mm to be taken away the first time. This whole ordeal has been so frustrating, it has me wanting to move to Briton or somewhere with no sun.

    I need a second opinion, anyone happy to share their thoughts?

  4. #4

    Should companies/ governments be held accountable for preventable skin cancer?

    My Melanoma on the back of my neck was the result of getting sun burnt on the back of my neck while driving around Brisbane this last summer. Now what I want to know is, why is it ok for the Australian Government to refuse people the ability to use strong tints on their car windscreens when in our extremely high UV environment it is criminal neglect to deny us this!

    Also regarding car manufacturers, don't they have an obligation to make sure their vehicles are safe? That includes ensuring their occupants are not burnt to smithereens every time they drive anywhere?

    I feel if I had a strong tint on my car, and the car was designed so sun didn't hit my body, I, and many others, would never get what are preventable skin cancers from badly designed cars and stupid government policies.

  5. #5
    Moderator Top User BobInBonita's Avatar
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    Frustrated2017,

    I'm really sorry about your melanoma diagnosis.

    This forum is for discussion of cancer topics. If you are worried about car safety, find an automotive forum. If you are worried about government policies, find a political forum, write your representative, etc.

    Melanoma takes longer to develop than from getting burnt last summer. Think about your sun exposure over the last 20 years.
    7/12 DX stage 3 pan can (adenocarcinoma) @ 65 - borderline resectable
    8/12 - 10/12 Chemo (GTX) & Stereotactic Radiation
    12/12 Whipple - R0 margins, 2/29 nodes pos.
    1/13 - 5/16 Vaccine clinical trial - randomized to control group - vaccine showed no benefit
    2/13 - 8/13 Gemzar for 6 months
    Quarterly scans - no evidence of disease to 10/14 - spot on lung being watched - possible infection 2 months on antibiotics
    3/15 - spot larger - probable met - surgery planned
    4/15 - PET prior to surg - recurrence & lung mets - Surgery cancelled - EUS w/ FNA showed adenocarcinoma - Stage 4
    5/15 - 9/15 Folfirinox @ reduced dosage - Stopped treatment after 11 infusions due to neuropathy
    10/15 - 8/16 maintenance 5-fu every other week
    8/16 - stable disease on both CT and PET/CT - chemo holiday while other treatments explored
    9/16 - lung biopsy confirms pan can met,
    10/16 -NanoKnife to pancreatic bed -PET after Nano showed new met in hilar lymph nodes - SBRT to both lung & lymph
    4/17 - PET/CT showed significant disease progression, multiple lung mets, pancreatic bed tumor has grown
    5/17 - Started hospice care - striving for acceptance

    Stay busy and live life to the best of your ability.

  6. #6
    Super Moderator Top User po18guy's Avatar
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    I have merged your threads, since they are melanoma centered. It is easier to track replies and support that way. As to the dangers of Australia - as a continent, it has a considerable skin cancer risk. Nations with generally cloudy weather have less risk. Depending on your skin type and your time of residence in Australia, you might have an assessment done of your general risk. I live in a cloudy, rainy area, but due to extensive chemotherapy, UV light therapy and radiation over a 9 year period, I have catapulted into the high risk skin cancer group. Thus, even though I live in a cloudy, rainy, foggy area, I still must wear UPF shirts, sun hats and high SPF lotion. That's just life and in my case, if I complain, I am complaining that I am alive.

    Also, note that 1mm is reasonable since it might not have been a melanoma. If they took 5mm and it was only, say, a lower-risk squamous cell carcinoma (SCC), then you would have had unnecessary tissue removed as well as the larger scar. So, until the diagnosis was finalised, doctor was essentially in a compromised situation from the start.

    I understand your overall frustration, but cancer of any type is a life-changer. The rules have changed and possibly substantially. Regardless of what it takes, best to see that all of it is removed. I would consider it a battle scar should you relate your 'war story' to family and friends.
    07/08 Age 56 DX 1) Peripheral T-Cell Lymphoma-Not Otherwise Specified. Stage IV-B, >50 ("innumerable") tumors, bone marrow involvement.
    08/08-12/08 Four cycles CHOEP14 + four cycles GND (Cyclofosfamide, Doxorubicin, Vincristine, Etoposide, Prednisone & Gemcitabine, Navelbine, Doxil)
    02/09 2) Relapse.
    03/09-06/13 Clinical trial of Romidepsin > long-term study. NED for 64 twenty-eight day cycles, dose tapered.
    07/13 3) Relapse, 4) Suspected Mutation.
    08/13-02/14 Romidepsin increased, stopped for lack of response. Watch & Wait.
    09/14 Relapse/Progression. Visible cervical nodes appear within 4 days of being checked clear.
    10/06/14 One cycle Belinostat. Discontinued to enter second clinical trial.
    10/25/14 Clinical trial of Alisertib/Failed - Progression.
    01/12/15 Belinostat resumed/Failed - Progression. 02/23/15
    02/24/15 Pralatrexate/Failed - Progression. 04/17/15
    04/15 Genomic profiling reveals mutation into PTCL-NOS + AngioImmunoblastic T-Cell Lymphoma. Stage IV-B a second time. Two dozen tumors + small intestine (Ileum) involvement.
    04/22/15 TREC (Bendamustine, Etoposide, Carboplatin). Full response in two cycles. PET/CT both clear. Third cycle followed.
    06/15-07/15 Transplant preparation (X-rays, spinal taps, BMB, blood test, MUGA scan, lung function, CMV screening, C-Diff testing etc. etc. etc.) Intrathecal Methotrexate during spinal tap.
    BMB reveals 5) 26% blast cells of 20q Deletion Myelodysplastic Syndrome MDS), a bone marrow cancer.
    07/11-12/15 Cyclofosfamide + Fludarabine conditioning regimen.
    07/16/15 Total Body Irradiation.
    07/17/15 Moderate intensity Haploidentical Allogeneic Stem Cell Transplant receiving my son's peripheral blood stem cells.
    07/21-22/15 Triple dose Cyclofosfamide + Mesna, followed by immunosuppressants Tacrolimus and Mycophenolate Mofetil.
    07/23-08/03/15 Marrow producing zero blood cells. Fever. Hospitalized two weeks.
    08/04/15 Engraftment occurs, and blood cells are measureable - released from hospital.
    08/13/15 Day 26 - Marrow is 100% donor cells. Platelets climbing steadily, red cells follow.
    09/21/15 Acute skin Graft versus Host Disease arrives.
    DEXA scan reveals Osteoporosis.
    09/26/-11/03/15 Prednisone to control skin GvHD.
    11/2015 Acute GvHD re-classified to Chronic Graft versus Host Disease.
    05/2016 Tacrolimus stopped. Prednisone from 30-90mg daily tried. Sirolimus begun.
    09/16/16 Three skin punch biopsies.
    11/04/16 GvHD clinical trial of Ofatumumab (Arzerra) + Prednisone + Methylprednisolone begun.
    12/16 Type II Diabetes, Hypertension - both treatment-related.
    05/17 Extracorporeal Photopheresis (ECP) begun in attempt to control chronic Graft-versus-Host-Disease (cGvHD.
    06/17 Trying various antibiotics in a search for tolerable prophylaxis.
    08/17 Bone marrow biopsy reveals the presence of 2% cells with 20q Deletion Myelodysplastic Syndrome, considered to be Minimum Residual Disease. Active surveillance is the course of choice.
    To date: 18 chemotherapeutic drugs in 9 regimens (4 of them at least twice), 5 salvage regimens, 3 clinical trials, 4 post-transplant immuno-suppressant drugs, the equivalent of 1,000 years of background radiation from scanning from 45+ CT series scans and about 24 PET scans. Two lymphoid malignancies plus a myeloid malignancy lend a certain symmetry to the journey.

    Believing in the redemptive value of suffering makes all the difference.

  7. #7
    Had the surgery. It looked a mangled mess before the surgery and I can only imagine what it is going to look like now. The amount of skin that was taken away was frightening when I saw it in the specimen jar. He did say that he had taken all the melanoma, as the tests indicated it was all within the piece he took out, but he was only doing this as a 'precaution'. Still I think its unnecessary. I am going in later this week to have one taken out on my torso and one taken out on my arm. They wanted to wait 14 days to take them out at my next consolation but I said I want them out asap.

    Also another thing, I excessively bleed during the procedure. I have since researched one of the causes of this is liver disease. And as i eat a very unhealthy diet it seems I also have liver disease. So I am going to start eating healthy and hope my liver fixes itself on its own.

    I really hope the removal was necessary and not about money. Although I suspect it is all about money. I don't know how you in the US survive. I can only afford this as it is bulk billed on my unemployment card. To be honest I wouldn't have minded if it was a stage three melanoma. Why? Because I have been trying to get a job since I was 16 and NOBODY will give me a chance, and now at 31, I have NEVER had a job. So death would be a welcome relief from the torture of my existence.

  8. #8
    Went and had stitches out today. So I appeared to have survived without getting any infections. The one on my torso above the heart and liver also closed without infection. Can only hope they don't reopen and heal properly.Treated myself to a maccas on the way home to take my mind off the fact I now have a disfigured neck that resembles Quasimodo himself( part of the wound healed awkwardly and protrudes 'upwards' as if I now have a permanent blind pimple on the back of my neck. I won't be able to ever wear t shirts again without being conscious of people staring at the scar. Waited in drive thru for over 20 minutes for a simple egg mcmuffin meal, obviously they were overwhelmed with orders and needed more staff. Didn't seem to bother the two young kids in drive thru window talking to each other the whole time....instead of one going into the kitchen to help out. I won't be buying from them again, if they want to give sloppy service because they won't hire people who WANT to be working there then good riddance to them. They don't respect their customers by allowing the sloppy service in the first place. Doc wants me back in 3 months for a check up but I probably won't be going cause once my rent runs out this week I will be homeless. Not that anyone cares. They'd sooner help orphans in Africa then help one of their own here.

  9. #9
    Administrator Top User ChemoMan's Avatar
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    Hi

    This is standard practice and not a money making exercise. They need to remove extra skin around the margins if the biopsy result is positive for melanoma. This is entirely normal procedure.

    Melanoma is a huge killer of young people in your state (Qld). Your doctor doing his job properly will prevent your early death from melanoma.

    One more thing...you appear to be depressed. Depression can kill you quicker than cancer can so do yourself a favour and go back to the docs and get some treatment for that depression. Make sure you get a health care plan done by the RN at the clinic that way you will get psychology consults for free from medibank...I think you can get 7 free visits in the first year.

    Good luck
    Age 60
    Diffuse Large B cell Lymphoma
    Stage 2a
    Finished six cycles of R chop 21 26th May 2008
    Officially in remission 9th July 2008
    Remission reconfirmed 1st October 2008
    Remission reconfirmed 17th June 2009
    Remission reconfirmed 7th June 2010
    Remission reconfirmed 6th July 2011

    NED AND DECLARED CURED on the 2/01/2013

    No more scheduled visits to the Prof
    http://cancerforums.net/viewtopic.php?t=9620

    RULE NUMBER 1.....Don't Panic
    RULE NUMBER 2..... Don't forget rule Number 1

    Great moments often catch us unaware-beautifully wrapped in what others may consider a small one.

    I may not have gone where I intended to go,
    but I think I have ended up where I needed to be.

  10. #10
    The scar on the back of my neck has opened up and I have a gaping hole there. I KNEW this would happen!

    I am walking around with a hole the size of a 20 cent piece and about 1cm deep on the back of my neck. What do I do?! I don't want to go back to the same clinic who did this to me and there are no nurses on call at this time of day.

    I'm not depressed. I only ever get negative feedback from people. I have tried applying for jobs since I was 16 and nobody would hire me. These were jobs online. And I now have been told those online job agencies use algorithms and if your resume doesn't exactly match specific keywords then your resume is never even looked at. So I have been naively applying for jobs online all these years without any prospect of getting work, despite me resume being quite good.

    I call employers and they always act like they don't want me calling them. Like they couldn't even be bothered. Thats why I stopped calling them and just applied online.

    I'm part of the 60% who haven't got degrees and am finding it is IMPOSSIBLE to get a job. Would LOVE to know how the other 60% find jobs. And it's not just people without degrees, there is a scientist in Brisbane who is picking up dog poo for a job, presumably because they can't find a science job.

    I resisted every urge in my body telling me to get up and walk out of that clinic when he wanted to cut the second time. Thinking he knew what he was doing. HE DIDN'T. The tests came back saying all the tissue around the first cut was fine, and it was then I should have got up and walked out of the clinic.

    Maybe if my rent was only paid up until Thursday and I have no where to go after that I would be happy and cheerful and not concerned about this. But because I will be homeless with nothing on Friday I am feeling a bit upset.

    Don't worry, just put us 'dole bludgers' on benefits, that will sort it out. Don't try and provide us with REAL jobs so we can live ourselves. Australia went down the drain the minute we allowed it to go from an internal to an international job market.

    Wish your grand kids luck in finding stable employment, cause it's highly unlikely they will have the same opportunities you boomers and your parents did in good old 'White' Australia. You really didn't know how good you had it. Or why we enacted those policies. Just like 'feminism' has now created a situation where there are more people looking for work, as opposed to in the past when one person would stay home and not work, because it was seen as socially unacceptable to have two people working when your neighbor was unemployed. It just happened that women would stay home because high investment parenting was something we as a society took seriously once, well not anymore. Men would stay home if their wives were working in the old days, so it wasn't all one way. But you never hear about that reality.

    You just need to look at the way a drug dealer can make $10 000 a week to see how morally corrupt, apathetic, and disillusioned our society has become as a result of abandoning the importance of high investment parenting as a social norm. Take down the social stigma associated with promiscuity and you have the modern Australia of 2017 where nobody has any self respect or care of themselves or others, and the only language they all speak is money.

    There are more people than there are jobs, especially now we are an international job market where your grand kids will have to compete with all the hundreds of thousands of University graduates being churned out of China and India each year looking for better pay and conditions here, so it's only a matter of time before larger segments of the population become permanently unemployed. Especially once these migrants begin enacting racial nepotism, something nobody ever acknowledges, yet we all too easily allow, despite it being downright discrimination.

    One of the jobs I applied for, I was waiting for 30 minutes in the store for the interview, while the staff all spoke in Chinese to each other. Then another man of asian descent came into the store, some more talking in Chinese, and the manager, who was also Asian, came out from the back of the store, and proceeded to interview the newly arrived Asian man ahead of me. That was when I woke up.

    Saying someone is depressed just because they don't always feel upbeat is very naive, and why this country has gone down the tubes.

    It amazes me how one generation can deny their descendants everything they had, and then tell their descendants it's all their fault. Incredible.

    The clinic I went to only employs one race of people, all of whom are immigrants. It's just incredible that anyone would deny our society is worse off with such nepotism.

    Just continue with your 'culture of critique' on our society until we are all dead and the society resembles that of our neighbors in the region. I am sure that will make you lot happy.

    I'm not depressed, I'm angry.

    BYE.
    Last edited by lisa1962; 05-29-2017 at 11:16 AM. Reason: Link removed per forum policy

 

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