Hi, my partner has recently been diagnosed with Stage IV melanoma with 4 x lesions in his brain. As a healthworker myself, I am really struggling to understand how this has happened and was hoping you could provide information about whether the correct pathway/timeframes were followed.
He had a primary mole excised from his calf in 2017 with negative sentinel node biopsy. He then had regular surveillance under Dermatology at our local hospital every 3 months.
Last July 22 a palpable lump was found in his groin by the dermatology CNS. It was biopsied - they said the results would take 2 weeks. After a lot of chasing, at 7 weeks (end of Sept) we were told the results confirmed BRAF+ melanoma. He had a Brain MRI which was clear and a full body CT which confirmed intense uptake in a axial lymph node (Sept).
They told us surgery would be needed to remove the malignant lymph node/s. No discussion of any systemic treatment or drug therapy. Another full-body PET CT in November showed no spread.
Start December we received the appointment for the lymphadenectomy for February 27th. He only saw the surgeon before this appointment. No other scans or tests were done. No appointment with oncology.
Had headaches for 3 weeks in leading up to the surgery which we put down to stress/life etc. Had the lymphadenectomy in Feb and when he came home he became extremely unwell with headaches, ataxia, vomiting. Back to A+E and a CT head confirmed 4 brain mets - 1 the largest one he had a craniotomy for 48hours later as it was causing mass effect. Has now had SRS and on ipi/nivo for the rest of the rest.
After doing a lot of reading, I am confused (angry) as to why it took almost 6 months for the lymphadenectomy to be done as he would have been classed as Stage 3 melanoma from the moment they got the biopsy results. From reading other forum posts, a lot of people appear to be offered drug treatment options for even Stage 2.
I understand it's in the past and not overly helpful to dwell on what could have been done differently, but I think having more information about if this is a normal timeframe and he was just 'unlucky' would help me deal with the situation.
Thankyou!
