Questions

Hi Sase and welcome to the group although I'm sorry you've had to join us.

When I had my appointment with a plastic surgeon after I was diagnosed with melanoma, it was to discuss the wide local excision (WLE) and sentinel lymph node biopsy (SLNB). Depending on the depth of your husband's melanoma will govern how large an additional area, usually 1-2cm, will be taken away. This is to make sure that no cancer cells have been left behind when the original excision biopsy was done. 

The depth of his melanoma also governs whether he will be offered a SLNB or not. This isn't a treatment for melanoma but is done to see if melanoma cells have travelled to the nearest lymph nodes. The SLNB is optional and, if it is being offered, then the plastic surgeon will explain the pros and cons of having that done.

I've had both of these procedures so I'm happy to go into more detail if you think it would help.

As for what questions to ask, I wanted to know how soon I'd have the operation/s, when I'd have the pre-op, how quickly I'd get the results, how quick a recovery I'd make, etc.

Do come back and let me know how your husband gets on today.

Thank you so much for your reply. More information on the procedures would be really helpful thank you. 

No problem Sase 

If your husband has both the WLE and SLNB then these will be done under a general anaesthetic, if it's just a WLE then that's usually done under a local anaesthetic.

The WLE is effectively the same as the excision biopsy, just bigger. You haven't said where on his body your husband's melanoma was. Mine was on my arm and the WLE was just stitched back up again with dissolvable stitches but if it's on an area of the body without much skin then sometimes a skin graft is needed.

If your husband is having the SLNB as well then, in my experience, there are two stages. First he'll have what's called a lymphoscintigraphy which identifies the location of the sentinel lymph node. A small amount of radioactive dye is injected as close to the original site of the melanoma as possible and then a scanner is used to see which sentinel lymph node that dye flows to. My lymphoscintigraphy was done on the afternoon before my surgery the next day.

The second stage is when he'll have both the WLE and SLNB under a GA. I didn't stay in hospital overnight but I think it depends how early in the day he has his ops.

I hope this helps and please feel free to come back to me with any questions.

Hello. I'm more than happy to answer questions if I can. Please read my profile and consider completing your own for you husbands diagnosis, it will help people answer questions if they know a little more about your own families journey. 

It's a very worrying time for you all, so use the group as much as you need, no question is silly, they answered soo many of mine. Stay strong.

Hi Sase 

How did the appointment go?

Hello, Thank you for getting in touch. It was very much as you said, he is on a waiting list for the WLB and SLNB. It was so helpful to have your information before as I felt we had a greater understanding of what we were being told before the appointment. We have been told that there will be a wait of a few months and if someone comes in that needs this sooner he will be bumped for them. I don’t know whether we should be looking in to the possibility and cost of going private. 

Hi that seems a long time to wait after I saw the consultant my surgery for wle and slnb were done 3 weeks later on nhs. I'm still recovering and waiting for results.

Sorry I didn't reply straight away Sase 

I asked about the possibility of going privately when I was told there'd be about a 10 week wait to have my WLE and SLNB. In the end I didn't investigate the costs involved as my SCNS was able to reassure me that they'd already got clear margins on the original excision biopsy. Obviously she couldn't tell me about possible spread to the lymph nodes but I decided to wait anyway.

If you do decide to investigate the timescales and costs involved going privately, it would be interesting to know as I don't think anyone here has ever done this.

Thank you for your reply. Yes, they said it would be around a 3 month wait at least. They are going to go in to the lymph nodes under my husband’s arms. We forgot to ask about recovery time and he does a physical job. How long did they say recovery time would be for you if you so t mind me asking? 

Mines was on foot. I went for  check up yesterday they  said anothef six weeks got to wait for skin graft to heal as my jobs on feet all day. I thought I would be OK in 2 weeks but a lot longer than I expected.