Do WLE and SLNB have to be done at same time?

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Hi, 

My husband was diagnosed stage 1a melanoma 2 wks ago. We were told it was caught early but they wanted to arrange a WLE as a precaution. This is booked for tomorrow. 

When he was told of his diagnosis he was given a thorough examination. The specialist nurse had no concerns on other moles but found enlarged lymph nodes in his armpit. This is nearest to the cancer site on his chest. At the time the nurse said he wasn't concerned as at stage 1a he would be very surprised if it indicated that the cancer had spread. It could be due to separte issue, an injury and surgery my husband had back in August, it could be his body still be fighting that. Although, in reflection, I would have thought that the lynph nodes in his groin would be enlarged, not his armpit, as this is right near where he had his accident and surgery. Anyway, they referred him for a scan, which he had last wk. Didn't expect the lady who scanned him to say anything but she said, 'yes they are enlarged but look fine to me. No evidence that they are in the cortex,'. Not sure what that meant but it felt like a relief. Then, this morning, his nurse calls up and says they have scan results back, have shown them to a professor and now want him to have a SLNB. Now I am panicking, as, to me, it implies there is something to be concerned about. We are now awaiting call to book that in. However, having had a quick Google search, it seems that WLE and SLNB tend to be done at the same time. Is this best practice? As my husband will now be having WLE done first thing tomorrow then the SLNB done whenever we get the appointment through. 

  • Hello!  That sounds a bit of a scary time for your husband.  I'm fairly new here too so don't have any expert advice as I'm currently waiting my SLNB & WLE.  All I will say is that my understanding is that they do them both at the same time as it's more efficient but I have seen there are some people on this forum who've had them done separately.  I hope your husband's WLE goes well.

  • Hi yeah done at same time.

  • As far as I know the reason they do the SLNB at same time as WLE is so they can have a good chance at finding the first draining lymph node(s) from the primary site. Once the WLE procedure is done, the primary site is ideally removed and it's probably less accurate to do scanning (using radioactive isotype/dye etc) and be sure that correct nodes are mapped.

  • Hi I had 6 nodes out I did not even know until other day no wonder its started swelling back up body got to get used to it.  So dye can go to more then one node.x

  • Hi, thank you for your response. Yes, all went well with WLE. I actually saw the nurse and was told he's just having a lymph node biopsy not a SLNB because his lymph nodes are enlarged. Just waiting for that appointment now