SLNB or not?

Here's my tuppence worth...

I also have Stage 2B melanoma. I was also offered SLNB at the same time as the wide local excision and accepted both. That was towards the end of August. They couldn't trace the SLN despite 3 radioactive injections in the morning prior to the wide local excision. I was then told the surgeon would use a blue dye method to try to locate the SLN. He didn't do that either. I did have a PET scan afterwards which found nothing but I'm not persuaded that it would have been sensitive enough to find early/small spread.

To your point about having doubts about the SLNB, I am now about 2 months post wide local excision (and 5 months post the original/first smaller excision). I am waiting for an oncologist appointment. And I am worried on 2 fronts. 1. I still don't really know if there has been ANY spreading. 2. I really don't know how sensitive I should be to the timing of the next (unknown) steps. I am not very happy with this situation. It is a real worry for me....and you might well put yourself in that same situation. For me it is the fer of the unknown.

I think generally you would be offered the SLNB because your consultant thinks it is in your best interests. (Of course you won't be conscious when this is done at the same time as the wide local excision.)

For what it is worth I would suggest having the SLNB. I regret, despite opting for it, that i the SLNB wasn't done. And it just adds to my natural worry. Finding no cancer cells in the SLNB would have been really reassuring. Even the 18-20% probability finding some cancer cells would be useful.

Incidentally my initial excision/biopsy was in late May. It was only then that the melanoma was diagnosed necessitating the wide local excision. So I have now been concerned/worried for 5 months and still have no oncology action plan.

I hope my experience/thoughts help with your decision process.

Hi 

I was in a similar situation to you. I was diagnosed in February with stage 2 had mri brain & body ct which were clear

I had wle 2cm with clear margins & decided to have snlb as I was told if it was positive for melanoma it would change the stage of my cancer & therefore the treatment plan but it was my choice to make 

had the snlb & it showed 1.2mm of disease therefore I was then stage 3 with clear brain & body scans in February… offered stage 3 treatment Pembrolizumab

 I was also offered a trial which I decided to sign up for  so I had to have new scans done in May 

new scans showed mets to lungs & brain & subcutaneous mets 

so I don’t want to frighten you but my scans went from clear to stage. 4 disease in 9 weeks if I had not had the snlb they would just have monitored my lymph nodes with ultrasound only 

I would have been treated with drugs which would’ve been ineffective for my advanced stage 

however my cancer was was/is aggressive as it’s nodular was deep & ulcerated … from October 2023 when I first noticed the growth/mole until it was removed in February had grown to 14mm deep & 3.5cm x 2cm 

So my advice would be think long & hard before you decide not to have it 

I’ve had no issues caused by snlb but I know it can cause lymphoedema in some people

best wishes with whichever path you choose 

Alli x

I agree. You put it very well," So my advice would be think long & hard before you decide not to have it".

Thanks for your thoughts, hope all works out for you, still not seeing to many benefits but hedging towards doing it, every little bit of info helps I suppose.

Thanks for taking the time Alli, still weighing my options, leaning towards getting it done, the more info the better. Best wishes in your journey.

Hi Flip me  - Just wanted to add my thoughts in case they help one way or another.

I was diagnosed with stage 2b in March after a February mole excision. I was offered WLE and SLNB too, and I decided to proceed with both. I wanted to have as much information as possible given that there is always a chance of spreading, even after I was told they should have had it all during the initial excision. I was glad I did, as I needed two lymph nodes removed (one from armpit, one from groin), and it showed that the melanoma had spread to my groin, which advanced it to stage 3c. While this hasn't affected my treatment plan (pembrolizumab once every 6 weeks), knowing that it had spread was worth the SLNB. Personally I would have always worried and questioned whether or not it had spread if I hadn't had it done, and this is information my medical team now have to inform them going forward. Other than recovery time from the operation which wasn't bad at all for the SLNB sites (my WLE wound dehissed though), I saw no negatives to getting it done, especially as it was done under GA at the same time as WLE.