Sentinel Lymph Node Biopsy for Melanoma

Hi Em Dee

I am at a similar stage to you.  Excision in October, got my results in November telling me that one of the moles was a Stage 1b Melanoma.  Quite a shock for me, as I’ve been led to believe that it was a basal cell carcinoma.  
Once I’d read all the leaflets I‘d been given, I decided that I did want to go for the SLNB, because I wanted to know whether or not it had spread to my lymph nodes.  At least then, if it had, I could start having some sort of treatment.  Without  the SLNB, I would have  been relying on three monthly checks and always wondering whether they were sufficiently robust to pick anything up.  

I met the plastic surgeon one week after my diagnosis and he threw another decision into the arena, by offering me an SLNB that didn’t use radio isotopes and blue dye, but fluorescent dye which is only injected during the surgery.  He was willing to do either procedure, and he explained that the one using radio isotopes prior to surgery is the gold standard method.  However, because there have been problems getting hold of the radioactive dye, the waiting list is much longer for that option.  The other procedure, using the fluorescent dye(called an ICG), Is used in quite a few hospitals, But as yet there are not enough studies to prove that it is as reliable in terms of locating the correct sentinel node.  He was confident that it worked as well, but wasn’t able to offer me the concrete scientific proof that it did

I mulled this decision over for a couple of days and then decided that  time was the most important factor for me. All this waiting is unbearable.  Even after surgery there is a 4 to 6 week wait for results. So I rang up my Macmillan nurse, who is absolutely fantastic, and said that I had decided to go for the ICG procedure. That afternoon I had a phone call from the hospital offering me a surgery date of the 30th of December, which I was really pleased about, as I had been expecting to have to wait until early February at least.

So here I am, booked in for my WLE and SLNB in 10 days. I’m really nervous about the surgery, but still glad that I made the decision to have it.

Have you been allocated a Macmillan nurse/key worker? If so, I would have a chat with them. They have access to your notes and can explain anything about the diagnosis, which might help you to decide whether or not you need to have the SLNB.  This is just my story, and I’m sure there are other people in this forum who decided against the surgery, and who might be willing to explain why they came to that decision.

Whatever you decide, good luck!

Thanks for replying so promptly, and I’m pleased to hear you have a date and send all my best wishes for a good result.

I have spoken to the Nurse and she has tried to reassure me about it all, but I can’t stop thinking about the 2 different Consultants opinion on the need or not for SLN biopsy

Maybe if I didn’t have to wait until the end of March at the earliest to have this procedure it would be easier to decide, but as it’s not I’m slowly going crazy with worry that it would’ve already spread and be to late anyway, hence the reason not to put myself through this if it has .

i wish you well with your procedure & hope the out come is a good one. 

Hi, I’m really sorry to hear that you’re going through this.

i was in a similar position a few weeks ago. I also was diagnosed with a stage 1b melanoma on my arm and had my WLE and SLNB on the 13th December (yip Friday the 13th! Not my first choice for surgery but needs must, lol!).

my NHS consultant told me that my risk level fell into a gray area. The NHS recommend a SLNB if there’s over 10% risk of spread  but don’t recommend it when it’s below 5% risk of spread. I came out as a 7% risk and like you was ill with the worry of having to make the decision myself. I looked at all the risks of the surgery and all the potential permanent side effects and it terrified me. My consultant wouldn’t guide me one way or another & said it was completely my decision.

i went to see another consultant for a second opinion and he said something that made my mind up immediately. He said that whilst the potential side effects of the SLNB could be life limiting, finding any spread into the lymph nodes early can enable quick treatment which could be life saving. After hearing this I decided to go for it & I haven’t once doubted my decision.

im one week after surgery now and so far all is healing well. I have been quite shocked at the amount of tissue that has been removed and so if you’re offered any psychological support for dealing with this I’d take it. I said initially that I wouldn’t need it but have since changed my mind as I think it will help me come to terms with everything if I have someone independent to talk to.

i hope this helps and I wish you all the very best. X

Thanks for getting in touch and sharing, 

hope all is healing well and you get a good out come.

I’m also in what they decided to call the grey area as mine in calculated as 5% chance of spreading, and after being told by my Consultant that I didn’t need the SLN Biopsy I was hand over to the Plastic Surgeon to do the WLE & that’s when he decided I might benefit from it.

this has completely confused me as previously I was told I was in the clear and would only need regular checkups, but no one has checked me since September & when I asked about this I was told to check myself and report anything I was worried about.

I don’t even know how to check myself as I haven’t been shown.

I’ve been left to it and have to wait until next spring for a date for the procedure 

Best Wishes Em.

Hope your procedures when well and you can now move on. Regarded Em 

Hope things are healing well and that you get a good result. Happy New Year

Thanks Em.  I was really nervous about the op, but everyone in the hospital was so helpful and willing to explain what they were doing.  I had to travel 80 miles each way for the surgery, so my husband and I stayed overnight the night before and the night after, as I wasn’t sure whether I’d be fit to tackle the long trip home after having a GA.  The actual anaesthetic was better than I expected, and apart from violent shivering as I came round , I didn’t suffer any other ill effects and felt perfectly normal within a couple of hours.  
The WLE on my arm feels very tight and tender today (two days after surgery), but nothing has been really painful so far. My dressings come off next Monday (another 160 mile round-trip with a forecast of snow!).  I’m not looking forward to seeing the site of the WLE, as the surgeon planned to remove 2cm from the arm.  However, I  accept that this is a necessary step, and if it ensures that the melanoma has been well and truly removed, it’s a small sacrifice to make

In terms of the SNLB, so far, there don’t seem to have been any unpleasant after effects, but it is very early days yet.

Now,  all I have to do is wait for those results-another 4 to 6 weeks, which seems very long. Then it’s either referred back to dermatology or on to oncology.  This is certainly a club that none of us asked to join.

I hope you manage to come to a decision. It’s really tough that you have to do this with what seems to be relatively little support. All I can say is that, in my case, the operation was more straightforward than I feared, and I don’t regret having it.

Hopefully you are now recovering well and feeling more comfortable 

wishing you all the best for a good outcome.