Do I really need a WIDE LOCAL EXCISION

Hi Em Dee 

The simple answer to your question is that no one can force you to have a wide local excision (WLE) or sentinel lymph node biopsy (SLNB) against your wishes. At your pre-op you have to sign consent forms to have these procedures done.

Like you my margins were clear, but the standard protocol after being diagnosed with melanoma is to have a WLE. Depending on the depth of the melanoma depends on whether 1cm or 2cm all around the original excision biopsy site is removed. I had a 2cm margin removed at the same time as having a sentinel lymph node biopsy (SLNB). I'm happy to answer any questions you might have about these procedures.

From having my excision biopsy to having the WLE and SLNB was about 4 months.

Anne

Thank you so much for taking the time to answer my question.

i think I know that I need this and will be having the WLE but not yet sure about the biopsy

My Melanoma is stage 1b and considered myself very lucky when the results came back to say that it had been completely removed and that I didn’t need the Sentinel Lymph Node Biopsy, just follow up skin checks.

But was referred to the Plastic Surgeon for consideration of a WLE, which is when he said I did need WLE & the Biopsy which completed floored me.

i think it’s the waiting time which I’m having trouble with and also the fact that I’ve just been left out there with no follow of any kind for the foreseeable 

I’ve just been reading your journey and what a journey you have had, and you still find time to try and help others.

Thank you so much for your kindness.

Hi Em Dee 

Em Dee said:

i think it’s the waiting time which I’m having trouble with and also the fact that I’ve just been left out there with no follow of any kind for the foreseeable 

I understand your concern about the waiting time between biopsy and WLE and SLNB and I phoned my SCNS (skin cancer nurse specialist) to chat things through with her. She was able to put my mind at ease about it. You could give yours a call and chat through any concerns you have.

As for "being left out there with no follow of any kind for the foreseeable", that's normal at this stage. Your skin check-ups won't start until after you've had the results from the WLE and SLNB.

Consultants have to follow the NICE guidelines for managing melanoma, and if you want to see what your follow-ups should be just click on the link I've created and then scroll down to 'Follow-up after stages I to IV melanoma' and you can see what will happen and how often.

Take care and feel free to ask me anything you like.

Anne

Thank you so much for all your help,

it’s much appreciated at times like this, when everything is up in the air and all I can do is wait.

Hi Em Dee - I feel the same way - mine was diagnosed as Stage 0 so insitu & they have still said that I need to have a WLE as a precaution but I have no idea when that will be so don’t really see the point either! X

Thanks for getting in touch, 

I was beginning to think it’s only me who was thinking like this.

having to wait so long for a appointment makes me think that there is no urgency, so why put

myself through all of that.

I’m now thinking that I’ll only have the WLE & not the Biopsy, 

that’s if they ever get back to me with a appointment.

Best Wishes Em

Hi,

I'm jumping on this just to add my meagre knowledge....

The WLE will identify if any cancer cells are migrating from the original lesion site.

The SLNB will identify whether any cancer cells have migrated to the nearest lymph node.

As someone who had no symptoms of melanoma (other than the lesion on my scalp, and therefore hidden by hair....), both WLE and SLNB showed migration of cancer cells.

These tests probably saved my life.

I make no further comment, other than to wish everyone all the best and good luck!

Thanks for replying,

this is what I was hoping to hear,  other people’s thoughts

it would be nice also to hear the thoughts from those of you who decided against the biopsy

as well as those who did have it. 

and then maybe it would help me to make a informed decision. 

Thank you x