Hi everyone,
I am posting on behalf of my 80 year old father. Biopsy on his right foot (on the “arch” of the foot, close to, but not on the sole) found melanoma in situ. He had WLE 3 weeks ago, but pathology indicated the margins were not clear. Over the phone the consultant discussed various options:
-Further excision, which the consultant indicated may impact my Dad’s mobility, given his age and the awkward location of the lesion on his foot (although he is very active for his age and in excellent health otherwise)
-Surveillance for any recurrence, with optional use of topical solution (imiquimod I believe?)
He will have a follow up consultation when the wound is fully healed.
A key issue here is my Dad’s anxiety when finding out abnormal cells remained - I have tried reassuring him this is currently non invasive but the anxiety and difficulty sleeping persists (we are managing this through his GP)
Also, if relevant, around the same time as the foot biopsy he also had his forehead (BCC) and back (benign) biopsied.
I am wondering if anyone has any thoughts on next steps bearing in mind my Dad’s age, particularly on the following:
-Would further excision guarantee removal of all abnormal cells?
-Of course every procedure/patient is different, but is there a possibility further excision could lead to significant impairment?
-How likely would a recurrence be?
-If a second visible lesion does appear, is there any chance this could have progressed to Stage 1 or even beyond?
Many thanks for any advice or opinions, much appreciated.
Hi Glasgow1980 and a very warm welcome to our corner of the online community.
My name's Anne and I was diagnosed with Stage 2 melanoma nearly 10 years ago now, although mine wasn't on my foot.
It's natural for your dad to be worried that clear margins weren't obtained but, as you've said, Stage 0 melanoma means that it is only in the top layer of the skin and hasn't grown down into the layers below. At one time Stage 0 used to be called pre-cancer.
You asked the following:
Would further excision guarantee removal of all abnormal cells?
No, because until the further excision is examined it wouldn't be known if clear margins had been obtained
Of course every procedure/patient is different, but is there a possibility further excision could lead to significant impairment?
Having not had a WLE on my foot, I can't comment on this
How likely would a recurrence be
Your father's consultant should be able to help with this question, based on your father's history
If a second visible lesion does appear, is there any chance this could have progressed to Stage 1 or even beyond?
If your father has another lesion anywhere on his body this could be Staged at anywhere from Stage 0 upwards.
Your father's SCNS or consultant should be able to answer all of these questions more fully. It's important that your father makes an informed decision, so he may need to speak to his SCNS or consultant again before finally deciding.
The fear of recurrence is something that we all have but by remaining vigilant and by being safe in the sun we can hope to avoid it. Hopefully, someone who has had a WLE on their foot will pop on to be able to help with how much of an impairment, or not, they found it.
Wishing you and your dad all the best
"Never regret a day in your life, good days give you happiness, bad days give you experience"
