Hello
I am just hoping there is somebody that can give me a tiny bit of reassurance :-(
I was diagnosed on Xmas eve with MM after a biopsy on my thumb, I was with the consultant and nurse specialist about 2 hours yesterday and nothing has sunk in.
I'm 40, healthy with a 6 year old child.
They advised they didn't get enough out from the biopsy and it's about 4mm which is scary in itself. I have to go back on the 9th Jan for a CT scan, can I ask why they are doing that before lymph nodes biopsy? is it bevsuse they think it's highly likely it's spread elsewhere ? He also offered my the lymph biopsy which I don't have to have but I accepted, this will be done after the CT scan and the pre op. no dates given yet. He said it's mid range but treating it as severe for now. He checked my nodes for lumps which were fine and I'm hoping this is s good sign? he said I am PT3A at the moment but it will more than likely change, can somebody tell me the meaning of this please.
I'm absolutely floored and I am trying to hold it together for my child and have a good Xmas but I just keep crying. I had no sleep at all last night and I'm exhausted.
Could somebody provide me with some information and what the outlook could be. I'm absolutely devastated. I'm sorry to put this on Xmas day but I have nowhere else to turn :-(
Thankyou for reading
Hope you've had a lovely Christmas xx
Hi and a very warm welcome to the online community and to the melanoma group in particular.
I'm very sorry to hear that you've been diagnosed with melanoma. I can remember only too well how numb I felt when I was diagnosed just over 2 years ago.
Like you, I don't think everything sank in on the day I was told so I made an appointment to go and see the skin cancer nurse specialist (SCNS) a few days later so I could ask her all the questions I didn't think of at the time I was told. I'd recommend that you write all your questions down along with the answers as it's only too easy to forget what you want to ask, and what you've been told, when you go to see the nurse or consultant.
If I'm understanding you correctly the depth of your melanoma is 4mm and you've been classified as stage pT3A. There's more information if you click here on melanoma staging. Although I'm not medically trained, just another melanoma patient, I believe this staging is the Breslow staging and means that your melanoma has been pathologically (p) staged as tumour (T) thickness 3, meaning between 2mm and 4mm. However, your SCNS will be able to tell you for definite.This then translates to a final staging and I believe yours is Stage 2A, as you'll see from the information I've linked you to.
Everyone who is diagnosed with melanoma has a follow up operation called a wide local excision (WLE). This isn't because they haven't got enough out but to make sure that no cancer cells have been left behind in the skin adjoining the melanoma. The amount they take away depends on the size of the melanoma. Also the size of your melanoma means that you should be offered a sentinel lymph node biopsy (SLNB) at the same time. The SLNB does not prevent the melanoma from spreading but is a staging tool to see if it has spread to the nearest lymph nodes. This information from NICE gives further information.
I had both a WLE and SLNB nearly two years ago so I'm happy to tell you about either of the procedures if you have any questions.
I hope that you still manage to have a nice Christmas even though the worry won't be far from your mind. However, one day you'll wake up and realise that melanoma is no longer the first thing on your mind when you wake up and the last thing you think about when you go to bed.
x
"Never regret a day in your life, good days give you happiness, bad days give you experience"
I think that your WLE excision will probably be the same size as mine as my melanoma was Stage 2a as I suspect your's is. For that Stage they like to take 2cm around the original scar area, although as your biopsy was on your thumb it might be different.
You say that they are removing your lymph nodes. Do you mean a sentinel lymph node biopsy, where just one or two are removed, or a lymphadenectomy where all of the lymph nodes are removed?
If the lymph nodes in the area that you're having the SLNB/lymphadenectomy feel swollen then this could indicate that they have cancer cells in them. If not then I don't think they'll know until they get the results back. However, you have mentioned that you're having a CT scan and this may show spread, if there is any, to the lymph nodes.My results from the WLE and SLNB took 2 weeks to come back but it all depends on how busy the path labs are. It's usually a good idea to ask when you go for the operations how long the results are currently taking to come back in your area.
Unfortunately, having a melanoma diagnosis does mean that you notice every tiny mark on your skin. However, for peace of mind I'd give your SCNS a call and she can arrange for you to go in and see the consultant. My consultant got me to take photos of my entire body, eg left leg front, top of right arm, back, etc which I use to check against each month as I'm a moley person and would have difficulty noticing if a new one appeared.
It's quite normal to be scared, but you will come to terms with this and once the operations are out of the way and you hopefully just have to have 3 monthly check-ups, then it becomes less of an all consuming worry.
If you think of anything else please just ask.
x
"Never regret a day in your life, good days give you happiness, bad days give you experience"
I would be confused too . I think the only way you're going to find out why he's treating your melanoma as more serious than it's staged is to speak to your SCNS. They're a mine of information and should be able to explain what's happening.
I too was staged at 2a as although it was only 1.45mm deep it was ulcerated. However, I just had the WLE and SLNB. Not having any swelling in the lymph nodes is a good sign and I have to be honest when I say that I don't know if a CT scan will pick up cancer in the lymph nodes. This information from NICE shows what a CT scan is used for when melanoma is involved.
x
"Never regret a day in your life, good days give you happiness, bad days give you experience"
Thanks Latchbrook, the information is really helpful. My partner said he's doing the CT just as an investigative precaution.
his take is it's mid range thickness which is why the biopsy to see if it's in the lymph which is what ypu said. He said they're pleased there's no lumps in the arm as well as lymph which I forgot about the arm.
He got permission to record the whole conversation on his phone again I forgot and we will listen to it in a few days when I feel strong and up to it.
Can I just say speaking to you and other people this eve had really helped ease my anxiety and it's helped me look at things differently, it's not a death sentence. it's treatable or manageable and im gunna kick it's butt 
How did you find out about yours? xxx
