Option to SLNB?

Hi  and a very warm welcome to the online community

I'm sorry to hear that you've recently been diagnosed with melanoma but you're right that 0.8mm is positive bad news.

I was diagnosed with melanoma nearly 3 years ago and was also offered the optional SLNB. It is a small operation done under a general anaesthetic at the same time as your WLE. The SLN is then sent off with the tissue from your WLE to check if any cancer cells have been caught in the lymph node. If there are cancer cells present then your cancer stage would be upgraded and you'd be offered further treatment.

You may find this decision aid from NICE helpful in coming to a decision about whether to have it or not. For me I didn't want to wonder 'what if I'd had it done' in the future if the melanoma was found to have spread.

Plenty of people here have had the SLNB and we'll all be happy to explain things in more detail if you want to know. There are some people who have chosen not to have it too and hopefully they'll be along to tell you why they chose not to have it.

As for what to ask, my main worry was being left with lymphoedema but I was reassured by my plastic surgeon who said that he'd only had a couple of cases in all the ones that he'd done.

You haven't said where your melanoma was. Mine was on my arm and I think that a SLNB from your armpit is easier to recover from that from your groin from what I've seen of other people's posts.

Let us know what you decide to do and also come back if you want to ask anything else.

x

Thank you latchbrook - I appreciate your reply. I’ll have a look at the NICE guidelines this evening. My melanoma is (was) on the top of my thigh. The mole was about 14mm wide and looks like a typical melanoma on the internet. How I wasn’t concerned about it I don’t know. I’ve had it years. I’m very lucky. 

I’m pretty fit and healthy apart from this. If I do have a SLNB it’ll be the same reason you did. It’ll stop me wondering. 

I’m pretty positive about it all though. It could be worse. 

Did you have to take much time off work for your WLE and SLNB?

thanks again 

I am retired so didn't need to worry about going back to work. The information I was given did say to take it easy for the first couple of weeks and not to drive until you could perform an emergency stop.

I think a lot does depend on where the WLE and SLNB are done. If I had been working I could have gone back after a week but I think I've seen people on here who've had the SLNB done from their groin and they needed much more time away. I'm going to tag Sonny09 into this reply as he has very recently had a WLE and SLNB for a melanoma on his thigh and might be able to give you more information on how he's doing.

x

Thanks latchbrook. I’ll be asking lots of questions next week I think. Is the WLE ok? Is it similar to the mole removal? I found that pretty straightforward. Sorry to ask questions. 

I just read your profile - I’m glad things are good for you now. 

Thanks for the tag Latchbrook, yes had my WLE on lower right calf and SLNB on top of right leg, just over a week ago, I am still bandaged up, back to hospital tomorrow for wound check. I am signed off work until 23rd Sept at the moment. Havent got a great deal of feeling in both sites generally, but when the nerves do fire they feel raw and it can take your breath away, managing any pain with mainly paracetamol/ibuprofen with an odd codeine tablet if it flares up, not brilliantly mobile, but am very wary of bursting my stitches, will know more after monday, any questions Margarita2019 just fire away.

Yes the WLE is similar to the original excision they just take a bigger area away all around the original excision. Because of the size of my melanoma I had 2cm taken away but you'll probably have 1cm taken away. The consultant should be able to advise you how much they'll be taking when you see them. If you're not having a SLNB then the WLE is done under a local anaesthetic.

They closed my WLE with dissolvable stitches, which I much prefer to ones that have to be removed! I had to do the usual thing of keeping the wound dry and covered for so may days after the operation but you'll be given instructions about that as well.

Don't apologise for asking questions - it's what we're here for.

x

Ah bless you Sonny09 - that sounds pretty full on. I hope you feel ok and you’ll be up and about very soon. I thought it was a bit easier than that and I’d be back at work in a couple of days. I don’t have a date yet. I had an appointment two weeks ago where I had the results and am meeting plastic surgeon next week where I assume I have to decide about whether to have the SLNB. I obviously have to have the WLE. I hope the procedure(s) will be done soon after next week’s appointment. It is hard to make plans otherwise. Did you have a choice for SLNB or did you have to have it? 

Thanks latchbrook. I prefer dissolvable ones too. The mole ones were normal ones so I had to have them removed. I have a 2 inch scar but it’s healed well. I guess a thigh is a good place to have it. Although it’ll be a new scar when they go back in! 

Due to thickness of original melanoma my plastic surgeon said I should have it, due to 20 % chance it could have spread

I was told the further away from your heart the longer it could take to heal, apparently lower limbs and feet can take longer to heal than other areas