Wide Local Excision

Hi Blaine, I Am not surprised that you are confused, I think the drs have some difficult decisions to make to weigh up risk of corona virus versus cancer treatment as normal or a moderated treatment. My experience with melanoma can be read in my profile, I had one node removed in March last year, I opted not to have the full dissection in that area as my melanoma had previously spread to that area a few years before so for me it was not a necessarily going to help further spread. For me another lymph node enlarged 9 months later but before surgery could be started it reduced again and they could see by the biopsy that the Pembrolizumab treatment I was on was working. For you, although I’m no medic, it sounds like they are trying to keep you safe by doing a minimal surgery, and with that node removed it may or may not spread again. When the corona virus threat and the pressure on the NHS is less, you could opt for a full dissection if you wanted to, if a further spread was identified. When I was first diagnosed in 2015 I had no primary but melanoma in many lymph nodes, too many to have surgery on, so I had targeted therapy and then later immunotherapy. I can give you some links to read about treatment if you want. 

You must be in a whole whirlwind at the moment.

Hi,

It's getting difficult now for the clinicians to balance the best care against the workload with Covid-19. I think the suggestion your consultant has made is the best way to deal with it. If melanoma is confirmed in your lymph node you will then be staged as Stage 3. This then means that you will be offered adjuvant drug therapy as a preventative treatment. You may also be offered a full lymph node clearance of the area at a later date, however most consultants now don't believe it's necessary as the drug treatment is the first line of defence, especially as a full clearance comes with it's own post surgery problems (possible lymphoedema, cellulitis and or seroma). 

I had a full groin & pelvic clearance under GA so I have no personal experience of how painful it may be. However, I have had many mole excisions under a local over the years & I would guess it may be only slightly more painful than they were - which was bearable. The node removal won't 100% prevent the cancer spreading but, together with the following drug treatment (should melanoma be found) you will have a very good chance of stopping it in it's tracks. 

I'm sure that your consultant will cover this in more detail before the procedure but don't be afraid to ask them any questions you have. If you have been given a contact number for a Specialist Cancer Nurse in the department then give them a ring with your questions. Good luck & please let us know how you get on x 

Thank you so much, that was very helpful and yes I would like some links. I’m so glad I joined this online community, yours and other comments are helping me feel less confused. I’m feeling tearful right know not because I’m sad but because I don’t feel I’m alone anymore

Hi, being newly diagnosed, I sometimes feel it can’t be happening to me, I sometimes can’t get my head around it that I have cancer. You and a previous post have been very helpful and I really appreciate it and I will let you know how, I get on, just waiting patiently for my appointment.

Hi Blaine, life is weird enough at the moment without having to have bloody Coronavirus affecting treatment options. I really feel for you.

If it helps, about a year ago now my melanoma spread to my lymph nodes - I found a lump myself - and I had a full groin dissection. I’m now on adjuvant Pembrolizumab and have been absolutely fine so far. I would have never said this at the time, but now, given the choice, I would actively choose not to have all the nodes removed. I have no official complications from the surgery and it all went really well, but the altered sensations in my leg are weird and unpleasant and a constant reminder of the surgery. I don’t think there’s enough evidence yet to show that a full dissection is no longer required because of immunotherapy, but the drugs have been so successful that I reckon it’s heading that way... but I’m no medic - just my opinion.

My point is, try not to worry too much about only having the affected node removed, it’s less serious surgery with fewer potential complications and still gets rid of the melanoma. I expect you’ll be offered immunotherapy following surgery to mop up any rogue cells and these are the game changing drugs you really want! Maybe that’s a question you need to ask to put your mind at rest.

Either way, it is all really scary and we’re here for any questions or just to offload.
Best wishes, Kate x

Hi Kate, your opinion is greatly appreciated. I’m not so worried now as I was the pass few days.

Hi Blaine,

I've had various surgeries for melanoma, under local and general anesthetic. Neither hurt me at all.  

I had a lymph node swell in my groin and having them all removed or just the swollen ones were my options. I chose to keep as many as possible, they are there for a reason afterall.  Happily I made a good choice and I have not had any subsequent problems nor side effects.

One of the reasons I want to keep my lymphnodes is that often if melanoma is spreading, a lymphnode will often swell and it gives you & your doctors an alarm to investigate. Scans are taken to search for cancer in your body and sometimes your head, but as far as I know legs and arms are not scanned. Two of my principle melanomas which have been removed were in my right leg and left arm, and my latest suspect lump in in my left foot...

I don't know where your lymphnodes -which are possibly going to be removed- are located, but if they are in your groin, you could check my profile for information re convalescence etc

Still we are all different, and we each have our own ideas, so theres no one size fits all approach to this. Let me know if you have any other questions you think I could help you answer.

Take care

J

Hi Blaine, I’m glad you’re not feeling so alone anymore, I thought a lot of people would join in to talk to you, so I’m glad you hopped over here. I’ve put a link below to some Macmillan info on targeted therapies and immunotherapies, and as you can see a few people on here are also having those.

https://www.macmillan.org.uk/cancer-information-and-support/melanoma/treatment-overview-for-melanoma#3_targeted_therapies_and_immunotherapies

There’s also an overview of surgery 

https://www.macmillan.org.uk/cancer-information-and-support/melanoma/treatment-overview-for-melanoma#2_surgery

and of course lots of people with personal experience here to help with their experiences.

Best wishes

Hi, with what people have said, it may not be a bad thing just to have the  lymph node with the cancer removed which is in my right grown at this stage, something to think about and read up on, weight out the pros and cons, I’m just waiting for my appointment and i will read your profile thank you x

Great, thank you x