Melanoma on sole of foot

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Evening! Hoping someone here can offer some insight…

A couple of weeks ago I had a “freckle” excised on the sole of my foot (near, but not on a weight bearing area). It was confirmed as a superficial spreading melanoma which I think both myself and my dermatologist were quite shocked about as it’s quite an unusual place (and I’m not fair skinned!). It was stage 1a.

the dermatologist offered the wide level excision himself but I expressed some concern about a 3 x 2.5 hole on the base of my foot and I’ve now been referred onto my plastics, who will presumably offer flap or graft surgery (this terminology is not new on me - I’ve had a preventative mastectomy and reconstruction!). 

has anyone had a growth somewhere similar and can ad use me on potential hospital stay (day case?!) and recovery times. I’m Paranoid I’ll spend 2 weeks plus with my foot in the air! I’m not someone to sit still…

thank you so much xxx

  • Hi and a very warm welcome to the online community

    I'm sorry to read that you've recently been diagnosed with melanoma on the sole of your foot. As mine was on my arm, so I don't have the experience you're looking for, I had a look in the group and found these previous posts which mention melanoma on the sole of the foot which you could have a look through.

    The most recent poster to mention having a melanoma in the same place as you is who I've 'tagged' into my reply. Hopefully, she pop on and tell you about her experience.

    It would be great if you could pop something about your diagnosis and treatment into your profile as it really helps others when answering or looking for someone with a similar pathway. It also means that you don't have to keep repeating yourself. To do this click on your username and then select 'Profile'. You can amend it at any time and if you're not sure what to write you can take a look at mine by clicking on my username.

    Let us know when you have your date for the wide local excision (WLE).

    x

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  • Hi. Yes like you I had a rather large mole on the sole of my foot. It was about the size of a 50p. it had been there for several years, as I couldn't see it I never paid it much attention(i wish I had). It became sore and started to weep.

    had dermatology appointment followed by biopsy. told it was a melanoma.

    had day surgery to remove it. was told would probably need second procedure to close wound.

    had results and told they'd removed all signs of cancer, but would defiantly need op to close quite large incision.at this time about 50mm in diameter.

    first op carried out with local anaesthetic. Second with general both day surgery

    had second op where skin graft performed all went well. 

    not wishing to add to your worries as every case is unique but i spent about six weeks off work. Some of this in a wheel chair.

    I have made a complete recovery. i have 3 monthly checks at hospital.

    I  had first class treatment at west Suffolk hospital and can't praise the staff enough.

    Hope this goes some way to putting you mind at ease.

    Jilly23
  • Jilly, thank you! I really appreciate your response. That helps me with my expectation of stay in hospital time Grinning
    You haven’t worried me about recovery time - think I may be slightly more fortunate in that my mole was perhaps only about 1cm x 0.6cm ish at its widest. So the hole should only be around 3 x 3cm. But I’ve tried squishing the skin up and i can see that it won’t  heal well without clever flap work or a graft! Nevertheless the fact that it’s been caught early is the biggest relief however long I’m sitting around for (the husband will disagree with this - that’s gonna be a lot of family meals for him to prep). 
    Whereabouts was yours on your foot? Was it on a weight bearing area? I’m really active - also our bedroom is in the loft, second floor. I’m guessing I may end up stuck there!!!

  • Pleased you’ve had no reoccurrence too. That’s fab! But I noticed from your profile you’re still in pain; has that improved?

  • Hi HappyMrsChicken, 

    I'm a longtime lurker of this forum but decided to reply to your post because I just went through a similar experience. I'm hoping my story can put your mind at ease a little.

    I had Stage 1a melanoma near the weight bearing area of the sole of my foot. It was excised almost exactly a year ago with a 1 cm margin all around, causing a wound that's oval in shape around 3 cm wide and 2 cm tall. The wound was repaired with split thickness skin graft, taken from my thigh. My thigh healed with no issues besides itchiness. My foot took was a bit more problematic. The wound developed hematoma that had to be released, which meant it took longer than usual to heal. 

    Pain level after surgery was very  manageable with paracetamol and ibuprofen. I was pretty much off the painkillers after 3-4 days. 

    I was told to kept the foot elevated as much as possible for 2 weeks. So, I was basically in bed/on the couch for that long! Two things that helped: a blanket lifter, which allowed me to elevate my foot on pillows without the blanket weighing it down, and two small seats for the shower (one for me to sit in the shower, one outside for my foot, since I had to keep it dry). 

    I attended a wound review at the local hospital every week, where they checked and re-dressed the wound with bulky soft boot. I moved around in crutches (I had to organise my own crutches before the surgery, so make sure you ask about this). After about 4-5 visits, I was allowed to wash and dress the foot myself at home. At around the same time, I was also seen by a physio, who advised me how to start putting weight on the foot again. Plastics were happy with the wound after about 8 weeks total, and I was discharged. All I had to do was to keep the wound moist and massaged every day to reduce scarring. I was on crutches for maybe a couple of weeks longer than that. 

    Well, it scarred, but not too badly, and not enough to cause issues with walking. The wound is actually still numb until today. There was nerve pain near it, which meant putting weight on it at the start was absolute agony, but I found that soft insoles helped a lot. I'm walking around fine now, a year later, and even did a whole lot of hillwalking in Scotland recently. It still occasionally aches, but not enough to stop me from going about my normal day. 

    I had a skin and lymph node check every 3 months for a year,  and have now been discharged because there were no further issues. 

    I hope this gives you some idea of what to expect and eases your stress a little bit. I will check back here in case you have questions about my experience. Good luck with your next steps. I do hope it goes smoothly. Tears are allowed. That and lots and lots of gin. 

  • Thank you so so much, I really appreciate the depth you went into re: your recovery. That’s really kind and I’m fortunate you saw my post! it does all sound very similar (in terms of size/stage/near weight bearing area etc). I’ve read about split thickness skin grafts and wondered if that would be first choice given the thick skin of the foot! I guess all will be revealed on Friday when I’m meeting my plastic surgeon. I can’t second guess a specialist but I have the type of brain that thrives on knowing lots!

    2 weeks on the sofa sounds doable and I’m delighted to hear you’re back hill walking now (my best days are wandering the South Downs near where I live). 


    thanks again and I will update you x

  • Like you, I like arming myself with as much information as possible. The surgeon offered 3 options: leaving the wound open to heal on its own, a split skin graft, and a full thickness graft. A flap was not an option for me because there just wasn't enough skin to stretch over the wound. The surgeon said he could try, but experience told him that it would just split open later on. I didn't like the sound of that!  I wasn't happy about leaving the wound open, either.  The final choice between a split and full thickness was basically a coin toss for me. Each had pros and cons. I do hope you have a good discussion with your surgeon. Mine was thorough and it really put my mind at ease. 

    FYI it was a half day stay at the hospital for me, with local anaesthetic only. The main ordeal took only 1 hour. The rest of the stay was sitting, waiting, and recovering. 

    All the best on Friday. I will keep you in my thoughts. 

    1. I have to admit squishing up my skin a bit to see what give there is, and it doesn’t seem so much on a foot! It looks like even if a flap is offered it’s in conjunction with a graft, so….it sounds like what you did went well for you! I’m not a fan of leaving it open either - that must take an AGE to heal. 
      Pleased to hear a local is possible; though I love the pre op “cocktail” (sedative) that’s given prior to a general anaesthetic, after 5 the novelty has worn off and the digestive after effects suck! I hope the same can be done for me! Was it 2 separate locals for the thigh and foot or a spinal? X
  • I had 2 separate locals for the foot and thigh. 

    Yes, I am happy with the outcome of the repair of my foot. I mean, it's slightly ugly to look at but it's my foot. It's not like anyone's gonna look at it. Not even I look at it everyday! I just wanted the melanoma out and to get back to hillwalking as soon as possible. The recovery felt frustratingly long and tedious at the time, but looking back now, it wasn't so bad. 

    I hope it goes smoothly for you and that soon it'll all be behind you, too. 

  • Had my surgeon appointment this morning and same options on the table as you but he very much disregarded everything except split thickness skin graft from thigh; so sounds like I’m on the same course as you! He said he will miss the weight bearing area and he expects me to be on my feet after a week, and potentially jogging/swimming etc after a month. :) we shall see! I will try and set some realistic expectations somewhere between the both of you…..

    looking to have the op around 3 weeks from now and I’ll likely opt for a local as I’m a bit tired of the after effects of general. Will let you know how it goes….