MARGINS SKIN CANCER

Hi Rubberball 

My name is Steph and I’m part of the team who look after the Online Community here at Macmillan. May I wish you a warm welcome to the site, I hope you will find it to be a safe place of comfort and support.

I am sorry to read that you have been through treatment for skin cancer and have some concerns about this being successful.

I have just moved your post here in the Skin cancer forum from the Cancer Chat forum. This will make it easier for you to connect with others going through treatment for skin cancer. It's normal to worry about cancer returning and we are here to support you through this.

Our members can only answer from their personal experience, so you might want to talk through your worries with a nurse on our Support Line. You can ask questions in our Ask a Nurse sessions or get in touch 7 days a week, 8am-8pm on freephone 0808 808 00 00, email or live webchat.

They may encourage you to speak to your team at the hospital when you have questions specific to your personalised treatment plan. They will be the best people to answer any follow up questions you might have about your diagnosis and treatment.

I hope this is helpful and that you'll continue using the Online Community. Do let us know if you have any questions by emailing us at community@macmillan.org.uk

Hi Rubberball and a very warm welcome to our corner of the online community.

I'm sorry to read that you were diagnosed with melanoma in situ and that you are concerned about the margin they took when you had the wide local excision.

As you are probably aware, melanoma in situ is a term used to describe the earliest stage of melanoma. As the melanoma is only in the top layer of skin, I wonder if this was the reason why the surgeon only removed the top layer and not all the way around as is normal for later stages of melanoma.

I've attached the leaflet produced by the British Association of Dermatologists for you here, and if you scroll down to the top of page 2, you'll see that it mentions having "melanoma in situ removed with a small rim of normal skin". From your description this sounds like what your surgeon did.

If you were assigned a skin cancer nurse specialist (SCNS), sometimes referred to as a keyworker or Macmillan nurse, it would be a good idea for your peace of mind to speak to them to express your concerns. If you weren't assigned a SCNS, you could speak to your consultant via his secretary to find out the thinking behind only the top layer being removed. 

Please do come back and let me know how you get on after you've spoken to one of your hospital team.

Anne

Hello Latchbrook 

Thank you for your response. I was diagnoised with Grade 1 A in the end and needed a clearer margins. I have asked my surgeons secretary to send me an email but nothing has come forward yet. I was told via the spec nurse that the prior surgery took the cancer out and was deep enough at time? Does that mean they went deeper at that time with situ protocol sizing that they thought it was?

Who says its deep enough, when clearer margins are being recommended, to be actioned. I have asked for the biopsy cancer outcome report via freedom of information to.understand ",the margin" recommendations. Thank you for your feed back, do you have information on margins for Grade 1A?  

Hi 

This information from the British Association of Dermatologists gives details on how Stage 1a melanoma is treated. You'll see it says that "the second procedure typically removes a further 1cm margin of skin around the first scar site". You haven't said where on your body the melanoma was but that might influence the size of the WLE.

You asked

Rubberball said:

Who says its deep enough

This is decided by NICE and you can see their recommendations here.

I hope this helps