Full lymph node dissection - DonnainRI

Procedure or Surgery Associated with Skin Cancer - Melanoma. Posted on April 29, 2016 View this journey (12 Experiences)

I had a modified wide excision of a melanoma in my left groin on Feb 25th 2016 but the story is more complicated than that. I had my first melanoma at age 24. It was on the back of my left thigh. I underwent wide excision with in-continuity inguinal node dissection. One node came back positive out of about 18 they removed. This was in 1976 and sentinel node biopsy had not yet been instituted. About 12 days post-op I developed lymphedema which has gotten worse over the years. I underwent treatment for it in 2010 and wear a compression garment and do nightly wrapping. Last May I discovered a mole that had enlarged and gotten dark. I had it removed on June 19th by a local surgeon and he called me on the 24th to confirm what I already knew - it was melanoma. The margins were barely clear and the lesion was 3.9 mm but follow up scans showed nothing in my nodes so in August I had a wide excision of that lesion. Recovery was not bad except for the fact that, due to my pre-existing lymphedema, both ends of the incision popped open when the staples were removed. It took another five weeks to close but fortunately I had no infection although it drained lymph and my skin was a mess from the dressings and tape. I finally found some really good tape that sticks well but does not tear your skin. Anyway, we decided to watch and wait and I was staged as IIb. In early January I felt a new bump in my groin near the scar from last year's wide excision. I looked at it and sure enough it was like a little black headlight staring back at me. I called Dana-Farber and they got me in to remove it the same day. As expected it was melanoma and changed my staging to IIIC. My next scan at the end of the month was negative so they did a modified wide excision on the Feb 25th but my surgeon did not let me go back to work until I was fully healed and no longer draining so I was out about 7 weeks. I just had another PET/CT and labs and all is still clear. I saw the oncologist this week and will be doing the every three month thing until I am clean for one year from the last procedure. We are holding on adjuvant treatment for now which is fine with me. My doc does not advocate for interferon and although I am now eligible for ipilimumab we are holding as long as I stay clear. I know this is high risk and my long-term prognosis is not good but I'd rather wait until there is something to treat and my doc is in favor of that as well, Immunotherapy has its limitations and some people either do not respond or stop responding after a time, so I think waiting is better rather than being exposed to it now and perhaps it would not work later when I really need it. I'm an RN so I have read many, many studies on melanoma over the years just to stay current but until the last few years there was not much in the way of hope. Now I know that they have quite a few drugs in development and early stage trials and they have also discovered more about how melanoma hides itself from the body's immune system. That could lead to another class of drugs that could work in tandem with the immunotherapy so I am hopeful that I'll outlive the statistics.

Went as Expected: Disagree
Minimal Recovery: Strongly Disagree
Minimal Side Effects: Strongly Disagree
Minimal Impact to Daily Life: Disagree
1 Comment
  • Moomin's Avatar
    Moomin

    The new treatments bring us some very tough decisions, that's for sure. Suddenly melanoma treatment is all over the news, so I am also hoping to ride the crest of the wave to the next big breakthrough. Good luck to us!

    about 2 years ago

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