What do you mean you don't know if it was in your nodes? The entire purpose of the sentinal node biopsy is to discover that. How many nodes did they take? I think you missed something along the way. Did they tell you a stage or any numbers?
Skin Cancer - Melanoma Questions
Asked by SRikard on Thursday, February 14, 2013
5 more spots taken off. I had my nurse daughter go in with me so she could see what he took off. So I wait to see if these are ok or not ok. Everytime I see him he asks me if I'm doing the interferon and I say no and wonder if I've made the right decision. I guess I should have explained how this all started. How about...mole taken off was fine...then it returned and came back melinoma. Had a sentinal node biopsy. Didn't find out if it's in my lympnodes. So onto a Pet Scan which showed nothing and oncologist which said let's just keep an eye on you. I hate being at the mercy of me making decisions and just doctors in general. Ya know what I mean? I know ya'll do that when I decided I needed some outside help with people who understand what I'm going through. Thank you for your comments.
6 Answers from the Community
When I went for my follow up after the surgery the dr told me they couldn't find my lympnode that was the closet to it. He was an ear nose and throat dr which I wondered why my derm sent me to him, but he said he was educated and I found out he has done this procedure numerous times. Anyway..so onto pet scan which was fine then oncologist. He said they got all the cancer the only question was the node closet to the cancer. So that's the only question I have. He had a nurse come into talk to me about doing the interferon but suggested (because I had pretty much made up my mind) that they just keep an eye on me. My daughter (after yesterday and if these places come back cancer) said I may have to do the interferon to get the cancer out of my body. The cancer was small...I don't remember the numbers but the stage I don't know. At the beginning the pathology was a possible IV. I've missed alot along the way cause I'm not the best at listening (LOL) and when I heard cancer...I sorta zoned out.
SRikard, boy can I identify with your “zoned out” comment. For the first two years after my diagnosis, I would see my oncologist either weekly or every three weeks, and for the past 18 months it’s been every six weeks. I’m very glad my wife accompanies me to appointments; I even today I still don’t always retain everything being said.
I do not envy you in your current position, quite a difficult choice. Interferon is not typically used for stage I or IV patients and without knowing all of the salient points, a guess on my part would say you are possibly stage II or III. You said “…the pathology was a possible IV”. If you can look at the pathology report, it probably called out Clarks Level IV. If it is Clark’s Level IV, that would also point to stage II or III. A positive sentinel node biopsy would progress you to stage III but in your case????
I personally think you need some help in the form of a second opinion. If you agree, try to find a melanoma oncologist. Also, gather up copies of all data that has been generated – pathology reports, blood work, scans, etc., they will become invaluable to you when seeing another doctor or when you are doing research on your own. Good luck.
KimKDVM (Best Answer!)
What is your exact stage, was your melanoma ulcerated? What was the Breslow depth? All those things may alter your risk for a recurance. Interferon doesn't prolong life expectancy, only time to relapse and is very toxic. Personally at stage IIA I was offered it in a clinical trial and refused. It wasn't worth it. I did become stage IV 8 years later but IL-2 and surgery has kept me cancer free for over 30 months.
I never regretted my decision NOT to do interferon. Run if your doc brushes off the side effects as only having mild flu-like symptoms, no biggie. It is no walk in the park treatment, and the effectiveness just wasn't worth it (at least for me).
Anxiety is normal and actually gets better over time. If you have lots of moles consider mole mapping and look for change. You will get better with all this over time, trust me. Even I no longer get as worked up when I go for scans. My mom on the other hand is always a wreck!
Take care, never regret your decision, and INF isn't all that great IMHO. My onc. agreed with me as well.
PS - Don't confuse Clark level with Stage. Clark level only describes depth of invasion into the different skin layers, Breslow depth is a better indicator of risk and Clark is only being used in thin lesions less than 1.0 mm deep.
Right now from what you are saying, you are NED - or have no detectable evidence of disease. You can also monitor your nodal basin by using periodic ultrasound. There is a study comparing interferon vs. nodal monitoring using ultrasound and the results were equal. I would avoid the drug and just do close monitoring.
I do get the "but I am not doing anything" actively to "kill" any remaining cancer mindset, I had it. From what you stated so far, the standard is close monitoring. Save any drug treatments as your ace in the hole should it return. If you get more moles, so long as they are not as deep or advanced as your first one, your stage will remain the same.
If you have several moles that keep coming back as mel, you may have a genetic mutation for familial melanoma which they can to blood tests for. If so, also keep an eye on your pancreas since familial mel carriers have an increased chance of pancreatic cancer as well.
Never ever ever go back and play the what if game, it won't do you any good. Do on the other hand have a plan B - Z for what if it comes back. Deal with the present and future, forget the past.
Cyber hugs - KK