› Forums › General Melanoma Community › just diagnosed w/ biopsy from nose
- This topic has 21 replies, 4 voices, and was last updated 11 years, 1 month ago by
mjcap.
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- June 15, 2014 at 3:04 am
My husband was recently diagnosed by a shaved biopsy from a spot on his nose. He also has a streak under his fingernail that has not been addressed.
Upon the diagnose of melanoma, he was referred to a dermatologist specializing is Moh's surgery who is recommending removal with plastic surgery repair the following day.
My question is that, with no full body exam done by either dermatologist, is the normal proticol?
Also, since we failed to point out the streak under his fingernail, is there possibly more going on and if so, is seeing a specialist with Moh's surgery enough to address a more systemic possiblity? He did do a physical exam by feeling each of his lymph nodes. Is this enough?
I read that some melanoma's, if caught early and by their location, were less likely to spread. Only, I do not know where these types of melanoma's are, nor what types of tests are needed to determine if they have or have not spread.
It is just over an hour to see these doctor's and would be the same amount of time to go on to MD Anderson.
Should we go on to MD Anderson to have the whole body addressed?
Thank you for answering…Vicki88
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- June 15, 2014 at 4:51 am
Go to MDA! !my husband had melanoma under his thumb nail which he ignored for too long. He is stage I've now but thankfully NED after surgery and ipi. Good luck
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- June 15, 2014 at 4:51 am
Go to MDA! !my husband had melanoma under his thumb nail which he ignored for too long. He is stage I've now but thankfully NED after surgery and ipi. Good luck
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- June 15, 2014 at 1:55 pm
Thank you for your reply…
These are the questions I directly asked the specialist:
1. Since the biopsy was shaved and you could not measure the original depth of the site, how secure are you that Victor's melanoma is not more of a threat?
2. I know that you did a physical test on his lymph nodes. How do you determine when to do more testing to see if the lymph nodes have indeed, been affected? And, what tests would this be?
3. Dr. **** has not done a full body search. He has mainly only dealt with those either pointed out, or in the upper torso and head section. Would not a more thorough exam be in order?
4. In the (hopefully UNLIKELY) event that a more systemic diagnose were to be reached…would you still be THE doctor to manage my husband's care?
Thank you,
Vicki
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- June 15, 2014 at 1:55 pm
Thank you for your reply…
These are the questions I directly asked the specialist:
1. Since the biopsy was shaved and you could not measure the original depth of the site, how secure are you that Victor's melanoma is not more of a threat?
2. I know that you did a physical test on his lymph nodes. How do you determine when to do more testing to see if the lymph nodes have indeed, been affected? And, what tests would this be?
3. Dr. **** has not done a full body search. He has mainly only dealt with those either pointed out, or in the upper torso and head section. Would not a more thorough exam be in order?
4. In the (hopefully UNLIKELY) event that a more systemic diagnose were to be reached…would you still be THE doctor to manage my husband's care?
Thank you,
Vicki
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- June 15, 2014 at 1:55 pm
Thank you for your reply…
These are the questions I directly asked the specialist:
1. Since the biopsy was shaved and you could not measure the original depth of the site, how secure are you that Victor's melanoma is not more of a threat?
2. I know that you did a physical test on his lymph nodes. How do you determine when to do more testing to see if the lymph nodes have indeed, been affected? And, what tests would this be?
3. Dr. **** has not done a full body search. He has mainly only dealt with those either pointed out, or in the upper torso and head section. Would not a more thorough exam be in order?
4. In the (hopefully UNLIKELY) event that a more systemic diagnose were to be reached…would you still be THE doctor to manage my husband's care?
Thank you,
Vicki
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- June 15, 2014 at 4:51 am
Go to MDA! !my husband had melanoma under his thumb nail which he ignored for too long. He is stage I've now but thankfully NED after surgery and ipi. Good luck
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- June 16, 2014 at 2:22 am
The priority is NOT a full body exam or scans or anything like that at this point. The priority is taking care of an exisitng melanoma. The body exams and all the rest can come later. Most melanoma warriors 90% only get ONE melanoma primary. Take care of the obvious first.
1. Get a copy of the pathology report. Shave biopsies may be totally fine if the deep margins is not involved.
2. Fingernail. Is this new? Is it growing out with the nail? Oftentimes, this type of lesion is just monitored to make sure it is/is not growing out. Acral melanoma (the type found under fingernails, palms, toenails, feet) is usually found on darker skinned individuals. It is quite unusual to have two separate melanomas let alone two different types.j
3. Mohs surgery is a staged approach to the WLE – removing remaining melanoma with margins while preserving the most tissue possible. It may be totally appropriate for this lesion.
4. Without more information (pathology on the nose), it is very hard for us to give you good information. The depth is THE most important factor here and we don't know what it is. Your husband will need the WLE (wide local excision). However, depending on the depth of the lesion, he might need a SNB. We can only speculate without further info.
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- June 16, 2014 at 2:22 am
The priority is NOT a full body exam or scans or anything like that at this point. The priority is taking care of an exisitng melanoma. The body exams and all the rest can come later. Most melanoma warriors 90% only get ONE melanoma primary. Take care of the obvious first.
1. Get a copy of the pathology report. Shave biopsies may be totally fine if the deep margins is not involved.
2. Fingernail. Is this new? Is it growing out with the nail? Oftentimes, this type of lesion is just monitored to make sure it is/is not growing out. Acral melanoma (the type found under fingernails, palms, toenails, feet) is usually found on darker skinned individuals. It is quite unusual to have two separate melanomas let alone two different types.j
3. Mohs surgery is a staged approach to the WLE – removing remaining melanoma with margins while preserving the most tissue possible. It may be totally appropriate for this lesion.
4. Without more information (pathology on the nose), it is very hard for us to give you good information. The depth is THE most important factor here and we don't know what it is. Your husband will need the WLE (wide local excision). However, depending on the depth of the lesion, he might need a SNB. We can only speculate without further info.
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- June 16, 2014 at 2:58 am
Thank you for replying!
As for the fingernail, I THINK it appears wider than say, last year… Definitely wider than the first go around from years ago. As far as darker skinned, well, he definitely has deep skin tones with his czech heritage 🙂
I really appreciate your detailed reply as it gives us some prespective, and questions to ask at the next appointment which will include not only the surgeon, but the plastic surgery team.
Sincerely,
Vicki
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- June 16, 2014 at 2:58 am
Thank you for replying!
As for the fingernail, I THINK it appears wider than say, last year… Definitely wider than the first go around from years ago. As far as darker skinned, well, he definitely has deep skin tones with his czech heritage 🙂
I really appreciate your detailed reply as it gives us some prespective, and questions to ask at the next appointment which will include not only the surgeon, but the plastic surgery team.
Sincerely,
Vicki
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- June 16, 2014 at 4:16 am
If he has had the fingernail lesion for years…. Then it's unlikely to be melanoma. It would have had significant changes, obvious sores or growth. A slight possible variation in size over years, this sounds much more benign than malignant. Never hurts to ask, but I wouldn't be stressing about that one right now. And think Bob Marley or African American when I say dark skin.
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- June 16, 2014 at 4:16 am
If he has had the fingernail lesion for years…. Then it's unlikely to be melanoma. It would have had significant changes, obvious sores or growth. A slight possible variation in size over years, this sounds much more benign than malignant. Never hurts to ask, but I wouldn't be stressing about that one right now. And think Bob Marley or African American when I say dark skin.
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- June 16, 2014 at 4:16 am
If he has had the fingernail lesion for years…. Then it's unlikely to be melanoma. It would have had significant changes, obvious sores or growth. A slight possible variation in size over years, this sounds much more benign than malignant. Never hurts to ask, but I wouldn't be stressing about that one right now. And think Bob Marley or African American when I say dark skin.
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- June 16, 2014 at 2:58 am
Thank you for replying!
As for the fingernail, I THINK it appears wider than say, last year… Definitely wider than the first go around from years ago. As far as darker skinned, well, he definitely has deep skin tones with his czech heritage 🙂
I really appreciate your detailed reply as it gives us some prespective, and questions to ask at the next appointment which will include not only the surgeon, but the plastic surgery team.
Sincerely,
Vicki
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- June 16, 2014 at 2:22 am
The priority is NOT a full body exam or scans or anything like that at this point. The priority is taking care of an exisitng melanoma. The body exams and all the rest can come later. Most melanoma warriors 90% only get ONE melanoma primary. Take care of the obvious first.
1. Get a copy of the pathology report. Shave biopsies may be totally fine if the deep margins is not involved.
2. Fingernail. Is this new? Is it growing out with the nail? Oftentimes, this type of lesion is just monitored to make sure it is/is not growing out. Acral melanoma (the type found under fingernails, palms, toenails, feet) is usually found on darker skinned individuals. It is quite unusual to have two separate melanomas let alone two different types.j
3. Mohs surgery is a staged approach to the WLE – removing remaining melanoma with margins while preserving the most tissue possible. It may be totally appropriate for this lesion.
4. Without more information (pathology on the nose), it is very hard for us to give you good information. The depth is THE most important factor here and we don't know what it is. Your husband will need the WLE (wide local excision). However, depending on the depth of the lesion, he might need a SNB. We can only speculate without further info.
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