› Forums › General Melanoma Community › SLNB after WLE?
- This topic has 21 replies, 6 voices, and was last updated 10 years, 10 months ago by
Bubbles.
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- April 23, 2015 at 10:37 pm
Anyone else have the SLNB weeks after the WLE? They initially measured my melanoma as thin based on the punch biopsy, and after the WLE, pathology showed that it was actually a 2mm depth. Tomorrow I am going back from the SLNB that they did not do initially several weeks ago.
I know this isn't ideal but I wondered if anyone else had theirs a while after the initial WLE?
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- April 23, 2015 at 11:51 pm
Yes same story.
I was orginally diagnosed at 2.06 mm, Clark IV. My idiot derm at a skin cancer center NEVER mentioned an SNB, sent me to a medical onc instead of a surgical one.
Fortunately his WLE wasn't big enough so the med. oncologist sent me to a surgical one for an SNB to complete my staging.
Again, not ideal. It was negative. 8 years later I became stage IV with a lung met and muscle met, but my lymph node basin never had any mets, went from IIA to IV without going to stage III. At least I have all my nodes and no lymphedema.
Basically I had hematogenous spread (blood stream) which happens about 20% of the time or less.
Surgery and IL-2 in 2010 made me NED, and I have been NED ever since. I just graduated to dropping one of my oncs (medical one) and now only see the surgical one yearly. No longer doing PET/CT which is nice considering I have had at least 9 on top of other CT scans.
Don't worry, you can't change things, only monitor closely and remember it can come back years later so just stay vigilant and live life to the fullest inbetween having to deal with this junk. Wishing you NED from here on.
FWIW – they can monitor your lymph node basins with ultrasound as part of your follow up which may help considering prior surgery to the SNB.
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- April 23, 2015 at 11:51 pm
Yes same story.
I was orginally diagnosed at 2.06 mm, Clark IV. My idiot derm at a skin cancer center NEVER mentioned an SNB, sent me to a medical onc instead of a surgical one.
Fortunately his WLE wasn't big enough so the med. oncologist sent me to a surgical one for an SNB to complete my staging.
Again, not ideal. It was negative. 8 years later I became stage IV with a lung met and muscle met, but my lymph node basin never had any mets, went from IIA to IV without going to stage III. At least I have all my nodes and no lymphedema.
Basically I had hematogenous spread (blood stream) which happens about 20% of the time or less.
Surgery and IL-2 in 2010 made me NED, and I have been NED ever since. I just graduated to dropping one of my oncs (medical one) and now only see the surgical one yearly. No longer doing PET/CT which is nice considering I have had at least 9 on top of other CT scans.
Don't worry, you can't change things, only monitor closely and remember it can come back years later so just stay vigilant and live life to the fullest inbetween having to deal with this junk. Wishing you NED from here on.
FWIW – they can monitor your lymph node basins with ultrasound as part of your follow up which may help considering prior surgery to the SNB.
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- April 23, 2015 at 11:51 pm
Yes same story.
I was orginally diagnosed at 2.06 mm, Clark IV. My idiot derm at a skin cancer center NEVER mentioned an SNB, sent me to a medical onc instead of a surgical one.
Fortunately his WLE wasn't big enough so the med. oncologist sent me to a surgical one for an SNB to complete my staging.
Again, not ideal. It was negative. 8 years later I became stage IV with a lung met and muscle met, but my lymph node basin never had any mets, went from IIA to IV without going to stage III. At least I have all my nodes and no lymphedema.
Basically I had hematogenous spread (blood stream) which happens about 20% of the time or less.
Surgery and IL-2 in 2010 made me NED, and I have been NED ever since. I just graduated to dropping one of my oncs (medical one) and now only see the surgical one yearly. No longer doing PET/CT which is nice considering I have had at least 9 on top of other CT scans.
Don't worry, you can't change things, only monitor closely and remember it can come back years later so just stay vigilant and live life to the fullest inbetween having to deal with this junk. Wishing you NED from here on.
FWIW – they can monitor your lymph node basins with ultrasound as part of your follow up which may help considering prior surgery to the SNB.
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- April 24, 2015 at 12:41 am
Just so you understand, the SNB is no longer a guarantee of anything. Actually, it never was, but there just is no guarantee that the node they find prior to the WLE is the same as the node they find after the WLE. If it is positive, then you know it probably was. But if it is negative, you can't just know for certain (and no doc should say otherwise).
Good luck.
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- April 24, 2015 at 1:18 am
This is exactly why I am nervous. There is no way to go back in time, but this is exactly what will bother me if I get the negative result that I am hoping for. I just want to do the right things!
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- April 24, 2015 at 1:18 am
This is exactly why I am nervous. There is no way to go back in time, but this is exactly what will bother me if I get the negative result that I am hoping for. I just want to do the right things!
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- April 24, 2015 at 1:18 am
This is exactly why I am nervous. There is no way to go back in time, but this is exactly what will bother me if I get the negative result that I am hoping for. I just want to do the right things!
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- April 24, 2015 at 6:52 am
That's a very good pont that many people dont seem to realise.
And after a WLE you can never be sure if they find the correct drainage patterns so you can be clear butthe melanoma maybe in a different lymph node.
I didnt even do a SNB and I have a very large melanoma. I monitored by ultrasound and ended up having two lymph nodes with melanoma which i had taken out. I rejected the CLND as being way too brutal an operation with no guarantee that you wont progress anyway.
So even a CLND if you have a positive sentinel node(s) is not actually proven to be any better than just getting the malignant ones taken out and continuing to monitor by ultrasound.
I am still clear 18months from inital surgery.
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- April 24, 2015 at 6:52 am
That's a very good pont that many people dont seem to realise.
And after a WLE you can never be sure if they find the correct drainage patterns so you can be clear butthe melanoma maybe in a different lymph node.
I didnt even do a SNB and I have a very large melanoma. I monitored by ultrasound and ended up having two lymph nodes with melanoma which i had taken out. I rejected the CLND as being way too brutal an operation with no guarantee that you wont progress anyway.
So even a CLND if you have a positive sentinel node(s) is not actually proven to be any better than just getting the malignant ones taken out and continuing to monitor by ultrasound.
I am still clear 18months from inital surgery.
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- April 24, 2015 at 6:52 am
That's a very good pont that many people dont seem to realise.
And after a WLE you can never be sure if they find the correct drainage patterns so you can be clear butthe melanoma maybe in a different lymph node.
I didnt even do a SNB and I have a very large melanoma. I monitored by ultrasound and ended up having two lymph nodes with melanoma which i had taken out. I rejected the CLND as being way too brutal an operation with no guarantee that you wont progress anyway.
So even a CLND if you have a positive sentinel node(s) is not actually proven to be any better than just getting the malignant ones taken out and continuing to monitor by ultrasound.
I am still clear 18months from inital surgery.
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- April 24, 2015 at 12:41 am
Just so you understand, the SNB is no longer a guarantee of anything. Actually, it never was, but there just is no guarantee that the node they find prior to the WLE is the same as the node they find after the WLE. If it is positive, then you know it probably was. But if it is negative, you can't just know for certain (and no doc should say otherwise).
Good luck.
-
- April 24, 2015 at 12:41 am
Just so you understand, the SNB is no longer a guarantee of anything. Actually, it never was, but there just is no guarantee that the node they find prior to the WLE is the same as the node they find after the WLE. If it is positive, then you know it probably was. But if it is negative, you can't just know for certain (and no doc should say otherwise).
Good luck.
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- April 24, 2015 at 2:55 am
I know this isn't an ideal situation but wanted to share my daughter's experience with SNB. They did hers during the WLE and took 2 nodes – both of them were below the melanoma, lit up, and absorbed the blue dye so should have been the right ones – and both were negative for melanoma. A month later a different lymph node, above the original melanoma, became enlarged and was positive for melanoma. So, even if they do everything right the SNB is not a sure thing for determining if the melanoma has spread to the surrounding lymph nodes. She went on to have lymph node dissection with no further lymph node involvement, received 3 rounds of biochemotherapy and has been NED for 2 years. I am hoping all goes well for you.
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- April 24, 2015 at 2:55 am
I know this isn't an ideal situation but wanted to share my daughter's experience with SNB. They did hers during the WLE and took 2 nodes – both of them were below the melanoma, lit up, and absorbed the blue dye so should have been the right ones – and both were negative for melanoma. A month later a different lymph node, above the original melanoma, became enlarged and was positive for melanoma. So, even if they do everything right the SNB is not a sure thing for determining if the melanoma has spread to the surrounding lymph nodes. She went on to have lymph node dissection with no further lymph node involvement, received 3 rounds of biochemotherapy and has been NED for 2 years. I am hoping all goes well for you.
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- April 24, 2015 at 2:55 am
I know this isn't an ideal situation but wanted to share my daughter's experience with SNB. They did hers during the WLE and took 2 nodes – both of them were below the melanoma, lit up, and absorbed the blue dye so should have been the right ones – and both were negative for melanoma. A month later a different lymph node, above the original melanoma, became enlarged and was positive for melanoma. So, even if they do everything right the SNB is not a sure thing for determining if the melanoma has spread to the surrounding lymph nodes. She went on to have lymph node dissection with no further lymph node involvement, received 3 rounds of biochemotherapy and has been NED for 2 years. I am hoping all goes well for you.
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- April 24, 2015 at 2:04 pm
What to do regarding melanoma treatment is always complicated, personal, and sadly lacking in absolutes. That said, here are a couple posts with data that may interest you.
Hope that helps. I wish you my best with whatever you decide. Celeste
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- April 24, 2015 at 2:04 pm
What to do regarding melanoma treatment is always complicated, personal, and sadly lacking in absolutes. That said, here are a couple posts with data that may interest you.
Hope that helps. I wish you my best with whatever you decide. Celeste
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- April 24, 2015 at 2:04 pm
What to do regarding melanoma treatment is always complicated, personal, and sadly lacking in absolutes. That said, here are a couple posts with data that may interest you.
Hope that helps. I wish you my best with whatever you decide. Celeste
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