Melanoma

[sciachetra]

My skn doctor detected and removed a melanoma with a 0.7 mm thickness (Clark level was III). The mitotic rate was 2/mm2.  The margins of skin around the removed tumor were cancer-free.  X-rays of my lungs, ultrasound of my internal organs, and bloodwork were all good (i.e., did not show any signs of metastases).

According to my physician, owing to the mititoc rate, it is necessary to remove the lymph node nearest the tumor in order to do a biopsy.  Should cancer cells be found, further lymph nodes will be removed.  The operation to remove the lymph node is set for the last week in August.

Is it normal to wait one month to do a lymph node biopsy?  Shouldn't they have done this while I was in the hospital having the melanoma removed?  The melanoma itself was removed two days after my dermatologist received the diagnosis from the pathology lab.  The dermatologist said the wait is due to the need for the removal site of the melanoma to fully heal -- it was located on the back of my right ear, and it required a skin graft.

Thanks very much for any info and suggestions.

Rob

[sciachetra]

Thank you very much for taking the time to respond to my query.  I will definitely keep you posted on my progress.

May I ask one follow-up question?   I have been searching for statistics relating the likelyhood of TIb melanoma spreading to the lymph nodes (or beyond).  Are you aware of the statistics?

Again, my sincere thanks.

Best Wishes,

Rob

[Bhupinder Kaur, MD]

Hello,
I agree with your doctor that since grafts were used, it is better to let the site of surgery heal first and then the closest lymph nodes in the vicinity of melanoma be biopsied or removed. ThEN FNAB can be done. FNAB is aspiration of the material of the glands which is done by a fine gauge needle (22 or 25 gauge) and a syringe. This will confirm the diagnosis.

It is very difficult to precisely confirm a diagnosis without examination and investigations and the answer is based on the medical information provided. For exact diagnosis, you are requested to consult your doctor. I sincerely hope that helps. Take care and please do keep me posted on how you are doing.