Is second sentinel lymph node biopsy necessary?

My husband has recently had two melanomas removed. One was 1.6mm thick, the other 0.2mm. He's having wide local incisions and SLNBs on both. We were told that not everyone it's for SLNBs. We feel that it's not necessary for place where thinner melanoma was and just increases chance of lymphoedema which scared us both. 

 

Has anyone had a similar dilemma? I'll going to phone specialist nurse on Monday but am worried, can't sleep, now 20 to 2am. We want to do the best we can but also avoid risk of side effects.

 

Thanks x

  • I'm not a medic, but have also faced similar dilemmas, which I asked about. I had penile cancer in the past. This required a sentinal node procedure on lymph nodes in my groin.
    A sentinal node procedure is specifically designed to remove the minimum number of nodes necessary. and so reduce the chances of side effects.
    I wanted to know what the chances were of having one or more positive sentinal nodes. I wanted to know what the consequences would be of having positive nodes, in the event of me not having a sentinal node procedure. I also wanted to know the chances of side effects, with particular attention to lymphodema, following sentinal node removal.
    A specialist nurse may not be able to give you this information. You may need to speak to a doctor. But you are entitled to answers to these questions. 
    It is not always easy for medical staff. Patients often want to have concrete information. But doctors may only be able to provide statistics and probabilities.  Nevertheless, these statistics and probabilities are essential, for both yourself and your medical team, when it comes to making treatment decisions. Understanding them will help you have confidence in the choices your doctors make. They usually get it right.
    In my particular case case (and all cancers and patients are different, of course) the chances of one or more positive nodes were around 20%,  the consequences of having undetected positive nodes were extremely serious, while treating positive nodes early gave a great chance of eliminating the cancer. The chances of lymphodema were very low. So I was happy to have the sentinal node procedure. It was clearly in my best interests. 
    Good luck. Harry

  • Thanks for that, Harry. 

     

    What side effects did you have from the SLNB? Hubby also worried that he won't be able to work if he gets lymphoedema (he's a self-employed builder). 

  • Zero side-effects, as expected. It was a few years ago now. 
    The doctor will tell you what the chances are lymphodema are. It will depend on the lymph nodes concerned (mine were in the groin) and how many of them (I had 4 removed).

  • Hi Fluffy Bull and thanks for posting.

    We have some information here about sentinel node biopsies, why they are required and the risks and benefits of the procedure. 

    Whether you are offered this procedure does depend on the stage of the melanoma.  It can help your husband's team decide on the most appropriate treatment, but of course there are also risks such as infection.

    Discussing the options with your husband's team can help you make an informed decision about this, and may help put your mind at rest. 

    I hope this information is useful.

    It may be helpful to talk things through with one of the nurses on our helpline.  The number to call is Freephone 0808 800 4040 and the lines are open from 9am till 5pm Monday to Friday.

    Take care

    Rachel