Hi David,

Skin Cancer Nurses (Cancer Nurse Specialist CNS) work alongside the Dermatology and Plastic Surgery consultants and they sometimes deal with check ups and post surgery/results appointments. They are also the 'middle man' when patients want to voice any concerns. They are authorised to give biopsy results to patients, whether good or bad. You can't really assume what they will tell you, just because it's the nurse rather than the consultant. Hopefully it's good news and nothing to worry about but you will just have to wait & see what tomorrow brings I'm afraid. Good luck and please let us know how you get on,

Angie (Stage 3 melanoma patient since 2009)

Hi both,

Thank you for your responses, that's reassuring to know that sometimes they may be used to give positive news. I just thought it was strange that I've seen the dermatology consultant at both of the previous appointments and now it's the cancer nurse.

I'll go in expecting the worst and then I can only be pleasantly surprised. I've been expecting bad results since the first appointment with the dermatologist as he said he was fairly certain it was a melanoma when he looked it over with the dermatoscope, so I've been bracing myself for bad news- just the waiting is the worst part! 

Just back from the hospital and it was unfortunately, as expected, a melanoma. 

It's Stage 2a with 3.6mm Breslow thickness, but no ulceration, so I guess that's a positive. From their initial excision, there was a 1mm width of non-cancerous cells around the outside and a 5.2mm depth of non-cancerous cells. 

Got to go back in and see the plastic surgeon on the 22nd and then following that will have to have WLE and SLNB. 

Feels like the first appointment with the plastic surgeon in 3 weeks is a bit of a waste of time to then have him go over everything again before a 3-4 week wait for the WLE and SLNB. 

Hi david,

I'm sorry to hear about your diagnosis. I know it may sound a waste of time but they always call the patient in pre-op to explain both procedures, especially the SLNB as this is optional. It's not a treatment but a diagnostic tool for more precise staging and some patients decide against it as the possible side effects outweigh the positives in some people's minds. They will explain this in detail and give you time to make up your mind. If you decide against the SLNB they usually offer ultrasound scans of the nodal area (about every 3 or 6 months for the first year) instead.

It's also so that you've had time to process the information and think of any questions you want to askl. One question to ask is - what is your BRAF status? Everyone has the BRAF gene but 50% of melanoma patients have a mutated gene. This is important to know if you have it (BRAF positive) or you don't (BRAF negative) because, should the melanoma spread, it determines what type of drug treatment would work for you. Hopefully that will never happen but it's important to know about. They may not have tested the melanoma tissue yet for the BRAF status so they may give you the results when the WLE and SLNB results come back. At that point you can also ask for a copy of your histology report which you will find helpful.

So, I would go to the Plastics appointment and arm yourself with any questions you have. Meanwhile, I will send you a friend request so that, should you accept it, I can send you further information in a private message.

Good luck,

Angie

Hello Davidgm8,

I am sorry to hear about your diagnosis of a melanoma.

I can appreciate that while this cancer has been removed, that you want to get the Wide Local Excision (WLE) and Sentinel Lymph Node Biopsy done as quickly as possible.  Being seen by the plastic surgeon initially, is important, so that you can be examined and the wound can be looked at.  The surgeon will explain the procedure and what to expect during and after surgery, this will be a chance for you to ask questions. You are also likely to be asked to sign a consent form. You may then be told when the surgery will take place. 

Waiting for treatment (surgery) to be done is difficult, so I hope you have some support and you will be okay. You may find it 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,

Caroline 

Hello, 

If you dont mind me asking how quick did you recieve your letter from the biopsy?

Thanks 

Hi Becky,

I got a phone call from the hospital 14 days after the initial biopsy asking for me to come in for an appointment with the skin cancer specialist nurse 2 days later- so it was 16 days in total. I did call them after 11 days and they said the results from the lab were back, but the consultant hadn't looked at them yet. 

I think the skin cancer nurse thought I'd already had the results though because when I went in she said, "Do you know why you're here today?" which was a little strange. 

She was great though, talked through everything and did a full-body scan. I was in there for about an hour in total and she was very thorough with all of the information she gave me in terms of staging, depth, margins, ulceration, next steps etc. 

In regards to [@AngieT]‍ - she said they hadn't tested BRAF yet but that they'd do it if the SLNB came back positive. I'll definitely go for the SLNB, but was just hoping it would be a bit quicker, another 7-8 weeks of waiting for the next surgery. I'm taking solace in the fact that there was a margin of clear skin all around it when they did the initial biopsy, but the thickness of 3.6mm is obviously concerning. 

Thank you, I had my biopsy last tuesday and she had said two weeks for the results but it would be by letter to confirm either way so just nervously waiting.