With stage 2A melanoma, I'd like to consider a sentinel lymph node biopsy. What are the advantages and disadvantages. Worried about lymphoedema, what are chances of this happening? , any advice from anyone who has experience with this? Thanks
I didn't have a SLNB as my melanoma was only 0.7mm depth but it then returned Stage 3, 13 years later. For those who are given the option, a small amount of patients prefer not go ahead because of the chance of possible side effects. Of the patients I know that did opt for it, only a small amount suffered a side effect - either an infection or a seroma or mild lymphoedema (dependant on how many nodes were removed). At the end of the day you have to weigh up the correct Staging that a SLNB will give you against the small to mid chance of suffering a side effect. An infection is slightly debilitating for a time until cured with antibiotics - a seroma causes discomfort for a few months until it breaks down and disappears whilst mild lymphodema is life long. However, if the warning signs are caught quickly and treament given, some people hardly notice it whilst others may have to wear a compression sleeve or stocking if it swells too much.
My personal experience - I wasn't offered a SLNB because my melanoma was under the threshold depth. If I had been offered it, knowing what I know now, I would still have taken it so that I accurately knew my Staging and wasn't worrying that mm may be in my node and spreading. I have mild lymphoedema after my full node clearance in my groin & pelvis (2 nodes positive with mm). I started with lymphoedema 2 weeks post surgery & I was quickly treated with regular checks by a lymph nurse and I wear compression tights. It's a small inconvenience compared to what could have happened.
So although the chances of you getting lymphoedema are small to medium, it all boils down to how you will feel mentally if you don't have it done. If you can cope with not knowing (most hospitals offer regular ultrasounds of the nodal area instead) and hate the thought of any side effect, then don't have it. Only you can decide I'm afraid. Good luck and please let us know how you get on,
I think your best source of information is going to be your hospital team so do be sure you speak to them and check out anything you come across online to be sure they agree with it. It is useful to hear from other people but everyone's situation is a bit different and some people's stories may not be representative or reflect your situation very closely.
Our website has information explaining the purpose of sentinel node biopsy in melanoma and the possible side effects - click here to see it. The risk of lymphoedema following a sentinel lymph node biopsy is low.
Another Charity, Melanoma Focus, has a decision aid which has more information about sentinel node biopsies as you go through the treatment options for your stage
Do talk to your hospital team and if you have a melanoma nurse try and get to speak to them. I hope you are able to reach a decision you feel comfortable with.
If you want to talk anything over please give us a call on 0808 800 4040, we are around weekdays from 9-5.
