Hi,

I'm sorry for your husband's diagnosis & the choice he has now to make. Many melanoma patients have to make this choice and it's difficult as there is not just the extra waiting time to consider. I will try to briefly explain what you have to look at to make a considered choice but I will also send you a friend request so that, should you wish to accept it, I can explain in more detail and give you more information & links that may help.

What he has to consider is - what type of person is your husband & yourself? Are you the type that want to try every intervention that is available or would you rather rely on the stage he's already been given in the hope that won't change? Are you & he happy to not have the Sentinel Lymph Node Biopsy and keep an eye out for any lumps that may appear or would you rather know now (in 3 months) whether the melanoma has already spread to the sentinel node? Some people don't want to wait longer for the SLNB so prefer to have the Wide Local Excision at an earlier date and rely on the 'watch & wait' approach whilst some prefer to know whether there has already been any spread, even if it means a longer wait for the procedures.

Before you make that decision you have to remember that, hopefully, all the melanoma was removed at the initial surgery. The Wide Local Excision is a 'belt & braces' procedure to mop up any cell(s) that have broken away & lodged in the surrounding tissue. Most WLE's come back negative. The SLNB however is more important in that most cells, if they have broken off, travel straight to the sentinel node. If melanoma is found in that node, that means the Stage 2a changes to Stage 3 and your husband would then be offered adjuvant drug treatment for a year to try & kill the melanoma in the node & prevent any further problem. Without the SLNB he wouldn't be offered the drug treatment, so you have to consider if he would be happy not knowing & not having access to extra ammunition in his arsenal until he finds a lump or develops symptoms that means it's spread further. 

The last thing to consider is that, as with any invasive surgery, a SLNB can sometimes cause side effects but these aren't common - these include possible infection and/or mild lymphoedema. 

I wasn't offered the SLNB as my melanoma wasn't deep enough. Unfortunately I still progressed to stage 3 several years later. Would a SLNB have found melanoma in the sentinel node if I'd had it done? No one can answer that as it's too long ago but I know, deep down, that if I'd been offered it I would have taken up the offer. 

Of those in the same position as your husband - approximately 8 out of 10 still choose the SLNB, even if it means a longer wait - because not having it & relying on 'watch & wait' means drug treatment will be delayed. I hope this helps and I will send you further information by private message if you wish. Good luck & hopefully, whatever he chooses, the results will come back clear.

Angie (Stage 3 melanoma patient since 2009)

Thank you very much for your detailed response. He had to make a decision within a week of consultation and the dead line is tomorrow.  I think we ave agreed to go down the SLNB route as especially for me I would constantly worry. I'm a glass half empty and hrs a glass half full which is probably the best combination!

Wishing you well for the future too.

Regards Jane

Thank you for your prompt reply. 

We have to have made a decision by tomorrow.  After a week of sleepless nights we have decided  to opt for the SLNB in the hope that we will get some peace of mind that we have done all we can. Still concerned re the waiting time but we obviously have no control over that we can only hope it's not detrimental! 

Best wishes for your future

Regards Jane