Once they have your CT results they will put together a treatment plan which will consist of further surgery - a Wide Local Excision aka as a WLE - and possibly a Sentinel Lymph Node Biopsy (aka SLNB). These procedures are done at the same time - the WLE removes a further margin of tissue from the melanoma site to mop up any cell(s) that have broken away into the surrounding tissue. The SLNB is to see if melanoma has travelled through the lymphatic system to lodge in the node closest to the melanoma site. Dye is injected into the site of the melanoma & tracked to the nearest node(s) which are then removed & sent, with the WLE tissue, for biopsy.
If the CT scan shows no melanoma activity elsewhere in the body & the biopsy results are clear, your Stage will remain 2b. If, however, the scan or the results show activity in the nodes, you will change to Stage 3. If the CT scan shows activity elsewhere in the body, other than the nodes, you may change to Stage 4.
Stage 2b & Stage 3 patients then have a year of adjuvant drug therapy. Your melanoma tissue will have been checked for the BRAF gene & this will determine which drug you will offered. All patients have the BRAF gene but in 50% of patients it mutates and is known as BRAF positive - those without the mutation are BRAF negative. BRAF positive patients have an option of Targeted therapy or Immunotherapy. BRAF negative patients are only offered Immunotherapy as the targeted drugs don't work for them.
If Stage 4, the same drug treatments are used but for much longer than a year. Surgery and/or radiotherapy may also be necessary dependent on where the melanoma has spread to.
I hope this helps. You should hopefully get an appointment through to discuss the CT results & the next stage in your treatment. Take a look at Melanoma Focus who have really good information & a Nurses Helpline if you have any worries. Patient Guide - Melanoma Focus
