Melanoma 1a Diagnosis

Hi Everyone,
 

Not the best start to the year, I found a mole on my back had begun to look suspicious. I had it removed in January 1 day before my son was born.

After going through quite a fast process i received the biopsy results last week and was told it was melanoma.

My head is completely confused right now and anxiety is rife.

it was classified as 0.75mm and I have been told it i am at 1a Stage. I have been googling like mad and need to stop this as it makes me think the worst. I find cases where 1a and 0.75mm have reached lymph nodes

The doctor and nurse have both told me I should be ok now it is removed but I worry it could already have spread and how would I know until it's too late...

I haven't been offered an SLNB as they think the risk is low but I feel I am right on the border of 1a and 1b

Does 0.75mm mole round upto 0.8? And if so should this mean I'm actually 1b and should have a SLNB?

I have a young family and feel it's my job to be here always to support them and the feeling of leaving them makes me sick

This is all quite new to me so sorry for being a little bit of a downer etc..
 

Cheers

Adam

  • Hi Adam,

    I'm sorry to hear about your diagnosis and the worry it causes. I hope I can help calm your fears a little.

    Don't Google - the only websites to look at are this one or the other recognised cancer and dermatology websites (The British Association of Dermatologists or the Australia Melanoma Institute are good ones). Everything else is out of date & focuses on worse case scenarios.

    Try not to get too hung up on the difference between 1a & 1b. A melanoma has to be at least 0.8mm in depth (at some hospitals it's 1mm) before a SLNB is offered. Not everyone takes up the offer as it can cause slight life changing side effects (lymphoedema in extreme cases, infection in some cases) and at the end of the day it is not used as a treatment - it's merely used for more accurate staging & that is why some consultants don't believe in it's efficacy. Also, the results can sometimes be a false negative and any spread to the nodes is missed until further down the line, so it's not an exact procedure. 

    Personally, my 0.7mm melanoma (on my shin) was removed almost 25 years ago when I was 39. I wasn't offered a SLNB and was monitored by regular checks over 5 years & then discharged. My Stage 1a diagnosis (Stage 1b under the old staging procedure) meant I had a 95% chance of never having a further problem - you too have the same odds. Unfortunately for me I'm a contrary old soul and it did return in 2009 - I found a lump in my groin which was the melanoma. A SLNB would not have picked it up because it had bypassed my sentinel node & lodged in the groin node for 13 years before becoming active again & had then also spread to a pelvic node. It is thought that this probably occurred in the year that I had left my dodgy mole before seeking medical attention! All that been said, after a full clearance of my groin & pelvic nodes I am still here, fit & healthy and free of disease 12 years later. 

    I hope my experience has shown you the vagaries of melanoma & a SLNB. The things to focus on is that your melanoma has been removed and that it is very shallow so you have a 95% chance of never having a further problem. You will be shown how to check your moles & nodal areas & you will have a period of monitoring by the hospital. If you have any concerns, don't be afraid to voice them & they will check you thoroughly. Over the years I have had 7 moles/lesions removed and only one was melanoma but that shows the care they take when checking you over! I will send you a friend request so that we can chat by private message for more information if you wish.

    Good luck,

    Angie (Stage 3 melanoma patient)

     

  • Hi Angie,

    Thanks for your message and friend request, it would be good to chat at some point thanks. I have been reading the forums for some time whilst nervously waiting for my results and you always post good advise

    Its great to hear your story and get advise from someone who has experienced this.

    I have contacted my Cancer nurse this morning I find they are good at reassuring me and put it into perspective.

    I find google is a wealth of information but very confusing and hard to get the right context.

    I find myself searching for statistics that are applicable to me Age, Depth, Mitotic Rate and location on body but always come up short. Maybe I shouldn't fixate on the statistics as it won't help in either outcome. I suppose I have to get to the point where I am at peace with either outcome. Which is very difficult  

    Thanks

    Adam

     

  • Sadly statistics for melanoma are only very general because everyone's experience is differerent. Melanoma is the most unreliable of cancers - that is why we don't use the word remission, because it can literally come back at any time without warning. Our 'version' of remission is 'No Evidence of Disease' because that's the closest we can come to saying that a patient is free of melanoma at the time they are checked. 

    Also, great strides have been made in finding treatments for melanoma that are helping later stage patients survive longer. These have only been available for Stage 4 patients, outside a drug trial setting, for about 5 years. Add to that the adjuvant drug treatment that has been available to newly diagnosed Stage 3 patients since the autumn 2018 and these are changing the landscape of survival. So for Stage 4 patients the survival rates for 10 years are still pre-drug treatment & don't look great but the 5 year stats will show improvement in the next couple of years. Similarly, less Stage 3 patients are progressing to Stage 4 but the stats won't reflect this for another few years (melanoma stats are about 2 years behind anyway so it will never show what the landscape is right now).

    Having worked with stats in my old job I have learned not to pay much attention to them anyway. All we do know is that the incidence of melanoma diagnoses is rising but the stats for recurrence in Stage 1 patients is staying pretty much the same with around 95% being successfully treated and having no further recuurence or spread in their lifetime. This, in the main, is due to people knowing about dodgy moles & then getting them looked at quicker. I hope this helps.

    Angie x