Hi,

I'm sorry you are both going through this anxious time.

Acral Lentiginous Melanoma occurs on the sole of the foot or palm of the hand and, because these are very unusual places to develop a mole or lesion, they are always treated with suspicion.

Results, whether good or bad, are always discussed at a MDT which are only carried out once a week so they can sometimes delay results being passed on to the patient by a few days. Also, results are taking longer than usual so I hope you aren't waiting too much longer.

If it is melanoma, the next course of action is usually a Wide Local Excision of the lesion and a safe margin of tissue surrounding it. The wound may be quite big depending on the depth of the melanoma. If it's a large wound and it's in a difficult location, it may require a skin graft but this will be discussed at the results appointment.

If the melanoma is more than 1mm in depth your husband will also be offered a Sentinel Lymph Node Biopsy. This is optional and the reasons will be discussed with you. The SLNB is carried out at the same time as the WLE. Dye is injected into the location of the melanoma and tracked to the nearest lymph node(s) - they are then removed for biopsy to see if melanoma cells have already spread. If your husband decided not to have it done he can ask for regular ultrasounds of the lymph node areas instead. 

The results of the WLE and SLNB (if offered) will show the depth of the melanoma and any spread - this will determine the Stage which then determines the next step. If the melanoma was caught early and is shallow and hasn't spread to the nodes (Stage 1a, 1b, 1c or 2a) he will have 5 years of regular check ups. If 2b or c, he may also be offered a course of adjuvant drug treatment to try and stop a recurrence or spread. NICE have only just authorised the use of drug treatment for Stage 2 patients. If Stage 3 (melanoma has already spread to the nodes), drug treatment will definitely be offered.

It's a lot to take in and hopefully the results will be benign or, at least, early stage and caught quickly. Your husband is young, fit and healthy and should have little problem with the treatment other than short term mobility issues. If drug treatment is necessary there are possible side effects but these are rarely serious or debilitating. Good luck to you both and please let us know how you get on.

Angie (Stage 3 melanoma patient since 2009)

Thankyou Angie for this information and replying

Best wishes