Hi Peachybreeze,

I know this has thrown you a curve ball but it may not be as bad as you fear. Sometimes they have cancellations and they may have slotted you in earlier so it helps them see someone further down the list at your original appointment slot. 

What leads you to believe that, if it's melanoma, that it's Stage 2? If you are going by the diameter of the mole (which you say was large) that does not equate to the Stage - only the depth tells them the Stage. A mole that's a large diameter doesn't always mean it's grown deep below the surface - some can be large on the skin but shallow under the surface. Similarly, a small mole on the skin can grow very deep under the surface so try not to second guess what it may be. There is still a good chance that it's not melanoma (it may be atypical/precancerous/dysplastic) or, if melanoma, it may still be Stage 0 (in situ) or 1.

If it's Stage 0 & it was excised with good margins it may only require a follow up appointment & then discharge. Otherwise it will need a Wide Local Excision (WLE) before discharge.

If it's Stage 1a it will require a WLE and then a short period of monitoring.

Stage 1b and 2a require a WLE and a Sentinel Lymph Node Biopsy would be offered to see if there is any spread to the nearest nodes - if there is any spread the Stage changes to 3. Scans are usually only carried out if the SLNB is positive. 

Stage 2b or c require the same as 2a but, if the SLNB is negative, a patient may be eligible for a year of adjuvant drug treatment to help stop a recurrence.

This website is a good resource Melanoma Information by Stage - Melanoma Focus

Good luck next week and please let us know how you get on,

Angie (Stage 3 melanoma patient since 2009)

Hi Angie,

This is so helpful, thank you ever so much. I feel I have a much better idea of what is involved now - the link is extremely helpful too, thank you again. I am also very reassured that it could still be in situ - I have perhaps rather foolishly presumed that 'in situ' or Stage 0 would be advised by letter, and anything else would require a consultation. I have no basis for that whatsoever, nor had I even considered the prospect of a cancellation! I am usually quite pragmatic but it seems the process has started to niggle more than I realised.

My only reason for concern that it may be more than Stage 1 is that the mole has been there a while, and I hadn't noticed the amount of change until recently. A large mole developed several years ago on my shoulder from nowhere - my husband kept commenting on it as it was new and stood out from my other moles (I have a lot!) so I went to the in-house dermatologist at the GP three years ago (who was quite dismissive if I'm honest) but had a look through the scope, said it was fine but to come back if any changes. 18 months ago I noted it had developed a risen centre and was getting darker, again went back to the same guy and was again told it was fine. I didn't give it much more thought and soon after, I moved area and house and have been elbow deep in renovating (so not many mirrors about!) and completely forgot about the mole until this December when I caught a glimpse of it. I compared it to the photo sent to the GP 18 months ago and noted it had spread out a lot, was very irregular, even more risen in the centre and now with two different colours. The GP measured it at 12mm and it hit every one of the 'ABCDE' flags on the referral list. I have no idea at what point in the past 18 months these changes occurred and, having now done a bit of research on red flags, there is a question mark as to whether I may have had a melanoma in situ originally which was missed and now escalated. Hopefully not, but hence that niggle it may have progressed more than I hope.

You have brought me back down to earth however, and I will try to revert back to not worrying until I know. I am so sorry to read that you have been a Stage 3 patient since 2009. I cannot imagine how difficult it must have been for you, and how frustrating it must be to see someone fretting when they don't even know the outcome yet! Your advice has been invaluable, so thank you again. 

I will of course advise the outcome next week. Everything crossed.  

Hi Angie,

I had my results yesterday - confirmed melanoma at Stage 1B. So not quite the 2 I feared! The SLNB was offered (which thanks to you wasn't a surprise!), and I was encouraged to go ahead with that given I'm 'young' at 36. I agreed to the SLNB but now I keep flitting between 'it's sensible' and 'it's needless'... it's very difficult. I really did not want another waiting game for results so in that respect it's not brilliant news as I don't feel I can fully relax as the potential of Stage 3 is still hanging over me. Nonetheless I am aware it could have been a Stage 2 so I feel lucky to have caught it just before that point. 

Thanks again for your help and advice. 

I've sent you a friend request so that, if you accept it, we can chat by pm & talk about the negatives & positives of having a SLNB. It may help you to know if you've made the right decision or if you want to change your mind.

That's very kind Angie, thank you. I have just accepted.