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My husband just diagnosed with melanoma

Posts: 1
Joined: Dec 2005

Hi. My huband just got diagnosed with a type2a malignant melanoma. He had this ugly mole on his back for at least 9 years but lately it had been looking worse. I always bugged him about going to the dermatologist but he kept making excuses. So his mole started bleeding and I made the appt. and told him he HAD to go and he went. As soon as the p.a. saw the mole she said " OK the Dr has a surgery in an hour but we're taking this off now." His mole was about the size of a nickle but his incision was about 6 inches long. Three dats later they told us it was maligant and he would have to go to an oncologist ASAP. They made it 2 days later. Well, we went yesturday and the dr. said it was a type2a without ulcerations and he made us appt. fora surgery to put in a dye for his lyphnodes. So you see I'm lost, confused and just need some help and knowledge from people who have been through this or are going through this right now.What can I expect with this upcoming surgery and what is it's purpose? I know i'll be coming back and asking more questions as the Dr. appts.continue. They also talked about a PET scan and an injection he may have to take for a year, what are the common side affects? They mentioned we could do the meds for 90 days along with chemo, which would be better? I would appeciate any help and responces. God bless.

Carvs's picture
Posts: 30
Joined: Jul 2005

I am sorry to hear about your husband's diagnosis.

From your description, I assume that he will be having a sentinel node biopsy. I am copy/pasting a description of this procedure below. First let me say that I assume after they do the sentinel node tracking your husband will have a wide excision where his primary tumor was removed to make sure there isn't any residual melanoma left where the primary was removed. When I say primary I meant the mole which has already been removed.

When I had the sentinel node biopsy I went to the hospital as an out patient. First they did the tracking of the sentinel node (described below); I was under general anesthetic for the sentinel node removal and wide excision so I can't describe the surgical part. My mole was on my hip and my sentinel node was in my groin area. I was able to go home that evening and within a week was fairly well recovered. I got the results of my sentinel node biopsy at my one week check up.

Since my sentinel node was positive I ended up having a complete node dissection later. Not everyone elects to do that even with a positive node and I recommend that you take this one step at a time. The complete node dissection does require a short hospital stay (one night for me but sometimes that is 2 or more). However, hopefully your husband won't have a positive sentinel node and that won't be an issue.

Since your husband's doctor mention injections for a year, I assume he/she was talking about interferon. Interferon is the only FDA approved adjuvant treatment for melanoma. However, there are many clinical trials for melanoma which some people choose to do instead.

I was offered interferon but elected not to do it. That is an individual choice and I wouldn't presume to advise you about that but I would advise that you and your husband do a google search on interferon and melanoma before making that decision. Some oncologists recommend it strongly, others are neutral and others have reservations in light of new studies which are coming out.

The other thing you mentioned was PET scans. PET scans work by the patient being injected with radioactive glucose which travels to metabolically active areas. Since cancer cells are metabolically active, it works by taking pictures to see where the dye travels (FDG uptake). PET scans can look at the whole body to make sure that melanoma hasn't metastasized anywhere beyond the primary. I don't mind that scan at all. It's shaped like a doughnut so you aren't enclosed like with an MRI (it's open at each end although you do you into a tunnel).

Sometimes, there are false positives though so even if the PET lights up, a biopsy or other scans are needed to confirm cancer. Hopefully if your husband has a PET scan he won't have any areas that are suspicious and this will be moot.

Information I copied for you about the sentinel node biopsy is below -

"The National Cancer Institute (NCI) describes sentinel lymph node mapping as: The use of dyes and radioactive substances to identify the first lymph node to which cancer is likely to spread from the primary tumor.  Cancer cells may appear first in the sentinel node before spreading to other lymph nodes and other places in the body.

Removing the sentinel lymph node serves two main purposes:

The pathologist studies the sentinel node for any evidence of cancerous cells. This allows the doctors to properly stage the cancer and recommend additional treatment options;
If the sentinel node is negative, or cancer-free, usually no additional lymph nodes need be removed."

Best of luck to your husband and you. Try to take this one step at a time if you can. I hope I haven't confused you even more than you already were.

Posts: 8
Joined: Dec 2005

I am so sorry to hear about your husband, but I know you two will get through it together. I was diagnosed with melanoma August of 2005. My mole was on my foot, I had the tumor and a portion of my foot removed, along with a skin graph and some lymph nods removed. The cancer did spread to my lymph nods and right now I am in my second month of the year treatment called Interferon. There are side effects, if you would like more information or someone to talk to, I am here for you.

Posts: 3
Joined: Jan 2006

Well the good news is they seem to be acting very quickly in your husbands case and time counts with this disease. I'm caring for my mother right now after she had a melanoma and lymph nodes removed in sept. She did have follow up treatment with interferon and we are still looking for information on the side effects. My best advice is keep strong and keep asking questions. Talking to others who have gone through this is the best way of navigating through the "doc talk". So often they overload you with medical info and you need to hear laymans terms and "what does this mean for my loved one". So keep talking to people I've found discussion groups to be an invaluable practical resource. Take care.

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