What happens when you have melanoma?
February 19, 2015 9:42 AM   Subscribe

Someone very close to me was diagnosed with early stage melanoma. What now?

This person is in their late sixties and otherwise in good health. They had a mole removed a few weeks ago. The doctor said the results showed early stage melanoma. They need to have surgery and no other treatment for now. That's all we know.

So what happens after the surgery? What are the likely outcomes? And how can I best support this person. Googling this is stressing me out and I know I'll get an honest and balanced response here. Would appreciate hearing from people who have been there or know someone who has. Thanks!
posted by anonymous to Health & Fitness (10 answers total) 4 users marked this as a favorite
 
Depends on which early stage you're talking about.

If it's melanoma in situ (aka stage zero), it's possible they already got it all with the mole removal and the surgery's going to take off a larger margin of skin around the mole just to be sure. Surgery may or may not involve general anesthesia depending on the amount of skin that will be excised and probably other factors I don't know anything about, and that is usually the riskiest part of surgery. The skin removed will be biopsied to see if there are any remaining malignant cells. If the biopsy doesn't find any, you just follow wound care instructions, wait for your fabulous new scar to heal up, and go on with life. Life will now include annual dermatology checkups to keep tabs on any future scary moles, being more careful about sunscreen, and making a decision about what you say about your awesome scar if it's visible (I usually go with "knife fight"), but those are the only real changes.

That is the most likely outcome for melanoma in situ. I understand it gets more complicated the more it's spread (though early stage melanoma in general is very treatable), but I don't have any experience with later stages. Surgery aftercare is annoying but not much more so than any other surgery, since at least it's just skin that got cut up and not anything underneath. Do pretty much the same things you'd do for anyone else recovering from surgery: keep them comfortable, and try to arrange things so they don't have to stretch the wound area while it's stitched up and healing. I'm no doctor and their doctor will be the best one to answer specific questions about what they can expect, but feel free to MeMail me if you'd like more info on the patient end of things.
posted by asperity at 10:22 AM on February 19, 2015 [3 favorites]


Hello!

I had my melanoma-in-situ removed from my forearm in 2012. Is this what your person has?

In my case, I had the melanoma removed, plus a lot of extra skin. It was done in my dermatologist's office, and they stitched me up and sent me on my way with a prescription for painkillers and some salve for the wound.

It wasn't pretty while it healed and because of where it was I needed my husband to help me with changing bandages (I think it was for about a week or two). I had to go back to get some stitches removed and for the doctor to check up on the healing. I think I had two follow-up appointments just related to the surgery.

I was told to protect the scar from the sun as it doesn't have any protection from the sun and can turn purple. After the scar has healed, you can rub it to soften it a bit.

After the surgery, I had to go back to the dermotologist every six months for a complete skin exam (and she took careful notice of lymph nodes). After two years of this, she said "You've graduated!" and I went back to the yearly visit schedule.

My dermotologist also insisted that I go to an opthamologist to make sure it wasn't in my eye.

The outcome for early melanoma treatment is very, very positive. It's a pain to go through (literally) and scary, but it's ok.

Good luck to your friend!
posted by potsmokinghippieoverlord at 10:27 AM on February 19, 2015 [2 favorites]


I can't speak for the likely outcomes b/c I'm not your doctor, but my husband was diagnosed with stage 0 melanoma in 2010. As far as we know it's all behind us at this point. His dr removed the growth in question, a perimeter of skin around the growth, and then over the course of the next few months several other moles, etc. that the dr. didn't like the look of. For various reasons my husband ended up having to switch doctors, his current dermatologist indicated that his old dr was perhaps overly aggressive in doing the other surgeries, and they may not have been necessary. He did 6 month follow ups for a couple years and is on a standard yearly schedule now. He doesn't seem to have any scarring.
posted by snowymorninblues at 10:33 AM on February 19, 2015 [1 favorite]


My mother had a melanoma in situ removed a couple of years ago. Although it was in situ, they had to go back in twice after the original biopsy to get enough skin to get a clear margin. Once they did, though, that was that -- she had some intense followup schedules but no further procedures or treatment.
posted by KathrynT at 10:35 AM on February 19, 2015 [1 favorite]


I had a very large chunk of skin and underlayment removed as described above- and then the lab announced it wasn't melanoma, just a mole after all. It's a pretty impressive scar because of where the mole was but it didn't hurt really at any point.

I also go with knife fight.
posted by fshgrl at 10:35 AM on February 19, 2015 [2 favorites]


If they got all the cancerous tissue & none of it has got into their lymph system, then they're cured.

If the cells have got into the lymph system and spread beyond the nearest lymph nodes then they have a median life expectancy of year, maybe two years if they happen to have a variant that's susceptible to BRAF inhibitors. Malignant melanoma doesn’t mess about :(

If you catch it before it's spread then the prognosis is very good indeed. Leave it too late & the prognosis is very poor.

(I have had two relatives with melanoma, one had a huge growth removed from her leg and went on to live a long, fulfilling life before dying of something else, the other one wasn't so lucky.)
posted by pharm at 12:08 PM on February 19, 2015 [1 favorite]


I had a stage 1B melanoma removed last summer. My Doc called it a thin melanoma but a little on the big side. He removed 1/2 inch of tissue in all directions from my upper chest area. It was one big ugly looking cut across my chest area, about 5-6 long. The scar is barely visible now. No further treatment is required because of the clean margins. Basically he got it all.
I get checked head to toe every six months for two years.

In my case I don't think I have much to worry about.
posted by cairnoflore at 12:30 PM on February 19, 2015 [4 favorites]


I don't know what stage it was, but I had a melanoma about a year ago. It was a little thicker than they were comfortable with, so they removed a big chunk of skin and 3 lymph nodes, as well. The big chunk of skin removed in surgery as well as the lymph nodes were all clear.

My oncologist told me that getting one melanoma doesn't lead to more, but my dermatology specialist who does a full body check on me every 3 months said the opposite. I see my oncologist every 3 months (after the first year it is every 6 months), and my dermatologist every 3 months. If anything looks off, she takes a picture of it and we recheck it at the next visit. If anything looks really off, she removes it immediately.
posted by getawaysticks at 5:50 AM on February 20, 2015 [1 favorite]


I don't know all the details, but my mom had a melanoma removed from her leg a couple years ago. She's had carcinomas for several years, so gets skin checks frequently. They also removed the closest lymph node - in the groin - to see if the cancer had spread. It hadn't. She did develop lymphoedema afterwards, however, and she had to keep her whole leg wrapped up for awhile. I don't believe there were any lasting effects other than the scar.
posted by Safiya at 12:30 PM on February 20, 2015


I don't know all the details, but my Dad's been dealing with melanoma for years. First, it was just a couple spots on the tops of his ears. Their removal has had him claiming to be part-Vulcan ever since. Most recently, it's been some good sized chunks on his legs, which have required skin grafts from other areas. If I have the times right (which I may not), I think the ears were about 15-20 years ago, and the legs were last year. He's 66 and utterly unconcerned about the melanomas.

At the stage your friend is at, it's not a OMG HUGE THING. At most, it's A Thing. Yes, it's cancer. Yes, that's a terrifying word. But as far as cancers go, stage 0 or stage 1 is like a baby cancer.

As far as support goes....in my family, we're big on humor and harassment. My response to my Daddy telling me he had fist-sized chunks of his legs removed was "Ok, now you're just cheating on this whole weight loss thing." And on hearing that skin from his butt was now grafted onto his calves, "You wanted to make it easier for people to kiss your ass?"
posted by The Almighty Mommy Goddess at 12:42 PM on February 23, 2015


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