Can anyone explain the Sentinal Lymph node Mapping? - Cancer: Skin Message Board

txlady3k · 04-18-2005, 07:34 PM

The past month has been a whirlwind for me and my family. I went in to the Dr. the end of February because I was feeling tired, asked him to go ahead and look at some moles I had on my back. He did a punch biopsy on the only one that looked suspicious him. A week later they called to tell me I had an appointment with our local surgeon to have it removed, it had come back cancerous and the following week I had it removed. Naive me, I thought that was the end of it. Four days before going in to have the 6 stitches removed I get another call from the nurse saying I have an apt. on March 24th with a plastic surgeon because the pathology report came back that I had stage 3 Melanoma. On April 11th I had a wide area excision on my back, my husband says it's about 6 inches long. Is this huge lump at the top of it normal and will it go away? They also injected this radio active stuff around the original site and mapped out my lymph nodes. They removed a lymph node from under each arm. Is this normal? The dr. told my husband under my arms light up like a christmas tree, but no lymph nodes in the pelvic light up. Does this stuff they injected attach to all lymph nodes or just to abnormal ones? I am so scared and getting so many conflicting answers. I have not been able to reach the surgeon and the results of the biopsy are due back this week, his nurse said he'd call when he gets them, but I'm going crazy. I have so many questions that I am writing down for when I go back in on the 25th, I've been so shocked at each appointment so far because I haven't expeted to hear what I'm being told, and I don't think of questions until I'm gone.

tomh · 04-19-2005, 03:45 PM

Sorry this is happening to you. It's natural to be concerned.

I had a wide area excision and Sentinal Node Biopsy for Melanoma on my arm. The "sentinal" node is the first lymph node that the inflicted area drains to. The blue die and radioactive dye help them identify that node. This is much prefered to taking all of the nodes.

They remove that node (sometimes several), and disect it to look for cancer. It is very efffective.

The lump at the top of the excision is probably where the skin puckered as the surgeon stitched you back up. My excision was egg shaped to try to avoid that pucker at the ends. Not to throw darts, but your lump could be a matter of the doc's technique. On the other hand, the thin skin on your back it tough to work with. Maybe he/she can fix it for you.

Writing down your questions is exactly the right thing to do. Write them donw as fast as them come. Organize them before the appointment. Take your husband or trusted friend with you to the appointment. You could use the company and support.

I wish you well.

BonBe · 04-20-2005, 06:56 AM

I agree. I also had the WLE six months ago from an area upper mid back just below the neck. Scar is 8 inches long (shoulder to shoulder) and he was able to do a 'skin flap' rather than a skin graft. Both ends were lumped up like giant golf balls. That is normal. One side now only is lumped up the other side has flattened. Muscle tissue and just tense old me. Unfort my scar did not behave nicely and I am at present have 'silicon gel' strip treatment for 12 weeks. The scar is nicely flattened.

Since my initial WLE was in such a rush (total shock that the biopsy showed Stage 2 mm (4mm thick) that no time was wasted. Our local hospital was not set up to do the SNB but when I went to my follow up appt at a major cancer hospital they said it was ok and are just a tad extra careful during my every three months exams. I have had three follow up CT scans, avoided adjuvant therapy (due to family situtation) and attend a dermatologist every three months, the cancer hospital every three months (for 3 years) then every six months for 2 years, then every year for everh.

This past monday I had another biopsy done on a suspicious mole that suddenly showed up. (Won't know for a few weeks if it is 'dangerous) Just keep VIGILANT and never go for shave biopsy (that type cannot be staged) sounds like you are getting correct treastment. Scars sometimes take long time to heal, sometimes they do not. The lump will go away, and your surgeon can explain to you why it is there. The eilipical type incision does afford proper wound closure, an and does save the extra aggrevation of a skin graft.

Good luck
Bonnie

txlady3k · 04-20-2005, 12:59 PM

Thank you both for your replys. I have a bit more insight as to what may be to come. I haven't asked any real questions everything has happend so fast and all been such a shock. My husband has said the lump on my back has gone down some. I do have another question, I wish I could reach the surgeon, they removed the lymph node under both of my arms. Since the lymph nodes they removed are really more towards the sides of my breasts, why does the under side of my arm, from the armpit area on down towards the bend of my elbow hurt so much? It's like just touching the skin really hurts.

Thanks again and God Bless
Kathy

esstwobee · 04-22-2005, 12:16 AM

txlady...I know about the whirlwind and roller coaster, with the radioactive mapping experience, surgery, lymph removal, recovery...however, for me it was two years ago, and I remain cancer free, and so wish the same good results for you too!

about the soreness under your arms...the lymphatic system works very well indeed to remove toxins from our body, all moving toward the lymph nodes for processing, and when this system is disrupted, as it was for you when they removed the sentinal nodes, the lymph (which is like a fluid, usually seen as green on an anatomy chart) didn't know where to go to be 'filtered' and so it begins building up, maybe even forming 'pools' or 'bubbles' of lymph under the skin, causing discomfort

my area of lymph node removal was in the groin, and it built up a lot of fluid, and was extremely hot to the touch and very uncomfortable...in some cases they will aspirate the site (remove the lymph with a hollow needle) however, that does not 'teach' the body what to do, nor how to re-route the lymph, so some doctors say "it will go away in time"

in my own situation I did some advanced study and found a natural remedy to enhance my lymphatic drainage, and I was back to my new normal without pain in just three days.

Again, I wish for you an easy recovery to a cancer-free life!