View Full Version : Stage II Melanoma (Clark Classification)

02-01-2009, 06:34 AM
I have just been diagnosed (3 days ago) with Malignant Melonoma approximately 0.25 mm in thickness. There is an associated melanocytic nevus. No evidence of ulceration, regression, intro-vascular involvement or satellite metastasis. The lesion extends to lateral margins. I was told to go to a surgeon and to an oncologist. I need to be informed. Do I have time to pick my doctors or should I just go with the ones my Dermatologist sent me too? What steps should I be taking and how quickly should I be taking them? It is my understanding by what little information I have been reading on the internet that level II can be cured...is this true...Also, I love the outdoors...does this mean no outdoors or just putting block out before I go outdoors...Any guidance and/or information you can send my way would be appreciated. Thank you. :-)

02-01-2009, 07:27 AM
May i ask, where was your melanoma? and how are you feeling?

02-01-2009, 04:23 PM
Let me begin by saying that I am sorry that you are having to deal with this. I also would like to point out that I do not think that you are "stage" II - you are a Clarks "Level" II which is often confused with stage.

With your breslow and the non-involvement of the other areas, you are probably a stage I. This is a much better place to be if you have melanoma. :)

I would think that there is time for you to see a doctor that you want to see, but ideally they should have melanoma experience. With your breslow, you are typically looking at an excision and regular skin checks. It is a very good idea to take measures to protect yourself from peak sun exposure from now on.

I wish you all the best and please keep us posted.

02-02-2009, 09:40 AM
I would concur with Mahnee. At a thickness of .25, you are probably not Stage II, but will probably staged at level I.

Just a note of clarification: there is no "cure" for melanoma - there is only treatment. In your case, if the numbers bear out, it seems as if you've caught this very early and the prognosis looks very, very good. As Mahnee stated, treatment will most likely involve wide excision and then regular skin checks for 5 years. However, you will need to be diligent for the remainder of your life.

At this stage you do have some time to search out the doctor of your choice. I wished I'd have known that when I was first diagnosed. I wouldn't wait overly long, however. Melanoma can be aggressive and fast growing, so I would definitely get to a doctor within a month. The earlier you catch this beast, the better off you are. And do go to a doctor that specializes in melanoma. It is worth it.

As far as being out of doors, no, you will not have to live like a mole. But you will have to take precautions. Keep in mind that even on cloudy days UVA/UVB rays are still bouncing around, and the sun's rays can bounce off of things such as concrete and the ground. Know the proper way to sunblock, and use it often. Protect your eyes, and wear a hat. Realize that you are more at risk than most people, and this applies to any children you might have. Incorporating sun safety for yourself and your family will enable you to enjoy the outdoors as much as you ever did before. Oh, and avoid tanning beds.

Good luck to you, but I think all will be well for you!

02-02-2009, 06:21 PM
The melanoma is on my right thigh approximately 6 inches above knee....I am emotionally a wreck, but physically I feel good.

02-02-2009, 06:25 PM
Chele60...Thank you for the insight and for the optimism...it means a great deal to me...Thank you.

02-02-2009, 06:34 PM
Mahnee...that you for you concern...I hope your right about the Stage being I, but on my pathology report it states Level II...what is breslow? If they do chemo or radiation, what am I to expect? Also will I still be able to go to the beach or spend a day in the yard if I have block out on? I checked out the surgeon and oncologist that my dermatologist had recommended...both are affiliated with Jefferson Hospital which is a very, very good hospital. Also my oncologist is a director of a melonoma center which is also affiliated with Jefferson Hosiptal. I was told to get a second opinion regarding my biopsy by another radiologist. I was told that the pathology report is only good as the person reading it. Any suggestions or comments?

02-03-2009, 09:07 AM
I just want to clarify some things for you, if I may.

With a melanoma diagnosis, there are 2 staging procedures. I've no idea why the medical community keeps both, as it causes more confusion. Let me see if I might be able to explain this for you. Historically, doctors used what is called the Clark's Level of Invasion to stage melanoma. This consists of 5 stages. I've tried to figure this system out, but it consists of depth of skin levels and seems so complicated to those not involved in the medical field. Even those involved in staging admit this method is not the best for staging, yet the Clark's Level is still used on pathology reports. For example, my Clark's Level was IV, which had me pretty frightened!

BUT! The Breslow Level of Invasion is slightly newer and has proved to be a more reliable method of staging melanoma. Very simply stated, the Breslow method uses the thickness of the melanoma to assist in staging the melanoma. When comparing Breslow to Clark's the numbers can seem badly skewed. The thickness of my melanoma was .7mm. For Breslow, that is an extremely thin melanoma, yet somehow with Clark's, I was a level IV. Go figure.

Now, many other factors come into play when staging melanoma: ulceration, slow growth vs fast growth, surface vs depth, nodule, etc. When staging melanoma the entire melanoma must be looked at, and that is often why melanoma patients are not officially "staged" until after surgery, when the doctors have all the information they need. I wasn't offically staged at IB until after my WLE, though it was a good guess that I was stage I. So see? It's a little more complicated, but there is a difference between Clark's Level and staging.

For a melanoma that .25 in thickness, I strongly doubt you will be doing ANY radiation or chemo. Radiation and chemo has shown to have little effect against melanoma anyway, and, if used at all, is brought in during stage IV. I'm quite surprised you are being directed to see an Oncologist! Wow! What will s/he do? Your melanoma is so small, and it should be such a simple procedure to treat, but perhaps your doc wants to bring in an onc just to be sure?

As far as a second opinion? It can't do any harm, I guess. If it will make you feel better and give your mind ease. But, keep this in mind: your melanoma is extremely thin and small RIGHT NOW. It may be slow growing, it may be fast growing. The doctor may have removed all of it with the biopsy. You don't know. Melanoma can be very aggressive. If you are going to get a second opinion, work on doing that now. You do have time, but I wouldn't let this go.

As far as being out in the sun? Why certainly! You will have to understand that you are now at higher risk than the average person. You will need to compare sun block (they are NOT the same), and find one that works for you. You will need to learn how to apply it - most people do not use enough, or reapply as often as they should. You will also need to learn sun safety: when UV rays are strongest, covering up, wearing a hat, sun block. And learn to protect any children you may have - they, too, are at greater risk now.

Your life is not ending! By everything you have posted here, you have caught this really, really early. And with melanoma, the earlier you can diagnos this, the better the prognosis!

02-08-2009, 04:23 PM
Chele60...Thank you for sharing your valuable information...which, I'm sure, came from alot of your own research...it was very much welcomed and appreciated...I also that you sooooo much for the optimism :-) I do have another question and I know it would depend upon many different factors and that is why I am asked how I feel...should it be and will it affect my health in the early stages? Also, if you don't mind me asking, when were you diagnosed, what treatment do you have, and how are you doing? Lori

02-09-2009, 10:33 AM
Why, thank you, Lori!

In general, my philosophy is that a positive outlook is simply better to help the mind assist with dealing with stress, as well as assist the body through illness. Does this mean that I believe serious illness, such as cancer, can be cured with laughs and giggles? Absolutely not! But stress, worry, and a downbeat attitude can sometimes place undo pressure on the body which already attempting to heal itself. However, all people are individual and must be in their own place at their own time. No one can be critical of another's journey, especially as relates a very serious illness. It really is very uniquely individual.

When I was first diagnosed with melanoma, I went directly against my doctor's suggestion and began doing searches on the internet. What I found there truly scared me. I came to a point where I had to take some serious steps back and truly do some serious research and not just read stories. I did eventually come to a place where I understood, mostly, melanoma as it affected me, and - most importantly - how to wage battle against it. That made me feel more powerful and more in control. As you are probably aware, receiving that initial diagnosis of "cancer" makes you feel completely vulnerable and powerless, and that is truly the scary part. Or so I discovered for me.

I was diagnosed with melanoma in 2007. I noticed what I thought was a mole growing on my left in November 2006. It had none of the characteristerics of melanoma (the "ABCDE's"), so I just figured it was another mole. However, it grew faster than any other mole I'd had, and it seemed darker. In Dec '07 it actually sort of "popped up" which was a little wierd. What I hadn't realized at the time was the center was slightly blue with a faintly white center. I hadn't realized this was a symptom of melanoma at the time, and I wasn't even certain I was seeing it.

In Jan '07 I went in my annual physical, and I brought it to my doctor's attention. We arranged for me to come back in Feb to have it removed. Neither of us were concerned. She was going to remove just as a precaution. I had a shave biopsy on Feb 21, and my doctor contacted me on Feb 23 with the news that the biopsy had tested positive for melanoma. I remember that hit me like a ton of bricks!

On Mar 5, I was consulting with a surgeon, and on Mar 27 I was in surgery for my wide excision. I was officially staged at IB, Breslow level .7. It has been almost 2 years, and I'm NED (no evidence of disease). I see my dermatologist every 3 months for a skin check, in addition to doing my own monthly skin checks. (Most melanomas are self-discovered, BTW) I take sun safety very seriously - I've learned a LOT about sun screens (I keep them EVERYWHERE!), and have quite the collection of hats. My 5 year rate of survival is in the mid- 90 percentile, and my 10 year rate of survival is 87% - and I intend on being in that 87%! I veiw my diagnosis as a sort of wake up call, as do many who have been diagnosed with cancer. Through internet blogs I have "met" far too many individuals who have lost their battle with melanoma. They were far too young, and left young children without moms and dads. I am determined now to live and enjoy life - it far too precious and far too short, and I am just so thankful that, for whatever reason, I was spared a much more serious diagnosis than some.

I realize I'm babbling now, and I do apologize for that! But, in so many ways, life is just so much more beautiful now!

02-15-2009, 12:05 PM
Hi Chele60...thank you for sharing your experience and knowledge with me...it is very much appreciated...And yes I agree life is precious...I have always known that...and yet with a diagnosis of melanoma it has become even more precious...it all seems so surreal...Chele60, I will keep you in my prayers...Were you a sun bather? You mentioned you have done your homework on the different sunscreens...can you pass some of that on to me? I, too, plan on being a 5 year survivor...you had mentioned you knew others that had lost their battle...were there any that were in our early stages? Also, I have read about diet and how it plays a role with cancer...such as refined sugar feed cancer...have you any information on that? Also, that cancer feeds on a high acidic body...What I do know is that the cancer has to be cut out...I have to use sun block and clothing and hats to protect myself...watch my diet...reduce stress...I also read that cancer thrives in a person with a compromised immune system...I myself have a compromised immune system and a very high acidic body...I have been working a lifetime to correct both...I hope it is enough...Chele60 have you found any cancer organization that is good for support? You mentioned going the dermatologist to be checked...does your insurance cover? I hope to hear from you soon.

02-15-2009, 05:16 PM
Hi Sparkle!

Both Chele and Oleander were such great help to me when my melanoma was first discovered on Dec 26th of 2008, Merry Christmas to me! :eek:

I had no idea what melanoma was! I was staged at what my surgeon called a 'T1" i believe. I'm not looking forward to having to see a dermatologist to look for more of these ugly moles, and I've yet to fill out all of the paperwork, so I come to this board to remind myself that this IS serious, and I need to take this seriously.

No. I was never a sun worshipper. I HATE the sun. But I have VERY fair skin, (I'm Irish) and burn easily. I received all of my burns either swimming, or some event outside. I've been covering myself up the last couple of years, so I'm still amazed that I got this type of cancer. Please stay in touch on this board because I need to chat with you and everyone else who understands what we are going through. :angel:

02-15-2009, 08:06 PM
Rockford, Chele, and everyone,

I am an Irish girl too......do not forget there are many ways to get skin cancers....Mine is where the sun don't shine!!

You must go and be checked. Even with seeing my Oncologist Gyne on 3/4 my Dermatologist says I must come in every 3 months for a head to toe skin check up from him since I have 2 blood relatives with melanoma. I know my dad and brother both did so well because all of theirs were caught early.

By the way my dad's Melanoma's were never a mole, always a lavender color and itched.
My brother's was a mole he had all of his life. It really never changed. Small, flat and dark. A very Smart doctor did not like the way it looked and wanted it off.

I also had something come up suddenly on my rt thigh last year. Came up overnight almost... light grey and it got big fast so I asked to have it off. It was pretty deep and it came back a Stucco Keratosis..path said normally found in elderly men..:confused: I am neither elderly or male. I was like HUH?"
Pretty weird.

My dad was a red head and he was militant about staying out of the sun and using sunscreen, wore hats and long sleeves. He had a total of 6 melanomas, several Squamous cells and basal cells.......Now we know the Bowen's disease was probably cause. Envoirmental exposure of some type.

Forgive me if I repeat myself.....Please get checked out often.

I myself am doing as much natural food as possible...taking ESSIAC tea concentrate and Vit D 2000 IU's a day. Trying to let go of worries.......

Make sure to take care of yourself.....Do not let work or anyone interfere with your checkups........

XXXX0000 Oleander

02-16-2009, 04:38 PM
Hi Orleander...Thank you for responding to my post...I do have so much to learn...I'm sorry that melanoma runs in your family...I'm not sure if it runs in my family only that my dad was told he had a cancerous mole and it was removed and my brother just last month was told he had basal and squamous cells on his head...he has yet to have them removed...And thank you for the encouragement about frequent check ups...I am not looking into a cancer diet...as I learn I will pass it on to you...I am not familiar with ESSIAC tea...please let me know how I can benefit from it....In rebard to the Vitamin D 2000...I take that all ready as much natural food as possible...taking ESSIAC tea concentrate and Vit D 2000...and I will remember you words not to worry...because I no stress can bring down your immune system. I am doing my best to take care of myself...but I am meeting with some difficulties getting off from work...I do not want to tell my employer at this time...with the economy as bad as it is...and the down sizing/lay offs...I didn't want to give them a reason to let me go...have any of you run into any problems with your work? Thanks again for you time, your kind words, and your friendship. :-)

02-16-2009, 04:49 PM
Hi Rockford2! I agree both Chele and Oleander have been a great help to me since I was just diagnosed with Malignant Melonoma...I'm sorry you have melanoma and you are a newbee just like me...and I am sensing a little anger about this situation...and I am as well...I know finding out at Christmas time was disheartening...could it not be blessing that you found it and you caught it in time...I think the worse would be to find it too late...As much as I do not want to go through the checkups....I am looking at it as if all I need to do is go to the dermatologist every three months and I will be melanoma free...you bet I am going to do it...we both have been blessed that we are not far gone...And let us keep it that way Rockford 2...As I learn more about melanoma I will be glad to share it with you...do keep it touch...I too need all of your support at this time...And I do plan to take it serious because my life depends upon it. I want to thank all of you for here for me :-). Sparkle

Report Bad Post Reply With Quote

02-16-2009, 05:45 PM
Yes the work situation.........

I have been very worried about cut backs at work. I am the breadwinner in the family and have a huge overhead with 2 in college. Yes I worry. Would not want to start a new job with Doctor appts and perhaps treatments ahead of me. Not to mention loss of insurance. Will telling them put your head on the chopping block? Depends on what kind of company you work for. I work for a private company and they do exactly what they want. I went ahead and put it out there...I hope I did the right thing. Time will tell.

Do you tell them or do you not? It has been mentioned to me that if you tell them they really cannot let you go and have to provide time off for you for Doctor appointments. But I believe it depends on what State you live in maybe and what type of business you work for. Our HR Dept always does what is best for the Company not the employees.

You need to check your State's labor laws about it. Terrible that we even have to worry about this.....but we do......


02-17-2009, 04:30 PM
I was diagnosed with melanoma 1.1mm thickness back in September 08. I was pretty scared once finding out but realized that even though it was past the 1.0mm thickness, I still had a small risk of it spreading to my lymph nodes.

I had surgery to remove the melanoma (leaving a pretty sweet scar:)) and they did a Sentinel Node Biopsy (SNB) taking out 4 lymph nodes which all came out clean. I've since had a sonogram followup with everything still checking out normal. .25mm thickness is still really early and should be nothing to worry about. Being overly cautious is never a bad thing but don't stress.

02-18-2009, 04:49 AM
Hi Dallas and welcome! :wave: So even though most of us had this melanoma caught early, is this really something that we need to continue to worry about? If they cut out the cancer, then why do we need to continuously worry about this?

This is what I don't understand. What I keep thinking is that the surgeon, doctors, and specialists just don't want to be sued IF something should show up, so they constantly monitor us. I, for one, would not sue, but there are some people...

So with thoughts like that, I keep thinking that if *I* should see something weird again, I'll just mention the mole to my regular doctor. I just know that by seeing a dermatoligist, she/he will have me worrying for every single mole I have on my body, and trust me, there is too many to count. :D

02-18-2009, 08:25 AM
Hi Rockford!

I can understand the need to question if those of us who have caught melanoma early the need for continuous followup by doctors and dermatologists. What is the need? If the entire cancer was removed, why the need to keep going back? Why not just go on with life? It would be so much easier, wouldn't it?

Well, allow me to share just one story with you? The name of this woman is Charli Wemkea Blue (yes, that is her real name!) When she was 17 years old melanoma was discovered on her left shoulder. She had a WLE (wide excision), and the doctors stated everything was removed. She continued with followup visits, but life gets busy, you know?

This young woman graduated from high school and attended college in northern California, where she eventually met her husband. They married in 2001, and ended up settling down in Seattle. They were young, newly married, just beginning, and so very happy. In 2006 they discovered Wemkea was pregnant - life was good, life was complete.

Wemekea gave birth to her daughter, Josslyn, in January 2007 - a healthy, beautiful girl. The parents were happy and proud! But, Wemkea told doctors she was experiencing pain in her lower back. The doctor determined it was probably a kidney infection, and placed her on antibiotics. The pain didn't ease up. There were other suggestions, other ideas, but the pain was consistent. Finally, in February, the doctors had Wemkea undergo an MRI. The news came back: Wemkea's lower back was riddled with tumors. It was eventually determined in March these tumors were melanoma - and inoperable. By the end of March/beginning of April doctors were telling Wemkea and her husband to take care of business, and they doubted she would be alive past May.

Charli Wemkea Blue died June 3, 2007. She was 27 years old. She left behind a grieving husband, and a 5 month old daughter. I never met this woman, I never corresponded with her. I've read her husband's word and felt the grief in his words. Her beauty shined through the web site he created in her memorium. I recall the heights of his happiness when she made past May, and the depths of his grief when she passed away.

On the web site he created, he speaks to seeking regular check ups with dermatologists and sun safety and education.

This woman's story is just one. It's heartbreaking - it had me in tears a year and a half ago. But there are others just like Wemkea - people diagnosed with melanoma in the earliest stages, who choose not to follow through with doctors. Life gets busy, they'll do it later, the cancer was all cut out already, excuse after excuse. I cannot tell you how many stories there are of people who are just like Wemkea!

The thing to keep in mind with melanoma? If it comes back, it doesn't always come back as another mole - that's the weird thing. I've talked to a lot of people who had early stage melanoma, and 10 years later melanoma showed up as stage III or IV. This why regular check ups are vital! Knowing and understanding one's body is so important! And sun safety is a key part of this.

I know when I make my appointments with my dermatologist, I'd rather be doing something else. And doing those monthly skin checks in the bathroom, well, those aren't exactly fun, either. But then I think of Wemkea (or Rebecca or Shannon or Marcus or ...) and I do these things if for not other reason, then for their memory and to not let melanoma win.

02-18-2009, 11:29 AM
My Dad's 6 melanoma's were never moles......they were flat lavender itchy spots. His last one was a Stage 4 on his earlobe and it was a dark purple spot. His first age 58 and his last age 93.......so you see you can live a long healthy life. All caught early with the exception of the last one. I lost him last March.

My Dad had melanoma's, basal and Squamous Cell carcinoma and Bowen's disease. Now I have Bowens and Squamous Cell Carcinoma. It sucks.

My brother's melanoma was a mole he had all of his life that had that look....dark and irregular. Luckily all caught early. My brother is now in his 3rd year post melanoma. He has no insurance but never misses a 3 month check up.

Please get your checkups....... it is just an office visit. Not a difficult thing to do..... Please do it. I have been lax also about this but no more.

Hey I am not big on the Medical community either but I am big on these check ups now.........

Care about Y'all.


02-19-2009, 10:38 AM

There's a difference between being worried and being cautious. Since my surgery I've had 2 moles removed and 2 others biopsied. I go every 3 months and insist they cut something off every time. It sucks but honestly you'll get used to it. It helps ease my mind. I understand you have a lot of moles. My derm said statistics show that if you've had melanoma, you probably have 3 to 4 precancerous moles. Not that they will turn into melanoma but I personally want to eliminate the chance by always getting checkups and biopsies done. If you have any questions, Moffitt cancer center has a "cancer answers" hotline run by RNs. It was really helpful for me.

To all others,

Being someone who has recently had melanoma, stories of people that have passed from this disease after being cured can do a number on one's mind. I get a headache and get a CT to make sure it didn't spread. It's very scary. I'm sorry for your losses. I can't imagine going through that. Just to let you know, people with melanoma are looking online for uplifting stories. When it comes down to it, survival rate is very high for melanoma especially if caught early. Checkups are really the only "cure" of melanoma.

02-19-2009, 11:06 AM
So melanoma can come back but not as a mole??? But then, how do the doctors find them??
I've read the Eva Cassidy story, and I THINK that if this young woman had had regular check ups, she might have lived, but I cannot help but think about all of the people who had ONE melanoma....caught at an early stage, and never had a problem again throughout their life.

02-19-2009, 06:59 PM
Hi Dallas!
If I had the doctor remove every mole that *I* thought was cancerous, I would have holes all over my body.

I guess what I want somebody to tell me is that they had ONE melanoma and they were fine........20 years later.
I'm angry at this whole situation because for YEARS, I dealt with severe endometriosis, and had many surgeries (laparoscopy, endometrial ablasion) and nothing worked until I had a complete hysterectomy in June of '07. I thought....FINALLY, a break from constant worrying, cautioness, doctors, the ugly probing for samples and doctor visits.....and now this.

I wanted at LEAST 5 good years......all to myself without doctors and specialists. And caution and worrying.
Sorry for sounding like a spoiled brat, but with everything else going on in my life right now, I could really use a break from hearing or talking about doctors.

02-22-2009, 05:49 AM
I also wonder about having to get checked out every 3 months. Mine is just a squamous cell. Can't I just go if I get another weird looking lump. It cost $25 dollars to just walk in there. If SCC do return how often to they come back. Wouldn't once a year be enough?

02-23-2009, 03:25 PM
I'm stage II melanoma as well...it was my experience when I went to the dermatologist that she not only examined me all over my body, but she also viewed each mark, spot, & mole with a special super super super super magnifying lens...which gave her the vision to not only view it better, but identify each thing and tell me if it were a skin cancer or not...I will be paying $50 each time I go...and to me it is worth the professional examination I receive and also peace of mind...and if I'm told to get checked up a couple times a year...that it will keep me alive...I will do it.

I have learned to accept that this is what one does when they have malignant melanoma...and that is get checkups for the rest of life...so we can have life!

Take care.

02-23-2009, 03:36 PM
Hi Dallas!
If I had the doctor remove every mole that *I* thought was cancerous, I would have holes all over my body.

I guess what I want somebody to tell me is that they had ONE melanoma and they were fine........20 years later.
I'm angry at this whole situation because for YEARS, I dealt with severe endometriosis, and had many surgeries (laparoscopy, endometrial ablasion) and nothing worked until I had a complete hysterectomy in June of '07. I thought....FINALLY, a break from constant worrying, cautioness, doctors, the ugly probing for samples and doctor visits.....and now this.

I wanted at LEAST 5 good years......all to myself without doctors and specialists. And caution and worrying.
Sorry for sounding like a spoiled brat, but with everything else going on in my life right now, I could really use a break from hearing or talking about doctors.
I had stage II melanoma 24 years ago and am doing fine. Yes, I have heard of it coming back after 16 years but hey, no one has tomorrow as a certainty so get out there and live! Do the prudent things in life like those annoying check-ups, keeping your immune system in as good shape as possible, sleep and eat like your life depends on it and laugh lots and love something. You can die while you are living or live while you are dying and we ALL are dying!

03-01-2009, 11:25 AM
I had stage II melanoma 24 years ago and am doing fine. Yes, I have heard of it coming back after 16 years but hey, no one has tomorrow as a certainty so get out there and live! Do the prudent things in life like those annoying check-ups, keeping your immune system in as good shape as possible, sleep and eat like your life depends on it and laugh lots and love something. You can die while you are living or live while you are dying and we ALL are dying!

03-01-2009, 11:32 AM
Topaz4998...that is great news 24 years of remission :-) I am so happy for you...I like your philosophy.."Do the prudent things in life like those annoying check-ups, keeping your immune system in as good shape as possible, sleep and eat like your life depends on it and laugh lots and love something. You can die while you are living or live while you are dying and we ALL are dying!..." I agree with you. My surgeon called me on Friday and told me that they got all of the Melanoma and that it was the subtype Nodular...Can anyone fill me in on this subtype? What I read so far is that it is the worse of all the Melanomas...I like being informed any information on NM would be appreciates... :-)

03-01-2009, 05:40 PM
Thanks so much for your post.

03-02-2009, 08:44 AM
There are several sup-types of melanoma, but the two more commonly known ones are nodular and superficial spreading. The basic differences is thickness and the way these two grow.

Superficial spreading melanoma is usually thin (though this can be misleading if one is using millimeter reading, as even superficial spreading melanoma can become thick quickly if left untreated.), but it grows along the surface of the skin first before growing down into the epidermis. This sub-type of melanoma is far more common.

Nodular melanoma is usually thick, but it grows vertically (down into the epidermis) right away. This usually results in a raised bump. This sub-type of melanoma is not as common. What makes this sub-type more deadly is the way it grows. Because it grows vertically, rather than horizontally, melanoma can reach the lymph and blood stream more quickly than superficial spreading melanoma, thereby spreading more quickly. However, nodular melanoma is staged the same as superficial spreading, and if caught in the earliest stages, is treatable with a great prognosis. I had nodular melanoma at .7 millimeters, staged at IB. Because it was nodular, it didn't really look like any of the melanomas pictured on the internet, except for the fact that it was raised. But it did grow fast!

If you caught your melanoma early, and all has been removed, you should be fine.

03-02-2009, 01:01 PM
Keep your chin up [hat low on face!] and get out there. Spring is here or at least is lurking. Keep in touch with this thread and let us encourage you along the way. Remember, hugs boost the white cell count!

03-02-2009, 01:59 PM
Thank you l adies for all the encouragement...:-) I will check in on the board periodically...we're all in it together...that helps me a lot to know I am not alone :-)... I do plan on enjoying the Spring and Summer...It will be an adjustment for me since I am accustom to being outdoors most of my days I have off from work...As for coverage...I do understand the purpose of a hat when comes to protection...but could I not wear lotion with a 50spf and have the same coverage...and what about the body.... can I wear seasonal clothes and wear 50spf all over my body instead of covering up? I'm sure one can say doing both is best...I do want to be over cautious either. Please advise.

03-02-2009, 04:06 PM
As far as the weather and being out of doors is concerned, just be sensible. There is no need to wear a turtleneck and long sleeves in August, or stay huddled indoors like a mole while everyone else is enjoying that bar-b-que out in the back yard!

Hats are a wise investment, and you can be surprised at the choices you have. And a good sun hat, with a wide, 4" brim can help to protect your face, neck, and shoulders, while you still look great.

Get knowleable now regarding sunscreens and sunblocks. Learn which ones are the best as far as protection and most comfortable to wear. Not all are alike. And don't think that 50spf is necessarily better than 30spf. You might find that 30spf is just fine for you and the brand you pick is more comfortable to wear. BUT...learn how to apply sunscreen, that's the biggest problem people have with the product. Most people apply too little and not often enough and not soon enough. Learn the proper amoung to apply, how often to apply it, and when. Then use it! I keep sunscreen on my dresser, at the front door, in my car, and in my purse. I simply don't have an excuse. Don't give yourself one, either. Also, sunscreen does lose its potency over time: it's best to buy new product every year. (I buy all new in the later part of spring)

The sun's rays are most intense between 10am and 2pm, so be extra diligent about using sunscreen then, or find shade. Do be mindful that UV rays can reflect off of surfaces, however. And if in water, sunscreen needs to be applied more often. Remember, the object now is to AVOID tan lines! And don't forget that time in the car! If you are like me and take road trips during the summer, be aware of where the sun might be. If you have the air conditioning, the UV rays can still be intensified through a car window. Slather on the sunscreen, use the car's sun visor, or cover up (if a passenger).

You don't need to get freakish about all this, but you do need to be more aware. Before you know it, you will start moving towards the shade when the sun hits its zenith or you will just "know" when it's time to put on more sunscreen. I'm just always aware of where I am in relation to where the sun is. But I still love being out of doors - walking, hiking, at the beach, back yard bar-b-ques, parks. If the weather is nice (or even not so nice) I love to be out there. But I want to be around long enough to enjoy it, so I do it safely. You'll get the hang of it. You're alive! Enjoy it!

03-02-2009, 09:19 PM
I agree with everything that Chelo60 said. My doctor told me that it would not matter if I stayed in a cave the rest of my life, the damage had already been done BUT to prevent other cancers and not to look like I was 110 when I was 60 to use cover, both material and liquid. There are clothes out there that have a uv protection added to them but suncreen and hats are best. I use a zinc oxide, one that is not white and I put it on in the morning after my lotion and before my makeup. My husband is a pilot and despite warnings from his nagging wife, failed to apply before flying and had to have several places taken off his face from the uv light exposure he had at altitude. I even put it on the days it rains, which isn't often here in Texas and on days it is completely overcast. It is habit now. I have had a couple of places on my legs that were 'premelanoma' but I am still paranoid enough that if ANYTHING worries me, it's taken out then I don't worry. I have to admit I have had one or two 'old-age tags' removed but mostly I do spot the changing ones that have potential for any type of skin cancer. I don't shun the outdoors at all, I herd sheep in all kinds of weather but I am careful about peak times as Chelo60 mentioned.
Common sense will guide you plus you can use your own paranoia to keep yourself safe and spread the word to others. I have faith that you can be your own best friend in dealing with this.

10-04-2009, 06:05 AM
Hi Everyone...as most of you are aware, I was diagnosed with stage II Nodular Melanoma in February 2009. This was my first summer without sunbathing. I love the sun and the outdoors and it was a very sad summer for me. I did not sunbath...I did wear sun block and a hat as well as protective clothing...it was mentally and emotionally a downer...I still do not know how to balance life and skin cancer when it comes to enjoying the sun and the outdoors. How do we go to the beach and enjoy it without doing us harm? The good thing that has happened is that I did give up the tanning bed and sunbathing. I DID IT!!!:D

Sparkle Plenty

10-05-2009, 08:34 AM
Congratulations on giving up the tanning bed and the sunbathing! I know it's tough to make lifestyle changes, but it's important to understand that sometimes it's "baby steps." It's also understanding that, having had a melanoma, exposure to the sun's UV rays (including a tanning bed) can and may shorten your life.

As far as enjoying the great outdoors - or even the beach - without it doing you harm? You can do so! You just need to be smart. I love being out-of-doors! I love going for walks, hiking, spending time at the park, being at the beach. I don't really consider myself limited. I just make certain I have my sunscreen (I keep it in my bag and my car, and it's always packed in my suitcase!), and I apply it often and liberally. I no longer look at hats as "frumpy" or "must haves." I have a collection of really cool, cute hats - and I'm always surprised at how many others I see wearing hats. I also don't relagate myself to long sleeves, but I will seek out shade. I have learned to think more about the situation that I'm in and how it may affect me and my skin, but if my friends want to go to the beach, hey, I'm cool with it! I'll be the one slathering on the sunscreen, and sitting under the umbrella, soaking up the warmth of the balmy air! (And remember, UV rays reflect off of sand!)

The first time you encounter something that challenges your lifestyle change, it's tough. But you learn to adapt and live with it, while still being who you are. You can still enjoy the out doors, the beach, being in a pool, at a bar-b-que. You will need to learn to adjust. It will come, you just need to give it some time!

Good luck!

10-05-2009, 06:01 PM
Keep up the good work! I herd sheep so I am out in the sun and the hot Texas temperatures but I go early, I wear shirts that have some uv protection, I wear a hat and a greased pig couldn't measure up to the amount of sunscreen I wear. Okay, that last was an exaggeration because you can only put so much on at a time but do it frequently! Don't forget your ears and back of your neck and even the back of your hands. I swim and garden but I do it early or late. It's easy to do that here with it being too hot most of the day but even if I am running errands I make certain I have put on the sunscreen even if I am just in the car. Be smart but have fun because life is fun and living is wonderful!

10-09-2009, 05:25 PM
Topaz498...thank you for the support and encouraging words...I have many changes in my life mostly dietary, however, I find this to the most challenging of my health issues...but one I am determine to overcome...My life depends upon it. Sparkle Plenty

10-09-2009, 05:29 PM
Hi Chelo60...Life has sent me many challenges...all of which I have handled...This one I find is the most challenging...Thank you for your support and encouragement...it really helps to know that I am not alone. Thanks for being there. Sparkle Plenty