A shave bx for a lesion on my back revealed a dysplastic nevus with severe changes. It reappeared in the same spot, and was bx'd again. This time, a dermatopath reviewed the case and said it was paucicellular, but was "very worrisome for a very early, evolving melanoma," hence my recent wide excision. I'm worried that not having a definite answer is affecting my follow up care, as I have had no additional testing. Should I ask for more? If it is Melanoma, I want to be as cautious as possible.
I'm Afraid my "Non-diagnosis" Will Affect my Follow Up and Treatment. I Possibly Have Melanoma?
Doctor Answers (2)
should have the dermatopathologist review the original slide and get another opinion...but in any event it appears you had sufficient therapy...and need nothing more other than a periodic general full body check...the recommendations are evolving and now are more realistic than as recently as a few years ago...assuming there's no history to suggest there's a family tendency to melanoma, then the idea of monitoring the skin frequently and undergoing blood tests or xrays/scans is outmoded and actually was never was a good idea...melanoma is extraordinarily common and not nearly as scary as most people think...the cure rate on average is in the high 90% range with nothing more than in-office surgery...of course deep invasion spells trouble, but that's relatively uncommon compared to the vast majority of melanomas...and don't forget to limit your sun exposure...
Melanoma and recommended guidelines
Since your melanoma was "very early, evolving melanoma" it sounds like you were extremely fortunate. The proper procedure now for monitoring is to have skin cancer examinations four times a year to watch this site and moreover to watch for signs of other malignancies elsewhere. It sounds like you are being treated well and you just have to be diligent about your skin cancer examinations. Make certain you are seeing a board certified dermatologist who has a lot of experience with skin cancer.
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