Help Me !! I Have Been Left In The Dark....

OK, heres my story in a nutshell.  I have had a patch of what I thought was excema on my right shoulder for at least a couple of years.  I even pointed it out to m y doctor a year or so ago and he said it was dry skin.  Anyway, this past December, it started growing a bump.  It was about pea-sized when my wife told me to get it checked.  I went to the family doctor and he did a shave biopsy of the bump.  A week later I get the phone call to come in and discuss the results.  Sure enough, Squamous cell carcinoma.  He referred me to a surgeon to have the tumour removed.  I ended up waiting about 4 months to get in to a surgeon, finally having the procedure done on APril 11,2007.  My surgeon said to book an appointment with my family doctor in a week.  I did.  The family doctor looked at my incision, changed the dressing and was about to send me on my way when i asked ( had to ask) about the Pathology report on the tumour.  Here's what he said :

1) the margins were clear     ( at this point I am thinking YAY )

2) Extensive Lympahtic Invasion ( not so happy now)

I asked him what that last part meant and all he could say was I need to talk to my surgeon.  I have an appointment on May 15 with the surgeon to discuss this but I am worried ( to say the least)

My question the the experts on this board and those of you that have lived through this......does Extensive Lymphatic Invasion mean what I think it does ?  Has the cancer metastized to the lymph nodes ?  I can't sit for 3 weeks until I talk to my surgeon not knowing.

Help....please.

First of all, I think you have a lousy family doctor to treat you with such disregard.  I'm a pre-nursing student who has had some personal experience with cancer.  Not myself, or so I won't know until my test results come in, but with family and patients.

 Anyhow, what I know is the lymphatic system is the filter system of your body.  The fluid, called lymph, is what carries waste material and dead blood cells from the tissues.  Lymph travels through the entire body.  This fluid is filtered through the lymph nodes.  These lymph nodes filter harmful substances such as bacteria, viruses, and malignant cells out of the lymph before the lymph is returned to the circulatory system.

Lymphatic invasion is when foreign and potentially harmful substances, such as cancer cells, have gotten into the lymph.

I would think that with these pathology reports you should have been taken in to see your surgeon sooner.  They are the ones who have read the reports, did the procedure, and need to follow up with you.

 I've never lived through this and the closest I've been is waiting for the pathology reporst for my mother's hysterectomy from her uterine cancer.  They were negative.

 I'm just giving you information I've learned through my studies and patients, and hope that all turns out well for you, and that you find the answers you are looking for.  Continue your insisting of knowing what the reports say and what is happening because you need to know everything.

You need to see a radiation oncologist for workup and possibly post op radiation to the area with wide margins.  Believe it or not I would also, if the Squamous Cell was extensive, get a PET/CT.  The worst Pathological finding is "perineural invasion".  The cure rate goes from better than 90 percent to 65 percent.

Squamous Cell of the skin is exactly the same type of tumor as Squamous Cell of the lung, mouth tongue, throat etc.  and can spread just as readily.  The reason the skin is cure more is simply that it is usually caught when small and less invasive.

Don't let the surgeon re resect the area, it would not be accurate and it would just "stir the pot".  Get worked up and if negative then all you need is Local treatment with superficial or electron beam irradiation.

Thank you for your responses.  I am still shocked at the lack of concern from the family doctor over the Pathology report.  Then at the same time, I think to myself, " Maybe he isn't worried because there is nothing to worrry about"  This is going to drive me nuts.

I actually phoned the family doctor back and requested a referral to the local Cancer Centre and this is what he said. " I don't see why you'd want that" and then he told me again that I need to talk to the surgeon.  Either I am overreacting, or this doctor is not willling to give the news.

When SCC spreads into the Lynph Nodes...what happens ?  does the cancer spread to other body parts through the lymphatic system?  What are the signs/symptoms of Lymphatic Invasion of SCC ? 

Ultimately I know I need to actually see a specialist here but until that happens any info you can give me helps.

On 4/22/2007 Fallingelevator wrote:

OK, heres my story in a nutshell.  I have had a patch of what I thought was excema on my right shoulder for at least a couple of years.  I even pointed it out to m y doctor a year or so ago and he said it was dry skin.  Anyway, this past December, it started growing a bump.  It was about pea-sized when my wife told me to get it checked.  I went to the family doctor and he did a shave biopsy of the bump.  A week later I get the phone call to come in and discuss the results.  Sure enough, Squamous cell carcinoma.  He referred me to a surgeon to have the tumour removed.  I ended up waiting about 4 months to get in to a surgeon, finally having the procedure done on APril 11,2007.  My surgeon said to book an appointment with my family doctor in a week.  I did.  The family doctor looked at my incision, changed the dressing and was about to send me on my way when i asked ( had to ask) about the Pathology report on the tumour.  Here's what he said :

1) the margins were clear     ( at this point I am thinking YAY )

2) Extensive Lympahtic Invasion ( not so happy now)

I asked him what that last part meant and all he could say was I need to talk to my surgeon.  I have an appointment on May 15 with the surgeon to discuss this but I am worried ( to say the least)

My question the the experts on this board and those of you that have lived through this......does Extensive Lymphatic Invasion mean what I think it does ?  Has the cancer metastized to the lymph nodes ?  I can't sit for 3 weeks until I talk to my surgeon not knowing.

Help....please.

 

 

 

The lymphatic invasion doesn't mean that the cancer is in the lymph nodes in your case.The surgeon removed the cancer with the healthy skin margin and he did not removed any lymph nodes at that time.

Generally speaking this is all what is required in your case assuming the surgeon examined you carefully and also checked for abnormal,enlarged lymph nodes in your body including nodes in the right axilla (armpit).If he did and there were no suspicious enlarged lymph nodes then you need follow up by your doctor who should examine you regularly and check the shoulder (the removed cancer area) and check you for enlarged lymph nodes .

Your prognosis is excellent or should be excellent.The basal type skin cancer and squamous cell skin cancers are the most common skin cancers in humans the world. You do not hear much of them because unless neglected for a long time they usually require simple resection as you had and recurrences or spread to other organs are very uncommon.The skin cancer called melanoma is the most risky to get but this doesn't applay to you.So get reassured , speak to surgeon or cancer doctor or speak with dermatologist so you get pace of mind but relax .You will do wery well. Aviod suntannig from now on , protect your skin from sun when outside and check your skin regularly by yourself and by your doctor.When you get something similar like your previous skin cancer have it biopsied right away or ask for referal to dermatologist (skin specialist for an opinion). Good luck and relax.

On 4/23/2007 Western Canadian wrote:

 

On 4/22/2007 Fallingelevator wrote:

OK, heres my story in a nutshell.  I have had a patch of what I thought was excema on my right shoulder for at least a couple of years.  I even pointed it out to m y doctor a year or so ago and he said it was dry skin.  Anyway, this past December, it started growing a bump.  It was about pea-sized when my wife told me to get it checked.  I went to the family doctor and he did a shave biopsy of the bump.  A week later I get the phone call to come in and discuss the results.  Sure enough, Squamous cell carcinoma.  He referred me to a surgeon to have the tumour removed.  I ended up waiting about 4 months to get in to a surgeon, finally having the procedure done on APril 11,2007.  My surgeon said to book an appointment with my family doctor in a week.  I did.  The family doctor looked at my incision, changed the dressing and was about to send me on my way when i asked ( had to ask) about the Pathology report on the tumour.  Here's what he said :

1) the margins were clear     ( at this point I am thinking YAY )

2) Extensive Lympahtic Invasion ( not so happy now)

I asked him what that last part meant and all he could say was I need to talk to my surgeon.  I have an appointment on May 15 with the surgeon to discuss this but I am worried ( to say the least)

My question the the experts on this board and those of you that have lived through this......does Extensive Lymphatic Invasion mean what I think it does ?  Has the cancer metastized to the lymph nodes ?  I can't sit for 3 weeks until I talk to my surgeon not knowing.

Help....please.

 

 

 

The lymphatic invasion doesn't mean that the cancer is in the lymph nodes in your case.The surgeon removed the cancer with the healthy skin margin and he did not removed any lymph nodes at that time.

Generally speaking this is all what is required in your case assuming the surgeon examined you carefully and also checked for abnormal,enlarged lymph nodes in your body including nodes in the right axilla (armpit).If he did and there were no suspicious enlarged lymph nodes then you need follow up by your doctor who should examine you regularly and check the shoulder (the removed cancer area) and check you for enlarged lymph nodes .

Your prognosis is excellent or should be excellent.The basal type skin cancer and squamous cell skin cancers are the most common skin cancers in humans the world. You do not hear much of them because unless neglected for a long time they usually require simple resection as you had and recurrences or spread to other organs are very uncommon.The skin cancer called melanoma is the most risky to get but this doesn't applay to you.So get reassured , speak to surgeon or cancer doctor or speak with dermatologist so you get pace of mind but relax .You will do wery well. Aviod suntannig from now on , protect your skin from sun when outside and check your skin regularly by yourself and by your doctor.When you get something similar like your previous skin cancer have it biopsied right away or ask for referal to dermatologist (skin specialist for an opinion). Good luck and relax.

OK....SO I phoned the local Cancer clinic myself and explained the situation.  I talked to the Nurse/Manager and she confirmed to me the EXtensive Lymphatic invasion does mean its spread at least regionally to the local lymph nodes.  The oncologist has referred me for a CT of the chest and neck to determine the extent of the lymphatic involvement and then we are going to discuss treatment options.

Dave

Western Canadian,

Are you a specialist in Oncology ?

On 4/26/2007 Fallingelevator wrote:

 

On 4/23/2007 Western Canadian wrote:

 

On 4/22/2007 Fallingelevator wrote:

OK, heres my story in a nutshell.  I have had a patch of what I thought was excema on my right shoulder for at least a couple of years.  I even pointed it out to m y doctor a year or so ago and he said it was dry skin.  Anyway, this past December, it started growing a bump.  It was about pea-sized when my wife told me to get it checked.  I went to the family doctor and he did a shave biopsy of the bump.  A week later I get the phone call to come in and discuss the results.  Sure enough, Squamous cell carcinoma.  He referred me to a surgeon to have the tumour removed.  I ended up waiting about 4 months to get in to a surgeon, finally having the procedure done on APril 11,2007.  My surgeon said to book an appointment with my family doctor in a week.  I did.  The family doctor looked at my incision, changed the dressing and was about to send me on my way when i asked ( had to ask) about the Pathology report on the tumour.  Here's what he said :

1) the margins were clear     ( at this point I am thinking YAY )

2) Extensive Lympahtic Invasion ( not so happy now)

I asked him what that last part meant and all he could say was I need to talk to my surgeon.  I have an appointment on May 15 with the surgeon to discuss this but I am worried ( to say the least)

My question the the experts on this board and those of you that have lived through this......does Extensive Lymphatic Invasion mean what I think it does ?  Has the cancer metastized to the lymph nodes ?  I can't sit for 3 weeks until I talk to my surgeon not knowing.

Help....please.

 

 

 

The lymphatic invasion doesn't mean that the cancer is in the lymph nodes in your case.The surgeon removed the cancer with the healthy skin margin and he did not removed any lymph nodes at that time.

Generally speaking this is all what is required in your case assuming the surgeon examined you carefully and also checked for abnormal,enlarged lymph nodes in your body including nodes in the right axilla (armpit).If he did and there were no suspicious enlarged lymph nodes then you need follow up by your doctor who should examine you regularly and check the shoulder (the removed cancer area) and check you for enlarged lymph nodes .

Your prognosis is excellent or should be excellent.The basal type skin cancer and squamous cell skin cancers are the most common skin cancers in humans the world. You do not hear much of them because unless neglected for a long time they usually require simple resection as you had and recurrences or spread to other organs are very uncommon.The skin cancer called melanoma is the most risky to get but this doesn't applay to you.So get reassured , speak to surgeon or cancer doctor or speak with dermatologist so you get pace of mind but relax .You will do wery well. Aviod suntannig from now on , protect your skin from sun when outside and check your skin regularly by yourself and by your doctor.When you get something similar like your previous skin cancer have it biopsied right away or ask for referal to dermatologist (skin specialist for an opinion). Good luck and relax.

OK....SO I phoned the local Cancer clinic myself and explained the situation.  I talked to the Nurse/Manager and she confirmed to me the EXtensive Lymphatic invasion does mean its spread at least regionally to the local lymph nodes.  The oncologist has referred me for a CT of the chest and neck to determine the extent of the lymphatic involvement and then we are going to discuss treatment options.

Dave

 

If the surgeon removed the patch of abnormal skin only how can anyone tell you that the cancer is in the lymph nodes???? Which were not removed!!! The skin has lymphatic netwirk and the cancer was in the network in the removed skin. Unless you did not described what went on. Did you have lymph nodes removed from the armpit or not?

In any case good luck and keep us posted if you wish.

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