I Am Confused

My FIL called us last week with a diagnosis of stage IV melanoma on his neck.  He said his doc told him it was "stage 5 on some other scale and stage 10 on another" (but he couldn't tell me what those were called).

 I immediately started looking online and found lots of scary info which I did NOT share with him.  

 Monday, he had a PET scan and a CAT scan.  He called yesterday to tell us that they found NOTHING on either scan.  He is going to have a sentinel node biopsy done at the same time as his surgery for the melanoma (which isn't scheduled yet... I know...ugh).

 My confusion lies in the original diagnosis... from what I've read "Stage IV" means the cancer HAS mets'ed *somewhere* so how could he have a stage IV melanoma and no mets?  

 How is stage IV diagnosed with just a biopsy?  

I know so little about the nuts and bolts of this disease and it's frustrating trying to make heads or tails of what he and my MIL tell us because they don't seem to ask a bunch of questions, etc. just take the doc's word at face value. 

To add a little history, my FIL has had multiple occurrences of basal cell and squamous cell, the last of which was in April where he had three stage III's removed.  At that time, the mole on his neck didn't send up any red flags, and even now, it was regular, tan and flat.  At this appointment, they also found other stage II and III's, I'm pretty sure on his head.

So, I'm confused.  Can anyone here please help me understand what is going on and whether or not I can stop holding my breath?  I'm scared to death for my FIL and if I don't need to be, I'd like to know that! 

Sorry, I hit post message before saying...

 

THANK YOU!!!!!!

 

Lo 

melanoma is confusing because there are several different terms used.   The Breslow scale is the tumor depth and is usually measured in mm from 0->1.5.  Clarks scale does have 5 levels which also indicate how far the melanoma is growing down into the skin.  Then there is the regular stages based on TNM.  Stage 4 does require distant mets.  Stage 3 requires LN involvement.  So you need to make sure the patient has the terminology correct.  You could have Clarks scale 4 but not have Stage 4. If his scans were clean then stage 4 is unlikely.  The surgery and LN biopsys are needed for staging.

Ah... Thank you!

That makes sense... that you'd need the surgery to determine staging... I thought it was weird.

 

I will quiz them again next time I talk to them about the "staging" issue LOL!

 

This has put my mind to a bit of rest :)