Sentinal Node Biopsy

My son is scheduled for a furher excision of a malignant melonoma (1.17.) with a sentinal node biopsy.  In your experience (anyone) , do they do the pathology at the time of the surgery and go ahead and remove any affected lymph nodes right then, or do you wait to get the results and then return for  removal of any affected nodes?

Thanks for any help or advice you may have.

Darlene in Md.

Darlene, I had the SNB done at the end of Nov. 2006. I did have to wait a couple of weeks for the results, which came back positive. I was scheduled rather quickly to have the remainder of the lymph nodes in my groin removed in Dec. 2006 (they removed an additional 9 lymph nodes, which all came back negative).  Unfortunately it's a wait and see game.  I'm sorry you and you're family are going through this, but know that's there's a lot of support on the web in terms of message boards which I've found to be very helpful during this difficult time.  I hope I was helpful, and I wish your family the best.

S.

On 1/26/2007 Red81 wrote:

Darlene, I had the SNB done at the end of Nov. 2006. I did have to wait a couple of weeks for the results, which came back positive. I was scheduled rather quickly to have the remainder of the lymph nodes in my groin removed in Dec. 2006 (they removed an additional 9 lymph nodes, which all came back negative).  Unfortunately it's a wait and see game.  I'm sorry you and you're family are going through this, but know that's there's a lot of support on the web in terms of message boards which I've found to be very helpful during this difficult time.  I hope I was helpful, and I wish your family the best.

S.

Thanks you S. for your reply - I have not been able to get a straight answer from my son and have not personally spoken to the doctor.  I feel much better just knowing what to expect on the day of the surgery.  My next question, if you don't mind, is how long did you need to recover after the excision with the SNB and how long after the removal of those 9 nodes?!  So glad for you that they all came back negative.  God willing, you will be cancer free now - did they do CAT/PET scans?  You can't imagine (or maybe you can) how much I appreciate this answer.  It is so scary. 

Hi Darlene, glad I was able to help.  In terms of recovery from the SNB, I layed low for a few days (tried not to walk too much), then I was able to go back to work, but didn't resume excersise (my doc told me to wait at least 2-3 weeks before getting back on a tredmill). The area around the incision was pretty tender for a couple of weeks but that was about it.  Oh, I did also have some swelling but I believe that's common after lymph node removal, you just have to be careful about what you do (no long walks/exercise, etc for a while).  After I had the SNB I waited 2 weeks for the results, in fact it was my two week followup when I found out that the lymph node removed was positive.  The surgery to remove the remaining lymph nodes was scheduled rather quickly (I found out on a Wed. and had the surgery the next Thursday), but I think the timing had a lot to do with how quickly they scheduled it (it was the week before Christmas, and I didn't think they wanted to post-pone to after the holidays). It was during this week that they scheduled a CT scan, which thankfully came back clear (I found out the results of that test 4 days later at my surgery). 

The recovery for the 2nd surgery was much more extensive. I spent the night in the hospital and checked myself out the next day (I didn't get much sleep there).  Walking was extremely difficult and painful initially (getting up stairs was a big problem).  I was prescribed some heavy duty pain killers, which did help, but the mobility of my leg was just not there and it was very difficult to lift my leg. The second week was better. The pain wasn't as bad but I still layed low.  The third week I was feeling a lot better, but still tried to lay low as much as possible. I had two drainage tubes in and two weeks after the surgery I had one removed and at the third week I had the second removed (this was so fabulous because I was unable to shower with the tubes in).  I was also fitted for a compression stalking during the 3rd week, which is annoying but really helps and cuts down on the swelling (and had prevented swelling in my ankle).  It's been about 5 weeks since my surgery and I'm feeling much better. I've even started walking regularly to build strengh back in my leg. I start the Interferon treatment next week, which I know will wipe me out, but it's necessary.

I hope and pray that your son doesn't have to go through the second surgery.  Melanoma is such a crazy disease, but I have found the support on the web very helpful (I also pop on to www.mpip.org).  Please let me know if you have any other questions.  Good luck and take care.

When I had my surgery in Sept. of 2006- I had the sentinal node biopsy done (where there map which lypmhnode the mole drained into) and the excisional surgery at the same time. Then by the time I woke up they already had the results of my biopsy- which came back clean. No cancer is the surrounding tissue and nothing in the lymphnode they removed. So it's possible that you might not have to wait. After my surgery I went to see an oncologists where he had me have a PET scan to ensure that it hadn't spread anywhere else! That scan came back clean as well. If you have any questions- respond to this. I know that when I was going through this - this website really helped me!!!!

THANK YOU!!!  The surgery is tomorrow and of course, I am anxious and then to check in and read your email really helped.  I feel it is better to be prepared with some personal experience so I can gently help him to know what to expect.  In my experience, doctors do not always give you the real scoop on recovery issues.  This has been so helpful and I will keep checking back with possible further questions.  Thanks for your time and I will be praying for your future treatment and recovery.

Darlene

On 1/29/2007 Red81 wrote:

Hi Darlene, glad I was able to help.  In terms of recovery from the SNB, I layed low for a few days (tried not to walk too much), then I was able to go back to work, but didn't resume excersise (my doc told me to wait at least 2-3 weeks before getting back on a tredmill). The area around the incision was pretty tender for a couple of weeks but that was about it.  Oh, I did also have some swelling but I believe that's common after lymph node removal, you just have to be careful about what you do (no long walks/exercise, etc for a while).  After I had the SNB I waited 2 weeks for the results, in fact it was my two week followup when I found out that the lymph node removed was positive.  The surgery to remove the remaining lymph nodes was scheduled rather quickly (I found out on a Wed. and had the surgery the next Thursday), but I think the timing had a lot to do with how quickly they scheduled it (it was the week before Christmas, and I didn't think they wanted to post-pone to after the holidays). It was during this week that they scheduled a CT scan, which thankfully came back clear (I found out the results of that test 4 days later at my surgery). 

The recovery for the 2nd surgery was much more extensive. I spent the night in the hospital and checked myself out the next day (I didn't get much sleep there).  Walking was extremely difficult and painful initially (getting up stairs was a big problem).  I was prescribed some heavy duty pain killers, which did help, but the mobility of my leg was just not there and it was very difficult to lift my leg. The second week was better. The pain wasn't as bad but I still layed low.  The third week I was feeling a lot better, but still tried to lay low as much as possible. I had two drainage tubes in and two weeks after the surgery I had one removed and at the third week I had the second removed (this was so fabulous because I was unable to shower with the tubes in).  I was also fitted for a compression stalking during the 3rd week, which is annoying but really helps and cuts down on the swelling (and had prevented swelling in my ankle).  It's been about 5 weeks since my surgery and I'm feeling much better. I've even started walking regularly to build strengh back in my leg. I start the Interferon treatment next week, which I know will wipe me out, but it's necessary.

I hope and pray that your son doesn't have to go through the second surgery.  Melanoma is such a crazy disease, but I have found the support on the web very helpful (I also pop on to www.mpip.org).  Please let me know if you have any other questions.  Good luck and take care.

THANK YOU ALSO - to have 2 answers like this the eve. before surgery is a God-Send.  So your results came back with no lymph node involvement and (I assume) your surgeon? recommended you to an oncolotgist who did the PET scan.  So even with no lymph node involvement, the PET should be done.  That answers my sons' question which was "even if there is no lymph node involvement, how do we know it's not on it's way?"

This message board has been so helpful and I thank you for taking the time to reply to an anxious mom's questions. 

May God bless you with future good health.

Darlene