Things are moving… finally

Things are finally moving again, which is good. I was right. My case had got stuck in the system. I chased it up and kept asking for answers until I got them.

My case will now be assessed on October 26th for a second opinion on whether a re-excision is needed on my right calf where a very early-stage melanoma was removed at the end of August. That’s nearly six weeks after I was told a second opinion would be sought. I know there’s no rush and my case is borderline, but that is quite a long time. I’ve been assured “it’s not usually like this”.

The issue is that while the melanoma was removed, they got slightly less healthy tissue from the area surrounding the melanoma than the guidelines recommend (Things are rarely straightforward). I’ve been told again that a re-excision – a narrow one – is probably what will be recommended so they do in fact get the full 1cm clear margin that the guidelines say we should have. It’s precautionary, but better safe than sorry. I’m happy with that. I’ll meet with the plastic surgeon to discuss the results and next steps on November 1st. As I said, there’s no rush. If a re-excision is indeed what we decide on, it can wait until after I get back from the two-week trip to Cambodia that I’m going on with one of my brothers on November 2nd. Yes, yes, it’s a complete self-indulgence but if there’s one thing I’ve learned from the whole breast cancer experience, it’s that life is for living.  If you can, then why not.

The leg wound is now well on the mend and I’m exercising again. I did my local 5k Parkrun last Saturday – my slowest time in well over a year after seven weeks of enforced inactivity – and I’ve been back on the tennis courts. I have four tennis matches planned over the next seven days. I’m clearly making up for lost time.

I’ve been thinking about how I’m feeling about this whole melanoma thing. It’s strange. I was pretty shell shocked initially (Melanoma? You’ve got to be kidding), as you’d expect. Now I’ve got my head round it, I’m at the stage where I see it as more of an annoyance than anything else. Friends who are only finding out about it now are more upset and outraged than I am. I know if this were a first cancer diagnosis I’d be freaking out and I know too that melanoma’s known as the nasty skin cancer because it can spread very quickly. But I really do feel I’ve got off lightly. Cut it out and hopefully that’s it. A possible re-excision? That’s ok too, although a skin graft would not be great if that’s what’s needed – I’m hoping it won’t be.

Perhaps I’m being naive. Or perhaps it’s sheer relief that it was caught so early. That’s not to say I’ll be able to just brush it off. I’m already looking at a couple of freckles/moles/brown spots – call them what you want – and wondering how long they’ve been there or whether they’ve always been that size. But I just cannot “do” worry the way I did with breast cancer. I know how destructive it is; I can’t do that again.

Let’s see what November 1st brings. Re-excision or not, skin graft or not, I’ll be taking my running shoes to Cambodia.

Things are rarely straightforward. Still waiting.

It’s been over a month since we got the histology results for the melanoma I had removed from my right calf at the end of August and I still don’t know for certain whether I’ll need a second procedure.

There’s no doubt that “we” (for want of a better term) got all the melanoma. “Completely excised,” reads the report from September 4th (I was told on September 5th). However, we didn’t get quite as much healthy tissue from the surrounding area as the guidelines recommend. That said, because the melanoma was so thin, and also it seems it’s not an exact science, it could be that what we did get might be considered enough.

Because it’s not clear cut (no pun intended), the doctor(s) involved in the initial diagnosis and procedure asked for a second opinion. I am, of course, more than happy with that but the second opinion – or rather the official second opinion – hasn’t been forthcoming. While the plastic surgeon has been told they will recommend a re-excision, we’re waiting for official word before we make any decisions. That also makes sense but we’re still waiting. And it’s not clear to me why that’s the case.

I had a wide local excision on August 29th (Melanoma? You’ve got to be kidding).  The surgeon cut out what turned out to be a very thin melanoma along with a “safety margin” of healthy-looking tissue around the lesion. The purpose of the safety margin is to remove both the primary tumour and any melanoma cells that might have spread into the surrounding skin. The recommended margins, both at the edges and in the depth, vary depending on the thickness of the tumour. Thicker tumours need larger margins. The definition of thin is a thickness of less than or equal to 0.5mm; in my case it was 0.3mm. Very thin by any normal measure and thankfully in melanoma terms too. I couldn’t be more relieved at that result, but it turns out there’s a question over the margins. Thus the need for the second opinion.

Things are rarely straightforward.

Also, the wound has taken longer to heal than it could have done so I still haven’t been able to get back to exercising. Your calf is not a good place to have a wound as basically you’re putting stress on it with every step. We’re nearly there, though… although if another excision is needed we’ll be back at square one.

The main thing is that the melanoma was thin. I understand a second procedure, if that’s what’s decided, would be a precautionary measure – albeit with potentially considerable consequences on a practical level if it involves a skin graft, as I’ve been told it may well. I also understand that you have to wait until the original wound is “safe” before you re-excise. However, regardless of when we’d do it, I’d really like to know for sure whether it’s happening or not.