Stage III Melanoma

Today we are going to go a little bit more in depth on what stage III melanoma is, and how it differs from the other stages of melanoma. Each stage is different, and each one represents the progression of the cancer.

Stage 0: Stage 0 tumors and in situ, which means they are noninvasive and have not penetrated below the surface of the skin

Stage I: Stage I tumors have invaded the skin but are small, non-ulcerated, and are growing at a slow mitotic rate

Stage II: Stage II tumors, though localized, are larger (generally over 1 mm. thick) and/or may be ulcerated or have a mitotic rate of greater than than 1/mm2; they are considered intermediate melanomas

Stage III: Stage III cancer have metastasized (spread) to lymph nodes

Stage IV: Cancer has spread to organs and other parts of the body, it then becomes terminal.

As I have said in my prior writings, my mother is stage III. This Managing Stage III Melanoma site gives a short and sweet explanation of what stage III melanoma is: " Stage 3 melanoma means that cancer is present in not just the skin cells at the time of diagnosis, but also the lymph nodes. Lymph nodes are small tissues located in your neck, under your arms, and in other areas throughout the body. Your lymph nodes may or may not be swollen in stage 3. Stage 3 melanoma is split into three categories: 3a, 3b, and 3c. Stage 3a is the least serious while stage 3c is the most advanced. Staging depends on the location of the cancer, the size of the tumors, and if they have ulcerated (spread to the mucus membranes)" Her cancer has spread to the lymph nodes nearest to where the cancer was found, which would be the lymph nodes in her groin. Since the cancer has advanced to this stage, surgical removal of all regional lymph nodes, as well as the removal of the primary cancer tumor (where the cancer was found). With the removal of the primary cancer, 2 centimeters of adjacent skin is also removed, so ensure there is no cancer left behind.

A huge chunk of patients have the risk of loco-regional relapse of melanoma. These means that people who have been diagnosed with melanoma an then cured, have a huge chance of the cancer returning. Texas Oncology states "Features associated with a high risk of recurrence at the primary site are positive microscopic margins, recurrent disease, and thick primary tumors with ulceration or satellitosis. Features associated with high risk for lymph node recurrence following surgical removal of the lymph nodes have also been defined and include involvement of 4 or more lymph nodes, lymph nodes measuring at lease 3 cm, lymph nodes in the neck (cervical region) and evidence of extra-capsular extension (tumor beyond the capsule of the normal lymph node)."

Now, an update on my momma! She unfortunately is still stuck in the same position s last week, she can't move on with surgeries or treatments until the infection of her skin is healed. We were told that the absolute soonest she would be able to start treatments is November 5th, but that's if they can get rid of her infection and get all of her surgeries done and healed before then. Since getting the mediciation to help get rid of the infection, her graft has been looking 10x better.

 This is the graft as of a few days ago, the scabs are starting to fall off and it is starting to look so much better.

This shows how the swelling of her foot has significantly gone down.

update on mom

Some crazy and unfortunate stuff has happened within the past two weeks, so this week I've decided to just write about some updates and what has been going on with my momma. We got the news that she was supposed to start immunotherapy treatments on Tuesday, and treatments within the hospital would be twenty straight days, and the rest of the treatments would be done at home, lasting for a total time of a year. So, she was supposed to have a surgery sometime last week, she was going to get a port inserted in her chest so every time she has to go in for treatments she doesn't have to get an iv, they can just do it through the port. And for some reason they pushed everything back by about two weeks. WELL, yesterday my mom and dad took a trip up to Estes Park, and a woman came up to my mom while they were eating pizza and said she deals with skin grafts and asked to see her skin graft. The second she looked at it she urged my mom to go to the ER. The woman said it looked very infected and she was worried because an infection in my mothers case could spread and kill her. They got to the ER and sure enough that woman was right. Her entire skin graft was infected, and also dying. They immediatly hooked her up to iv's and got some medicine flowing through her. She also had to go back today to get more medicine to fight off the infection. So now she possibly can't have her port put in, and she is going to have to have another surgery to have a new skin graft done, which means she won't be able to start treatments. It is very frustrating that she can't start treatments and that they keep getting put off, treating spreading cancer isn't something you can necessarily put off.

This was her foot and the graft the night she went to the hospital. Notice how the graft itself is totally black, and how swollen her foot is.

My moms oncologist told her that only about 30% of skin grafts take the first go around, so I guess she is fitting in with the statistic.

so just HOW bad is melanoma?

My mom is a few weeks out from surgery and she seems to be getting better and better everyday. She still struggles to get around just because she still can't bend her ankle because of the graft, but she is finally able to hop around without crutches! She also got all of her stitches removed from her groin and thigh area. She meets with an oncologist sometime within the next week to discuss and figure out what her treatments are gonna be. We all know she is going to have to go through some sort of chemotherapy and/or radiation. The thing my mom is most worried about is losing her hair, which I think is ludicrous. There is a good possibility that she is going to be fighting for her life, and all she is worried abut is losing her hair?! I guess that can be looked at in a somewhat positive way- all she has to worry about is being a bald lady for a while.

This is her thigh and groin area, where her stitches
were and where her lymph nodes were.

This is what her skin graft looks like today. Still grosses me out.

So, after talking about melanoma, let's figure out how bad it really is. Cancer.net is a website that speaks of melanoma and its survival rates, among other things. "This year an estimated 76,380 adults (46,870 men and 29,510 women) in the United States will be diagnosed with melanoma of the skin. Melanoma is the fifth most common cancer among men and the seventh most common cancer in women. Before age 50, more women are diagnosed with melanoma than men. However, by age 65, the rate is more than 2 times higher in men. By age 80, the rate in men is nearly 3 times higher than in women. Melanoma accounts for about 1% of all skin cancers diagnosed in the United States, but it causes most of the skin cancer deaths. It is estimated that 10,130 deaths (6,750 men and 3,380 women) from melanoma will occur this year. The number of people diagnosed with melanoma has risen sharply over the past 3 decades." Kinda scary huh? The site says the survival rate of someone whose melanoma was located only in the site where it was initially found, is 98%. If the cancer has spread to the lymph nodes, 63%, and if it has spread to other parts of the body, 17%. Now that's really scary. Of course all of this depends on the location, thickness, depth, and many more things. Disease Management gives an abundance of things that factor into survival rate and prognosis of melanoma, here are their top factors:

• Thickness of lesion
• Presence or absence of ulceration
• Number of lymph nodes involved
• Size of lymph nodes
• Presence or absence of distant metastasis

The main factor that I believe affects people diagnosed with melanoma would be their outlook on the situation. You could go through all the treatments in the world and have the best doctors and oncologists taking care of you, but if you don't have a good outlook or perspective of the situation, then what do you have?

how do you treat melanoma?

My momma is a week post-surgery and she is recovering very slowly. She has to wear a walking boot in order to protect her skin graft, and because of the location of the graft she is unable to walk so she has to get around with crutches. On the upside she got her drain removed! We got the news back on her lymph nodes and the cancer has spread; this officially makes her cancer stage III. Stage III cancer requires treatment such as chemotherapy and radiation. But because of her surgery she has to wait till she is completely healed to start treatments, so about 4-6 weeks. Momma is tough and stubborn, so this cancer shit ain't nothing to her.

Cancer requires some sort of treatment, no matter the stage or the degree of the cancer. There are many different things that can be done to help treat the progression of the cancer; some are successful, other are not. In order for you to better understand some of the treatments, here is a few descriptions of them.

Surgery: Surgery is the main part of therapy for early stage melanoma and for the resection of an isolated metastatic melanoma site. There are several different types of surgeries that are regularly performed to treat melanoma.

Clinical trials: Clinical trials are research studies to test promising new or experimental cancer treatments. There are hundreds of clinical trials happening at any given time, and most experts agree that for a late-stage diagnosis, clinical trials are the best treatment option.

 Immunotherapy: Immunotherapy is a type of systemic therapy used in the treatment of melanoma at high risk for recurrence and metastases

Targeted Therapy:  Targeted therapy is a type of therapy where drugs (or other substances) “target” the abnormal aspects of tumor cells without harming normal cells.

Chemotherapy:  Chemotherapy is a type of systemic therapy intended to destroy melanoma cells throughout the body. Chemotherapy has shown limited success in the treatment of melanoma

Early stage melanoma can often be treated with surgery alone, but more advanced cancers most likely have to have multiple treatments. Like everything else, treatments have side effects. Some of these side effects are: 

• Diarrhea
• Vitiligo (loss of pigment)
• Skin rash
• Lymphedema
• Thyroid issues
• Colitis
• Fatigue
• Nausea
• Itching
• Fever
• Constipation
• Joint pain 

Going through treatments, whether it is you or a family member or friend,  can be difficult and emotionally, mentally, and physically draining. It is essential to have a good support system to get through treatments.