UK Skin Cancer and Melanoma Patients

[wilster]

Hi my name is Sonya and I am fairly new to melanoma having being diagnosed last Sept with a 0.6mm SSM. I have my first six monthly check up next week and am feeling very nervous. I have been reading lots of posts on this forum with interest, especially about SNB which I was not offered I presume due to my SSM being 'thin'. However, I have since read online that if the 'mitotic rate' is high even with a thin melanoma it means a greater chance of recurrence and an SNB should be done. Does anyone know anything about mitotic rate? It was not mentioned to me at diagnosis and I was not shown a copy of the lab report. Should I ask about this at my check up? Many thanks and I just want to say it has been such a help reading about peoples experiences here, it makes me feel less alone. If only I had come here before I was diagnosed I may have been a bit quicker in getting my mole checked out.

[seanty]

Hi Sonya,

mitotic rate is a measure of how fast the cells are dividing. The higher it is, the worse it is. Like many other secondary factors however, it is insignificant compared with Breslow depth. Only Breslow depth has shown a strong correlation with outcome.

For example, I had a nodular melanoma (poor prognosis) with a high mitotic rate (poor prognosis), with a good immune response (good prognosis), on my trunk (medium-bad prognosis), I am a man (poorer prognosis), and so on. By all means get the histopathology report, and have all of the elements explained to you. There will be a mix of "good" and "bad", but in the end only Breslow matters. Thin melanomas are highly survivable.

[wilster]

Hi Sean
Thanks for your quick response. You explained it very well I will try not to worry about it. Best wishes, Sonia

[iomara]

Hi Sonya,
just found an article about the new AJCC staging of melanoma. As Seanty explained above, it takes in consideration many factors and don't just look at the "poor prognosis" ones. The new thing with this classification is that the mitotic rate will replace the Clark level in diferentiating Ia and Ib melanomas. This new classification hasn't been implemented yet. Here's a link of the abstract http://jco.ascopubs.org/cgi/content/abstract/27/36/6199
Regards,
Iomara

[Glen]

Hi Iomara

Thanks for the link to this interesting information.

It appears that there will be a revised staging system for melanoma "early 2010" from the AJCC (American Joint Committee on Cancer), being based on analysis from 39,000 melanoma patients (stages 1 to 4).

Quote : "Conclusion - using an evidence based approach, revisions to the AJCC melanoma staging system have been made that reflect our improved understanding of the disease. These revisions will be formally incorporated into the seventh edition (2009) of the AJCC Cancer Staging Manual and implemented by early 2010."

If anyone on this forum gets to hear of when this is available, please let us all know.

Thanks

[seanty]

Thanks Iomara....