Posted by: cg00n | June 13, 2008

An interesting case

Today’s medical appointment was with a general surgeon.  It was a productive and helpful meeting and a good deal more positive than I had expected.  The doctor said that she had heard from my plastic surgeon who told her that an “interesting case” was coming her way.  Apparently only a very small proportion of melanoma patients end up with positive lymph nodes in the knee and not in the groin.  What she is proposing to do is to put me through an MRI (of knee through groin and also my liver) and a bone scan (just in case…) to see if any lymph nodes or any parts of the liver show up as being infected.  How magnetic resonance applies in this case I don’t know but the idea is that:

  1. if there is evidence of cancer anywhere other than my leg there is no point in doing more lymph node surgery
  2. if any lymph nodes in my groin show up I will have to consider having all the inguinal nodes removed
  3. if any lymph nodes in my knee show up I will have to consider having all the nodes behind my knee removed

This sounds fairly sensible.  Assuming that they do not find anything beyond my knee (and there is no reason to suppose they will given the previous biopsies and the CAT scan) the worst case will be that I have to lose the lymph nodes that form the drainage for my lower right leg.  At least they aren’t proposing to remove all my leg lymph nodes, which is kind of what I thought was at stake.  This is less of a shotgun attack.  I will at least know that there  is a good reason to remove the ones they do.  There is, of course, a down side:  my lower leg might well suffer from swelling etc. for the rest of my life.  I get the impression that being an interesting case is good.  The doctors may not be able to prognosticate very effectively because my case is too rare, but perhaps if forces them to think a little outside the box and not just resort to some curative formula.

The MRI and bone scan should happen within a couple of weeks and I am quite optimistic about the results.  If they come back entirely negative, which they might well, then for now at least I’m cured!  <insert bad joke about ham here>

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Responses

  1. Has anyone suggested a PET scan as additional screening? I can’t remember what the initials stand for, but I know that it can be an effective screening device at looking for small deposits of cancer.

    The downside, is that we don’t have one in Nova Scotia – or we didn’t when we were dealing with the cancer diagnosis in our family and one had to travel in order to get one done.


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