Together we will beat cancer


2 Week Referral Subungual Melanoma

14 Jul 2019 16:37

Hi All, 

Finally bucked up the courage to go to the doctors last Thursday, and have been referred under the 2 week system to see a Dermotologist this Thursday. 

I understand they will investigate, and potentially conduct a biopsy. 

I have done some research and can't get my head around the general treatment. I am assuming after surgery (if required), the body is then clear and you are classed as melanoma free? Some websites state a survival rate of 5 years which has its obvious concerns. 

Some guidance from someone who has been through a similar situation would help, I like to have an understanding prior to appointments so I dont get too overwhelmed. 

In addition I know i can follow this through the private healthcare route, but would assume the NHS is just as quick in these situations?

Thank you in advance.


2 Week Referral Subungual Melanoma

14 Jul 2019 19:05 in response to RCJ90

Hi RJ,

There really isn't much in it when choosing between private or NHS for melanoma. I asked this many years ago when first diagnosed and again 10 years ago when it returned and I was told the same both times - there may be a little less time to wait for surgery etc but the difference is negligible. The NHS care I have received over 23 years with this disease has been top notch.

Your first question is much harder to answer. If the dermatologist thinks you need a biopsy, either a punch biopsy of the nail will be done or the who!e nail and tissue removed. If the results show melanoma, further surgery will be needed to ensure the surrounding tissue is removed. Dependant on the depth of the cancer will depend if amputation of the digit is essential to stop spread. They may also check the nearest lymph nodes for existing spread by removing them for biopsy at this point. If no spread is found you would have regular check ups for between 1 and 5 years (again dependant on the depth which signifies the Stage). If it's a!ready spread then more surgery may be necessary and drug treatment would be the next step (immunotherapy or targeted therapy). 

If melanoma is diagnosed as Stage 1 or 2 (the depth is shallow and there is no spread) there is a good chance you would have no further problem and, after check ups and eventual discharge you could be classed as melanoma free. If, however, it's deep and has spread (Stage 3 or 4), if scans show no disease after treatment, you are classed as No Evidence of Disease (melanoma equivalent of remission). Unfortunately, you will always be classed as a melanoma patient though - as it can come back at any time (the odds being worse of recurrence for this type of cancer at this stage).

I really hope all this information will be unnecessary for you and the dermatologist or the results show no evidence of cancer. Good luck and please let us know how you get on.

Angie (Stage 3 melanoma patient)

2 Week Referral Subungual Melanoma

14 Jul 2019 19:13 in response to RCJ90


Just had my biopsy on my thumb nail yesterday and now awaiting results.

Upon removing the nail the consultant noted unusual pigment changes on the nail matrix and removed some of that too. She also said it didn’t look malignant but can’t be sure until biopsy results came back. 

With regards to further treatment if melanoma is detected, it seems to depend on lots of things. Personally, I’m not thinking too much. Very much looking ahead to either getting the all clear and moving on or not and moving forward. As a “control enthusiast”, the unknown is feeling frustrating for me. 


Best of luck and keep the thread updated on the outcome x 

2 Week Referral Subungual Melanoma

14 Jul 2019 19:31 in response to AngieT

Hi Angie, 


Thank you very much for taking the time to reply so comprehensively, you've answered my questions perfectly.

I hope you are well, and I honestly applaud you for the contribution I've seen you make on these forums, it truly is helpful.


Thanks again



2 Week Referral Subungual Melanoma

14 Jul 2019 19:33 in response to Gryffindormum

Hi Gryffindormum, 


Thank you for taking the time to reply, and advising on what i should expect. I am too very controlling, so this is a worry, but will have to wait and see. 


I hope your results are nothing to worry about, please keep us updated also. 




2 Week Referral Subungual Melanoma

14 Jul 2019 22:06 in response to RCJ90

Thank you, that is so kind. I'm very well and feel very lucky to be 'no evidence of disease ' for so long. I've seen the landscape of melanoma treatment change so much over the years so helping those who are going through biopsies is important to me. Both yourself and Gryffindormum speak of 'control ' - something we don't have when waiting for referral appointments or biopsy results - that is why the waiting is the hardest part. You will find that, once you receive your results, no matter what they are, you can then take back some control of your life.