Hi Kaylouise and welcome to the Cancer Chat forum.

One of our lovley regulars [@AngieT]‍ is quite knowledgeable in this field so fingers crossed she'll stop by to share her thoughts with you now I've mentioned her in this post.

Our cancer nurses are just a phone call away on 0808 800 4040 if you'd like to have a quick chat with them about this as well. They're available Monday - Friday between 9a.m - 5p.m.

Waiting for appointments is always tough but if you're able to keep busy and distract yourself, Monday will be here before you know it.

Kind regards, 

Steph, Cancer Chat Moderator

Hi Kaylouise87,

I'm sorry that you have got this confusion to cause you added worry. I'm struggling to understand what the receptionist meant by a 'certain type of appointment, not a general mole removal' as I've never come across this (in my 23 years of being a melanoma patient & having 8 suspect moles removed over the years). Was the receptionist the consultant's secretary or the receptionist at the referrals & appointments department (a central department that deals with appointments for the whole hospital)? If it was the latter then I wouldn't put much store in their remark as they have little knowledge of this type of surgery. If it was the consultant's secretary or a member of the Plastc Surgery department (sometimes the nurses answer the phone) I don't know what they meant.

The normal surgery in all suspected melanoma cases is for the mole to be removed with a small margin of clear skin surrounding it. This is done under local anaesthetic and at the Plastic Surgery day clinic (usually takes half a day from booking in, being triaged by a nurse, the surgery and then recovery time). The mole is then sent for biopsy and measuring (the depth). If it comes back as melanoma the consultant will then arrange for a second surgery called a Wide Local Excision where further tissue is removed in the area to mop up the surrounding cells in case any melanoma has already spread. This link explains the type of surgery involved www.uhb.nhs.uk/.../PiWideLocalExcision.pdf Dependant on the depth of the mole - if over 1mm in depth - some consultants also offer a Sentinel Node Biopsy at the same time. This is where dye is injected into the area of the mole and tracked to the nearest lymph node (Sentinel Node). They then remove the node(s) and biopsy them to see if melanoma has spread there.

My only guess, if you spoke to the secretary or nurse, is that in very rare cases they do a Wide Local Excision at the initial surgery because the dermatologist is 99.9% sure it's melanoma. I only know of a couple of patients this has happened to so it may not be the case with you. All I can suggest is that, if the dermatologist didn't completely outline what your surgery would entail and you are worried about it, ring the consultant's secretary and ask for someone to contact you with details of what surgery is planned. They may get one of the nurses to ring you back with the details. It's important that you are fully briefed as to what to expect as the Wide Local Excision surgery is a larger procedure and takes longer to heal - you need to know so you can make domestic arrangements accordingly. If your mole is between your shoulder blades it's important you don't do any lifting for a week or so until it's healed (the skin is very stretched there - I found to my cost)!

I wish I could give you a definate answer but I would certainly ring them back for more information, unless they said they are sending further information in the post. Good luck and please let us know how you get on,

Angie

Thank you for your reply AngieT. 

I had the mole removed yesterday.

It was a mole excision. 

I asked the dermatologist what he thought it looked like, he seemed to avoid my question his response was “ I agree with my colleague that it had to be removed, but I’m confident I got it all, whatever it was” (His words) 

He said the results can take around 4 weeks. Do you know if they let you know sooner if the results aren’t normal? 

Thank you again 

I'm glad to hear it has now been removed. Surgeons won't commit themselves when asked after an excision, mainly because they can never be completely sure - only histology can reveal if it's cancerous or not. 

As for the time waiting for results - it's currently averaging 4 weeks at most hospitals. They say this to give them time to receive the results and examine them before seeing you, especially if it's cancerous as they have to have a Multi Disciplinary Meeting to discuss your case to decide the proposed treatment (MDT is the dermatologist, plastic surgeon, oncologist and nurses). Sometimes you can be called back sooner because it's good news & an MDT hasn't been required whilst sometimes you can be called back sooner because the histology dept have fast tracked it and an MDT has been done quickly. So in answer to your question - yes you can be called back sooner but it doesn't necessarily mean it's because it's bad news. Sadly you can't second guess the workload and the internal workings of the NHS. 

Try to keep busy now to distract yourself and hopefully you will get good results in a few weeks time. Please let us know how you get on,

Angie

Good evening Angie, 

Thank you again for taking the time to reply. 

I’m one of those people that aren’t very good with the not knowing and like to know everything! In these circumstances I know I can’t know but still seem to obsess a bit  

I’ll let you know when my results have returned thank you again for your replies. 

Kay