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From: J on 14 Jul 2008 23:45
Bob wrote:

> Thanks for the information and concern. I have gotten an appointment to be
> seen by a GP this next month; he can then refer me to a specialist.
>
> "xela56" <noaccount(a)nw.nl> wrote in message
> news:BZ-dnYCO-qWuSebVnZ2dnUVZ_obinZ2d(a)comcast.com...
> > Bob,
> >
> > See dermatologist, they can biopsy the area, they can also do a clinical
> > exam.
> > If you can't get an appointment soon with a derm your PCP can biopsy and
> > give you a treatment plan.

Have you got your insurance sorted out, Bob?
(was why I suggested hospital - they're required to treat/investigate, I think,
although they might send a bill later.
Best of luck,
J

http://www.skincancer.org/content/view/17/3/1/4/
When it comes to the early stages of the disease, the future is bright. Most
people with thin, localized melanomas are cured by appropriate surgery. Early
detection still remains the best weapon in fighting skin cancer.

More treatments are available for more advanced disease. The cure rate continues
to rise. Research has produced a greater understanding of melanoma, leading to
the development of new drugs.

Surgical Excision: The first step in treatment is the removal of the melanoma,
usually by surgical excision (cutting it out). Most surgical excisions, also
called resections, are done in a doctor's office or as an outpatient procedure
with local anesthesia. Scars are usually small and improve over time. Surgery is
less extensive than in the past, so scars are smaller.

Discolorations and areas that are depressed or raised following the surgery can
be concealed with cosmetics specially formulated to provide camouflage. If the
melanoma is larger and requires more extensive surgery, a better cosmetic
appearance can be obtained with flaps made from skin that is near the tumor, or
with grafts of skin taken from another part of the body. For grafting, the skin
is removed from areas that are normally or easily covered with clothing.

There is now a trend towards performing a sentinel lymph node biopsy and tumor
removal at the same time.


Setting the Margins

In today's technique, much less of the normal skin around the tumor is removed.
The borders of the entire area to be excised � both tumor and healthy skin � are
known as the margins. Margins are much narrower than they ever were before. Most
surgeons today are following the guidelines recommended by the National
Institutes of Health (NIH) and the American Academy of Dermatology Task Force on
Cutaneous Melanoma:

* When there is an in situ melanoma, the surgeon excises 0.5 centimeter of
the normal skin surrounding the tumor and takes off the skin layers down to the
fat.
* In removing a melanoma that is 1 mm or less in thickness, the margins of
surrounding skin are extended to 1 cm, and the excision goes through all skin
layers and down to the fascia.
* If the melanoma is equal to or greater than 2 mm in Breslow�s thickness, a
margin of 2�3 cm is taken.


From: Bob on 15 Jul 2008 20:53
Point taken. I am not sure the general hospital here would take me as a
walk-in. I called their outpatient clinic which has a sliding-fee scale of
payment and will hope that offers reasonable care. Like most everyone else,
no I don't have any medical coverage.

>> "xela56" <noaccount(a)nw.nl> wrote in message
>> news:BZ-dnYCO-qWuSebVnZ2dnUVZ_obinZ2d(a)comcast.com...

> Have you got your insurance sorted out, Bob?
> (was why I suggested hospital - they're required to treat/investigate, I
> think,
> although they might send a bill later.
> Best of luck,
> J

From: xela56 on 15 Jul 2008 22:28
US Hospitals are required to render emergent care, a skin biopsy would not
fall into that category. Out patient clinic sounds right, that is where the
ER would refer you to. But why not go to your GP? They can reassure you, and
probably do a biopsy.

From: J on 16 Jul 2008 00:52
Bob wrote:

> Point taken. I am not sure the general hospital here would take me as a
> walk-in. I called their outpatient clinic which has a sliding-fee scale of
> payment and will hope that offers reasonable care. Like most everyone else,
> no I don't have any medical coverage.

Bob,
You seem to have freckles or moles. Fiar skin.
Those are some of the factors that can increase the risk of developing a
melanoma.
It also seems to have an irregular border and inflammation (redness) around it.

All mentioned here
http://www.southerncross.co.nz/index.cfm?64DF3D9E-F9E7-468E-AB75-57FFD0D5F7BB
and almost every melanoma information webpage I've ever seen.
Don't pay attention to the part where it says males tend to get it on the back.

My cousin had it first on his elbow. He died of it a few years later.
In our Province (I"m in Canada), GP's don't do biopsies; needle biopsies can
miss important tissue.

Most people who show the "lesion" here, I tell to see their GP, but i'm
concerned about yours.

The way I see it, if you go to GP and misdiagnoses, there's a delay, while it
continues to grow and until you get to a specialist.
Hopefuly, if you go to the outpatient clinic, they'll be honest if they think
it's something else but you're closer and quicker to get to the specialist, if
they feel an excisional biopsy should be done.
I don't want to waste your money or time; only want the best for you.
It's your decision.
J

From: xela56 on 17 Jul 2008 06:15

Dangerous to seek medical advice on the internet, good luck with your
appoitment. If you live in the US, it is common for internist to do the
initial biospy. The wait for a dermalogist can be months even for people
with a history of skin cancer.

Here is a picture of melanona,This is from the Irish Cancer society.

http://www.cancer.ie/images/melanoma.jpg


http://www.skincancer.org/melanoma/index.php

The only person qualified to diagnose you is a licensed health professional.

Cancer does not read stats, my breast surgeon who was a very dark black
woman with limited sun exposer died of melanom.....go figure.

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