Topic: 2nd cancer - melanoma

Forum: Just Diagnosed — Discuss next steps, options, and resources.

Posted on: Jun 14, 2022 09:11AM

Posted on: Jun 14, 2022 09:11AM

btwnstars wrote:

I can't believe I am back to the beginning again. After surviving the last year of IDC dx, surgery, chemo, rads + hormonal blockers...I just had a skin biopsy come back as melanoma.

Not sure where to post, I thought maybe there was somewhere for secondary type cancers. I am wondering if there is a link somehow? I am always vigilant about sunscreen, I don't even stay out much in the sun uncovered. And I esp haven't been out in the past year with my bc treatment.

To make matters worse, it is on my left arm which is my lymphedema risk side. I totally forgot (!) when the dermatologist went to do the biopsy. So far no signs of LE, but now have to have more of a spot excised.

Anyone else experience this? I am off to research links with BC and melanoma. I am having a hard time understanding how this can happen after I did dose dense AC+T, wiping out all my cells. I don't get it.

Dx 3/25/2021: IDC, Left 1.5 cm, Stage IB/IIA, grade 2, ER+/PR+, HER2- Surgery 5/12/21 Lumpectomy, Oncoplastic reduction, sentinel lymph node removal 0/6 Chemotherapy 6/30/21 AC+T
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Jun 14, 2022 09:38AM specialk wrote:

Sorry you are having this experience, I can sympathize - I have not had melanoma (yet) but have had at least 50 basal cell carcinomas of differing types, including infiltrating, and many since my breast cancer diagnosis. There is a school of thought that chemo can bring these to the surface because of the assault on the immune system, but I am not sure how well documented that is. There is also some thought about a link between breast cancer and BCC, and breast cancer and melanoma. I had probably half of my BCCs prior to breast cancer, starting at 35 years old in a place the sun doesn't shine. I have not been in the sun for many years because of the strong skin cancer history, but they just keep coming. I have had a number of wide excisions and MOHS surgeries on my lymphedema arm - 2-3 inch incisions with at least a cubic inch of flesh removed, and other than some irritation initially it has not worsened my situation, which is well controlled. Ice and elevate your arm after the removal - I assume you will have MOHS since this is a melanoma. Hang in there!

There is a thread for those with another type of primary cancer, I will link it. I believe others on this thread have also been diagnosed with melanoma and might have some insights.

https://community.breastcancer.org/forum/142/topics/819406?page=35#post_5716956

Breast cancer and skin cancer info:

https://www.wederm.com/2021/10/28/the-surprising-link-between-breast-cancer-and-skin-cancer/#:~:text=Young%20breast%20cancer%20survivors%20at%20increased%20melanoma%20risk&text=In%20a%202011%20study%2C%20female,risk%20for%20melanoma%20was%2012%25.

https://pubmed.ncbi.nlm.nih.gov/15252852/

https://www.vanguardskin.com/breast-cancer-and-increased-melanoma-risk-what-you-need-to-know-if-youve-had-breast-cancer/

Here is an article from BCO about BCC and breast cancer, that discusses the why part:

https://www.breastcancer.org/research-news/skin-cancers-linked-to-increased-bc-risk

BMX w/ TE 11/1/10, ALND 12/6/10. 16 additional surgeries. TCHx6 2/17-6/2/11. Herceptin until 1/19/12. Femara 8/1/11, Arimidex 6/20/12, back to Femara 2013-2018. Dx 9/27/2010, IDC, Right, 2cm, Stage IIB, Grade 3, 2/14 nodes, ER+/PR+, HER2+, IHC
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Jun 14, 2022 09:53AM monarchandthemilkweed wrote:

first off I’m so sorry to hear this. We went through treatment at the same time. my friend has had a couple spots come up as melanoma. But they’ve all been “in situ”. So she just has the area removed. And that’s it. Do you know what stage yours is

Dx 3/11/2021, IDC, Left, <1, Stage IA, Grade 2, ER+/PR+, HER2- Hormonal Therapy 3/11/2021 Tamoxifen pills (Nolvadex, Apo-Tamox, Tamofen, Tamone) Surgery 10/5/2021 Mastectomy (Left): Skin Sparing; Mastectomy (Right): Skin Sparing; Prophylactic mastectomy (Right); Reconstruction (Left); Reconstruction (Right): Tissue Expander Surgery 6/15/2022 Chemotherapy Cytoxan (cyclophosphamide), Taxotere (docetaxel)
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Jun 14, 2022 05:40PM btwnstars wrote:

@specialK thank you for sharing and for all the info. I will look thru it. Yes, mohs surgery was mentioned. I spoke to my PCP, who reassure me it is early stage, the dermatologist described it as "superficial" so just on the skin, on top. They think it will be fine, but yea...heard that before.

@monarchandthemilkweed how are you doing?! Good to hear from you. Yes, so far I think it is considered "in situ" as it was described as early/superficial. Hoping it is a matter of just cutting it out. It just feels like one can never be too optimistic on this ride of cancer....

I see my MO next week so will go thru all of it with her. Wondering if I will still continue doing my zometa infusion next week, just due to any immune issue. I've been wanting to talk to her about some bone/joint pain which is most likely from hormone blockers and lack of exercise (my return to work full time + long commute is not good for recovery), but not sure if I should push for more screening...

Thank you for the support.

Dx 3/25/2021: IDC, Left 1.5 cm, Stage IB/IIA, grade 2, ER+/PR+, HER2- Surgery 5/12/21 Lumpectomy, Oncoplastic reduction, sentinel lymph node removal 0/6 Chemotherapy 6/30/21 AC+T
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Jun 14, 2022 05:59PM monarchandthemilkweed wrote:

glad to hear it’s in situ. Though it’s still a worry. My dermatologist told me since I had breas cancer I’m at a higher chance of having another cancer. I had a weird spot on my scalp that did not look good. When I lost my hair it was very apparent. It ended up being something benign. But I was worried. Please update here when you know more.

I’m doing well. Headed into surgery tomorrow to get my ovaries and Fallopian tubes out. As preventative since I have a strong family history of ovarian cancer and because my breast cancer was er positive.

Dx 3/11/2021, IDC, Left, <1, Stage IA, Grade 2, ER+/PR+, HER2- Hormonal Therapy 3/11/2021 Tamoxifen pills (Nolvadex, Apo-Tamox, Tamofen, Tamone) Surgery 10/5/2021 Mastectomy (Left): Skin Sparing; Mastectomy (Right): Skin Sparing; Prophylactic mastectomy (Right); Reconstruction (Left); Reconstruction (Right): Tissue Expander Surgery 6/15/2022 Chemotherapy Cytoxan (cyclophosphamide), Taxotere (docetaxel)
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Jun 14, 2022 06:20PM btwnstars wrote:

Aw, good luck with your surgery. Will you stay on tamoxifen still?

Yes, I know they always say about the risks. I guess the only way to get thru is to always hope it won't be you. It's hard to not wonder if it is me doing something wrong?!

And I should explain that this was a mole/spot I did notice. I haven't been to the derm in a while due to bc and covid. I also have a lot of moles and have had to doctor hop to get away from cut-happy docs. I knew I needed to make a check up, and then I noticed the spot on my arm. I knew it was usually 2 small moles, but noticed it looked different, almost like the 2 were joining. I scheduled appointment right away, when I went in I saw a PA. I told her I had a concerning spot on my arm but didn't point it out. She did a full body check and zeroed in on that spot. She thought it looked concerning and said it was 3 colors versus just 2. She gave me the option to biopsy or wait (I always explain how I do not like cut-happy dermatologists) but I was concerned enough to say lets do it now. Thank goodness.

So yea, it's like the old "if you see something, say something!"

Dx 3/25/2021: IDC, Left 1.5 cm, Stage IB/IIA, grade 2, ER+/PR+, HER2- Surgery 5/12/21 Lumpectomy, Oncoplastic reduction, sentinel lymph node removal 0/6 Chemotherapy 6/30/21 AC+T
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Jun 14, 2022 06:24PM monarchandthemilkweed wrote:

i need to get in to the derm for a full body check too. I firmly believe cancer of any kind is never our fault you know? I’m glad you went and got it checked out. And did the biopsy.

I’ll switch from tamoxifen to arimidex. I thin

Dx 3/11/2021, IDC, Left, <1, Stage IA, Grade 2, ER+/PR+, HER2- Hormonal Therapy 3/11/2021 Tamoxifen pills (Nolvadex, Apo-Tamox, Tamofen, Tamone) Surgery 10/5/2021 Mastectomy (Left): Skin Sparing; Mastectomy (Right): Skin Sparing; Prophylactic mastectomy (Right); Reconstruction (Left); Reconstruction (Right): Tissue Expander Surgery 6/15/2022 Chemotherapy Cytoxan (cyclophosphamide), Taxotere (docetaxel)
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Jun 15, 2022 08:44AM specialk wrote:

Just in case you are unfamiliar with MOHS procedures, I thought I might briefly describe it for you, or at least my experience at the med center I go to for derm stuff. My regular derm is the MOHS surgeon but not all derms are, so you could be referred to someone else. Generally, they put you in a gown, you sign a consent, and they numb the area. The doc removes the area, they bandage you, and you go to a waiting room. Pathology is done immediately to determine margins. If the margins are clean you go back in and they close the wound. If not, they take another pass, and repeat pathology. Depending on the area, and whether there is a need to be conservative - mostly my experience with having this done on my face where they are striking the balance between going deep/wide enough to get clean margins, and the aesthetics - you could be there for a while since the pathology takes about an hour for each pass. Where I go there are surgery days so often there are several people in the MOHS waiting area with assorted bandages in assorted locations. If your derm just does individual surgeries this process may be faster. I also needed a documented negative Covid test for the first MOHS I needed after the start of the pandemic, but subsequently I have only needed a negative Covid test for my most recent MOHS since I could not wear a mask as the area was on the side of my face. Wishing you the best, and also want you to know that I have multiple friends and family that have had fairly superficial melanomas that have required MOHS surgery only, no further treatment. They are surveilled much like we are for breast cancer but not one of them has had a recurrence or a new melanoma in another area.

BMX w/ TE 11/1/10, ALND 12/6/10. 16 additional surgeries. TCHx6 2/17-6/2/11. Herceptin until 1/19/12. Femara 8/1/11, Arimidex 6/20/12, back to Femara 2013-2018. Dx 9/27/2010, IDC, Right, 2cm, Stage IIB, Grade 3, 2/14 nodes, ER+/PR+, HER2+, IHC
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Jun 16, 2022 06:51PM btwnstars wrote:

Thank you for the info, good to know. I am a little unsure as to the urgency. I feel like I’m back at dx when it was all so unknown!

I have an appt with a dermatologist that does MOHs but I have a consultation for 10 days from now, and the surgery date would be almost a month. Hoping that is soon enough. I will see current dermatologist tomorrow and check with them.

Dx 3/25/2021: IDC, Left 1.5 cm, Stage IB/IIA, grade 2, ER+/PR+, HER2- Surgery 5/12/21 Lumpectomy, Oncoplastic reduction, sentinel lymph node removal 0/6 Chemotherapy 6/30/21 AC+T

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