Thursday, January 15, 2009

Let's back up a bit more--1960's to the present

I got to thinking that some of you really don't know the background and are sort of being made to jump into the middle of Woody's story...so let's back up a few years.

When I first met Woody (1967) he had a mole on his forehead. We married in 1969 and lived in Tullahoma. Woody went to work for ARO out in California in 1971 for two years. When we returned to Tullahoma in 1973, one of Woody's co-workers noticed that the mole had grown while we were away and mentioned it to Woody. So Woody made an appt. to have Dr. Harvey remove it (1973). The lab reports came back that it was benign. Over time it started coming back in three small spots. We assumed they were just places that got missed when the mole was removed. When those spots grew back together, the mole was irregularly shaped. So we never thought anything about its shape since it had a reason to be an irregular shape. People mentioned it to him from time to time, but again he would always say--he'd had it removed once and it tested ok--so he was sure that it was still ok. Dr. Chris Dunlap told Woody that if Woody were his dad that he would tell him to have it removed (early 2000's). It was our dentist, Dr. Troy McDonald, who finally convinced Woody to have it removed again. That was 2 1/2 years ago (2006). Woody decided to have Dr. Marvel here in Tullahoma remove it, since it was on his face and Dr. Marvel is a plastic surgeon. Dr. Marvel was pretty sure that it was melanoma so he removed an extra margin around the mole at the time he excised it. The lab report did come back that it was melanoma and the lab report recommended reexcision of the area. Dr. Susan Harlow, our family physician, referred Woody to Dr. Bell, a dermatologist in Murfreesboro. Dr. Bell referred him to Dr. Akins and Dr. Converse--both are surgeons in Murfreesboro. Dr. Akins did the reexcision and Dr. Converse did the sentinel node surgery. These two surgeries were performed on the same day in the hospital in Murfreesboro.

The sentinel node is the first lymph node that the melanoma would spread to from the original site. A radioactive dye is injected close to the original melanoma site and then they wait for it to drain to a lymph node--that first lymph node that the dye drains to is called the sentinel node. If the melanoma hasn't reached the sentinel node then it is assumed that it hasn't gotten into the lymph system.

During the surgeries, Dr. Akins reexcised even more tissue than had been advised and Dr. Converse was able to remove the sentinel node. Everything from those surgeries tested cancer free. So Woody was just to have follow-ups with the dermatologist. And those check-ups he did faithfully.

So we breathed a sigh of relief and got on with our lives...until he found the lump behind his ear in early November this past year (2008).

Due to the fact that the sentinel node was removed and showed that the melanoma hadn't spread, then the melanoma that Woody now has is considered a recurrance.

The fact that it has metastasized to other parts of the body away from the original Melanoma site puts it at Stage 4. The places we know that it has metastasized to in Woody's body are: the bone in the upper left arm, soft tissue mass (lymph nodes) in his upper chest, lymph nodes on his back in the shoulder area, and perhaps in a muscle on his upper chest toward his side. Those are places that have been indicated to us.

He is having some pain and that is from the cancer in the bone in his upper left arm. I guess we will find out more about that when we see the orthopedic oncologist next week on Jan. 20th.

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