I got the results for the pathology of my melanoma today. My surgeon writes
Great news for you! Margins are clear and all the nodes are negative. Your staging remains a Stage IIA. You do not need more surgery. I will check with our medical oncologist regarding the need for immunotherapy
He has setup a referral to oncology so I'll meet with them next.
So, to break this down :
I don't need further ear surgery because the surgeons got all of the melanoma on the first attempt ("margins are clear"). I may have reconstruction done (a month out from now) to recreate some ear lobe with medical magic. This should go well as I retained a good amount of my ear, providing a good foundation to build from.
I won't need any further lymph nodes removed because all four sentinel lymph nodes that they took did not contain any cancer. Sometimes when they find cancer in the nodes, they may go back and take more nodes.
The staging of the cancer remains the same from when the first biopsy was done. This means that the assessment from the first biopsy (of just the melanoma tumor on the ear lobe) which was based on the type of tumor (T3a), depth of the tumor (2.5mm), the absence of ulceration, the increased mitotic rate, and other attributes remains the same. The internet has lots of assertions about survivability and most of it looks good based on this, but I'm going to hold until I talk to an oncologist to understand specifically what this means for me in regards to statistical survivability, what treatments come next, and what to expect in the future.
I'm cautiously optimistic, I know this pathology isn't bad news (which I'm very happy about), but I don't yet know to what degree it's good news. I'm looking forward to meeting with an oncologist to find out more.