Having this biopsy gives psychological benefits

EDITOR—The editorial by Thomas and Patocskai summarises the current state of sentinel lymph node biopsy for malignant melanoma.1 What the authors omitted to address was patients' perception of the procedure.

Anecdotal evidence suggests that patients with melanoma derive psychological benefit from having the procedure, regardless of the result. To investigate any such benefit our unit carried out a study looking at the acceptability and benefits of the procedure. A specially designed questionnaire was sent to 110 patients who had undergone the procedure between August 1997 and February 1999.

Ninety eight patients (89%) replied, including all those in whom the result had been positive (19/110). To study any time dependent trends the respondents were subdivided into three subgroups, depending on length of follow up (table). Most patients (95/98) were glad that they had had the procedure, though the effects decreased with time (table). Overall 89 of the patients believed that they had gained some benefit from the biopsy, and 96 said that they would recommend it to other patients.

Most patients with melanoma undoubtedly derive at least short term psychological benefits from having a sentinel lymph node biopsy. This effect seems to be independent of the result of the biopsy itself. The decreased reassurance with time may simply represent a time dependent factor but might be due to the frequent clinic visits and additional biopsies of suspicious lesions, which cause increased anxiety in patients with melanoma.2

The procedure has high patient acceptability and offers patients a proactive option in addition to regular clinic reviews after initial diagnosis. It does not, however, seem greatly to influence patients' worries about being “cured” or fully enable patients to plan for the future. The small psychological …