› Forums › General Melanoma Community › Interferon Alfa for Stage IIC melanoma
- This topic has 21 replies, 6 voices, and was last updated 9 years, 1 month ago by
Beehappy.
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- April 27, 2016 at 1:07 pm
Hi everyone,
I was recently diagnosed with a large (10mm) melanoma behind my ear. I'm a 30-year-old male in fairly good health. As far as I know, I have no family history of melanoma except a half-sister who was diagnosed with stage I about 10 years ago and has had no further complications. I live in Korea, where melanoma is extremely rare. I don't speak the language well, so my treatment has been very stressful and often confusing. My test results so far have been good, though.
PET/CT – no evidence of distant metastasis
Ultrasound of lymph nodes – no evidence of metastasis
Wide excision biopsy – no evidence of local metastasis
While I'm of course happy about these results, I have a few concerns about my treatment here.
1) I did not have a sentinel node biopsy. From what I've gathered online, a sentinel node biopsy is standard procedure for Stage IIC, especially for a melanoma as large as mine. I will be asking my oncologist about this when I see him again in a couple days.
2) My dermatologist told me that one year of high dose Interferon Alfa injections is mandatory treatment for Stage IIC in order to prevent recurrences of melanoma. However, when I met with my oncologist, he told me it is optional, and many doctors think the severe side effects outweigh the potential benefits. Further research online suggests that Interferon is not particularly effective in reducing recurrence rates. Is Interferon necessary/worth the risk for treatment of Stage IIC?
Thank you for your help!
- Replies
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- April 27, 2016 at 1:35 pm
With a 10mm deep melanoma, the PET scan may be more telling than the SNB. I think I remember reading long ago that for very deep lesions, the SNB isn't all that accurate in predicting spread because the melanoma may travel via blood vessels as opposed to lymph vessels – so the PET may be as important. I had a friend with a deep melanoma who had done some research (over 10 years ago). BTW, she did no treatment and is still melanoma free. The ultrasound is good in that it did not show any abnormally enlarged nodes and followup ultrasounds would be a good choice. There is a small subset of patients who can be helped by interferon but it is definitely small. I'm including a link that I think gives a balanced analysis.
http://theoncologist.alphamedpress.org/content/10/9/739.full
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- April 27, 2016 at 1:35 pm
With a 10mm deep melanoma, the PET scan may be more telling than the SNB. I think I remember reading long ago that for very deep lesions, the SNB isn't all that accurate in predicting spread because the melanoma may travel via blood vessels as opposed to lymph vessels – so the PET may be as important. I had a friend with a deep melanoma who had done some research (over 10 years ago). BTW, she did no treatment and is still melanoma free. The ultrasound is good in that it did not show any abnormally enlarged nodes and followup ultrasounds would be a good choice. There is a small subset of patients who can be helped by interferon but it is definitely small. I'm including a link that I think gives a balanced analysis.
http://theoncologist.alphamedpress.org/content/10/9/739.full
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- April 27, 2016 at 3:20 pm
Hi sseuregitong, just to add some more information to what Janner has already given you is a video featuring 4 top Melanoma Oncologist on Onclive (Jan 2016). If you go to the 4 min point, Dr. Weber talks about the present and future treatments in the Adjuvant setting for melanoma. https://www.youtube.com/watch?v=RIaGfNsG6w4 Best wishes!!! Ed
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- April 27, 2016 at 3:20 pm
Hi sseuregitong, just to add some more information to what Janner has already given you is a video featuring 4 top Melanoma Oncologist on Onclive (Jan 2016). If you go to the 4 min point, Dr. Weber talks about the present and future treatments in the Adjuvant setting for melanoma. https://www.youtube.com/watch?v=RIaGfNsG6w4 Best wishes!!! Ed
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- April 27, 2016 at 7:53 pm
The article from the ONcologist is kind of old, but the news is that immunotherapy, called Yervoy was approved for stage III and should ask for it but at the lower dose. It is way more effective than interferon which is hardly in use anywhere. You probably need to see an expert if this place is still giving out intron.
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- April 27, 2016 at 7:53 pm
The article from the ONcologist is kind of old, but the news is that immunotherapy, called Yervoy was approved for stage III and should ask for it but at the lower dose. It is way more effective than interferon which is hardly in use anywhere. You probably need to see an expert if this place is still giving out intron.
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- April 28, 2016 at 12:10 pm
I'm only diagnosed as Stage 2C. From what I understand, Yervoy is only approved for Stage 3 and 4, even in the States. Even if it's in clinical trials for Stage 2, I doubt I'll be able to get it here in Korea, but I'll ask.
The doctor I saw here is actually the leading melanoma expert in Korea, so if I want to see anyone more knowledgeable, I'd have to quit my job and move back to the States. I certainly don't want to do that, but if it becomes necessary, I will. Then of course I'd have to get my insurance situation sorted in the States… that $250,000 a year for treatment is certainly worrisome for me going back to the States unemployed and uninsured.
I think at this point, I'm going to just go with "watch and wait." I'll be getting quarterly checkups (ultrasound), and if the Stage 3 diagnosis comes, I'll pack up and move back to the States for treatment.
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- April 28, 2016 at 12:10 pm
I'm only diagnosed as Stage 2C. From what I understand, Yervoy is only approved for Stage 3 and 4, even in the States. Even if it's in clinical trials for Stage 2, I doubt I'll be able to get it here in Korea, but I'll ask.
The doctor I saw here is actually the leading melanoma expert in Korea, so if I want to see anyone more knowledgeable, I'd have to quit my job and move back to the States. I certainly don't want to do that, but if it becomes necessary, I will. Then of course I'd have to get my insurance situation sorted in the States… that $250,000 a year for treatment is certainly worrisome for me going back to the States unemployed and uninsured.
I think at this point, I'm going to just go with "watch and wait." I'll be getting quarterly checkups (ultrasound), and if the Stage 3 diagnosis comes, I'll pack up and move back to the States for treatment.
-
- April 28, 2016 at 12:10 pm
I'm only diagnosed as Stage 2C. From what I understand, Yervoy is only approved for Stage 3 and 4, even in the States. Even if it's in clinical trials for Stage 2, I doubt I'll be able to get it here in Korea, but I'll ask.
The doctor I saw here is actually the leading melanoma expert in Korea, so if I want to see anyone more knowledgeable, I'd have to quit my job and move back to the States. I certainly don't want to do that, but if it becomes necessary, I will. Then of course I'd have to get my insurance situation sorted in the States… that $250,000 a year for treatment is certainly worrisome for me going back to the States unemployed and uninsured.
I think at this point, I'm going to just go with "watch and wait." I'll be getting quarterly checkups (ultrasound), and if the Stage 3 diagnosis comes, I'll pack up and move back to the States for treatment.
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- May 1, 2016 at 4:33 am
My husband was initially diagnosed 2C but was bumped to 3C after his SLNB came back positive for 1 node. He went on to have a CLND and they found an additional positive node. We were pretty devastated, but the bump in level qualified him for a trial study and he is currently receiving either Ipi or Nivo.
I was pretty assertive in conversations with his doctor and insisted he look into trials that my husband would qualify for. We weren't happy with Interferon as the only treatment being approved at that time.
Many of the trials we looked into we're taking place in countries all around the world. Push your doctor to look into it for you.
Wishing you continued health and NED.
– Rebecca
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- May 1, 2016 at 4:33 am
My husband was initially diagnosed 2C but was bumped to 3C after his SLNB came back positive for 1 node. He went on to have a CLND and they found an additional positive node. We were pretty devastated, but the bump in level qualified him for a trial study and he is currently receiving either Ipi or Nivo.
I was pretty assertive in conversations with his doctor and insisted he look into trials that my husband would qualify for. We weren't happy with Interferon as the only treatment being approved at that time.
Many of the trials we looked into we're taking place in countries all around the world. Push your doctor to look into it for you.
Wishing you continued health and NED.
– Rebecca
-
- May 1, 2016 at 4:33 am
My husband was initially diagnosed 2C but was bumped to 3C after his SLNB came back positive for 1 node. He went on to have a CLND and they found an additional positive node. We were pretty devastated, but the bump in level qualified him for a trial study and he is currently receiving either Ipi or Nivo.
I was pretty assertive in conversations with his doctor and insisted he look into trials that my husband would qualify for. We weren't happy with Interferon as the only treatment being approved at that time.
Many of the trials we looked into we're taking place in countries all around the world. Push your doctor to look into it for you.
Wishing you continued health and NED.
– Rebecca
-
- April 27, 2016 at 7:53 pm
The article from the ONcologist is kind of old, but the news is that immunotherapy, called Yervoy was approved for stage III and should ask for it but at the lower dose. It is way more effective than interferon which is hardly in use anywhere. You probably need to see an expert if this place is still giving out intron.
-
- April 28, 2016 at 12:17 pm
Thank you! This is the kind of stuff I was looking for. I'm happy to hear there are better treatments becoming available. From what I understand, Yervoy is not approved for Stage 2? Is there any evidence that Yervoy or interferon can help prevent a Stage 2 diagnosis from advancing to Stage 3?
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- April 28, 2016 at 12:17 pm
Thank you! This is the kind of stuff I was looking for. I'm happy to hear there are better treatments becoming available. From what I understand, Yervoy is not approved for Stage 2? Is there any evidence that Yervoy or interferon can help prevent a Stage 2 diagnosis from advancing to Stage 3?
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- April 28, 2016 at 12:17 pm
Thank you! This is the kind of stuff I was looking for. I'm happy to hear there are better treatments becoming available. From what I understand, Yervoy is not approved for Stage 2? Is there any evidence that Yervoy or interferon can help prevent a Stage 2 diagnosis from advancing to Stage 3?
-
- April 27, 2016 at 3:20 pm
Hi sseuregitong, just to add some more information to what Janner has already given you is a video featuring 4 top Melanoma Oncologist on Onclive (Jan 2016). If you go to the 4 min point, Dr. Weber talks about the present and future treatments in the Adjuvant setting for melanoma. https://www.youtube.com/watch?v=RIaGfNsG6w4 Best wishes!!! Ed
-
- April 27, 2016 at 1:35 pm
With a 10mm deep melanoma, the PET scan may be more telling than the SNB. I think I remember reading long ago that for very deep lesions, the SNB isn't all that accurate in predicting spread because the melanoma may travel via blood vessels as opposed to lymph vessels – so the PET may be as important. I had a friend with a deep melanoma who had done some research (over 10 years ago). BTW, she did no treatment and is still melanoma free. The ultrasound is good in that it did not show any abnormally enlarged nodes and followup ultrasounds would be a good choice. There is a small subset of patients who can be helped by interferon but it is definitely small. I'm including a link that I think gives a balanced analysis.
http://theoncologist.alphamedpress.org/content/10/9/739.full
-
- April 29, 2016 at 2:39 pm
I would have thought that most doctors would recommend 'watch and wait' for stage II.
The side effeccts if interferon can be very severe.
Ipi/Yervoy is only FDA approved for stage III in the US and for stage IV in the UK. Again, it is an issue of balancing the liklihood of reoccurence against the possible side effects.
At the moment, I believe that the other immunotherapies are only FDA approved for stage IV.
-
- April 29, 2016 at 2:39 pm
I would have thought that most doctors would recommend 'watch and wait' for stage II.
The side effeccts if interferon can be very severe.
Ipi/Yervoy is only FDA approved for stage III in the US and for stage IV in the UK. Again, it is an issue of balancing the liklihood of reoccurence against the possible side effects.
At the moment, I believe that the other immunotherapies are only FDA approved for stage IV.
-
- April 29, 2016 at 2:39 pm
I would have thought that most doctors would recommend 'watch and wait' for stage II.
The side effeccts if interferon can be very severe.
Ipi/Yervoy is only FDA approved for stage III in the US and for stage IV in the UK. Again, it is an issue of balancing the liklihood of reoccurence against the possible side effects.
At the moment, I believe that the other immunotherapies are only FDA approved for stage IV.
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