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New to cancer and have questions

Forums General Melanoma Community New to cancer and have questions

  • Post
    piii
    Participant

      New to this site and to tell you the truth I never talk on boards but I never thought I would have cancer. I was diagnosted on 7/21/11 with a depth of 1.45mm no ulceration. I had the node bi and left arm pit was pos. I am waiting for my drain to be removed after having 41 lymph nodes removed from my left are pit. The drain has been in for 4 ½ weeks and can’t wait to get it out of me. Looks like Friday. One node came back with melanoma but the doctor said it was extranodal extention present.  My question is should I push for Radiation.

      New to this site and to tell you the truth I never talk on boards but I never thought I would have cancer. I was diagnosted on 7/21/11 with a depth of 1.45mm no ulceration. I had the node bi and left arm pit was pos. I am waiting for my drain to be removed after having 41 lymph nodes removed from my left are pit. The drain has been in for 4 ½ weeks and can’t wait to get it out of me. Looks like Friday. One node came back with melanoma but the doctor said it was extranodal extention present.  My question is should I push for Radiation. I see from the board that melanoma is resistant to radiation but I am concern about cancer cells “floating” around and finding an organ. Also they tell me the risk for recurrence is higher because of extranodal extention.  Is that the case? Also I do plan to start interferon as soon as the drain is out. I am a young man at 41 and want to do everything I can to fight this. Anyway thanks for reading.

      Peter

    Viewing 7 reply threads
    • Replies
        FormerCaregiver
        Participant

          Peter, welcome to our forum. Thanks for fill in the details on your profile page. I encourage you to update this whenever you get more info.

          Are you seeing an oncologist who specialises in melanoma? What have they said regarding radiation treatment? I feel that it can be useful in preventing local recurrence. However, as you may have read melanoma is unpredictable in what it does.

          I am concerned that you may not been offered any treatment apart from interferon. Please be aware that it is a very old drug and its use is controversial these days.

          Hope this helps.

          Frank from Australia

          FormerCaregiver
          Participant

            Peter, welcome to our forum. Thanks for fill in the details on your profile page. I encourage you to update this whenever you get more info.

            Are you seeing an oncologist who specialises in melanoma? What have they said regarding radiation treatment? I feel that it can be useful in preventing local recurrence. However, as you may have read melanoma is unpredictable in what it does.

            I am concerned that you may not been offered any treatment apart from interferon. Please be aware that it is a very old drug and its use is controversial these days.

            Hope this helps.

            Frank from Australia

              piii
              Participant

                Frank thanks for the reply. Yes I am seeing a melanoma specialist. I had my surgery with a doctor from a different hospital but am making a move to Dana-Farber because they are known to one of the best for cancer and the doc I am seeing specializes in melanoma.  I am going for an appointment tomorrow to talk to her about starting IFN and see about radiation but last visit she expressed concern about causing swelling and irritation due to the fact they took out 41 nodes. I do plan on pushing for it. Also she is willing to look at other options and trails.

                piii
                Participant

                  Frank thanks for the reply. Yes I am seeing a melanoma specialist. I had my surgery with a doctor from a different hospital but am making a move to Dana-Farber because they are known to one of the best for cancer and the doc I am seeing specializes in melanoma.  I am going for an appointment tomorrow to talk to her about starting IFN and see about radiation but last visit she expressed concern about causing swelling and irritation due to the fact they took out 41 nodes. I do plan on pushing for it. Also she is willing to look at other options and trails.

                  jim Breitfeller
                  Participant

                    Welcome to the Board. You may want to rethink your adjuvant therapy. Interferon slows down the recurrence but  does not extend survival (based on data). With this in mind, I would suggest looking into Anti-PD1 therapy as an adjuvant therapy. There may be openings at the Moffit in Florida with Dr. Weber. Or if there is a clinical trial with Yervoy that you qualify for.

                    I wish you all the best

                    Jimmy B

                    jim Breitfeller
                    Participant

                      Welcome to the Board. You may want to rethink your adjuvant therapy. Interferon slows down the recurrence but  does not extend survival (based on data). With this in mind, I would suggest looking into Anti-PD1 therapy as an adjuvant therapy. There may be openings at the Moffit in Florida with Dr. Weber. Or if there is a clinical trial with Yervoy that you qualify for.

                      I wish you all the best

                      Jimmy B

                      lhaley
                      Participant

                        Jim,

                        That particular trial is only for those who are HLA 0201 positive.  That definitely limits many for adjuvant therapy. This is because it also adds a peptide vaccine along with the Anti-PD1 therapy.

                        Linda

                        lhaley
                        Participant

                          Jim,

                          That particular trial is only for those who are HLA 0201 positive.  That definitely limits many for adjuvant therapy. This is because it also adds a peptide vaccine along with the Anti-PD1 therapy.

                          Linda

                          jim Breitfeller
                          Participant

                            Linda,

                            I was told that there was a trial opening without any HLA resrtictions.

                            "Jim: we have two trials for resected stage IV melanoma, one with PD-1 ab, the other soon to open with MAGE-3 vaccine without an HLA restriction. Jeff"

                            Straight from Dr. W

                             

                            Best regards

                            Jimmy B

                             

                            jim Breitfeller
                            Participant

                              Linda,

                              I was told that there was a trial opening without any HLA resrtictions.

                              "Jim: we have two trials for resected stage IV melanoma, one with PD-1 ab, the other soon to open with MAGE-3 vaccine without an HLA restriction. Jeff"

                              Straight from Dr. W

                               

                              Best regards

                              Jimmy B

                               

                            lhaley
                            Participant

                              Peter,

                              Welcome to the board, I'm sorry you've had to join us but hopefully will be able to get some information

                              I recently finished 6 weeks ago radiation due to lymph nodes with etranodal extentions. My history is different than yours and my disease is at the point where they "cherry pick" tumors and did not take many of the nodes. This time the node was sitting on the ulnar node and they pealed it off of the nerve so they know that cells were left behind.  I did get minor lymphademia but after a few lymphademia massages and now wearing a compression sleeve I'm doing well.  The swelling is reduced and now the pain from the nerve is just an annoyance and not even always that much.  

                               The tumor board was concerned with lymphademia and nerve damage vs good and thought I should go listen to the radiologist and make my own decision.  Kind of scary thought. I did consult with a radiologist that gathered info for my case and presented enough information about radiation that I decided there were more pro's then con's. My next PET is next Tuesday and hopefully will find that the radiation has kept the cells in check. 

                              I had the treatments at a local hospital since it was over 4 weeks long. The local rad had little melanoma experience and the consulted radiologist talked to her.  However, at first she marked me short of the elbow area because she was trying to save the joint. I did understand but to me if this was going to work I needed margins to clear the area! She did remark the area.  One other issue also but again I spoke up. It's worth it to also have 2 consults with different radiologists also if you decide on radiation.

                              The best you can do is to educate yourself and then move on and be part of your plan.

                              Linda   Stage IV since 06

                              lhaley
                              Participant

                                Peter,

                                Welcome to the board, I'm sorry you've had to join us but hopefully will be able to get some information

                                I recently finished 6 weeks ago radiation due to lymph nodes with etranodal extentions. My history is different than yours and my disease is at the point where they "cherry pick" tumors and did not take many of the nodes. This time the node was sitting on the ulnar node and they pealed it off of the nerve so they know that cells were left behind.  I did get minor lymphademia but after a few lymphademia massages and now wearing a compression sleeve I'm doing well.  The swelling is reduced and now the pain from the nerve is just an annoyance and not even always that much.  

                                 The tumor board was concerned with lymphademia and nerve damage vs good and thought I should go listen to the radiologist and make my own decision.  Kind of scary thought. I did consult with a radiologist that gathered info for my case and presented enough information about radiation that I decided there were more pro's then con's. My next PET is next Tuesday and hopefully will find that the radiation has kept the cells in check. 

                                I had the treatments at a local hospital since it was over 4 weeks long. The local rad had little melanoma experience and the consulted radiologist talked to her.  However, at first she marked me short of the elbow area because she was trying to save the joint. I did understand but to me if this was going to work I needed margins to clear the area! She did remark the area.  One other issue also but again I spoke up. It's worth it to also have 2 consults with different radiologists also if you decide on radiation.

                                The best you can do is to educate yourself and then move on and be part of your plan.

                                Linda   Stage IV since 06

                                Hereiam
                                Participant

                                  Hi Peter,

                                  I am very sorry to hear about your diagnosis but you definitely have found a good place to get as much info and support you need!

                                  I cannot decide whether you should go for radiation or no, I can just share my experience. Well, actually my cousins experience. She was diagnosed wit melanoma stage 2 in 2009. After a few surgeries she had to decide on treatment, and she was definitely interested in treatment with the strongest effect but also with relatively small side-effects. She decided to have radio + virotherapy in order to kill the malignant cells effectively but at the same time she wouldn`t have the loss of hair, weakness, nausea or unstable emotions. Well, she became NED quite fast so I can say only good things about this combination. After doing a small research about virotherapy, I found that it not only treats melanoma, but activizes immune system and improves life quality after such fight as recovery of melanoma!

                                  Wishing you all the success in finding the right treatment method!

                                  Hereiam
                                  Participant

                                    Hi Peter,

                                    I am very sorry to hear about your diagnosis but you definitely have found a good place to get as much info and support you need!

                                    I cannot decide whether you should go for radiation or no, I can just share my experience. Well, actually my cousins experience. She was diagnosed wit melanoma stage 2 in 2009. After a few surgeries she had to decide on treatment, and she was definitely interested in treatment with the strongest effect but also with relatively small side-effects. She decided to have radio + virotherapy in order to kill the malignant cells effectively but at the same time she wouldn`t have the loss of hair, weakness, nausea or unstable emotions. Well, she became NED quite fast so I can say only good things about this combination. After doing a small research about virotherapy, I found that it not only treats melanoma, but activizes immune system and improves life quality after such fight as recovery of melanoma!

                                    Wishing you all the success in finding the right treatment method!

                                      piii
                                      Participant

                                        Thanks for all the replies. I have my appointment in 1 hr with the doc and you all have helped me come up with good questions to ask. I am taking notes with me. It does help to have a board to run things by and I am glad I found this site. Just a note I had my drain removed this morning from my left arm pit. Did not feel a thing. I did make a mess of the exam room I guess I slowed down because I clotted in the tub so when he pulled it out I was a fountain for a few minutes.  So now I just need to make sure my arm does not fill with fluid. I will update when after doc visit.

                                         

                                        Thanks Again

                                        Peter

                                        piii
                                        Participant

                                          Thanks for all the replies. I have my appointment in 1 hr with the doc and you all have helped me come up with good questions to ask. I am taking notes with me. It does help to have a board to run things by and I am glad I found this site. Just a note I had my drain removed this morning from my left arm pit. Did not feel a thing. I did make a mess of the exam room I guess I slowed down because I clotted in the tub so when he pulled it out I was a fountain for a few minutes.  So now I just need to make sure my arm does not fill with fluid. I will update when after doc visit.

                                           

                                          Thanks Again

                                          Peter

                                        Jim M.
                                        Participant

                                          Hi Peter,

                                           My doctor is Jeffrey Weber, one of the foremost immunologists in the country. After an LND to the right axilla he recommended radiation. He said the radiation would reduce the chance of a local recurrence from 60% to 10%. That's pretty good in my book.

                                          With surgery alone you have a 21% chance of getting lymphedema in your left arm. It doubles to 42% possibility of lymphedema if you add radiation to the area.

                                          I had radiation. I do have lymphedema which is manageable and I have no recurrence to date.

                                          God Bless,

                                           Jim M.

                                          stage 3C

                                          Jim M.
                                          Participant

                                            Hi Peter,

                                             My doctor is Jeffrey Weber, one of the foremost immunologists in the country. After an LND to the right axilla he recommended radiation. He said the radiation would reduce the chance of a local recurrence from 60% to 10%. That's pretty good in my book.

                                            With surgery alone you have a 21% chance of getting lymphedema in your left arm. It doubles to 42% possibility of lymphedema if you add radiation to the area.

                                            I had radiation. I do have lymphedema which is manageable and I have no recurrence to date.

                                            God Bless,

                                             Jim M.

                                            stage 3C

                                              piii
                                              Participant

                                                I talked to my doctor and I start interferon next Monday 4 weeks High dose, then 11 months self injection. I also am seeing the radiologist Tuesday morning and we will talk about starting radiation. Don’t know what I am going to do. The risk of lymphedema and other issues or the pros of killing off any cell that are in the area. Also I did press my doctor about other options other than Interferon and basically she said with stage 3 that is all they have now and all the new drugs coming onto the market are not available to me at this time.  I know there maybe trials out there but I am OK with the course of action so far and just need to decide on radiation. She did say it is up to me and if I thought I wanted to do it she would support it.

                                                 

                                                Thanks

                                                Peter

                                                piii
                                                Participant

                                                  I talked to my doctor and I start interferon next Monday 4 weeks High dose, then 11 months self injection. I also am seeing the radiologist Tuesday morning and we will talk about starting radiation. Don’t know what I am going to do. The risk of lymphedema and other issues or the pros of killing off any cell that are in the area. Also I did press my doctor about other options other than Interferon and basically she said with stage 3 that is all they have now and all the new drugs coming onto the market are not available to me at this time.  I know there maybe trials out there but I am OK with the course of action so far and just need to decide on radiation. She did say it is up to me and if I thought I wanted to do it she would support it.

                                                   

                                                  Thanks

                                                  Peter

                                                  DonW
                                                  Participant

                                                    Peter — Good luck with your descision on radiation. I know from reading this board that radiation is often used when there is extranodal extension, so it is reasonable option. I'm surprised your doctor says it's up to you. Does she recommend it or not? Of course it's your decision, but usually the doc will tell you what they think you should do.

                                                    DonW
                                                    Participant

                                                      Peter — Good luck with your descision on radiation. I know from reading this board that radiation is often used when there is extranodal extension, so it is reasonable option. I'm surprised your doctor says it's up to you. Does she recommend it or not? Of course it's your decision, but usually the doc will tell you what they think you should do.

                                                      piii
                                                      Participant

                                                        She is leaning on the side of not doing it  – and knows I am looking to do everything I can to keep it from coming back. I will say my first doctor that did the operation at RI hospital also said he was not sure if the risk was worth doing. I moved to Dana Farber because they are one of the best cancer hospitals in MA and one of there centers is close to me. So again if I did not push I think she would of said she did not recommend it but I am glad she left the door open and is letting me make an informed decision. 

                                                        I would love any imput from the board on experiance with radiation after they had LN removal. Maybe I should start a new topic.

                                                         

                                                        Thanks

                                                        Peter

                                                        piii
                                                        Participant

                                                          She is leaning on the side of not doing it  – and knows I am looking to do everything I can to keep it from coming back. I will say my first doctor that did the operation at RI hospital also said he was not sure if the risk was worth doing. I moved to Dana Farber because they are one of the best cancer hospitals in MA and one of there centers is close to me. So again if I did not push I think she would of said she did not recommend it but I am glad she left the door open and is letting me make an informed decision. 

                                                          I would love any imput from the board on experiance with radiation after they had LN removal. Maybe I should start a new topic.

                                                           

                                                          Thanks

                                                          Peter

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