SLNB Back Stage 3a

Here is a link to ASCO series from June meetings 2019, series of 4 or five videos covering various aspects of stage 3 (adjuvant) treatment. Basic questions to ask would be is tissue being tested for Braf mutation? If you are going to just watch and wait then what kind of follow up will be offered and how often will scans(ultrasound) be done? Pembro adjuvant trial included 3a patients, so I would want to know what benefit did this specific group 3a have in the adjuvant keynote trial. What toxicity risk are you comfortable with is something you are going to have to come to terms with if you decide or are offered treatment! Here is the link to ONclive (which is worth joining, no cost!!!) https://www.onclive.com/peer-exchange/malignant-melanoma-management/stage-iii-melanoma-personalized-management

Sorry to hear about your results! I was hoping all your nodes would come back negative. I am stage 3. After my SLNB came back positive (2 out of the 3 nodes they took were positive, and I think my surgery was just as surprised about the results as I was) I met with my medical oncologist and he recommended I have a complete axillary lymph node removal. My surgically oncologist didn’t think that was necessary. He suggest just monitory that area with an ultrasound every 3 months. I wanted to be as aggressive as possible and after lots of thinking and prayers I decided to have the surgery and he removed a total of 17 nodes that all came back negative. Again, being as agresssive as possible I started immunotherapy therapy. I am in Opdivo and have treatment every four weeks. My big questions were what the side effects of the treatment would be. And before I started treatment I went to a ‘Opdivo teaching’ appointment with one of their nurse practitioners and she went over all the common and possible side effects and what they monitor in my blood work (thyroid function, liver enzymes, WBC count…) it’s a big decision to make and I think Ed’s link will help give you more info along with the info the oncologist gives you. Best of luck!

Sorry you are dealing with this, Momto3. You may be interested in this thread as it relates to 2 patients, one 3a and one 3b (though one has a pre-existing autoimmune diagnosis…so that complicates things and is not, as I understand it, part of your reality. The article linked in my post is pretty good as is the link I provided to adjuvant reports. Here is a link to a primer I put together that may be helpful when thinking about the various treatment options: https://chaoticallypreciselifeloveandmelanoma.blogspot.com/2017/08/melanoma-intel-primer-for-current.html Hope this helps. I wish you my best. Celeste

Another ONclive video from 2018 on adjuvant treatment options and issues, this video features dr. Postow of NY. https://www.onclive.com/peer-exchange/advanced-melanoma-paradigms/adjuvant-therapy-in-melanoma-safety-and-efficacy

This one hits one for me as I go was found to be stage 3a with SLNB in my neck. I opted for surgery with removal of an addition 8 lymph nodes which were all thankfully negative. I was not offered close observation and not immunotherapy. I get CT scans every 6 months and see my Derm every three and so far 18 months later I am clear with no recurrence. That said the thought often creeps into my head if I should have sought a second opinion because if I ever do have a recurrence did I do all I could have to prevent it. It is a hard choice and an educated decision. Good luck and let us know. Your in my thoughts and prayers

I find it very annoying that people always tend to ignore statistics and get recently diagnosed stage 3 patients more worried that they should be. If you are 3A you have on average a 63% chance that melanoma will never return (without treatment) and if your tumor load in you SLNs is very low *dwar, starz or Rotterdam model applied* you have an well above 80% chance of staying in remission.

Even a stage 3b has on average a better than 50:50 chance of NON- RECURRENCE !

So please stop insinuating to newly diagnosed people that you are the fortunate ones, just because you are NED. You are the majority (in case of stage 3a). Besides, this forum is not representative at all, since people who are in remission long term tend to enjoy their lives and don’t bother visiting melanomg.org !!!

I hope this gives you a more positive perspective on the subject besides the tremendous advancements in melanoma treatment.
Chris