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JonathanB

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      JonathanB
      Participant

        BuckyTom: the lymph node dissection is a fairly standard protocol given your diagnosis. I myself have had two neck dissections in the past year. It never hurts to get a second opinion, but I suspect most oncologists/surgeons would recommend the same thing. Depending on the extent, location and number of nodes removed, the procedure can often be completed in under an hour, almost certainly under a general anaesthetic. Preferrably, you will want this done by an experienced surgical oncologist or ENT surgeon familiar with melanoma and in coordination with your oncologist.

        Ideally, the surgery will remove the melanoma and your follow-up scans will be clear. If they are not clear and there is evidence the melanoma has spread, you will want to begin having discussions with your oncologist regarding other therapies, most likely targeted gene therapies such as Zelboraf or Yervoy. Both of these drug therapies are discussed widely on this board and many patients are reporting favorable results.

        The initial diagnosis is a real shocker of course, but the best thing you can do in my opinion is avoid the statistics, educate yourself on the growing number of drug therapies available, adjust your diet to help fortify your body with the good stuff and find a qualified melanoma oncologist/clinic that you can work with.  Stay strong and I sincerely wish you all the best. Jonathan

        JonathanB
        Participant

          BuckyTom: the lymph node dissection is a fairly standard protocol given your diagnosis. I myself have had two neck dissections in the past year. It never hurts to get a second opinion, but I suspect most oncologists/surgeons would recommend the same thing. Depending on the extent, location and number of nodes removed, the procedure can often be completed in under an hour, almost certainly under a general anaesthetic. Preferrably, you will want this done by an experienced surgical oncologist or ENT surgeon familiar with melanoma and in coordination with your oncologist.

          Ideally, the surgery will remove the melanoma and your follow-up scans will be clear. If they are not clear and there is evidence the melanoma has spread, you will want to begin having discussions with your oncologist regarding other therapies, most likely targeted gene therapies such as Zelboraf or Yervoy. Both of these drug therapies are discussed widely on this board and many patients are reporting favorable results.

          The initial diagnosis is a real shocker of course, but the best thing you can do in my opinion is avoid the statistics, educate yourself on the growing number of drug therapies available, adjust your diet to help fortify your body with the good stuff and find a qualified melanoma oncologist/clinic that you can work with.  Stay strong and I sincerely wish you all the best. Jonathan

          JonathanB
          Participant

            BuckyTom: the lymph node dissection is a fairly standard protocol given your diagnosis. I myself have had two neck dissections in the past year. It never hurts to get a second opinion, but I suspect most oncologists/surgeons would recommend the same thing. Depending on the extent, location and number of nodes removed, the procedure can often be completed in under an hour, almost certainly under a general anaesthetic. Preferrably, you will want this done by an experienced surgical oncologist or ENT surgeon familiar with melanoma and in coordination with your oncologist.

            Ideally, the surgery will remove the melanoma and your follow-up scans will be clear. If they are not clear and there is evidence the melanoma has spread, you will want to begin having discussions with your oncologist regarding other therapies, most likely targeted gene therapies such as Zelboraf or Yervoy. Both of these drug therapies are discussed widely on this board and many patients are reporting favorable results.

            The initial diagnosis is a real shocker of course, but the best thing you can do in my opinion is avoid the statistics, educate yourself on the growing number of drug therapies available, adjust your diet to help fortify your body with the good stuff and find a qualified melanoma oncologist/clinic that you can work with.  Stay strong and I sincerely wish you all the best. Jonathan

            JonathanB
            Participant

              I was also quoted $40,000 for a consult at MD Anderson. The acutal consult would not likely cost that whole amount (depending on time, tests, analysis of existing scans, slides, etc.) but Anderson asks for the $40K as an up-front deposit. I ended up going for a second opinion consult at the Seattle Cancer Care Alliance (associated with the University of Washington), who asked for a $1600 deposit up front. The oncologist I spoke with, Dr. Tykodi, is a superb doctor and personable man, knows much about melanoma and current treatments/therapy and the clinic itself seems to provide excellent all around cancer care and treatment. MD Anderson is no doubt good, but so are many other, lesser expensive places. The real challenge is finding a melanoma specialist you trust and feel you can work with. Best of luck.

              JonathanB
              Participant

                I was also quoted $40,000 for a consult at MD Anderson. The acutal consult would not likely cost that whole amount (depending on time, tests, analysis of existing scans, slides, etc.) but Anderson asks for the $40K as an up-front deposit. I ended up going for a second opinion consult at the Seattle Cancer Care Alliance (associated with the University of Washington), who asked for a $1600 deposit up front. The oncologist I spoke with, Dr. Tykodi, is a superb doctor and personable man, knows much about melanoma and current treatments/therapy and the clinic itself seems to provide excellent all around cancer care and treatment. MD Anderson is no doubt good, but so are many other, lesser expensive places. The real challenge is finding a melanoma specialist you trust and feel you can work with. Best of luck.

                JonathanB
                Participant

                  I was also quoted $40,000 for a consult at MD Anderson. The acutal consult would not likely cost that whole amount (depending on time, tests, analysis of existing scans, slides, etc.) but Anderson asks for the $40K as an up-front deposit. I ended up going for a second opinion consult at the Seattle Cancer Care Alliance (associated with the University of Washington), who asked for a $1600 deposit up front. The oncologist I spoke with, Dr. Tykodi, is a superb doctor and personable man, knows much about melanoma and current treatments/therapy and the clinic itself seems to provide excellent all around cancer care and treatment. MD Anderson is no doubt good, but so are many other, lesser expensive places. The real challenge is finding a melanoma specialist you trust and feel you can work with. Best of luck.

                  JonathanB
                  Participant

                    sFeldman: thanks for the comments and support.

                    Very happy to hear your scans were clear from the GSK Braf/Mek medication. I have been doing some research on the drug and will definitely bring it up with my oncologist. Did you suffer side-effects while undergoing the treament? How long did you take it for?

                    I couldn't agree more with your recommendation of a diet loaded with high nutrient cruciferous green vegetables, fruit, whole grains, mushrooms and turmeric. I would also add onions, leeks, garlic, etc. (the allium vegetables) and select nuts and seeds – walnuts, hazelnuts, flaxseed, etc. The hard part, for me anyway, was the elimination of refined sugars, although it does get easier as the cravings subside and you genuinely feel "full" from the abovementioned foods. I have even got my kids eating many of the foods now, although they won't go near the turmeric or spicy dishes ๐Ÿ™‚

                    Jonathan

                    JonathanB
                    Participant

                      sFeldman: thanks for the comments and support.

                      Very happy to hear your scans were clear from the GSK Braf/Mek medication. I have been doing some research on the drug and will definitely bring it up with my oncologist. Did you suffer side-effects while undergoing the treament? How long did you take it for?

                      I couldn't agree more with your recommendation of a diet loaded with high nutrient cruciferous green vegetables, fruit, whole grains, mushrooms and turmeric. I would also add onions, leeks, garlic, etc. (the allium vegetables) and select nuts and seeds – walnuts, hazelnuts, flaxseed, etc. The hard part, for me anyway, was the elimination of refined sugars, although it does get easier as the cravings subside and you genuinely feel "full" from the abovementioned foods. I have even got my kids eating many of the foods now, although they won't go near the turmeric or spicy dishes ๐Ÿ™‚

                      Jonathan

                      JonathanB
                      Participant

                        sFeldman: thanks for the comments and support.

                        Very happy to hear your scans were clear from the GSK Braf/Mek medication. I have been doing some research on the drug and will definitely bring it up with my oncologist. Did you suffer side-effects while undergoing the treament? How long did you take it for?

                        I couldn't agree more with your recommendation of a diet loaded with high nutrient cruciferous green vegetables, fruit, whole grains, mushrooms and turmeric. I would also add onions, leeks, garlic, etc. (the allium vegetables) and select nuts and seeds – walnuts, hazelnuts, flaxseed, etc. The hard part, for me anyway, was the elimination of refined sugars, although it does get easier as the cravings subside and you genuinely feel "full" from the abovementioned foods. I have even got my kids eating many of the foods now, although they won't go near the turmeric or spicy dishes ๐Ÿ™‚

                        Jonathan

                        JonathanB
                        Participant

                          Denise: thanks for the comments. I tend to agree with you about leaving alone for now the two visible tumors on my leg, as they are fairly small at this point and may provide a measureable indication of Zelboraf's ability to shrink tumors. I have yet to discuss the pros/cons with my surgeon, who is normally pretty aggressive about removing what he can, but now that I will be taking Zelboraf he may have a different outlook. In general I believe that surgically removing tumors where possible is the best approach, but of course this is not always easily possible, or even practical when there get to be many. And as you may have experienced, the surgery often involves removing more than just the tumor, as many surgeons like to get margins as wide as possible and will often take out any nearby lymph nodes and sometimes tissue as well. About nine months ago, my ENT surgeon decided he wanted to "pop out" a smallish tumor on the back of my neck, which he felt would be about a 1/2 hour operation. I was a little shocked to find out afterwards that not only did he "pop out" the melanoma mass, he also made an incision clear across the back of my neck and removed a swath of tissue and who knows what else, "as a preventative measure." That one hurt for quite a while afterwards.

                          The good news, for both of us, is that Zelboraf has a better than average track record of stopping new tumor growth and sometimes shrinking existing ones. The hope is that the reported side effects are not too difficult to handle. If you don't have one already, ask your Doctor for the Zelboraf "Kit", which is a package of literature that comes directly from Roche, the drug's manufacturer. It's fairly informative and includes a little log book to keep track of your daily dosages and reported side effects. Apparently Roche also has a nurse on call to speak with regarding your treatment and side-effects, which could be useful.

                          I will post updates once I begin taking Zelboraf and let you know how things progress. It is no understatement to say I am counting on this drug to bring a halt to the tumor growth and give me some renewed hope. My fall back plan if Zelboraf doesn't work is to ask my oncologist to prescribe Yervoy/Ipi, which a second-opinion oncologist I spoke with in Seattle informed me was their clinic's first line drug to recommend, sometimes followed by Zelboraf. At my clinic, it seems to be the other way around.

                          I do wish you success with your treatment and hope you can let us know of your progress.

                          Jonathan

                          JonathanB
                          Participant

                            Denise: thanks for the comments. I tend to agree with you about leaving alone for now the two visible tumors on my leg, as they are fairly small at this point and may provide a measureable indication of Zelboraf's ability to shrink tumors. I have yet to discuss the pros/cons with my surgeon, who is normally pretty aggressive about removing what he can, but now that I will be taking Zelboraf he may have a different outlook. In general I believe that surgically removing tumors where possible is the best approach, but of course this is not always easily possible, or even practical when there get to be many. And as you may have experienced, the surgery often involves removing more than just the tumor, as many surgeons like to get margins as wide as possible and will often take out any nearby lymph nodes and sometimes tissue as well. About nine months ago, my ENT surgeon decided he wanted to "pop out" a smallish tumor on the back of my neck, which he felt would be about a 1/2 hour operation. I was a little shocked to find out afterwards that not only did he "pop out" the melanoma mass, he also made an incision clear across the back of my neck and removed a swath of tissue and who knows what else, "as a preventative measure." That one hurt for quite a while afterwards.

                            The good news, for both of us, is that Zelboraf has a better than average track record of stopping new tumor growth and sometimes shrinking existing ones. The hope is that the reported side effects are not too difficult to handle. If you don't have one already, ask your Doctor for the Zelboraf "Kit", which is a package of literature that comes directly from Roche, the drug's manufacturer. It's fairly informative and includes a little log book to keep track of your daily dosages and reported side effects. Apparently Roche also has a nurse on call to speak with regarding your treatment and side-effects, which could be useful.

                            I will post updates once I begin taking Zelboraf and let you know how things progress. It is no understatement to say I am counting on this drug to bring a halt to the tumor growth and give me some renewed hope. My fall back plan if Zelboraf doesn't work is to ask my oncologist to prescribe Yervoy/Ipi, which a second-opinion oncologist I spoke with in Seattle informed me was their clinic's first line drug to recommend, sometimes followed by Zelboraf. At my clinic, it seems to be the other way around.

                            I do wish you success with your treatment and hope you can let us know of your progress.

                            Jonathan

                            JonathanB
                            Participant

                              Denise: thanks for the comments. I tend to agree with you about leaving alone for now the two visible tumors on my leg, as they are fairly small at this point and may provide a measureable indication of Zelboraf's ability to shrink tumors. I have yet to discuss the pros/cons with my surgeon, who is normally pretty aggressive about removing what he can, but now that I will be taking Zelboraf he may have a different outlook. In general I believe that surgically removing tumors where possible is the best approach, but of course this is not always easily possible, or even practical when there get to be many. And as you may have experienced, the surgery often involves removing more than just the tumor, as many surgeons like to get margins as wide as possible and will often take out any nearby lymph nodes and sometimes tissue as well. About nine months ago, my ENT surgeon decided he wanted to "pop out" a smallish tumor on the back of my neck, which he felt would be about a 1/2 hour operation. I was a little shocked to find out afterwards that not only did he "pop out" the melanoma mass, he also made an incision clear across the back of my neck and removed a swath of tissue and who knows what else, "as a preventative measure." That one hurt for quite a while afterwards.

                              The good news, for both of us, is that Zelboraf has a better than average track record of stopping new tumor growth and sometimes shrinking existing ones. The hope is that the reported side effects are not too difficult to handle. If you don't have one already, ask your Doctor for the Zelboraf "Kit", which is a package of literature that comes directly from Roche, the drug's manufacturer. It's fairly informative and includes a little log book to keep track of your daily dosages and reported side effects. Apparently Roche also has a nurse on call to speak with regarding your treatment and side-effects, which could be useful.

                              I will post updates once I begin taking Zelboraf and let you know how things progress. It is no understatement to say I am counting on this drug to bring a halt to the tumor growth and give me some renewed hope. My fall back plan if Zelboraf doesn't work is to ask my oncologist to prescribe Yervoy/Ipi, which a second-opinion oncologist I spoke with in Seattle informed me was their clinic's first line drug to recommend, sometimes followed by Zelboraf. At my clinic, it seems to be the other way around.

                              I do wish you success with your treatment and hope you can let us know of your progress.

                              Jonathan

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