Lab Work Prior to Yervoy
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Lab Work Prior to Yervoy

› Forums › General Melanoma Community › Lab Work Prior to Yervoy

  • Post
    • February 25, 2015 at 3:13 pm
    dmk252003
    Participant

    My mom's oncologist is suggesting she has yervoy treatments for her stage IV cancer.

    She has not suggested doing any lab work prior to yervoy treatments. I am concerned since my mom was in the hospital a few weeks ago with irregular heart rate and very high blood pressure.

    I would like to hear feedback regarding this. Thank you.

Viewing 8 reply threads
  • Replies
      • February 25, 2015 at 3:36 pm
      _Paul_
      Participant

      Is your mom's oncologist a melanoma specialist? Its very important to have one. Each time I had a Yervoy infusion (and now each time I have  Keytruda infusion), blood is drawn, then I meet with the oncologist who checks the results to ensure I am healthy enough for the infusion, and then the actual infusion.

      • February 25, 2015 at 3:36 pm
      _Paul_
      Participant

      Is your mom's oncologist a melanoma specialist? Its very important to have one. Each time I had a Yervoy infusion (and now each time I have  Keytruda infusion), blood is drawn, then I meet with the oncologist who checks the results to ensure I am healthy enough for the infusion, and then the actual infusion.

        • February 25, 2015 at 4:19 pm
        dmk252003
        Participant

        Hi Paul

        She is not a melanoma specialist. This onclogist just expected my mom to get Yervoy treatment done without explaining the procedure to us and no lab work prior.

        • February 25, 2015 at 4:19 pm
        dmk252003
        Participant

        Hi Paul

        She is not a melanoma specialist. This onclogist just expected my mom to get Yervoy treatment done without explaining the procedure to us and no lab work prior.

        • February 25, 2015 at 7:50 pm
        AnitaLoree
        Participant

        DMK:  I am sorry your Mom has more health issues than melanoma, which is enough!  This oncologist sounds like someone by whom I would not want my husband treated and for a similar reason we changed oncologists, & are now in competent hands.  Specific baseline lab tests need to be done just before each infusion of any immunotherapy.  The oncologist needs to be on top of the game in promptly & properly handling side effects from Yervoy & especially if there are concurrent cardiac, other health problems.  What does your Mom's cardiologist think about Yervoy rx?  My husband is on Keytruda (PD-1 rx) which has a much lower side effect profile.  Can you opt for a melanoma treatment ctr where your Mom is likely to get much more comprehensive care? Wishing you both successful outcomes.  A.L.

        • February 25, 2015 at 7:50 pm
        AnitaLoree
        Participant

        DMK:  I am sorry your Mom has more health issues than melanoma, which is enough!  This oncologist sounds like someone by whom I would not want my husband treated and for a similar reason we changed oncologists, & are now in competent hands.  Specific baseline lab tests need to be done just before each infusion of any immunotherapy.  The oncologist needs to be on top of the game in promptly & properly handling side effects from Yervoy & especially if there are concurrent cardiac, other health problems.  What does your Mom's cardiologist think about Yervoy rx?  My husband is on Keytruda (PD-1 rx) which has a much lower side effect profile.  Can you opt for a melanoma treatment ctr where your Mom is likely to get much more comprehensive care? Wishing you both successful outcomes.  A.L.

        • February 26, 2015 at 3:03 am
        dmk252003
        Participant

        Thanks for your reply.

        We saw her oncologist today and I told her that I wanted my mom to have lab work prior to therapy.  Labs were done (all look good) and we are starting my mom on Yervoy tomorrow morning.

        My mom is with Kaiser in Southern California. I am going to look into melanoma specialists at Kaiser starting tonight. It is very frustrating when you are dealing with Doctors that you question.

        • February 26, 2015 at 3:03 am
        dmk252003
        Participant

        Thanks for your reply.

        We saw her oncologist today and I told her that I wanted my mom to have lab work prior to therapy.  Labs were done (all look good) and we are starting my mom on Yervoy tomorrow morning.

        My mom is with Kaiser in Southern California. I am going to look into melanoma specialists at Kaiser starting tonight. It is very frustrating when you are dealing with Doctors that you question.

        • February 26, 2015 at 6:56 am
        AnitaLoree
        Participant

        DMK:  We are also with Kaiser (No Calif) and, fortunately, you are entitled to get a 2nd opinion with another oncologist.  I read all the CVs of the oncologists available to us (we live between 2 Kaiser centers) and requested a certain one to whom we switched and are receiving much more competent, interested care.  I doubt there are any melanoma specialists; Riverside was the only facility that had a focus on melanoma several yrs ago but the lead doc has left.  All are general oncologists altho' someone may have more experience with one type of cancer over another. You have to ask.  Because Keytruda was not available at the time, we asked for a consult at UCSF melanoma treatment ctr which is where we preferred to get treatment.  Kaiser pays for the 1st consult visit.  Husband was going to start a clinical trial there but Keytruda got early approval so Kaiser could give. This was the immunotherapy we wanted. With Kaiser you must absolutely advocate for yourself and be knowledgeable about treatment options; ask questions and take notes. Ask the doc how he plans to manage your Mom's treatment.  Be sure you know what to do if a serious side effect occurs, Yervoy can cause some, and know what to do if you have to go to the ER on a weekend because personnel there are not up on the med & its side effects. I have a packet to take in to ER should the need arise that includes the complete pharmacology info on Keytruda and managing side effects.  I requested it from Merck. Bristol Myers Squibb makes Yervoy. Ask how soon your Mom can switch to Keytruda. She should be able to switch if she fails/advances or side effects too problematic. There are good melanoma treatment ctrs in SoCA.  So hope her treatment goes well with minimal annoyance and knocks old mel out.  A.L.

        • February 26, 2015 at 6:56 am
        AnitaLoree
        Participant

        DMK:  We are also with Kaiser (No Calif) and, fortunately, you are entitled to get a 2nd opinion with another oncologist.  I read all the CVs of the oncologists available to us (we live between 2 Kaiser centers) and requested a certain one to whom we switched and are receiving much more competent, interested care.  I doubt there are any melanoma specialists; Riverside was the only facility that had a focus on melanoma several yrs ago but the lead doc has left.  All are general oncologists altho' someone may have more experience with one type of cancer over another. You have to ask.  Because Keytruda was not available at the time, we asked for a consult at UCSF melanoma treatment ctr which is where we preferred to get treatment.  Kaiser pays for the 1st consult visit.  Husband was going to start a clinical trial there but Keytruda got early approval so Kaiser could give. This was the immunotherapy we wanted. With Kaiser you must absolutely advocate for yourself and be knowledgeable about treatment options; ask questions and take notes. Ask the doc how he plans to manage your Mom's treatment.  Be sure you know what to do if a serious side effect occurs, Yervoy can cause some, and know what to do if you have to go to the ER on a weekend because personnel there are not up on the med & its side effects. I have a packet to take in to ER should the need arise that includes the complete pharmacology info on Keytruda and managing side effects.  I requested it from Merck. Bristol Myers Squibb makes Yervoy. Ask how soon your Mom can switch to Keytruda. She should be able to switch if she fails/advances or side effects too problematic. There are good melanoma treatment ctrs in SoCA.  So hope her treatment goes well with minimal annoyance and knocks old mel out.  A.L.

        • February 27, 2015 at 7:53 am
        dmk252003
        Participant

        Thanks for your reply.

        We decided not to have my mom start yervoy today. We are waiting to hear back from her oncologist to refer her to a Kaiser facility that has a doctor who has more experience with melanoma. She said that Riverside or Baldwin Park may have one.

        How is your husband doing on Keytruda?

        • February 27, 2015 at 7:53 am
        dmk252003
        Participant

        Thanks for your reply.

        We decided not to have my mom start yervoy today. We are waiting to hear back from her oncologist to refer her to a Kaiser facility that has a doctor who has more experience with melanoma. She said that Riverside or Baldwin Park may have one.

        How is your husband doing on Keytruda?

        • February 27, 2015 at 7:53 am
        dmk252003
        Participant

        Thanks for your reply.

        We decided not to have my mom start yervoy today. We are waiting to hear back from her oncologist to refer her to a Kaiser facility that has a doctor who has more experience with melanoma. She said that Riverside or Baldwin Park may have one.

        How is your husband doing on Keytruda?

        • February 26, 2015 at 6:56 am
        AnitaLoree
        Participant

        DMK:  We are also with Kaiser (No Calif) and, fortunately, you are entitled to get a 2nd opinion with another oncologist.  I read all the CVs of the oncologists available to us (we live between 2 Kaiser centers) and requested a certain one to whom we switched and are receiving much more competent, interested care.  I doubt there are any melanoma specialists; Riverside was the only facility that had a focus on melanoma several yrs ago but the lead doc has left.  All are general oncologists altho' someone may have more experience with one type of cancer over another. You have to ask.  Because Keytruda was not available at the time, we asked for a consult at UCSF melanoma treatment ctr which is where we preferred to get treatment.  Kaiser pays for the 1st consult visit.  Husband was going to start a clinical trial there but Keytruda got early approval so Kaiser could give. This was the immunotherapy we wanted. With Kaiser you must absolutely advocate for yourself and be knowledgeable about treatment options; ask questions and take notes. Ask the doc how he plans to manage your Mom's treatment.  Be sure you know what to do if a serious side effect occurs, Yervoy can cause some, and know what to do if you have to go to the ER on a weekend because personnel there are not up on the med & its side effects. I have a packet to take in to ER should the need arise that includes the complete pharmacology info on Keytruda and managing side effects.  I requested it from Merck. Bristol Myers Squibb makes Yervoy. Ask how soon your Mom can switch to Keytruda. She should be able to switch if she fails/advances or side effects too problematic. There are good melanoma treatment ctrs in SoCA.  So hope her treatment goes well with minimal annoyance and knocks old mel out.  A.L.

        • February 26, 2015 at 3:03 am
        dmk252003
        Participant

        Thanks for your reply.

        We saw her oncologist today and I told her that I wanted my mom to have lab work prior to therapy.  Labs were done (all look good) and we are starting my mom on Yervoy tomorrow morning.

        My mom is with Kaiser in Southern California. I am going to look into melanoma specialists at Kaiser starting tonight. It is very frustrating when you are dealing with Doctors that you question.

        • February 25, 2015 at 7:50 pm
        AnitaLoree
        Participant

        DMK:  I am sorry your Mom has more health issues than melanoma, which is enough!  This oncologist sounds like someone by whom I would not want my husband treated and for a similar reason we changed oncologists, & are now in competent hands.  Specific baseline lab tests need to be done just before each infusion of any immunotherapy.  The oncologist needs to be on top of the game in promptly & properly handling side effects from Yervoy & especially if there are concurrent cardiac, other health problems.  What does your Mom's cardiologist think about Yervoy rx?  My husband is on Keytruda (PD-1 rx) which has a much lower side effect profile.  Can you opt for a melanoma treatment ctr where your Mom is likely to get much more comprehensive care? Wishing you both successful outcomes.  A.L.

        • February 25, 2015 at 4:19 pm
        dmk252003
        Participant

        Hi Paul

        She is not a melanoma specialist. This onclogist just expected my mom to get Yervoy treatment done without explaining the procedure to us and no lab work prior.

      • February 25, 2015 at 3:36 pm
      _Paul_
      Participant

      Is your mom's oncologist a melanoma specialist? Its very important to have one. Each time I had a Yervoy infusion (and now each time I have  Keytruda infusion), blood is drawn, then I meet with the oncologist who checks the results to ensure I am healthy enough for the infusion, and then the actual infusion.

      • February 26, 2015 at 7:38 am
      Patina
      Participant

      Hi,

      I am sorry to hear about your Mom. You have a tough road and for what my 2 cents is worth I'd find a different doctor regardless is she has Yervoy tomorrow. With your Mom's health you need someone who is a specialist and frankly there are a lot of people out there that think they can manage this, but it really takes someone who knows this disease inside and out to really give you the best advice, care and ensure she's taken care of.

      My Mom (stage IV) was seen by a melanoma specialist and they are not right 100% of the time, which is why I insisted on a 2nd and 3rd opinion.  We got lucky and the 3rd opinion (a melanomoa specialist) diagnosed my Mom with brain mets (brain cancer) too.  It really pays, in my opinion, to consult with more than one doctor and find a specialist who really understands the disease and does their due dilligence and checks others work. – That is the kind of doctor you want and she deserves.

      With that said, I can recommend 2 melanoma specialists  in Southern California. The specialist who did his due dilligence (3rd) and the one who treated her (4th). Both doctors are amazing, at the top of their fields and frankly have the bedside manner of a doctor from the 50's, which our whole family loved. We had options to have a oncologist treat her in Santa Barbara, where we are from, but we knew we wanted her at a facility with access to the best research, which is wny we headed south and one of the reasons we ended up at USC, where my Mom was treateded for Stage IV Melonma and where she had unbelievalgle care from her oncologist (Dr. Mike Wong) and radiologist (Dr. Eric Chang) for the brain mets. – She had 25 brain mets. No cognitive issues and 21 of them are gone wit Yervoy and gamma knife treatment.

      However, without first seeind Dr. Peter Bosaberg I know my Mom would not be here today because he found the brain mets two others specialists missed. – They read reports and did not look at the scans….

      Here is the information I have on Dr. Bosaberg and Dr. Wong:

      Dr. Petter Bosaberg – Does his due diligence and double/triple checks everything. 

      Angeles Clinic

      Santa Monica

      http://www.TheAngelesClinic.org

      Dr. Mike Wong – He also does is due diligence and frankly my Mom wouldn't have the outlook she has without him.

      USC Norris Comprehensive Cancer Center

      Los Angeles

      http://www.KeckMedicine.org

      – My Mom has had amazing results and its as if nothing happened. For her, she had very little sickness or diabiity. Thrush she says today was what was going to kill her. So, you can imagine the rest was a walk in the park for her.

      Good luck.

      • February 26, 2015 at 7:38 am
      Patina
      Participant

      Hi,

      I am sorry to hear about your Mom. You have a tough road and for what my 2 cents is worth I'd find a different doctor regardless is she has Yervoy tomorrow. With your Mom's health you need someone who is a specialist and frankly there are a lot of people out there that think they can manage this, but it really takes someone who knows this disease inside and out to really give you the best advice, care and ensure she's taken care of.

      My Mom (stage IV) was seen by a melanoma specialist and they are not right 100% of the time, which is why I insisted on a 2nd and 3rd opinion.  We got lucky and the 3rd opinion (a melanomoa specialist) diagnosed my Mom with brain mets (brain cancer) too.  It really pays, in my opinion, to consult with more than one doctor and find a specialist who really understands the disease and does their due dilligence and checks others work. – That is the kind of doctor you want and she deserves.

      With that said, I can recommend 2 melanoma specialists  in Southern California. The specialist who did his due dilligence (3rd) and the one who treated her (4th). Both doctors are amazing, at the top of their fields and frankly have the bedside manner of a doctor from the 50's, which our whole family loved. We had options to have a oncologist treat her in Santa Barbara, where we are from, but we knew we wanted her at a facility with access to the best research, which is wny we headed south and one of the reasons we ended up at USC, where my Mom was treateded for Stage IV Melonma and where she had unbelievalgle care from her oncologist (Dr. Mike Wong) and radiologist (Dr. Eric Chang) for the brain mets. – She had 25 brain mets. No cognitive issues and 21 of them are gone wit Yervoy and gamma knife treatment.

      However, without first seeind Dr. Peter Bosaberg I know my Mom would not be here today because he found the brain mets two others specialists missed. – They read reports and did not look at the scans….

      Here is the information I have on Dr. Bosaberg and Dr. Wong:

      Dr. Petter Bosaberg – Does his due diligence and double/triple checks everything. 

      Angeles Clinic

      Santa Monica

      http://www.TheAngelesClinic.org

      Dr. Mike Wong – He also does is due diligence and frankly my Mom wouldn't have the outlook she has without him.

      USC Norris Comprehensive Cancer Center

      Los Angeles

      http://www.KeckMedicine.org

      – My Mom has had amazing results and its as if nothing happened. For her, she had very little sickness or diabiity. Thrush she says today was what was going to kill her. So, you can imagine the rest was a walk in the park for her.

      Good luck.

        • February 27, 2015 at 8:00 am
        dmk252003
        Participant

        Thanks for your reply.

        Unfortunetly my mom can't swithch to another insurance until October. In the meantime we are waiting to get a referall to another Kaiser facility for either a melanoma specialist or a doctor with more experience with melanoma.

        I have a few friends who see Dr  Piro at the Los Angeles clinic and have wonderful things to say about him. My  mom can't switch insurance until October so we are stuck with Kaiser in the meantime.

        I am praying for your mom

        • February 27, 2015 at 8:00 am
        dmk252003
        Participant

        Thanks for your reply.

        Unfortunetly my mom can't swithch to another insurance until October. In the meantime we are waiting to get a referall to another Kaiser facility for either a melanoma specialist or a doctor with more experience with melanoma.

        I have a few friends who see Dr  Piro at the Los Angeles clinic and have wonderful things to say about him. My  mom can't switch insurance until October so we are stuck with Kaiser in the meantime.

        I am praying for your mom

        • February 28, 2015 at 1:38 pm
        Kdw2012
        Participant

        City of Hope in Duarte is a fantastic facility also, that is where I am being seen.

        • February 28, 2015 at 1:38 pm
        Kdw2012
        Participant

        City of Hope in Duarte is a fantastic facility also, that is where I am being seen.

        • February 28, 2015 at 1:38 pm
        Kdw2012
        Participant

        City of Hope in Duarte is a fantastic facility also, that is where I am being seen.

        • February 27, 2015 at 8:00 am
        dmk252003
        Participant

        Thanks for your reply.

        Unfortunetly my mom can't swithch to another insurance until October. In the meantime we are waiting to get a referall to another Kaiser facility for either a melanoma specialist or a doctor with more experience with melanoma.

        I have a few friends who see Dr  Piro at the Los Angeles clinic and have wonderful things to say about him. My  mom can't switch insurance until October so we are stuck with Kaiser in the meantime.

        I am praying for your mom

      • February 26, 2015 at 7:38 am
      Patina
      Participant

      Hi,

      I am sorry to hear about your Mom. You have a tough road and for what my 2 cents is worth I'd find a different doctor regardless is she has Yervoy tomorrow. With your Mom's health you need someone who is a specialist and frankly there are a lot of people out there that think they can manage this, but it really takes someone who knows this disease inside and out to really give you the best advice, care and ensure she's taken care of.

      My Mom (stage IV) was seen by a melanoma specialist and they are not right 100% of the time, which is why I insisted on a 2nd and 3rd opinion.  We got lucky and the 3rd opinion (a melanomoa specialist) diagnosed my Mom with brain mets (brain cancer) too.  It really pays, in my opinion, to consult with more than one doctor and find a specialist who really understands the disease and does their due dilligence and checks others work. – That is the kind of doctor you want and she deserves.

      With that said, I can recommend 2 melanoma specialists  in Southern California. The specialist who did his due dilligence (3rd) and the one who treated her (4th). Both doctors are amazing, at the top of their fields and frankly have the bedside manner of a doctor from the 50's, which our whole family loved. We had options to have a oncologist treat her in Santa Barbara, where we are from, but we knew we wanted her at a facility with access to the best research, which is wny we headed south and one of the reasons we ended up at USC, where my Mom was treateded for Stage IV Melonma and where she had unbelievalgle care from her oncologist (Dr. Mike Wong) and radiologist (Dr. Eric Chang) for the brain mets. – She had 25 brain mets. No cognitive issues and 21 of them are gone wit Yervoy and gamma knife treatment.

      However, without first seeind Dr. Peter Bosaberg I know my Mom would not be here today because he found the brain mets two others specialists missed. – They read reports and did not look at the scans….

      Here is the information I have on Dr. Bosaberg and Dr. Wong:

      Dr. Petter Bosaberg – Does his due diligence and double/triple checks everything. 

      Angeles Clinic

      Santa Monica

      http://www.TheAngelesClinic.org

      Dr. Mike Wong – He also does is due diligence and frankly my Mom wouldn't have the outlook she has without him.

      USC Norris Comprehensive Cancer Center

      Los Angeles

      http://www.KeckMedicine.org

      – My Mom has had amazing results and its as if nothing happened. For her, she had very little sickness or diabiity. Thrush she says today was what was going to kill her. So, you can imagine the rest was a walk in the park for her.

      Good luck.

      • February 27, 2015 at 10:57 pm
      Marianne quinn
      Participant

      Kaiser does not have a melanoma specialist which is ridiculous. Kaiser has thousands of patients and makes lots of money. We were unable to get a referal to a melanoma specialist, but fortunately, my husband responded to the treatment they offered. Kaiser said we would have to pay for a second opinion outside of Kaiser.

      It sounds like she is getting appropriate first line care. I am not sure you would gain much right now by seeing a specialist. There have been Kaiser people on this forum who did get a referral to a melanoma specialist, but it sounded like their cases were less straight forward then your case appears to be. Good luck

      • February 27, 2015 at 10:57 pm
      Marianne quinn
      Participant

      Kaiser does not have a melanoma specialist which is ridiculous. Kaiser has thousands of patients and makes lots of money. We were unable to get a referal to a melanoma specialist, but fortunately, my husband responded to the treatment they offered. Kaiser said we would have to pay for a second opinion outside of Kaiser.

      It sounds like she is getting appropriate first line care. I am not sure you would gain much right now by seeing a specialist. There have been Kaiser people on this forum who did get a referral to a melanoma specialist, but it sounded like their cases were less straight forward then your case appears to be. Good luck

        • February 27, 2015 at 11:07 pm
        Marianne quinn
        Participant

        My husband had Yervoy through a clinical trial at Kaiser. I think the oncologists are a lot more comfortable with Yervoy now then they were 18 months ago when he first started. His general oncologist is very cautious and we had no problems managing the side effects. I think it is a good idea to get another opinion from a Kaiser doc for the time being if you are concerned, but I think Yervoy is the first line of treatment unless you can get into a clinical trial. 

        • February 27, 2015 at 11:07 pm
        Marianne quinn
        Participant

        My husband had Yervoy through a clinical trial at Kaiser. I think the oncologists are a lot more comfortable with Yervoy now then they were 18 months ago when he first started. His general oncologist is very cautious and we had no problems managing the side effects. I think it is a good idea to get another opinion from a Kaiser doc for the time being if you are concerned, but I think Yervoy is the first line of treatment unless you can get into a clinical trial. 

        • February 27, 2015 at 11:07 pm
        Marianne quinn
        Participant

        My husband had Yervoy through a clinical trial at Kaiser. I think the oncologists are a lot more comfortable with Yervoy now then they were 18 months ago when he first started. His general oncologist is very cautious and we had no problems managing the side effects. I think it is a good idea to get another opinion from a Kaiser doc for the time being if you are concerned, but I think Yervoy is the first line of treatment unless you can get into a clinical trial. 

        • February 28, 2015 at 1:09 am
        dmk252003
        Participant

        Hi Marianne

        I spoke to Riverside Kaiser and was told they are the only Kaiser in Southern California that has melanoma speciialists.

        My mom has an appointment next Friday.

        If I find out there is not a melanoma specialist, I will be pretty upset considering it is a long drive.

         

        • February 28, 2015 at 1:09 am
        dmk252003
        Participant

        Hi Marianne

        I spoke to Riverside Kaiser and was told they are the only Kaiser in Southern California that has melanoma speciialists.

        My mom has an appointment next Friday.

        If I find out there is not a melanoma specialist, I will be pretty upset considering it is a long drive.

         

        • February 28, 2015 at 1:09 am
        dmk252003
        Participant

        Hi Marianne

        I spoke to Riverside Kaiser and was told they are the only Kaiser in Southern California that has melanoma speciialists.

        My mom has an appointment next Friday.

        If I find out there is not a melanoma specialist, I will be pretty upset considering it is a long drive.

         

      • February 27, 2015 at 10:57 pm
      Marianne quinn
      Participant

      Kaiser does not have a melanoma specialist which is ridiculous. Kaiser has thousands of patients and makes lots of money. We were unable to get a referal to a melanoma specialist, but fortunately, my husband responded to the treatment they offered. Kaiser said we would have to pay for a second opinion outside of Kaiser.

      It sounds like she is getting appropriate first line care. I am not sure you would gain much right now by seeing a specialist. There have been Kaiser people on this forum who did get a referral to a melanoma specialist, but it sounded like their cases were less straight forward then your case appears to be. Good luck

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