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3A -decision time. Input appreciated!

Forums General Melanoma Community 3A -decision time. Input appreciated!

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      Hello all! I appreciate everyone who has posted here – all the posts have been so much help to me over the past 2 months from diagnosis to now.

      History: end of June had WLE (back) and had a SNB with one of 3 nodes removed testing positive.  

      I am currently at a point where I have to decide on adjuvant therapy- between doing the Yervoy therapy or watching with 3 month scans and derm appts.  Because I have a  low WBC generally, the dr and I have ruled out the only other available option- interferon.

      I am lucky to live in Boston with the great care of Dana Farber so I know I can't really make a bad choice.  I just seemed to be in analysis paralysis!  I have friends in cancer field who say immunotherapy is the way to go, but looks to me that it would only give me 20% reduction in chance of recurrence. And 25% chance of getting side effects which will put me in hospital? Numbers seem to point against doing it.  

      But is watching and waiting just putting me at bigger risk of the cancer – already activated from surgery -spreading?

      i can't get the Dr to just give me a decision- wouldn't that be easy?! 

      Any input you have appreciated either way. I have one more week to decide.  

      Best to everyone here!


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          3A is low risk, so doing observation is a really good option. Interferon shouldn't even be brought up, that is not an option ever anymore.. that'll for sure make you sick as a dog. With Ipi there is no guarantee you'll get a bad side effect, many have gone through it with only minor side effects. But, again, with 3A, many have done the observation and are still NED many years later and not dealing with side effect issues. There is no evidence that shows surgery "activates spreading" so no need to worry there. 


              I really have to speak up.  We went to Dana Farber 5 months ago excited to meet Steve Hodi, who is head of Melanoma Institute.  My husband is Stage 3b.  We were expecting to hear all about the latest and greatest treatment.  I almost fell off the chair when he said Interferon.  I said to him that's like 10 years old and only works in 10% of the people.  His comment was, actually that it is 20 years old and for the 10% it is worth it.  We left there extremely depressed, we had hoped for much more.  Being such a big cancer institute, our thoughts were how can you present this old of treatment! 

              So, in the end we did 3 out of 4 rounds of Yervoy at 10 mg.  He had to stop due to toxicity, scan next week.



              Hi Beth, My experience is similar to yours … even the location of my initial melanoma.  I too am 3a.  I saw Dr. Kirkwood at Hillman Cancer Center and his only recommendation was to send me back to my local oncologist and do interferon.  My local oncologist told me to seek a 2nd opinion.  I saw Dr. Schucter at Penn Medical Center in Philadelphia and she recommendated no treatment but if I wanted to persue treatment, she would send pre-approval for my insurance to approve Yervoy at 3mg.  My insurance did approve and I have been on that treatment plan for a year.  Had my insurance not approved Yervoy at 3 mg, I would have done watch and wait rather than interferon.  

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