Anal melanoma treatment

What were you expecting should be done differently?  Checking the sentinel node is more appropriate for cutaneous melanoma.  6 month scans are certainly not out of the ordinary.  There aren't any treatments for stage II melanoma — realistically, the only current "treatment" is for stage IV.  Anal melanoma is certainly rare, but you need to understand there are only so many options.  Clinical trials or stage IV treatments are really all that exist for melanoma except surgery.

Second opinions are always good, however.

What were you expecting should be done differently?  Checking the sentinel node is more appropriate for cutaneous melanoma.  6 month scans are certainly not out of the ordinary.  There aren't any treatments for stage II melanoma — realistically, the only current "treatment" is for stage IV.  Anal melanoma is certainly rare, but you need to understand there are only so many options.  Clinical trials or stage IV treatments are really all that exist for melanoma except surgery.

Second opinions are always good, however.

What were you expecting should be done differently?  Checking the sentinel node is more appropriate for cutaneous melanoma.  6 month scans are certainly not out of the ordinary.  There aren't any treatments for stage II melanoma — realistically, the only current "treatment" is for stage IV.  Anal melanoma is certainly rare, but you need to understand there are only so many options.  Clinical trials or stage IV treatments are really all that exist for melanoma except surgery.

Second opinions are always good, however.

To me, this sounds pretty standard. My father was Stage III at diagnosis with a clear PET/CT, and the standard of care called for re-checks with the oncologist every six months. Unfortunately, he developed new tumors after five months, and a follow-up scan showed metastases. It's my understanding that PET/CTs are not covered by insurance except when there is reason to suspect disease progression because they are so costly; otherwise, I'm sure they'd be routine. As for the lymph nodes, Dad's doctor checked those during the physical exam in the office. FYI: my dad's onc is one of the leaders in the field.

To me, this sounds pretty standard. My father was Stage III at diagnosis with a clear PET/CT, and the standard of care called for re-checks with the oncologist every six months. Unfortunately, he developed new tumors after five months, and a follow-up scan showed metastases. It's my understanding that PET/CTs are not covered by insurance except when there is reason to suspect disease progression because they are so costly; otherwise, I'm sure they'd be routine. As for the lymph nodes, Dad's doctor checked those during the physical exam in the office. FYI: my dad's onc is one of the leaders in the field.

To me, this sounds pretty standard. My father was Stage III at diagnosis with a clear PET/CT, and the standard of care called for re-checks with the oncologist every six months. Unfortunately, he developed new tumors after five months, and a follow-up scan showed metastases. It's my understanding that PET/CTs are not covered by insurance except when there is reason to suspect disease progression because they are so costly; otherwise, I'm sure they'd be routine. As for the lymph nodes, Dad's doctor checked those during the physical exam in the office. FYI: my dad's onc is one of the leaders in the field.

Full article is interesting.

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3241890/
"The main conclusion from this multi-center retrospective study patients with metastatic melanoma treated with HD IL-2 is that there was a statistically significant difference in the response rate (CR or PR) based on the tumor mutation status. Patients with NRAS mutations were more than twice as likely to respond to HD IL-2 than patients who were WT for NRAS (47% versus 19%, p=0.04). This is the first time that mutation status has been associated with response to HD IL-2 therapy for melanoma. We also observed a strong trend for a lower chance of response to HD IL2 among patients with elevated serum LDH, which also has not been reported previously."

Full article is interesting.

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3241890/
"The main conclusion from this multi-center retrospective study patients with metastatic melanoma treated with HD IL-2 is that there was a statistically significant difference in the response rate (CR or PR) based on the tumor mutation status. Patients with NRAS mutations were more than twice as likely to respond to HD IL-2 than patients who were WT for NRAS (47% versus 19%, p=0.04). This is the first time that mutation status has been associated with response to HD IL-2 therapy for melanoma. We also observed a strong trend for a lower chance of response to HD IL2 among patients with elevated serum LDH, which also has not been reported previously."

Full article is interesting.

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3241890/
"The main conclusion from this multi-center retrospective study patients with metastatic melanoma treated with HD IL-2 is that there was a statistically significant difference in the response rate (CR or PR) based on the tumor mutation status. Patients with NRAS mutations were more than twice as likely to respond to HD IL-2 than patients who were WT for NRAS (47% versus 19%, p=0.04). This is the first time that mutation status has been associated with response to HD IL-2 therapy for melanoma. We also observed a strong trend for a lower chance of response to HD IL2 among patients with elevated serum LDH, which also has not been reported previously."

What does “Access c kit Nras if recurs and follow expectantly.' Mean ?

C-kit and BRAF mutations are believed to be mutually exclusive, having never been found to o be co-located in any melanoma tumor.  BRAF and NRAS mutations have, at times, been found to be co-located in ones tumors.

As far as timing on the emergence of the melanoma tumors from the anus to the groin lymph nodes to the lungs, Yes, that can occur almost together.  My local surgeon never did any follow up after my second anal operation in July 2006   I found the melanoma in my groin lymph nodes within 5 months myself .  A PET scan in late Jan (after the groin operation) said my lungs were clear.  My “new” experienced melanoma specialist surgeon and researcher had an x-ray done to check on the lungs a  month after the groin operation, since this was the most likely location for melanoma to appear next.  . The x-ray in late February said something was suspicious.  The CT in early March 2007 said innumerable, rapidly growing melanoma tumors were then present in both lungs.  

        With ulceration and a mitosis rate greater than one, there should have been a consistent followup on the groin nodes and the lungs. This was poor followup.  I had ulceration and a low mitotic rate. 

Gleevec, has converted most GIST cases from an immediately catastrophic cancer into an ongoing manageable chronic problem. (Gleevec is still not FDA approved for c-kit melanoma.) I have been stable for 5 ¾ years now on the off-label usage of Gleevec for my c-kit melnoma. All growth, of all the doubly innumerable tumors, ceased withing 30 days of starting the cyctostatic targeted chemo, Gleevec.  I still here, still stable.  Would like further personal contct on mucosale melanoma followup.

What does “Access c kit Nras if recurs and follow expectantly.' Mean ?

C-kit and BRAF mutations are believed to be mutually exclusive, having never been found to o be co-located in any melanoma tumor.  BRAF and NRAS mutations have, at times, been found to be co-located in ones tumors.

As far as timing on the emergence of the melanoma tumors from the anus to the groin lymph nodes to the lungs, Yes, that can occur almost together.  My local surgeon never did any follow up after my second anal operation in July 2006   I found the melanoma in my groin lymph nodes within 5 months myself .  A PET scan in late Jan (after the groin operation) said my lungs were clear.  My “new” experienced melanoma specialist surgeon and researcher had an x-ray done to check on the lungs a  month after the groin operation, since this was the most likely location for melanoma to appear next.  . The x-ray in late February said something was suspicious.  The CT in early March 2007 said innumerable, rapidly growing melanoma tumors were then present in both lungs.  

        With ulceration and a mitosis rate greater than one, there should have been a consistent followup on the groin nodes and the lungs. This was poor followup.  I had ulceration and a low mitotic rate. 

Gleevec, has converted most GIST cases from an immediately catastrophic cancer into an ongoing manageable chronic problem. (Gleevec is still not FDA approved for c-kit melanoma.) I have been stable for 5 ¾ years now on the off-label usage of Gleevec for my c-kit melnoma. All growth, of all the doubly innumerable tumors, ceased withing 30 days of starting the cyctostatic targeted chemo, Gleevec.  I still here, still stable.  Would like further personal contct on mucosale melanoma followup.

What does “Access c kit Nras if recurs and follow expectantly.' Mean ?

C-kit and BRAF mutations are believed to be mutually exclusive, having never been found to o be co-located in any melanoma tumor.  BRAF and NRAS mutations have, at times, been found to be co-located in ones tumors.

As far as timing on the emergence of the melanoma tumors from the anus to the groin lymph nodes to the lungs, Yes, that can occur almost together.  My local surgeon never did any follow up after my second anal operation in July 2006   I found the melanoma in my groin lymph nodes within 5 months myself .  A PET scan in late Jan (after the groin operation) said my lungs were clear.  My “new” experienced melanoma specialist surgeon and researcher had an x-ray done to check on the lungs a  month after the groin operation, since this was the most likely location for melanoma to appear next.  . The x-ray in late February said something was suspicious.  The CT in early March 2007 said innumerable, rapidly growing melanoma tumors were then present in both lungs.  

        With ulceration and a mitosis rate greater than one, there should have been a consistent followup on the groin nodes and the lungs. This was poor followup.  I had ulceration and a low mitotic rate. 

Gleevec, has converted most GIST cases from an immediately catastrophic cancer into an ongoing manageable chronic problem. (Gleevec is still not FDA approved for c-kit melanoma.) I have been stable for 5 ¾ years now on the off-label usage of Gleevec for my c-kit melnoma. All growth, of all the doubly innumerable tumors, ceased withing 30 days of starting the cyctostatic targeted chemo, Gleevec.  I still here, still stable.  Would like further personal contct on mucosale melanoma followup.