› Forums › General Melanoma Community › Bronchoscopy scheduled – matted nodes
- This topic has 6 replies, 3 voices, and was last updated 14 years, 7 months ago by
MariaH.
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- June 29, 2011 at 10:02 pm
My husband Dave and I met with the thoracic surgeon today and scheduled a bronchoscopy for Friday. The mass seen in Dave's CT scan is multiple matted lymph nodes (the largest measuring 3.7 cm in short axis). We were told that it is not surgically resectable. The biopsy will reveal whether it is the melanoma coming back or possibly a lymphoma. Regardless of what it is, it looks as though since we can't cut it out, and systematic treatment is on the horizon. My question, though, is if it IS melanoma, do we try IL-2 first and then switch to
My husband Dave and I met with the thoracic surgeon today and scheduled a bronchoscopy for Friday. The mass seen in Dave's CT scan is multiple matted lymph nodes (the largest measuring 3.7 cm in short axis). We were told that it is not surgically resectable. The biopsy will reveal whether it is the melanoma coming back or possibly a lymphoma. Regardless of what it is, it looks as though since we can't cut it out, and systematic treatment is on the horizon. My question, though, is if it IS melanoma, do we try IL-2 first and then switch to IPI if it doesn't work? Or has IPI shown to wipe out melanoma (not just prolong survival)?
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- June 30, 2011 at 10:21 am
If the biopsy confirms that it is melanoma, then there are a number of options to
consider. As surgery is always the preferred option for something like this, perhaps it
would be wise to get a second opinion from a surgical oncologist. Local radiation
treatment can also be used, and that may control the growth of the tumours for some time.IL-2 could be tried first, but it is a very difficult treatment for many patients. Yervoy
(ipi) is a much newer drug that may work better with milder adverse effects.
Unfortunately, no available drug is guaranteed to completely eradicate melanoma for an
extended period of time. The best that most people can hope for is that the cancer is kept
under control until better drugs are developed. Of course, surgery should also be used if
possible.A different approach that does seem to be very promising is adoptive cell therapy (also
called TIL treatment). It looks like this offers the greatest chance of achieving durable
remission in some cases.Hope this helps.
Frank from Australia
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- June 30, 2011 at 10:21 am
If the biopsy confirms that it is melanoma, then there are a number of options to
consider. As surgery is always the preferred option for something like this, perhaps it
would be wise to get a second opinion from a surgical oncologist. Local radiation
treatment can also be used, and that may control the growth of the tumours for some time.IL-2 could be tried first, but it is a very difficult treatment for many patients. Yervoy
(ipi) is a much newer drug that may work better with milder adverse effects.
Unfortunately, no available drug is guaranteed to completely eradicate melanoma for an
extended period of time. The best that most people can hope for is that the cancer is kept
under control until better drugs are developed. Of course, surgery should also be used if
possible.A different approach that does seem to be very promising is adoptive cell therapy (also
called TIL treatment). It looks like this offers the greatest chance of achieving durable
remission in some cases.Hope this helps.
Frank from Australia
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- June 30, 2011 at 1:41 pm
Dear Maria, I am sorry that this is the outcome so far. I am not knowledgeable enough about IL-2 or IPI to know which is on what base, when. You probably have thought of this: but when this brochoscopy is done, when the facts are in front of you, the do-able 2nd opinion route from our geographic area would seem to be James Wilmot Cancer Center in Rochester or U of Penn (Dr. Kirkwood) in Pittsburgh. Maybe you already know of those two places; I just wanted to put them in your mind b/c you will probably hear about getting a 2nd opinion. Roswell is up on melanoma treatments, but sometimes doctors differ in their approaches.
I do know of a mel patient who had brain mets and Roswell wouldn't do what she wanted (which was to buy a little more time by zapping the buggers) and James Wilmot in Rochester concurred with her. She got her Christmas with her family. I am not suggesting that Dave is at that level. My point is that geographically these aren't that far away for another opinion if you and Dave aren't comfortable with the approaches offered at RPCI. Often when I read of patients going to highly recommended cancer facilities, I become curious as to the $$$ involved in this process, the travel from north to south, etc. UPenn is an excellent facility, and a realistic, driveable destination for us. My best and frequent prayers will be for Dave for a good outcome on Friday. I pray that the outcome will be readily treatable and that you will be blessed with good advice and resources available to assist you and your family I just hate that this is happening. ~~Carol
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- June 30, 2011 at 1:41 pm
Dear Maria, I am sorry that this is the outcome so far. I am not knowledgeable enough about IL-2 or IPI to know which is on what base, when. You probably have thought of this: but when this brochoscopy is done, when the facts are in front of you, the do-able 2nd opinion route from our geographic area would seem to be James Wilmot Cancer Center in Rochester or U of Penn (Dr. Kirkwood) in Pittsburgh. Maybe you already know of those two places; I just wanted to put them in your mind b/c you will probably hear about getting a 2nd opinion. Roswell is up on melanoma treatments, but sometimes doctors differ in their approaches.
I do know of a mel patient who had brain mets and Roswell wouldn't do what she wanted (which was to buy a little more time by zapping the buggers) and James Wilmot in Rochester concurred with her. She got her Christmas with her family. I am not suggesting that Dave is at that level. My point is that geographically these aren't that far away for another opinion if you and Dave aren't comfortable with the approaches offered at RPCI. Often when I read of patients going to highly recommended cancer facilities, I become curious as to the $$$ involved in this process, the travel from north to south, etc. UPenn is an excellent facility, and a realistic, driveable destination for us. My best and frequent prayers will be for Dave for a good outcome on Friday. I pray that the outcome will be readily treatable and that you will be blessed with good advice and resources available to assist you and your family I just hate that this is happening. ~~Carol
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- June 30, 2011 at 9:28 pm
Carol, you read my mind. My next question was where to go for a second opinion. Wilmot was where Dave was originally supposed to go when he was DX'd in 2008, but they didn't take his insurance at the time. We have since changed insurance, and we will be going there – U of Penn is going be after that if I don't like what Wilmot says. I want a doctor who is willing to work with us – not give is a "sorry" and be on our way.
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- June 30, 2011 at 9:28 pm
Carol, you read my mind. My next question was where to go for a second opinion. Wilmot was where Dave was originally supposed to go when he was DX'd in 2008, but they didn't take his insurance at the time. We have since changed insurance, and we will be going there – U of Penn is going be after that if I don't like what Wilmot says. I want a doctor who is willing to work with us – not give is a "sorry" and be on our way.
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