› Forums › General Melanoma Community › Curious on adjuvant treatment for stage 3
- This topic has 39 replies, 9 voices, and was last updated 7 years, 10 months ago by
Georgi524.
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- July 18, 2016 at 1:48 pm
I am trying to learn as much as possible from the experiences of others when choosing treatment options when you are stage 3 or 4. My personal experience has been that Dr.s shy away from yervoy and recommend interferon. There is an emphasis with the toxicity and the side effects of yervoy.
I am not sure if I am over simplifying things but I don't understand why the potential side effects are a reason to stear a patient from the treatment if it is in fact the best option to become NED or at least increase OSR. I know immunotherapy isn't a guarantee to beat melanoma but it sures seems like a better option than interferon.
My Dr.s options given to me:
1) DO NOTHING AND BE STAGE 4 IN 12 MONTHS.
2) INTERFERON AND BE SICK FOR AS LONG AS YOU TAKE IT BUT THERE ARE NO STUDIES TO SUPPORT IT REALLY HELPS.
3) YERVOY 3 OR 10 MG WOULD GIVE ME A 50-50 CHANCE AT BEING NED.
I chose Yervoy 10 mg and he tried for a week to get me to change my mind. I have currently finished 3 doses with minimal side effects yet. I know they may kick my butt soon but very happy I gave yervoy a chance. I don't know what tomorrow holds but I want what I feel gives me the best chances NOT what the Dr. feels is the traditional treatment because noone dies from it.
I am curious for the input of people that have had similar experiences when choosing treatment or adjuvant therapies.
- Replies
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- July 18, 2016 at 2:49 pm
Hi Lee, it is very interesting indeed to have Ipi help up to be the toxic one and Interferon sound safe when in fact there have been cases of suicides attributed to depression causes by the use of Interferon. I remember my month of high dose Interferon back in 2012 like it was yesterday. Interferon can cause a lot of damage as well to the liver, I remember them having to continually reduce my dose amount each week as I got sicker and sicker. I think the main reason why some Oncologist are being carefull about giving Ipi, is the 10mg/kg amount that was approved at, while the level for stage 4 patients is 3mg/kg, if I remember the dose level correctly. Make sure to tell your Oncologist of any side effects, like increase in diarrhea or skin rash. I hope you continue to have a smooth ride. Best wishes!!!Ed
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- July 18, 2016 at 2:51 pm
Oh ya, I had a link from ASCO about Interferon side effects that I forgot to add above. http://jco.ascopubs.org/content/20/17/3703.short
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- July 18, 2016 at 2:51 pm
Oh ya, I had a link from ASCO about Interferon side effects that I forgot to add above. http://jco.ascopubs.org/content/20/17/3703.short
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- July 18, 2016 at 2:51 pm
Oh ya, I had a link from ASCO about Interferon side effects that I forgot to add above. http://jco.ascopubs.org/content/20/17/3703.short
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- July 18, 2016 at 2:49 pm
Hi Lee, it is very interesting indeed to have Ipi help up to be the toxic one and Interferon sound safe when in fact there have been cases of suicides attributed to depression causes by the use of Interferon. I remember my month of high dose Interferon back in 2012 like it was yesterday. Interferon can cause a lot of damage as well to the liver, I remember them having to continually reduce my dose amount each week as I got sicker and sicker. I think the main reason why some Oncologist are being carefull about giving Ipi, is the 10mg/kg amount that was approved at, while the level for stage 4 patients is 3mg/kg, if I remember the dose level correctly. Make sure to tell your Oncologist of any side effects, like increase in diarrhea or skin rash. I hope you continue to have a smooth ride. Best wishes!!!Ed
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- July 18, 2016 at 2:49 pm
Hi Lee, it is very interesting indeed to have Ipi help up to be the toxic one and Interferon sound safe when in fact there have been cases of suicides attributed to depression causes by the use of Interferon. I remember my month of high dose Interferon back in 2012 like it was yesterday. Interferon can cause a lot of damage as well to the liver, I remember them having to continually reduce my dose amount each week as I got sicker and sicker. I think the main reason why some Oncologist are being carefull about giving Ipi, is the 10mg/kg amount that was approved at, while the level for stage 4 patients is 3mg/kg, if I remember the dose level correctly. Make sure to tell your Oncologist of any side effects, like increase in diarrhea or skin rash. I hope you continue to have a smooth ride. Best wishes!!!Ed
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- July 18, 2016 at 3:36 pm
I am in the UK. I really struggle to understand why interferon is still being offered in the USA. From reading posts on this website, the short term side effects sound awful and some of the long-term side effects sound terrifiying. Looking at the research, the chances of interferon doing some good are very, very low.
However, I do not understand where you got to 50:50 chance with ipi/Yervoy. I was told 15% of patients respond and not all the responders who get to NED remian so. The data I saw was that if you make it past 3 years NED after ipi, the odds are you will make it to 10 years. There was no large-scale data beyond 10 years.
Don't get me wrong. I am a grateful ipi-responder (3mg/kg, four infusions, no maintenance doses). Huge upside: tumours shrank and I was NED at my last two scans. Downside: my anterior pituitary gland no longer functions, which has wiped out a chunk of my endocrine system.
My melanoma specialist did not even mention interferon and, as far as I know, it is not on offer in the UK by the NHS as an approved treatment for any stage of melanoma. That means it has not got through NICE, which insists that there are measurable benefits given the cost.
Ipi (Yervoy) and anti-PD-1 (e.g. nivo) have been approved and the combination is in the pipeline.
No adjuvant treatments for after-surgery stage 3 have been approved yet by the NHS. I got ipi because I could not have surgery.
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- July 18, 2016 at 3:36 pm
I am in the UK. I really struggle to understand why interferon is still being offered in the USA. From reading posts on this website, the short term side effects sound awful and some of the long-term side effects sound terrifiying. Looking at the research, the chances of interferon doing some good are very, very low.
However, I do not understand where you got to 50:50 chance with ipi/Yervoy. I was told 15% of patients respond and not all the responders who get to NED remian so. The data I saw was that if you make it past 3 years NED after ipi, the odds are you will make it to 10 years. There was no large-scale data beyond 10 years.
Don't get me wrong. I am a grateful ipi-responder (3mg/kg, four infusions, no maintenance doses). Huge upside: tumours shrank and I was NED at my last two scans. Downside: my anterior pituitary gland no longer functions, which has wiped out a chunk of my endocrine system.
My melanoma specialist did not even mention interferon and, as far as I know, it is not on offer in the UK by the NHS as an approved treatment for any stage of melanoma. That means it has not got through NICE, which insists that there are measurable benefits given the cost.
Ipi (Yervoy) and anti-PD-1 (e.g. nivo) have been approved and the combination is in the pipeline.
No adjuvant treatments for after-surgery stage 3 have been approved yet by the NHS. I got ipi because I could not have surgery.
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- July 18, 2016 at 3:36 pm
I am in the UK. I really struggle to understand why interferon is still being offered in the USA. From reading posts on this website, the short term side effects sound awful and some of the long-term side effects sound terrifiying. Looking at the research, the chances of interferon doing some good are very, very low.
However, I do not understand where you got to 50:50 chance with ipi/Yervoy. I was told 15% of patients respond and not all the responders who get to NED remian so. The data I saw was that if you make it past 3 years NED after ipi, the odds are you will make it to 10 years. There was no large-scale data beyond 10 years.
Don't get me wrong. I am a grateful ipi-responder (3mg/kg, four infusions, no maintenance doses). Huge upside: tumours shrank and I was NED at my last two scans. Downside: my anterior pituitary gland no longer functions, which has wiped out a chunk of my endocrine system.
My melanoma specialist did not even mention interferon and, as far as I know, it is not on offer in the UK by the NHS as an approved treatment for any stage of melanoma. That means it has not got through NICE, which insists that there are measurable benefits given the cost.
Ipi (Yervoy) and anti-PD-1 (e.g. nivo) have been approved and the combination is in the pipeline.
No adjuvant treatments for after-surgery stage 3 have been approved yet by the NHS. I got ipi because I could not have surgery.
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- July 18, 2016 at 4:55 pm
Hi Lee,
Great news, and excellent choice you made. I just don't understand the constant barrage, even here on this site against Yervoy, even at 10mg. There are many, like you, who do not suffer serious side-effects. There is always an assumption of the worst by many. So good for you, and yes, immunotherapy has a much better chance of beating back the beast than interferon which has such a poor track record. One thing to note. Since your doctor was so insistent on interferon, I suspect he/she is not a genuine melanoma specialist, one that ONLY treats melanoma patients. If I'm right, find yourself a specialist even if you have to travel to get the care you deserve. I must say that as strange as it sounds, if you do progress to stage IV in spite of current treatment, many new and more aggressive approaches become available, but we will all hope that you stop the spread in its tracks right now.
Gary
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- July 18, 2016 at 4:55 pm
Hi Lee,
Great news, and excellent choice you made. I just don't understand the constant barrage, even here on this site against Yervoy, even at 10mg. There are many, like you, who do not suffer serious side-effects. There is always an assumption of the worst by many. So good for you, and yes, immunotherapy has a much better chance of beating back the beast than interferon which has such a poor track record. One thing to note. Since your doctor was so insistent on interferon, I suspect he/she is not a genuine melanoma specialist, one that ONLY treats melanoma patients. If I'm right, find yourself a specialist even if you have to travel to get the care you deserve. I must say that as strange as it sounds, if you do progress to stage IV in spite of current treatment, many new and more aggressive approaches become available, but we will all hope that you stop the spread in its tracks right now.
Gary
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- July 18, 2016 at 9:27 pm
Lee,
I am in the same exact boat you are in. I am Stage 3a and do not qualify for the clinical trial at HIllman Cancer center because I had 1 lymph node positive and not 2. So Dr. Kirkwood at Hillman Cancer Center in PIttsburgh is recommending interferon. He says I don't want to do Yervoy at 10 mg because of it being so toxic. And interferon is not???? I am so frustrated right now. I am refusing interferon.
I am meeting with Dr. Schucter tomorrow in Philadelphia to see if she has any other options for me. If she does not have any other options for me, I will go back to Kirkwood and insist on Yervoy.
Have you or anyone else considered contacting Mercek or Bristol Myers to see if you can get Keytruda or Opdivo outside of a clinical trial? I don't even know if this can be done or even an option.
Glad to hear your side effects have been min with Yervoy.
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- July 18, 2016 at 9:27 pm
Lee,
I am in the same exact boat you are in. I am Stage 3a and do not qualify for the clinical trial at HIllman Cancer center because I had 1 lymph node positive and not 2. So Dr. Kirkwood at Hillman Cancer Center in PIttsburgh is recommending interferon. He says I don't want to do Yervoy at 10 mg because of it being so toxic. And interferon is not???? I am so frustrated right now. I am refusing interferon.
I am meeting with Dr. Schucter tomorrow in Philadelphia to see if she has any other options for me. If she does not have any other options for me, I will go back to Kirkwood and insist on Yervoy.
Have you or anyone else considered contacting Mercek or Bristol Myers to see if you can get Keytruda or Opdivo outside of a clinical trial? I don't even know if this can be done or even an option.
Glad to hear your side effects have been min with Yervoy.
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- July 19, 2016 at 2:18 am
For stage IIIa, you cannot get Keytruda or Opdivo outside of a clinical trial. It is only FDA approved for stage IV at this point. The clinical trials are to see if it is at all effective as an adjuvant therapy and until they see those results, it won't be available for stage 3.
The only approved therapies (translate insurance will pay and doctors will prescribe) are Interferon and Yervoy 10mg. Some docs MIGHT get away with prescribing the 3mg Yervoy "off label" (meaning approved treatment but not approved for this situation) but most doctors won't do this and most insurances won't cover off label.
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- July 19, 2016 at 2:18 am
For stage IIIa, you cannot get Keytruda or Opdivo outside of a clinical trial. It is only FDA approved for stage IV at this point. The clinical trials are to see if it is at all effective as an adjuvant therapy and until they see those results, it won't be available for stage 3.
The only approved therapies (translate insurance will pay and doctors will prescribe) are Interferon and Yervoy 10mg. Some docs MIGHT get away with prescribing the 3mg Yervoy "off label" (meaning approved treatment but not approved for this situation) but most doctors won't do this and most insurances won't cover off label.
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- July 19, 2016 at 2:18 am
For stage IIIa, you cannot get Keytruda or Opdivo outside of a clinical trial. It is only FDA approved for stage IV at this point. The clinical trials are to see if it is at all effective as an adjuvant therapy and until they see those results, it won't be available for stage 3.
The only approved therapies (translate insurance will pay and doctors will prescribe) are Interferon and Yervoy 10mg. Some docs MIGHT get away with prescribing the 3mg Yervoy "off label" (meaning approved treatment but not approved for this situation) but most doctors won't do this and most insurances won't cover off label.
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- July 18, 2016 at 9:27 pm
Lee,
I am in the same exact boat you are in. I am Stage 3a and do not qualify for the clinical trial at HIllman Cancer center because I had 1 lymph node positive and not 2. So Dr. Kirkwood at Hillman Cancer Center in PIttsburgh is recommending interferon. He says I don't want to do Yervoy at 10 mg because of it being so toxic. And interferon is not???? I am so frustrated right now. I am refusing interferon.
I am meeting with Dr. Schucter tomorrow in Philadelphia to see if she has any other options for me. If she does not have any other options for me, I will go back to Kirkwood and insist on Yervoy.
Have you or anyone else considered contacting Mercek or Bristol Myers to see if you can get Keytruda or Opdivo outside of a clinical trial? I don't even know if this can be done or even an option.
Glad to hear your side effects have been min with Yervoy.
-
- July 18, 2016 at 4:55 pm
Hi Lee,
Great news, and excellent choice you made. I just don't understand the constant barrage, even here on this site against Yervoy, even at 10mg. There are many, like you, who do not suffer serious side-effects. There is always an assumption of the worst by many. So good for you, and yes, immunotherapy has a much better chance of beating back the beast than interferon which has such a poor track record. One thing to note. Since your doctor was so insistent on interferon, I suspect he/she is not a genuine melanoma specialist, one that ONLY treats melanoma patients. If I'm right, find yourself a specialist even if you have to travel to get the care you deserve. I must say that as strange as it sounds, if you do progress to stage IV in spite of current treatment, many new and more aggressive approaches become available, but we will all hope that you stop the spread in its tracks right now.
Gary
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- July 18, 2016 at 9:53 pm
Hi Lee,
Sorry you're going through this. I'm curious – did you change Dr's since you were prescribed Yervoy? Since you're on Yervoy and (so far) tolerating it well – why would the Doctor recommend taking you off of it?
Anyway, interferon is being used less and less by the major melanoma centers due to most studies showing it does not improve survivability. I think Yervoy is a better choice. Another question: Is Dr. Khanna a melanoma specialist? As trricky as this disease is, it's best to have a specilaist look after your care.
Finally – a suggestion: IF you're not sure of your doctor's approach, get a second opinion from another specialist.
Good luck!
Stan
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- July 18, 2016 at 9:53 pm
Hi Lee,
Sorry you're going through this. I'm curious – did you change Dr's since you were prescribed Yervoy? Since you're on Yervoy and (so far) tolerating it well – why would the Doctor recommend taking you off of it?
Anyway, interferon is being used less and less by the major melanoma centers due to most studies showing it does not improve survivability. I think Yervoy is a better choice. Another question: Is Dr. Khanna a melanoma specialist? As trricky as this disease is, it's best to have a specilaist look after your care.
Finally – a suggestion: IF you're not sure of your doctor's approach, get a second opinion from another specialist.
Good luck!
Stan
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- July 18, 2016 at 10:37 pm
I should have been a little more clear on my situation.I had left groin lymph node removal in March and my pet scan was clear so my visible melanoma had been resected. I am not sure where his odds came from on the 50-50. To me it was like saying I don't know but it is better than interferon odds. I was the first patient he had allowed to receive the 10 mg dose.
And no, he is not a melanoma specialist and yes I am in the process of changing to a melanoma Dr. I will be going to Duke University next week. I have learned that a melanoma Dr. is essential even if it is a 4 hour drive.
To answer a few of you:
Greg: I really am not sure if the 10 mg dose of yervoy is recomended for stage 3 adjuvant therapy. I finally got so sick of arguing that I said this is what I am going to get. I live in fear everyday that the side effects are going to attack any day.
MoiraM: I don't know where the odds came from. They seemed fairly standard based on my stage diagnosis with all melanoma resected. He did tell me that only 10-15% of people were total responders so maybe that's where that figure comes from. I pray I can make my last dose without event. I will be looking for my melanoma troop to keep me company on here if I get my butt kicked.
Polymath: You are right on. No he is not a melanoma specialist. I am going to one at Duke in Durham next week to read my latest pet scan.I appreciate the words of encouragement.
Laulamb: I really do feel your pain. It is so frustrating untangling red tape when you feel like, Let's get it rolling now! I have not tried anything other than Ipi. Other than what I have read on those, I have no personal experience. Keep fighting and let the Docs know, you are the boss, they are the advisor.
Sabklyn: To answer your question I didn't change Dr.s because I had finally gotten my yervoy started. I however am going to add a Melanoma Dr. into the mix as the main Dr. I was afraid to change after I finally got my treatment started. I will be travelling 4 hours to Duke next week to get her input. At this point, I still don't know if I am even a responder or not. But she is in charge of treatment after I finish Ipi.
I wanted to see if others have had or are having the same issues as I have. We are told there are immunotherapies with better results than the traditional treatment. But the Doc recommends the traditional treatment. This is such a vicious and scary disease. You want Dr.s that will include you in the treatment rather than yes there is a better option but I don't recomend it.
Things I have learned in my short journey.
1) Melanoma Dr is a must
2) Be your voice! Don't do a treatment you don't want if you feel there is a better choice.
3) Yes there are side effects to immuntherapy but there is a much worse side effect to spreading melanoma.
4) I never want to say the words, I wish I had followed my choice of treatment when I had the chance.
I appreciate everyone responding. It means a lot to me and thank you for taking the time!!!! Hopefully if there is anyone with anxiety about Ipi, just tell yourself, if that old corn fed coal miner could try it, why not me?
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- July 18, 2016 at 10:37 pm
I should have been a little more clear on my situation.I had left groin lymph node removal in March and my pet scan was clear so my visible melanoma had been resected. I am not sure where his odds came from on the 50-50. To me it was like saying I don't know but it is better than interferon odds. I was the first patient he had allowed to receive the 10 mg dose.
And no, he is not a melanoma specialist and yes I am in the process of changing to a melanoma Dr. I will be going to Duke University next week. I have learned that a melanoma Dr. is essential even if it is a 4 hour drive.
To answer a few of you:
Greg: I really am not sure if the 10 mg dose of yervoy is recomended for stage 3 adjuvant therapy. I finally got so sick of arguing that I said this is what I am going to get. I live in fear everyday that the side effects are going to attack any day.
MoiraM: I don't know where the odds came from. They seemed fairly standard based on my stage diagnosis with all melanoma resected. He did tell me that only 10-15% of people were total responders so maybe that's where that figure comes from. I pray I can make my last dose without event. I will be looking for my melanoma troop to keep me company on here if I get my butt kicked.
Polymath: You are right on. No he is not a melanoma specialist. I am going to one at Duke in Durham next week to read my latest pet scan.I appreciate the words of encouragement.
Laulamb: I really do feel your pain. It is so frustrating untangling red tape when you feel like, Let's get it rolling now! I have not tried anything other than Ipi. Other than what I have read on those, I have no personal experience. Keep fighting and let the Docs know, you are the boss, they are the advisor.
Sabklyn: To answer your question I didn't change Dr.s because I had finally gotten my yervoy started. I however am going to add a Melanoma Dr. into the mix as the main Dr. I was afraid to change after I finally got my treatment started. I will be travelling 4 hours to Duke next week to get her input. At this point, I still don't know if I am even a responder or not. But she is in charge of treatment after I finish Ipi.
I wanted to see if others have had or are having the same issues as I have. We are told there are immunotherapies with better results than the traditional treatment. But the Doc recommends the traditional treatment. This is such a vicious and scary disease. You want Dr.s that will include you in the treatment rather than yes there is a better option but I don't recomend it.
Things I have learned in my short journey.
1) Melanoma Dr is a must
2) Be your voice! Don't do a treatment you don't want if you feel there is a better choice.
3) Yes there are side effects to immuntherapy but there is a much worse side effect to spreading melanoma.
4) I never want to say the words, I wish I had followed my choice of treatment when I had the chance.
I appreciate everyone responding. It means a lot to me and thank you for taking the time!!!! Hopefully if there is anyone with anxiety about Ipi, just tell yourself, if that old corn fed coal miner could try it, why not me?
-
- July 18, 2016 at 10:37 pm
I should have been a little more clear on my situation.I had left groin lymph node removal in March and my pet scan was clear so my visible melanoma had been resected. I am not sure where his odds came from on the 50-50. To me it was like saying I don't know but it is better than interferon odds. I was the first patient he had allowed to receive the 10 mg dose.
And no, he is not a melanoma specialist and yes I am in the process of changing to a melanoma Dr. I will be going to Duke University next week. I have learned that a melanoma Dr. is essential even if it is a 4 hour drive.
To answer a few of you:
Greg: I really am not sure if the 10 mg dose of yervoy is recomended for stage 3 adjuvant therapy. I finally got so sick of arguing that I said this is what I am going to get. I live in fear everyday that the side effects are going to attack any day.
MoiraM: I don't know where the odds came from. They seemed fairly standard based on my stage diagnosis with all melanoma resected. He did tell me that only 10-15% of people were total responders so maybe that's where that figure comes from. I pray I can make my last dose without event. I will be looking for my melanoma troop to keep me company on here if I get my butt kicked.
Polymath: You are right on. No he is not a melanoma specialist. I am going to one at Duke in Durham next week to read my latest pet scan.I appreciate the words of encouragement.
Laulamb: I really do feel your pain. It is so frustrating untangling red tape when you feel like, Let's get it rolling now! I have not tried anything other than Ipi. Other than what I have read on those, I have no personal experience. Keep fighting and let the Docs know, you are the boss, they are the advisor.
Sabklyn: To answer your question I didn't change Dr.s because I had finally gotten my yervoy started. I however am going to add a Melanoma Dr. into the mix as the main Dr. I was afraid to change after I finally got my treatment started. I will be travelling 4 hours to Duke next week to get her input. At this point, I still don't know if I am even a responder or not. But she is in charge of treatment after I finish Ipi.
I wanted to see if others have had or are having the same issues as I have. We are told there are immunotherapies with better results than the traditional treatment. But the Doc recommends the traditional treatment. This is such a vicious and scary disease. You want Dr.s that will include you in the treatment rather than yes there is a better option but I don't recomend it.
Things I have learned in my short journey.
1) Melanoma Dr is a must
2) Be your voice! Don't do a treatment you don't want if you feel there is a better choice.
3) Yes there are side effects to immuntherapy but there is a much worse side effect to spreading melanoma.
4) I never want to say the words, I wish I had followed my choice of treatment when I had the chance.
I appreciate everyone responding. It means a lot to me and thank you for taking the time!!!! Hopefully if there is anyone with anxiety about Ipi, just tell yourself, if that old corn fed coal miner could try it, why not me?
-
- July 19, 2016 at 12:14 am
Awesome, thank you.
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- July 19, 2016 at 12:14 am
Awesome, thank you.
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- July 19, 2016 at 12:14 am
Awesome, thank you.
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- July 18, 2016 at 9:53 pm
Hi Lee,
Sorry you're going through this. I'm curious – did you change Dr's since you were prescribed Yervoy? Since you're on Yervoy and (so far) tolerating it well – why would the Doctor recommend taking you off of it?
Anyway, interferon is being used less and less by the major melanoma centers due to most studies showing it does not improve survivability. I think Yervoy is a better choice. Another question: Is Dr. Khanna a melanoma specialist? As trricky as this disease is, it's best to have a specilaist look after your care.
Finally – a suggestion: IF you're not sure of your doctor's approach, get a second opinion from another specialist.
Good luck!
Stan
-
- July 19, 2016 at 1:25 am
Congrats on your success so far avoiding Yervoy side effects and I wish you the best for continued health. If I were in your shoes, I would've made the same choice. I was in similar shoes to you two years ago and I chose Interferon (the only choice available at the time). There are a number of credible arguments to be made for and against Yervoy as an adjuvant therapy, and doctors, including the big time Melanoma experts, do not always agree on the best course of action. Stage 3 is always the most fruitful area for disagreement (and fights) on these boards and I suspect it will remain that way for a while. Unfortunately, there is no silver bullet for Stage 3.
At the end of the day, you made an informed decision that is reasonable, supported by evidence of some increase in relapse-free survival and that you feel good about. You're an active participant in your own care and that will serve you well down the road if you need to make any more hard choices, which hopefully you don't.
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- July 19, 2016 at 1:25 am
Congrats on your success so far avoiding Yervoy side effects and I wish you the best for continued health. If I were in your shoes, I would've made the same choice. I was in similar shoes to you two years ago and I chose Interferon (the only choice available at the time). There are a number of credible arguments to be made for and against Yervoy as an adjuvant therapy, and doctors, including the big time Melanoma experts, do not always agree on the best course of action. Stage 3 is always the most fruitful area for disagreement (and fights) on these boards and I suspect it will remain that way for a while. Unfortunately, there is no silver bullet for Stage 3.
At the end of the day, you made an informed decision that is reasonable, supported by evidence of some increase in relapse-free survival and that you feel good about. You're an active participant in your own care and that will serve you well down the road if you need to make any more hard choices, which hopefully you don't.
-
- July 19, 2016 at 1:25 am
Congrats on your success so far avoiding Yervoy side effects and I wish you the best for continued health. If I were in your shoes, I would've made the same choice. I was in similar shoes to you two years ago and I chose Interferon (the only choice available at the time). There are a number of credible arguments to be made for and against Yervoy as an adjuvant therapy, and doctors, including the big time Melanoma experts, do not always agree on the best course of action. Stage 3 is always the most fruitful area for disagreement (and fights) on these boards and I suspect it will remain that way for a while. Unfortunately, there is no silver bullet for Stage 3.
At the end of the day, you made an informed decision that is reasonable, supported by evidence of some increase in relapse-free survival and that you feel good about. You're an active participant in your own care and that will serve you well down the road if you need to make any more hard choices, which hopefully you don't.
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