› Forums › General Melanoma Community › Has anyone used Imiquimod cream for insitu melanoma on nose?
- This topic has 19 replies, 6 voices, and was last updated 5 years, 4 months ago by
Hopeful19.
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- October 1, 2015 at 11:07 am
I have melanoma insitu on my nostril. Everything I read and the couple of doctors i have seen want to do MOHS surgery which has the potential to take off half my nose if not more depending on whether they get clear margins. The unknown of not knowing where the stopping point is is terrifying me. Maybe to the point I'm willing to not do anything. Since it is insitu it may take a long time to spread if it and when it does spread – right?? I've heard a little about this Imiquimod cream. Does anyone know anything about it? I've heard that it is sometimes used when the potential for disfigurement is a possibility. It just seems like i'm hearing so many cases of having it and then having surgery and then having it reappear somewhere else. An endless cycle. How many people out there are walking around clueless that they may have this and live a fairly long fulfilling life without the constant fear that now invades me. I think sometimes we are our worst enemies by trying to always be one step ahead of our health. Don't get me wrong, i have always been proactive in my health care. But i am just having a heard time believing that by cutting off half my face that my life is going to be so much better. Depression will surely set in and succomb a portion of my time before i get back on my feet and rise above it. When talking to people i feel like i am the only one who feels this way. You say the word cancer and everyones life immediately changes because they choose to try to defeat it. Quality of life is more important than quantity in my opinion. People suffer through chemo and all of these treatments that are out for what?? I few extra years on their life. I've always heard once you cut on someone for cancer it has a greater chance of spreading and there are cases where i honestly believe this. One minute i am ready for surgery the next no way. I don't know how to be at peace with either answer. Anyhow, thanks for listening and GOD be with all of you.
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- October 1, 2015 at 11:41 am
Hi
I think I remember you posting a week or so ago, or someone in a very similar situation to you. I'm sorry that you are really struggling with this. I think you will find that when you finally choose to act, whichever path you take, you will feel a whole lot better. This period of indecision is probably the worst of it. It's an awful situation to be in, and indecision makes it worse.
What you have is a melanoma in situ. It has no metastatic potential. You are the luckiest of the lucky. However, if you choose to take a risk of leaving some or all of that melanoma in situ on your skin, it may evolve into an invasive melanoma. For now, fortunately, you have a pretty much 100% curable melanoma. I hope over time this becomes a source of peace for you, not a source of stress as it is now.
So your choice is how to cure it. Well, there's imiquimod. Some say its got potential:
http://www.ncbi.nlm.nih.gov/pubmed/22338583
Others say it can actually cause skin cancer
http://www.hindawi.com/journals/crim/2014/267535/
To my mind, it's a very distant second to surgical excision. However, I really feel that you need to have a good heart to heart with a good plastic surgeon about your very valid concerns about disfigurement, and whether surgery can be done with minimal disfigurement OR an alternative like Imiquimod.
I think you need to have a good think about what 'doing nothing' means, as in doing nothing at all in the way of treatment. It could mean that all melanoma is already gone with initial excision (unlikely) and you never hear of it again. It could mean that although some is left but it remains in situ and never enters an invasive stage (unlikely). It could mean that some is left and over time it starts to become invasive which means EITHER accepting an even more drastic surgery (in situ requries 0.5mm margins, anything above that would require 1-2cm margins) OR a very serious disease with metastatic risk.
I hope you find some peace with this soon.
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- October 1, 2015 at 11:41 am
Hi
I think I remember you posting a week or so ago, or someone in a very similar situation to you. I'm sorry that you are really struggling with this. I think you will find that when you finally choose to act, whichever path you take, you will feel a whole lot better. This period of indecision is probably the worst of it. It's an awful situation to be in, and indecision makes it worse.
What you have is a melanoma in situ. It has no metastatic potential. You are the luckiest of the lucky. However, if you choose to take a risk of leaving some or all of that melanoma in situ on your skin, it may evolve into an invasive melanoma. For now, fortunately, you have a pretty much 100% curable melanoma. I hope over time this becomes a source of peace for you, not a source of stress as it is now.
So your choice is how to cure it. Well, there's imiquimod. Some say its got potential:
http://www.ncbi.nlm.nih.gov/pubmed/22338583
Others say it can actually cause skin cancer
http://www.hindawi.com/journals/crim/2014/267535/
To my mind, it's a very distant second to surgical excision. However, I really feel that you need to have a good heart to heart with a good plastic surgeon about your very valid concerns about disfigurement, and whether surgery can be done with minimal disfigurement OR an alternative like Imiquimod.
I think you need to have a good think about what 'doing nothing' means, as in doing nothing at all in the way of treatment. It could mean that all melanoma is already gone with initial excision (unlikely) and you never hear of it again. It could mean that although some is left but it remains in situ and never enters an invasive stage (unlikely). It could mean that some is left and over time it starts to become invasive which means EITHER accepting an even more drastic surgery (in situ requries 0.5mm margins, anything above that would require 1-2cm margins) OR a very serious disease with metastatic risk.
I hope you find some peace with this soon.
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- October 1, 2015 at 11:41 am
Hi
I think I remember you posting a week or so ago, or someone in a very similar situation to you. I'm sorry that you are really struggling with this. I think you will find that when you finally choose to act, whichever path you take, you will feel a whole lot better. This period of indecision is probably the worst of it. It's an awful situation to be in, and indecision makes it worse.
What you have is a melanoma in situ. It has no metastatic potential. You are the luckiest of the lucky. However, if you choose to take a risk of leaving some or all of that melanoma in situ on your skin, it may evolve into an invasive melanoma. For now, fortunately, you have a pretty much 100% curable melanoma. I hope over time this becomes a source of peace for you, not a source of stress as it is now.
So your choice is how to cure it. Well, there's imiquimod. Some say its got potential:
http://www.ncbi.nlm.nih.gov/pubmed/22338583
Others say it can actually cause skin cancer
http://www.hindawi.com/journals/crim/2014/267535/
To my mind, it's a very distant second to surgical excision. However, I really feel that you need to have a good heart to heart with a good plastic surgeon about your very valid concerns about disfigurement, and whether surgery can be done with minimal disfigurement OR an alternative like Imiquimod.
I think you need to have a good think about what 'doing nothing' means, as in doing nothing at all in the way of treatment. It could mean that all melanoma is already gone with initial excision (unlikely) and you never hear of it again. It could mean that although some is left but it remains in situ and never enters an invasive stage (unlikely). It could mean that some is left and over time it starts to become invasive which means EITHER accepting an even more drastic surgery (in situ requries 0.5mm margins, anything above that would require 1-2cm margins) OR a very serious disease with metastatic risk.
I hope you find some peace with this soon.
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- October 1, 2015 at 2:46 pm
Immiquod may be used if the melanoma is Lentigo Maligna. Immiquod has been studied in this role and yes, it can reduce the size of the lesion prior to MOHs. However if your lesion is not Lentigo Maligna and is mucosal or superficial spreading, then I don't believe that is an appropriate application. Banking on this taking time to spread is playing Russian roulette with your life and more disfiguring options in the future. Surgery and early intervention really is the only cure for melanoma. Once it gets to the stage where you need systemic treatments, all bets are off. Handling this now is your best bet at a long and uneventful (after you heal) future.
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- October 1, 2015 at 2:46 pm
Immiquod may be used if the melanoma is Lentigo Maligna. Immiquod has been studied in this role and yes, it can reduce the size of the lesion prior to MOHs. However if your lesion is not Lentigo Maligna and is mucosal or superficial spreading, then I don't believe that is an appropriate application. Banking on this taking time to spread is playing Russian roulette with your life and more disfiguring options in the future. Surgery and early intervention really is the only cure for melanoma. Once it gets to the stage where you need systemic treatments, all bets are off. Handling this now is your best bet at a long and uneventful (after you heal) future.
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- October 1, 2015 at 2:46 pm
Immiquod may be used if the melanoma is Lentigo Maligna. Immiquod has been studied in this role and yes, it can reduce the size of the lesion prior to MOHs. However if your lesion is not Lentigo Maligna and is mucosal or superficial spreading, then I don't believe that is an appropriate application. Banking on this taking time to spread is playing Russian roulette with your life and more disfiguring options in the future. Surgery and early intervention really is the only cure for melanoma. Once it gets to the stage where you need systemic treatments, all bets are off. Handling this now is your best bet at a long and uneventful (after you heal) future.
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- October 2, 2015 at 12:41 am
Your best bet is definitely with surgery. That is clearly the most effective way to deal with it as it is actually physically removed and can no longer harm you. As you mention quality of life being more important than quantity, have you investigated or considered any Alternative treatments?
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- October 2, 2015 at 11:45 pm
Sorry, I should have been more specific. By Alternative I meant treatments that are outside of conventional medical treatment and are therefore very controversial. However, if you were deciding to do nothing because you do not like your options, then maybe an Alternative approach would appeal to you instead of doing nothing. It might not help but then again it might. These treatments have not been subjected to or passed rigorous scientific study but you do find anecdotal stories of people that claim to have been individually helped. Surgery is the closest you can get to a "sure thing" with Stage I melanoma.
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- October 2, 2015 at 11:45 pm
Sorry, I should have been more specific. By Alternative I meant treatments that are outside of conventional medical treatment and are therefore very controversial. However, if you were deciding to do nothing because you do not like your options, then maybe an Alternative approach would appeal to you instead of doing nothing. It might not help but then again it might. These treatments have not been subjected to or passed rigorous scientific study but you do find anecdotal stories of people that claim to have been individually helped. Surgery is the closest you can get to a "sure thing" with Stage I melanoma.
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- October 2, 2015 at 11:45 pm
Sorry, I should have been more specific. By Alternative I meant treatments that are outside of conventional medical treatment and are therefore very controversial. However, if you were deciding to do nothing because you do not like your options, then maybe an Alternative approach would appeal to you instead of doing nothing. It might not help but then again it might. These treatments have not been subjected to or passed rigorous scientific study but you do find anecdotal stories of people that claim to have been individually helped. Surgery is the closest you can get to a "sure thing" with Stage I melanoma.
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- October 2, 2015 at 12:41 am
Your best bet is definitely with surgery. That is clearly the most effective way to deal with it as it is actually physically removed and can no longer harm you. As you mention quality of life being more important than quantity, have you investigated or considered any Alternative treatments?
-
- October 2, 2015 at 12:41 am
Your best bet is definitely with surgery. That is clearly the most effective way to deal with it as it is actually physically removed and can no longer harm you. As you mention quality of life being more important than quantity, have you investigated or considered any Alternative treatments?
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- October 3, 2015 at 6:07 pm
The only super-minor disfiguration I have is a 1.5-inch "I"-shaped scar on my forhead from a wide local excision. That one was caught far later than in situ, unfortunately it was already 2mm deep.Is (catching) a bird in the hand worth (missing) two or more in the bush? If melanoma spreads with distant metastases, that can cause a menagerie of quality of life issues, depending where it goes and what type of treatment options are available.Imiquimod to me sounds better than doing nothing. -
- October 3, 2015 at 6:07 pm
The only super-minor disfiguration I have is a 1.5-inch "I"-shaped scar on my forhead from a wide local excision. That one was caught far later than in situ, unfortunately it was already 2mm deep.Is (catching) a bird in the hand worth (missing) two or more in the bush? If melanoma spreads with distant metastases, that can cause a menagerie of quality of life issues, depending where it goes and what type of treatment options are available.Imiquimod to me sounds better than doing nothing. -
- October 3, 2015 at 6:07 pm
The only super-minor disfiguration I have is a 1.5-inch "I"-shaped scar on my forhead from a wide local excision. That one was caught far later than in situ, unfortunately it was already 2mm deep.Is (catching) a bird in the hand worth (missing) two or more in the bush? If melanoma spreads with distant metastases, that can cause a menagerie of quality of life issues, depending where it goes and what type of treatment options are available.Imiquimod to me sounds better than doing nothing. -
- August 1, 2019 at 6:56 pm
I am facing the same situation with a melanoma in Situ on my left nostril. I had two tiny brown spots that re-appeared after being “frozen” off twice more than 5 years ago. There was no sign of cancer then.I am having a difficult time dealing with the images of the surgery, the length of time required for recovery, etc. I want to try the imiquioid cream instead of the surgery. I am 62 so not a young person with children to raise. I had a shave biopsy and the pathology report doesn’t say how deep the melanocytes were found but that they are pleomorphic and atypical. I am having a hard time understanding why not try this drug first and if it doesn’t work, then have the surgery performed. From the limited reading I have done, it sounds like this is slow growing. I am assuming I have a lentigo maligna as the diagnosis was malignant melanoma D03.39.
What did you finally decide to do? Thank you for your response.
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