If Stage IV becomes resectable

I believe Carter's liver resection was how they diagnosed that his cancer was melanoma. I'm not certain that they knew, prior to the mass removal, that it was melanoma. He had lesions in his brain and liver, but without knowing the lesion pathology, the doctors had to get a diagnosis somehow. 

I had a large lung mass, a few additional smaller lung lesions, a "suspect" spot on my liver, as well as lesions in the brain. My diagnosis came from a pathology report after having my first brain surgery. Prior to the FDA approved availability of Keytruda, I was on Ipi, which did nothing for me as we watched the largest lung tumor continue to grow. My oncologist managed to get me into a research project involving "odd" BRAF mutations, and I was on MEK for 2 months. We had enough shrinkage in the largest lung lesion, that a surgeon agreed to remove the lower right lobe. I could have continued on the MEK until the tumors either disappeared, or began to grow again… buuuuuuut… not knowing if a surgeon would be willing to do resection on a patient with progression, we opted not to wait it out. By the time I began Keytruda (3 months post thoracic surgery), I had only the "suspect" liver spot on imaging, a couple of new brain mets, and one small lesion in the lower left lung lobe.  A round of gamma, and two Keytruda infusions later… everything was GONE… with the exception of the brain mets, which take some time to completely disappear after being radiated. However, the Keytruda kept any new brain lesions from cropping up, which was extraordinarily unusual, given my ongoing history of 2-4 new mets per month. Surgery can be a difficult decision, but knowing that surgeons are sometimes hesistant to remove lesions when a patient has actively growing metastasis… I wanted anything cut out that could reasonably be removed. How aggressive you (and your team) are, is an intensely personal choice. 

I believe Carter's liver resection was how they diagnosed that his cancer was melanoma. I'm not certain that they knew, prior to the mass removal, that it was melanoma. He had lesions in his brain and liver, but without knowing the lesion pathology, the doctors had to get a diagnosis somehow. 

I had a large lung mass, a few additional smaller lung lesions, a "suspect" spot on my liver, as well as lesions in the brain. My diagnosis came from a pathology report after having my first brain surgery. Prior to the FDA approved availability of Keytruda, I was on Ipi, which did nothing for me as we watched the largest lung tumor continue to grow. My oncologist managed to get me into a research project involving "odd" BRAF mutations, and I was on MEK for 2 months. We had enough shrinkage in the largest lung lesion, that a surgeon agreed to remove the lower right lobe. I could have continued on the MEK until the tumors either disappeared, or began to grow again… buuuuuuut… not knowing if a surgeon would be willing to do resection on a patient with progression, we opted not to wait it out. By the time I began Keytruda (3 months post thoracic surgery), I had only the "suspect" liver spot on imaging, a couple of new brain mets, and one small lesion in the lower left lung lobe.  A round of gamma, and two Keytruda infusions later… everything was GONE… with the exception of the brain mets, which take some time to completely disappear after being radiated. However, the Keytruda kept any new brain lesions from cropping up, which was extraordinarily unusual, given my ongoing history of 2-4 new mets per month. Surgery can be a difficult decision, but knowing that surgeons are sometimes hesistant to remove lesions when a patient has actively growing metastasis… I wanted anything cut out that could reasonably be removed. How aggressive you (and your team) are, is an intensely personal choice. 

I believe Carter's liver resection was how they diagnosed that his cancer was melanoma. I'm not certain that they knew, prior to the mass removal, that it was melanoma. He had lesions in his brain and liver, but without knowing the lesion pathology, the doctors had to get a diagnosis somehow. 

I had a large lung mass, a few additional smaller lung lesions, a "suspect" spot on my liver, as well as lesions in the brain. My diagnosis came from a pathology report after having my first brain surgery. Prior to the FDA approved availability of Keytruda, I was on Ipi, which did nothing for me as we watched the largest lung tumor continue to grow. My oncologist managed to get me into a research project involving "odd" BRAF mutations, and I was on MEK for 2 months. We had enough shrinkage in the largest lung lesion, that a surgeon agreed to remove the lower right lobe. I could have continued on the MEK until the tumors either disappeared, or began to grow again… buuuuuuut… not knowing if a surgeon would be willing to do resection on a patient with progression, we opted not to wait it out. By the time I began Keytruda (3 months post thoracic surgery), I had only the "suspect" liver spot on imaging, a couple of new brain mets, and one small lesion in the lower left lung lobe.  A round of gamma, and two Keytruda infusions later… everything was GONE… with the exception of the brain mets, which take some time to completely disappear after being radiated. However, the Keytruda kept any new brain lesions from cropping up, which was extraordinarily unusual, given my ongoing history of 2-4 new mets per month. Surgery can be a difficult decision, but knowing that surgeons are sometimes hesistant to remove lesions when a patient has actively growing metastasis… I wanted anything cut out that could reasonably be removed. How aggressive you (and your team) are, is an intensely personal choice.