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Latest surgery now today, questions on upcoming radiation plans

Forums General Melanoma Community Latest surgery now today, questions on upcoming radiation plans

  • Post
    jenny22
    Participant

      Hi All- After recent 2nd recurrence (last week), just had surgery today at MSK….very early today….home now.

      Since this is 2nd recurrence docs (both surgeon, COIT at MSK and ONC Pavlick at NYU) are recommending a course of radiation in the hopes of preventing more local recurrences….

      After surgery today, Dr. Coit told my husband it is as much an art as a science to get it right…..size of radiation field among other things.  In my case its more tricky since its on the NECK.

      So my question is, wonder if i need RAD ONC whose specialty is Melanoma or Head/Neck….I know my docs will weigh in, but wondered if anyone here had any thoughts on this subect.

      After Radiation of course trying to find/decide on adjuvant systemic treatment……

      Must say, this is a little scary these days….

      Any thoughts appreciated.

       

      Best to all,

      jenny

       

    Viewing 14 reply threads
    • Replies
        Squash
        Participant

          I would be asking a few more questions about radiation especially getting it around the neck area.

          I dont think the stats are that great for radiation with melanoma.

          I would really want to know the statistical benefit vs the obvious risks.

           

           

           

           

          Squash
          Participant

            I would be asking a few more questions about radiation especially getting it around the neck area.

            I dont think the stats are that great for radiation with melanoma.

            I would really want to know the statistical benefit vs the obvious risks.

             

             

             

             

              jenny22
              Participant

                Hi Anon- thanks…and agreed…i have read that in the past that melnoma had been a radiation resistant cancer….but have also read the can be useful in recurrent mel to for local control.

                Addtionally both my surg onc (MSK NY) and med onc (MYU) , both of whom are considered TOP melanoma specailsts are each recommending this as next step.

                I am also pursuing systemic treatment.

                Want to fully undertstand if radiation now would preclude me from certain treaments down the road IF i ever need them….hopefully wont.

                Lots more homework to do!

                tks,

                j

                jenny22
                Participant

                  Hi Anon- thanks…and agreed…i have read that in the past that melnoma had been a radiation resistant cancer….but have also read the can be useful in recurrent mel to for local control.

                  Addtionally both my surg onc (MSK NY) and med onc (MYU) , both of whom are considered TOP melanoma specailsts are each recommending this as next step.

                  I am also pursuing systemic treatment.

                  Want to fully undertstand if radiation now would preclude me from certain treaments down the road IF i ever need them….hopefully wont.

                  Lots more homework to do!

                  tks,

                  j

                  jenny22
                  Participant

                    Hi Anon- thanks…and agreed…i have read that in the past that melnoma had been a radiation resistant cancer….but have also read the can be useful in recurrent mel to for local control.

                    Addtionally both my surg onc (MSK NY) and med onc (MYU) , both of whom are considered TOP melanoma specailsts are each recommending this as next step.

                    I am also pursuing systemic treatment.

                    Want to fully undertstand if radiation now would preclude me from certain treaments down the road IF i ever need them….hopefully wont.

                    Lots more homework to do!

                    tks,

                    j

                  Squash
                  Participant

                    I would be asking a few more questions about radiation especially getting it around the neck area.

                    I dont think the stats are that great for radiation with melanoma.

                    I would really want to know the statistical benefit vs the obvious risks.

                     

                     

                     

                     

                    arthurjedi007
                    Participant

                      My radiation doc is not a melanoma specialist. One of the areas they targeted last winter was the left side of my neck. Very close to my throat but fortunately not there. If you are going to do it you just need a good one I would think. If you can get proton beam that would be the best because it is super precise and dissipates rapidly so not as much doesn't hit the target. Mine was just regular beam therapy so it travelled through everything. I'm very glad I had it done though.

                      It is very much an art how they lay out their beams at various angels and things. I would also want to make sure the total dose is no more than 30 gray. That should be spread among either 5 or 10 treatments. Probably 10. My doc won't do more than that for some reason so I think it's important.

                      My neck there still doesn't grow much of a beard. More like peach fuzz. Other than that it seems great. 

                      Artie

                        jenny22
                        Participant

                          Thanks Artie-

                          I have an appt scheduled with a RAD ONC at MSK who specializes in Melanoma…..will schedule a few more and then be better equipped to make best decision.

                           

                          Tks and hope you are felling OK.

                          jenny22
                          Participant

                            Thanks Artie-

                            I have an appt scheduled with a RAD ONC at MSK who specializes in Melanoma…..will schedule a few more and then be better equipped to make best decision.

                             

                            Tks and hope you are felling OK.

                            jenny22
                            Participant

                              Thanks Artie-

                              I have an appt scheduled with a RAD ONC at MSK who specializes in Melanoma…..will schedule a few more and then be better equipped to make best decision.

                               

                              Tks and hope you are felling OK.

                            arthurjedi007
                            Participant

                              My radiation doc is not a melanoma specialist. One of the areas they targeted last winter was the left side of my neck. Very close to my throat but fortunately not there. If you are going to do it you just need a good one I would think. If you can get proton beam that would be the best because it is super precise and dissipates rapidly so not as much doesn't hit the target. Mine was just regular beam therapy so it travelled through everything. I'm very glad I had it done though.

                              It is very much an art how they lay out their beams at various angels and things. I would also want to make sure the total dose is no more than 30 gray. That should be spread among either 5 or 10 treatments. Probably 10. My doc won't do more than that for some reason so I think it's important.

                              My neck there still doesn't grow much of a beard. More like peach fuzz. Other than that it seems great. 

                              Artie

                              arthurjedi007
                              Participant

                                My radiation doc is not a melanoma specialist. One of the areas they targeted last winter was the left side of my neck. Very close to my throat but fortunately not there. If you are going to do it you just need a good one I would think. If you can get proton beam that would be the best because it is super precise and dissipates rapidly so not as much doesn't hit the target. Mine was just regular beam therapy so it travelled through everything. I'm very glad I had it done though.

                                It is very much an art how they lay out their beams at various angels and things. I would also want to make sure the total dose is no more than 30 gray. That should be spread among either 5 or 10 treatments. Probably 10. My doc won't do more than that for some reason so I think it's important.

                                My neck there still doesn't grow much of a beard. More like peach fuzz. Other than that it seems great. 

                                Artie

                                DZnDef
                                Participant

                                  Hi Jenny,

                                  I can't speak to radiation as I haven't had any so far.  But I just wanted to commend you on how thoroughly you are researching this option.  I am often amazed and saddened when folks just do whatever their first doctor tells them without getting even a second opinion or specialist even when finances are not an issue.  No doubt, with your dedication, you will determine the best course of action for yourself.  Best of luck to you.

                                  DZnDef
                                  Participant

                                    Hi Jenny,

                                    I can't speak to radiation as I haven't had any so far.  But I just wanted to commend you on how thoroughly you are researching this option.  I am often amazed and saddened when folks just do whatever their first doctor tells them without getting even a second opinion or specialist even when finances are not an issue.  No doubt, with your dedication, you will determine the best course of action for yourself.  Best of luck to you.

                                      jenny22
                                      Participant

                                        Thanks Maggie- It seems no matter how many opinions i get it hasnt been a clear path for me since day 1…..

                                        But with 2 recurrences now, ths takes are higher, so i want to make the best and most informed decisions I can.

                                        Since I am still very interested  in whwhat he sytemic options may be i need to make sure of the order of treament…..radiation first?????

                                        Also want to see whats out there for NRAS mutations……

                                        Thought for stage IIIB, NED, not sure what is available besides IPI which I dont thik my ONC is in favor of….

                                        OH well, more research and appts to come.

                                         

                                        Thanks again for your note.

                                         

                                        best,

                                        j

                                         

                                        jenny22
                                        Participant

                                          Thanks Maggie- It seems no matter how many opinions i get it hasnt been a clear path for me since day 1…..

                                          But with 2 recurrences now, ths takes are higher, so i want to make the best and most informed decisions I can.

                                          Since I am still very interested  in whwhat he sytemic options may be i need to make sure of the order of treament…..radiation first?????

                                          Also want to see whats out there for NRAS mutations……

                                          Thought for stage IIIB, NED, not sure what is available besides IPI which I dont thik my ONC is in favor of….

                                          OH well, more research and appts to come.

                                           

                                          Thanks again for your note.

                                           

                                          best,

                                          j

                                           

                                          nikkibeesley00
                                          Participant

                                            Hi J, I had stage 2B melanoma in my parotid gland (its a salivory gland behind your ear) i had the gland removed with clear margins and 21 lymph nodes removed which also came back clear. I then did 25 rounds of proton beam radiation therapy and it was a bitch. Here's what i wish i knew (and this may be specific to me but just an FYI because all the possible side effects always seem to happen to me) 

                                            1. Started with burns on my skin all around my neck and ear area, by the end it was so bad you would've thought i ran through a fire. 

                                            2. When they radiate near your neck area and again this may be specific to my case, they were killing all the healthy tissue etc from my jaw line all over the right side of neck, they were also killing and interuppting these things calling HT3 receptor cells which communicate with your gut, it made me SEVERELY sick (throwing up) the whole month AFTER i finsihed radiation. i wasn't sick during, it was afterwards when the burns finally got worse. it was a kind of build up thing, when your going through it it wasnt bad but you finish and all of a sudden it hit me.

                                            3. i lost my sense of taste and could not swallow anything. I was taking lidocaine to numb my throat but everything hurt, i lived on pudding and baby food and shakes. 

                                            4. i lost hearing in my right ear the entire month after radiation stopped. at first it happened slowly, i got a ringing in my ear that would come and go and then it gave out completely. i never thought i would hear again, one day before my follow up with my radiatologist it came back (THANK GOD!) but it was scarey and frustrating. and loosing it completely is a possible side effect, or the constant ringing. Sometimes to this day i still get a high pitched ringing but it comes and goes within a minute. 

                                            I wish i could say whether it was helpful or not but i received radiation in December 2014 and in April 2015 I woke up with facial paralysis which unfortunately turned out to be the melanoma in my brain. i had that sucessfully removed and we also found spots on my liver and instestines and several surgeries and 11 treatments of Opdivo later my tumors/lesions have all shrunk by 50% so i am doing great now! Those are just the things i wish someone wouldve clearly told me would happen when i was going through radiation. Whether it helped or not i can't say, it spread anyways but who knows if it would have been worse had i not done that. I really do reccomment immunotherapy though, i see a melanoma specialist and previsouly to my getting sick i worked in the pharmaceutical industry and also had a friend who underwent chemotherapy and radiation for cervical cancer and honestly i dont think that by destroying your body in those ways is that effective. to a point, yes, i also had to undergo another round of radiation after my brain surgery but it was one round and called gamma knife which is even more precise then traidation or proton beam radiation. i would say if the doctor is recommending it, do it, because you never want to say, "What if…" but expect the worst and if it doesn't turn out so bad then great! Good luck to you and your family! 

                                            nikkibeesley00
                                            Participant

                                              Oh and also, i lost all the hair from my ears down on the back of my head, luckily as a female i had long hair and keep it down. It took about 3-4 months but it finally started growing back in, im a blonde but it is growing it dark and curly which i have heard can happen! hope all this helps you!

                                              nikkibeesley00
                                              Participant

                                                Oh and also, i lost all the hair from my ears down on the back of my head, luckily as a female i had long hair and keep it down. It took about 3-4 months but it finally started growing back in, im a blonde but it is growing it dark and curly which i have heard can happen! hope all this helps you!

                                                nikkibeesley00
                                                Participant

                                                  Oh and also, i lost all the hair from my ears down on the back of my head, luckily as a female i had long hair and keep it down. It took about 3-4 months but it finally started growing back in, im a blonde but it is growing it dark and curly which i have heard can happen! hope all this helps you!

                                                  jenny22
                                                  Participant

                                                    OMG, what a story……I am so happy you seem to be doing better……Your radiation experince is frightening….i am doing TONS of research and will have multiple opinions.  I read in your profile that when you left DANA Farber, you moved to Morristown (Eric Whitman)…..did you have your radiation done at Morristown or elsewhere?

                                                    Thanks for sharing your story, albeit a scary one!

                                                     

                                                    best,

                                                    j

                                                     

                                                    jenny22
                                                    Participant

                                                      OMG, what a story……I am so happy you seem to be doing better……Your radiation experince is frightening….i am doing TONS of research and will have multiple opinions.  I read in your profile that when you left DANA Farber, you moved to Morristown (Eric Whitman)…..did you have your radiation done at Morristown or elsewhere?

                                                      Thanks for sharing your story, albeit a scary one!

                                                       

                                                      best,

                                                      j

                                                       

                                                      jenny22
                                                      Participant

                                                        OMG, what a story……I am so happy you seem to be doing better……Your radiation experince is frightening….i am doing TONS of research and will have multiple opinions.  I read in your profile that when you left DANA Farber, you moved to Morristown (Eric Whitman)…..did you have your radiation done at Morristown or elsewhere?

                                                        Thanks for sharing your story, albeit a scary one!

                                                         

                                                        best,

                                                        j

                                                         

                                                        jenny22
                                                        Participant

                                                          Nikkibeesleyoo-

                                                          Just reread your profile and see you did have your radiation at Morristown….we are almost neighbors….

                                                           

                                                          wishing you all the best,

                                                          j

                                                           

                                                          jenny22
                                                          Participant

                                                            Nikkibeesleyoo-

                                                            Just reread your profile and see you did have your radiation at Morristown….we are almost neighbors….

                                                             

                                                            wishing you all the best,

                                                            j

                                                             

                                                            jenny22
                                                            Participant

                                                              Nikkibeesleyoo-

                                                              Just reread your profile and see you did have your radiation at Morristown….we are almost neighbors….

                                                               

                                                              wishing you all the best,

                                                              j

                                                               

                                                              nikkibeesley00
                                                              Participant

                                                                Hi, Yes, I had my neck radiation at Morristown, with Dr. Yana Goldberg. I see Dr. Eric Whitman a melanoma specialist at Morristown as well. If you have any questions please feel free to reach out! Im happy to share my experiences with anyone! 

                                                                nikkibeesley00
                                                                Participant

                                                                  Hi, Yes, I had my neck radiation at Morristown, with Dr. Yana Goldberg. I see Dr. Eric Whitman a melanoma specialist at Morristown as well. If you have any questions please feel free to reach out! Im happy to share my experiences with anyone! 

                                                                  nikkibeesley00
                                                                  Participant

                                                                    Hi, Yes, I had my neck radiation at Morristown, with Dr. Yana Goldberg. I see Dr. Eric Whitman a melanoma specialist at Morristown as well. If you have any questions please feel free to reach out! Im happy to share my experiences with anyone! 

                                                                    lmhl
                                                                    Participant

                                                                      I think that the "what if's" work both ways.  My experience would have been "what if" we didn't do radiation. It was a horrible experience and the beginning of a downward spiral.  Because of radiation, ipi was deferred for too long (and too late) for my spouse.  Radiation was completed approx 6 weeks following a neck CLND, and then ipi started 3 months after radiation was completed. From what I read here, that doesn't seem right.

                                                                      Like someone else said here-good for you for checking everything out and not just following your doctor's advice blindly.

                                                                      Best WIshes to you. Please let us know how it goes.

                                                                       

                                                                      lmhl
                                                                      Participant

                                                                        I think that the "what if's" work both ways.  My experience would have been "what if" we didn't do radiation. It was a horrible experience and the beginning of a downward spiral.  Because of radiation, ipi was deferred for too long (and too late) for my spouse.  Radiation was completed approx 6 weeks following a neck CLND, and then ipi started 3 months after radiation was completed. From what I read here, that doesn't seem right.

                                                                        Like someone else said here-good for you for checking everything out and not just following your doctor's advice blindly.

                                                                        Best WIshes to you. Please let us know how it goes.

                                                                         

                                                                        lmhl
                                                                        Participant

                                                                          I think that the "what if's" work both ways.  My experience would have been "what if" we didn't do radiation. It was a horrible experience and the beginning of a downward spiral.  Because of radiation, ipi was deferred for too long (and too late) for my spouse.  Radiation was completed approx 6 weeks following a neck CLND, and then ipi started 3 months after radiation was completed. From what I read here, that doesn't seem right.

                                                                          Like someone else said here-good for you for checking everything out and not just following your doctor's advice blindly.

                                                                          Best WIshes to you. Please let us know how it goes.

                                                                           

                                                                          nikkibeesley00
                                                                          Participant

                                                                            Hi J, I had stage 2B melanoma in my parotid gland (its a salivory gland behind your ear) i had the gland removed with clear margins and 21 lymph nodes removed which also came back clear. I then did 25 rounds of proton beam radiation therapy and it was a bitch. Here's what i wish i knew (and this may be specific to me but just an FYI because all the possible side effects always seem to happen to me) 

                                                                            1. Started with burns on my skin all around my neck and ear area, by the end it was so bad you would've thought i ran through a fire. 

                                                                            2. When they radiate near your neck area and again this may be specific to my case, they were killing all the healthy tissue etc from my jaw line all over the right side of neck, they were also killing and interuppting these things calling HT3 receptor cells which communicate with your gut, it made me SEVERELY sick (throwing up) the whole month AFTER i finsihed radiation. i wasn't sick during, it was afterwards when the burns finally got worse. it was a kind of build up thing, when your going through it it wasnt bad but you finish and all of a sudden it hit me.

                                                                            3. i lost my sense of taste and could not swallow anything. I was taking lidocaine to numb my throat but everything hurt, i lived on pudding and baby food and shakes. 

                                                                            4. i lost hearing in my right ear the entire month after radiation stopped. at first it happened slowly, i got a ringing in my ear that would come and go and then it gave out completely. i never thought i would hear again, one day before my follow up with my radiatologist it came back (THANK GOD!) but it was scarey and frustrating. and loosing it completely is a possible side effect, or the constant ringing. Sometimes to this day i still get a high pitched ringing but it comes and goes within a minute. 

                                                                            I wish i could say whether it was helpful or not but i received radiation in December 2014 and in April 2015 I woke up with facial paralysis which unfortunately turned out to be the melanoma in my brain. i had that sucessfully removed and we also found spots on my liver and instestines and several surgeries and 11 treatments of Opdivo later my tumors/lesions have all shrunk by 50% so i am doing great now! Those are just the things i wish someone wouldve clearly told me would happen when i was going through radiation. Whether it helped or not i can't say, it spread anyways but who knows if it would have been worse had i not done that. I really do reccomment immunotherapy though, i see a melanoma specialist and previsouly to my getting sick i worked in the pharmaceutical industry and also had a friend who underwent chemotherapy and radiation for cervical cancer and honestly i dont think that by destroying your body in those ways is that effective. to a point, yes, i also had to undergo another round of radiation after my brain surgery but it was one round and called gamma knife which is even more precise then traidation or proton beam radiation. i would say if the doctor is recommending it, do it, because you never want to say, "What if…" but expect the worst and if it doesn't turn out so bad then great! Good luck to you and your family! 

                                                                            nikkibeesley00
                                                                            Participant

                                                                              Hi J, I had stage 2B melanoma in my parotid gland (its a salivory gland behind your ear) i had the gland removed with clear margins and 21 lymph nodes removed which also came back clear. I then did 25 rounds of proton beam radiation therapy and it was a bitch. Here's what i wish i knew (and this may be specific to me but just an FYI because all the possible side effects always seem to happen to me) 

                                                                              1. Started with burns on my skin all around my neck and ear area, by the end it was so bad you would've thought i ran through a fire. 

                                                                              2. When they radiate near your neck area and again this may be specific to my case, they were killing all the healthy tissue etc from my jaw line all over the right side of neck, they were also killing and interuppting these things calling HT3 receptor cells which communicate with your gut, it made me SEVERELY sick (throwing up) the whole month AFTER i finsihed radiation. i wasn't sick during, it was afterwards when the burns finally got worse. it was a kind of build up thing, when your going through it it wasnt bad but you finish and all of a sudden it hit me.

                                                                              3. i lost my sense of taste and could not swallow anything. I was taking lidocaine to numb my throat but everything hurt, i lived on pudding and baby food and shakes. 

                                                                              4. i lost hearing in my right ear the entire month after radiation stopped. at first it happened slowly, i got a ringing in my ear that would come and go and then it gave out completely. i never thought i would hear again, one day before my follow up with my radiatologist it came back (THANK GOD!) but it was scarey and frustrating. and loosing it completely is a possible side effect, or the constant ringing. Sometimes to this day i still get a high pitched ringing but it comes and goes within a minute. 

                                                                              I wish i could say whether it was helpful or not but i received radiation in December 2014 and in April 2015 I woke up with facial paralysis which unfortunately turned out to be the melanoma in my brain. i had that sucessfully removed and we also found spots on my liver and instestines and several surgeries and 11 treatments of Opdivo later my tumors/lesions have all shrunk by 50% so i am doing great now! Those are just the things i wish someone wouldve clearly told me would happen when i was going through radiation. Whether it helped or not i can't say, it spread anyways but who knows if it would have been worse had i not done that. I really do reccomment immunotherapy though, i see a melanoma specialist and previsouly to my getting sick i worked in the pharmaceutical industry and also had a friend who underwent chemotherapy and radiation for cervical cancer and honestly i dont think that by destroying your body in those ways is that effective. to a point, yes, i also had to undergo another round of radiation after my brain surgery but it was one round and called gamma knife which is even more precise then traidation or proton beam radiation. i would say if the doctor is recommending it, do it, because you never want to say, "What if…" but expect the worst and if it doesn't turn out so bad then great! Good luck to you and your family! 

                                                                              jenny22
                                                                              Participant

                                                                                Thanks Maggie- It seems no matter how many opinions i get it hasnt been a clear path for me since day 1…..

                                                                                But with 2 recurrences now, ths takes are higher, so i want to make the best and most informed decisions I can.

                                                                                Since I am still very interested  in whwhat he sytemic options may be i need to make sure of the order of treament…..radiation first?????

                                                                                Also want to see whats out there for NRAS mutations……

                                                                                Thought for stage IIIB, NED, not sure what is available besides IPI which I dont thik my ONC is in favor of….

                                                                                OH well, more research and appts to come.

                                                                                 

                                                                                Thanks again for your note.

                                                                                 

                                                                                best,

                                                                                j

                                                                                 

                                                                              DZnDef
                                                                              Participant

                                                                                Hi Jenny,

                                                                                I can't speak to radiation as I haven't had any so far.  But I just wanted to commend you on how thoroughly you are researching this option.  I am often amazed and saddened when folks just do whatever their first doctor tells them without getting even a second opinion or specialist even when finances are not an issue.  No doubt, with your dedication, you will determine the best course of action for yourself.  Best of luck to you.

                                                                                JoshF
                                                                                Participant

                                                                                  Jenny-

                                                                                  Glad to hear surgery went well!!! I wish I had some advice on radiation…I've heard same thing; not always effective against mel. I also heard bad & good stories from radiation…tough call but you have great docs and they know risk & reward. Wish you best on everything!!!

                                                                                  Josh

                                                                                  JoshF
                                                                                  Participant

                                                                                    Jenny-

                                                                                    Glad to hear surgery went well!!! I wish I had some advice on radiation…I've heard same thing; not always effective against mel. I also heard bad & good stories from radiation…tough call but you have great docs and they know risk & reward. Wish you best on everything!!!

                                                                                    Josh

                                                                                    JoshF
                                                                                    Participant

                                                                                      Jenny-

                                                                                      Glad to hear surgery went well!!! I wish I had some advice on radiation…I've heard same thing; not always effective against mel. I also heard bad & good stories from radiation…tough call but you have great docs and they know risk & reward. Wish you best on everything!!!

                                                                                      Josh

                                                                                      Bubbles
                                                                                      Participant

                                                                                        Hi Jenny,

                                                                                        All melanoma choices are tough ones! So glad you are thinking yours through. Radiation certainly has pros and cons, but it is becoming better understood in relation to melanoma and a variety of benefits, even abscopal ones and the facillitation of the benefits of immunotherapy, have been found.  Here is some of that data: http://chaoticallypreciselifeloveandmelanoma.blogspot.com/2015/03/radiation-for-melanomabetter-when.html

                                                                                        I wish you well. Celeste

                                                                                        Bubbles
                                                                                        Participant

                                                                                          Hi Jenny,

                                                                                          All melanoma choices are tough ones! So glad you are thinking yours through. Radiation certainly has pros and cons, but it is becoming better understood in relation to melanoma and a variety of benefits, even abscopal ones and the facillitation of the benefits of immunotherapy, have been found.  Here is some of that data: http://chaoticallypreciselifeloveandmelanoma.blogspot.com/2015/03/radiation-for-melanomabetter-when.html

                                                                                          I wish you well. Celeste

                                                                                          Bubbles
                                                                                          Participant

                                                                                            Hi Jenny,

                                                                                            All melanoma choices are tough ones! So glad you are thinking yours through. Radiation certainly has pros and cons, but it is becoming better understood in relation to melanoma and a variety of benefits, even abscopal ones and the facillitation of the benefits of immunotherapy, have been found.  Here is some of that data: http://chaoticallypreciselifeloveandmelanoma.blogspot.com/2015/03/radiation-for-melanomabetter-when.html

                                                                                            I wish you well. Celeste

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