New to board – Stage IV treatment decisions to be made!

Sorry to hear that you have joined the stage IV club, but no sense crying over spilled milk.

Option #3 Interleukin 2 has the most side effects and also the greatest chance of being successful.

Sorry to hear that you have joined the stage IV club, but no sense crying over spilled milk.

Option #3 Interleukin 2 has the most side effects and also the greatest chance of being successful.

Hi Val Jane,

I can't answer all your questions but I probably can answer a few.  I have not done IL-2 but I have been a Stage IV patient for 5 years now.  I understand that the side effects of IL-2 are much more severe than Dacarbazine.  When receiving IL-2 you will have to be admitted to the hospital usually for about 5-7 days with each round.  Dacarbazine is usually given as an outpatient.

I wouldn't choose a "wait and watch" approach with confirmed active disease.  I know others that have had active disease confined to a limb and have had an isolated limb perfusion/infusion.  Two people that come to mind are Donna in VT and Rocklove.  I know Rocky has had a recurrence since then and I think Donna might have as well.

There is no correct answer as to how quickly melanoma can progress from lymph nodes to other areas.  Some people never progress beyond the lymph nodes.  My disease progressed from the lymph nodes to my liver within 15 months and that was after a groin lymph node dissection and 12 months of Interferon.

Hopefully, some IL-2 responders will see your post.  Jane from Maine and DebbieVA had a complete response to IL-2.

Stay Strong
King

Stage IV 7/05 Liver mets

Hi Val Jane,

I can't answer all your questions but I probably can answer a few.  I have not done IL-2 but I have been a Stage IV patient for 5 years now.  I understand that the side effects of IL-2 are much more severe than Dacarbazine.  When receiving IL-2 you will have to be admitted to the hospital usually for about 5-7 days with each round.  Dacarbazine is usually given as an outpatient.

I wouldn't choose a "wait and watch" approach with confirmed active disease.  I know others that have had active disease confined to a limb and have had an isolated limb perfusion/infusion.  Two people that come to mind are Donna in VT and Rocklove.  I know Rocky has had a recurrence since then and I think Donna might have as well.

There is no correct answer as to how quickly melanoma can progress from lymph nodes to other areas.  Some people never progress beyond the lymph nodes.  My disease progressed from the lymph nodes to my liver within 15 months and that was after a groin lymph node dissection and 12 months of Interferon.

Hopefully, some IL-2 responders will see your post.  Jane from Maine and DebbieVA had a complete response to IL-2.

Stay Strong
King

Stage IV 7/05 Liver mets

Dear Val Jane

Sorry you have joined the stage IV club.  I am currently on compassionate 'ipi' trial in Montreal. I am rather confused as to why your doctor is suggesting Pittsburgh.  I believe there are IL-21 treatments in Canada..for instance, in Montreal and possibly Edmonton. Also, you would have to ensure that any other form of care in Pittsburgh is covered by the clinical trial….e.g. doctor's visits, hospital costs, scans, otherwise it could get costly. From what I hear Dr. Michael Smylie an Medical Oncologist at the Cross Cancer Institute in Edmonton comes highly recommended, is there any chance of going to him for a second opinion.  He also is involved in many of the latest clinical trials.  Also I believe, ipi is available in Edmonton (Cross Cancer), Toronto (Princess Margaret) and Montreal (RVH).

I did the interferon route (recurrence) and then more surgery (recurrence again) then I did one round of temodar – 5 days (oral chemo) in order to qualify for the compassionate ipi trial…temodar did not work (chemo only works for a very few).  It was costly but LESS harsh than the dacarbazine option. Quebec medicare did not cover temodar but would have covered dacarbazine probably that applies to Manitoba as well..but my husband's health coverage from work covered 90% of the temodar. The cost was $4000 for one week of pills and I paid $400 of that…do you have any health coverage at work?  If you took dacarbazine you would have to do at least one round then off for 30 days before acceptance into ipi.

As for how quickly melanoma progresses…I believe that melanoma does what melanoma wants to do and it would be impossible to give an educated guess as to time frame.

Best wishes, Val

Dear Val Jane

Sorry you have joined the stage IV club.  I am currently on compassionate 'ipi' trial in Montreal. I am rather confused as to why your doctor is suggesting Pittsburgh.  I believe there are IL-21 treatments in Canada..for instance, in Montreal and possibly Edmonton. Also, you would have to ensure that any other form of care in Pittsburgh is covered by the clinical trial….e.g. doctor's visits, hospital costs, scans, otherwise it could get costly. From what I hear Dr. Michael Smylie an Medical Oncologist at the Cross Cancer Institute in Edmonton comes highly recommended, is there any chance of going to him for a second opinion.  He also is involved in many of the latest clinical trials.  Also I believe, ipi is available in Edmonton (Cross Cancer), Toronto (Princess Margaret) and Montreal (RVH).

I did the interferon route (recurrence) and then more surgery (recurrence again) then I did one round of temodar – 5 days (oral chemo) in order to qualify for the compassionate ipi trial…temodar did not work (chemo only works for a very few).  It was costly but LESS harsh than the dacarbazine option. Quebec medicare did not cover temodar but would have covered dacarbazine probably that applies to Manitoba as well..but my husband's health coverage from work covered 90% of the temodar. The cost was $4000 for one week of pills and I paid $400 of that…do you have any health coverage at work?  If you took dacarbazine you would have to do at least one round then off for 30 days before acceptance into ipi.

As for how quickly melanoma progresses…I believe that melanoma does what melanoma wants to do and it would be impossible to give an educated guess as to time frame.

Best wishes, Val

Hi,

The person I was primary caregiver for, Will, underwent IL2 treatment (high dose) and was a responder but not a long term responder.  However, I am sure that if I were looking at treatment options, it is one I would go for because there ARE long term (durable) responders and that is a chance worth taking.  He had a lot of temporary side effects and that is why it's done in the hospital but rebounded fairly well from it. 

Have you had genetic testing done?  That is something I think we waited too long to get done; having some of that info early on would have perhaps changed some of the course of the treatments we chose.

Hi,

The person I was primary caregiver for, Will, underwent IL2 treatment (high dose) and was a responder but not a long term responder.  However, I am sure that if I were looking at treatment options, it is one I would go for because there ARE long term (durable) responders and that is a chance worth taking.  He had a lot of temporary side effects and that is why it's done in the hospital but rebounded fairly well from it. 

Have you had genetic testing done?  That is something I think we waited too long to get done; having some of that info early on would have perhaps changed some of the course of the treatments we chose.

Hi!

I agree with the others that IL-2 is a more severe treatment. Although there's no guarantee that it will work, if it does work, it works well. Dacarbazine, not so much. Melanoma is quite chemo-resistant. I also agree with Val in Mtl about going to the US for IL-2. Why do that when IL-2 is available in Canada? It will be covered by Medicare, and your travel will be covered if you have to leave Winnipeg for treatment. I've done clinical trials in Pennsylvania when I was Stage III, and it can be VERY expensive.

I had an ILP in Halifax in 2007, and was NED for almost a year, but then recurred in my leg, and eventually progressed to Stage IV in early 2009. If you're Stage IV already, an ILP is not an option, as you would need something more systemic. ILP would just treat your leg, lay you out for several months, allowing the systemic cells to have a field day on your body. So I am surprised that your Dr has tossed that in as a consideration at this point. It's like closing the barn door after the horses are gone..

It's not that the 1 yr of INF makes you ineligible for Ipi. INF is "standard" for Stage III, but in order to do Ipi, you have to have tried and failed a standard of care treatment for Stage IV, like Dacarbazine, Temodar, or IL-2.

Whatever you do, don't take the "wait and see" approach. Melanoma is so unpredictable, you don't want to take a chance with it. No one can say whether it will progress, nor how fast it would progress. Everyone is different. I've been told that statistically I shouldn't still be alive, given the type of mel that I have, but to look at me, you'd never know I had a thing wrong with me. I was given 3 yrs to live, and that was 5 years ago. Go figure!

Someone suggested seeing Dr Michael Smylie at the Cross Cancer Institute in Edmonton for a second opinion. That's not a bad idea if you can swing it.

Also, may I suggest checking out the Melanoma Network of Canada. http://melanomanetwork.ca  It's a new site, and steadily growing, but it's geared to Canadian mel patients, since the mel scene in Canada is somewhat helter-skelter (in my opinion). You may find it helpful in finding Canadian mel specialists in different areas.

Good luck with your decision. Let us know how it goes.

Hugs

Sharyn, Stage IV 

Hi!

I agree with the others that IL-2 is a more severe treatment. Although there's no guarantee that it will work, if it does work, it works well. Dacarbazine, not so much. Melanoma is quite chemo-resistant. I also agree with Val in Mtl about going to the US for IL-2. Why do that when IL-2 is available in Canada? It will be covered by Medicare, and your travel will be covered if you have to leave Winnipeg for treatment. I've done clinical trials in Pennsylvania when I was Stage III, and it can be VERY expensive.

I had an ILP in Halifax in 2007, and was NED for almost a year, but then recurred in my leg, and eventually progressed to Stage IV in early 2009. If you're Stage IV already, an ILP is not an option, as you would need something more systemic. ILP would just treat your leg, lay you out for several months, allowing the systemic cells to have a field day on your body. So I am surprised that your Dr has tossed that in as a consideration at this point. It's like closing the barn door after the horses are gone..

It's not that the 1 yr of INF makes you ineligible for Ipi. INF is "standard" for Stage III, but in order to do Ipi, you have to have tried and failed a standard of care treatment for Stage IV, like Dacarbazine, Temodar, or IL-2.

Whatever you do, don't take the "wait and see" approach. Melanoma is so unpredictable, you don't want to take a chance with it. No one can say whether it will progress, nor how fast it would progress. Everyone is different. I've been told that statistically I shouldn't still be alive, given the type of mel that I have, but to look at me, you'd never know I had a thing wrong with me. I was given 3 yrs to live, and that was 5 years ago. Go figure!

Someone suggested seeing Dr Michael Smylie at the Cross Cancer Institute in Edmonton for a second opinion. That's not a bad idea if you can swing it.

Also, may I suggest checking out the Melanoma Network of Canada. http://melanomanetwork.ca  It's a new site, and steadily growing, but it's geared to Canadian mel patients, since the mel scene in Canada is somewhat helter-skelter (in my opinion). You may find it helpful in finding Canadian mel specialists in different areas.

Good luck with your decision. Let us know how it goes.

Hugs

Sharyn, Stage IV 

I haven't read all the replies so much of this may be repeat info!

Many trials require you to fail at standard treatments, which for melanoma include decarbazine and IL2, even though the decarbazine has virtually zero support for it working.  Crazy, huh?

Many people do the decarb. just in case it can help and because it is easier / shorter time than the IL2 and then once they "fail" at that treatment they can then move on to other trial options.

I had d. in a cocktail of several chemos & IL2 & interferon (called biochem).  It slowed things down some and I do know others who have had good responses to it.  Varies greatly from patient to patient.  It's horrible – I would never do it again.  It almost killed me.  But I bet the d. alone would not be too big a deal.  I have done temador which is very similar, in fact t. was developed from d., and the temador was nothing.  No side effects for me on that one.

I haven't done high dose IL2.  I have done intrathecal IL2 which is a lower dose injected directly into the part of the brain that produces the spinal fluid.  It's not fun.  But it's doable.  It's typically only done for leptomeningial disease / spinal fluid  / spinal column mets.  And I think only Dr. Papadopolous at MD Anderson in Houston does it.  Sounds like your brain / central nervous system is clear.  That's great!  And it keeps you eligible for many trial options that I am excluded from.

I had a great response to targeted therapy.  I am BRAF mutation positive so I did a BRAF inhibitor for 8 months in 2009 / 2010 till it came back in my brain, thus booting me off the drug.  But I would absolutely do one again as it had zero side effects for me and I could literally feel my disease in the lymph nodes & subq tissues shrinking within 2 days.

Many people have had success with IL2.  It's a hard course.  Usually it's 2 weeks inpatient, followed by a few weeks to regain your strength and then repeat.  I had a hard time on biochem and I think IL2 way be even worse.  I definitely needed someone with me most of the time, but some have been able to do it alone with just the nursing help at the hospital.  My problem was that I was so out of it I often couldn't remember or comprehend instructions / info from docs/ nurses, so things would get lost in the shuffle unless I had a friend or family member with me.

I am sorry you're facing these hard decisions.  There are no right or wrong choices.  Each person responds so differently that there is no way to really know how bad a treatment will be or how good a response they may see.  So pick what seems best for you in terms of your comfort level / travel / finances / peace of mind / physical demands.  And then don't 2nd guess youself or regret any decisions.  No way to ever go back and know what could have been.

I wish you the best of luck in your fight.  Stay strong.  It's a Beast.  We call it that for a reason.  But there are many of us who have been fighting & winning for years.  And I for one have no intention of stopping!  So hang in there and know you are not alone!

Love,

Amy

Stage 3 – 2003, Stage 4 – 2009

just started ipi comp. use this past week

I haven't read all the replies so much of this may be repeat info!

Many trials require you to fail at standard treatments, which for melanoma include decarbazine and IL2, even though the decarbazine has virtually zero support for it working.  Crazy, huh?

Many people do the decarb. just in case it can help and because it is easier / shorter time than the IL2 and then once they "fail" at that treatment they can then move on to other trial options.

I had d. in a cocktail of several chemos & IL2 & interferon (called biochem).  It slowed things down some and I do know others who have had good responses to it.  Varies greatly from patient to patient.  It's horrible – I would never do it again.  It almost killed me.  But I bet the d. alone would not be too big a deal.  I have done temador which is very similar, in fact t. was developed from d., and the temador was nothing.  No side effects for me on that one.

I haven't done high dose IL2.  I have done intrathecal IL2 which is a lower dose injected directly into the part of the brain that produces the spinal fluid.  It's not fun.  But it's doable.  It's typically only done for leptomeningial disease / spinal fluid  / spinal column mets.  And I think only Dr. Papadopolous at MD Anderson in Houston does it.  Sounds like your brain / central nervous system is clear.  That's great!  And it keeps you eligible for many trial options that I am excluded from.

I had a great response to targeted therapy.  I am BRAF mutation positive so I did a BRAF inhibitor for 8 months in 2009 / 2010 till it came back in my brain, thus booting me off the drug.  But I would absolutely do one again as it had zero side effects for me and I could literally feel my disease in the lymph nodes & subq tissues shrinking within 2 days.

Many people have had success with IL2.  It's a hard course.  Usually it's 2 weeks inpatient, followed by a few weeks to regain your strength and then repeat.  I had a hard time on biochem and I think IL2 way be even worse.  I definitely needed someone with me most of the time, but some have been able to do it alone with just the nursing help at the hospital.  My problem was that I was so out of it I often couldn't remember or comprehend instructions / info from docs/ nurses, so things would get lost in the shuffle unless I had a friend or family member with me.

I am sorry you're facing these hard decisions.  There are no right or wrong choices.  Each person responds so differently that there is no way to really know how bad a treatment will be or how good a response they may see.  So pick what seems best for you in terms of your comfort level / travel / finances / peace of mind / physical demands.  And then don't 2nd guess youself or regret any decisions.  No way to ever go back and know what could have been.

I wish you the best of luck in your fight.  Stay strong.  It's a Beast.  We call it that for a reason.  But there are many of us who have been fighting & winning for years.  And I for one have no intention of stopping!  So hang in there and know you are not alone!

Love,

Amy

Stage 3 – 2003, Stage 4 – 2009

just started ipi comp. use this past week

If you are otherwise healthy, IL-2 will give you the best bet for a prolonged remission.  I had only 1 lung nodule removed by VATS and a small muscle tumor in my chest wall.  I chose IL-2 because it is a short course of therapy with the best chance for a prolonged remission if I was a complete responder.  You currently don't get that with any other treatment.  DTIC has similar response rates to IL-2 but doesn't have as good a track record of prolonged survival if you do become NED.

I did 23 bags if IL-2 and am now NED.  It was tough but doable and after 1 month (one week on, rest 10 days, one week on, recovery) I was back to normal.  My scans only 6 weeks later showed I was a complete responder.  Like you I had minimal disease which was creepy crawly.  I was 2A ,7 1/2 years prior before become stage IV.  I honestly think if you are in good hands you need to go for it.  Yes you get sick but it is over quickly and the side effects are practically all gone within 10 days.  Other therapies you take for a prolonged period of time, or stay on indefinately.

IMHO.  The side effects are treatable and I slept through the worst of it.  Jane from Maine has a great checklist of things to bring.  Do have someone stay in your room throughout treatment.  You will get sick, it's only a matter of what organs, when, and how bad.  It is worth doing.  I also like the idea of charging up my immune system to beat mel versus having to take a chemo like drug.  Again, doing IL-2 now with minimal disease and a healthier immune system will give you the best chance of becoming NED.  Personally, as scary as it is, it has gotten better.  Perhaps more would respond if they didn't wait until they had heavy burdens of disease.

IMHO – once you make your mind up, go for it and don't look back.

Best of luck,

Kim – NED since July, 2010

If you are otherwise healthy, IL-2 will give you the best bet for a prolonged remission.  I had only 1 lung nodule removed by VATS and a small muscle tumor in my chest wall.  I chose IL-2 because it is a short course of therapy with the best chance for a prolonged remission if I was a complete responder.  You currently don't get that with any other treatment.  DTIC has similar response rates to IL-2 but doesn't have as good a track record of prolonged survival if you do become NED.

I did 23 bags if IL-2 and am now NED.  It was tough but doable and after 1 month (one week on, rest 10 days, one week on, recovery) I was back to normal.  My scans only 6 weeks later showed I was a complete responder.  Like you I had minimal disease which was creepy crawly.  I was 2A ,7 1/2 years prior before become stage IV.  I honestly think if you are in good hands you need to go for it.  Yes you get sick but it is over quickly and the side effects are practically all gone within 10 days.  Other therapies you take for a prolonged period of time, or stay on indefinately.

IMHO.  The side effects are treatable and I slept through the worst of it.  Jane from Maine has a great checklist of things to bring.  Do have someone stay in your room throughout treatment.  You will get sick, it's only a matter of what organs, when, and how bad.  It is worth doing.  I also like the idea of charging up my immune system to beat mel versus having to take a chemo like drug.  Again, doing IL-2 now with minimal disease and a healthier immune system will give you the best chance of becoming NED.  Personally, as scary as it is, it has gotten better.  Perhaps more would respond if they didn't wait until they had heavy burdens of disease.

IMHO – once you make your mind up, go for it and don't look back.

Best of luck,

Kim – NED since July, 2010

If you are otherwise healthy, IL-2 will give you the best bet for a prolonged remission.  I had only 1 lung nodule removed by VATS and a small muscle tumor in my chest wall.  I chose IL-2 because it is a short course of therapy with the best chance for a prolonged remission if I was a complete responder.  You currently don't get that with any other treatment.  DTIC has similar response rates to IL-2 but doesn't have as good a track record of prolonged survival if you do become NED.

I did 23 bags if IL-2 and am now NED.  It was tough but doable and after 1 month (one week on, rest 10 days, one week on, recovery) I was back to normal.  My scans only 6 weeks later showed I was a complete responder.  Like you I had minimal disease which was creepy crawly.  I was 2A ,7 1/2 years prior before become stage IV.  I honestly think if you are in good hands you need to go for it.  Yes you get sick but it is over quickly and the side effects are practically all gone within 10 days.  Other therapies you take for a prolonged period of time, or stay on indefinately.

IMHO.  The side effects are treatable and I slept through the worst of it.  Jane from Maine has a great checklist of things to bring.  Do have someone stay in your room throughout treatment.  You will get sick, it's only a matter of what organs, when, and how bad.  It is worth doing.  I also like the idea of charging up my immune system to beat mel versus having to take a chemo like drug.  Again, doing IL-2 now with minimal disease and a healthier immune system will give you the best chance of becoming NED.  Personally, as scary as it is, it has gotten better.  Perhaps more would respond if they didn't wait until they had heavy burdens of disease.

IMHO – once you make your mind up, go for it and don't look back.

Best of luck,

Kim – NED since July, 2010

If you are otherwise healthy, IL-2 will give you the best bet for a prolonged remission.  I had only 1 lung nodule removed by VATS and a small muscle tumor in my chest wall.  I chose IL-2 because it is a short course of therapy with the best chance for a prolonged remission if I was a complete responder.  You currently don't get that with any other treatment.  DTIC has similar response rates to IL-2 but doesn't have as good a track record of prolonged survival if you do become NED.

I did 23 bags if IL-2 and am now NED.  It was tough but doable and after 1 month (one week on, rest 10 days, one week on, recovery) I was back to normal.  My scans only 6 weeks later showed I was a complete responder.  Like you I had minimal disease which was creepy crawly.  I was 2A ,7 1/2 years prior before become stage IV.  I honestly think if you are in good hands you need to go for it.  Yes you get sick but it is over quickly and the side effects are practically all gone within 10 days.  Other therapies you take for a prolonged period of time, or stay on indefinately.

IMHO.  The side effects are treatable and I slept through the worst of it.  Jane from Maine has a great checklist of things to bring.  Do have someone stay in your room throughout treatment.  You will get sick, it's only a matter of what organs, when, and how bad.  It is worth doing.  I also like the idea of charging up my immune system to beat mel versus having to take a chemo like drug.  Again, doing IL-2 now with minimal disease and a healthier immune system will give you the best chance of becoming NED.  Personally, as scary as it is, it has gotten better.  Perhaps more would respond if they didn't wait until they had heavy burdens of disease.

IMHO – once you make your mind up, go for it and don't look back.

Best of luck,

Kim – NED since July, 2010

Hi I am a stage IV survivor and I had a radical neck dissection to get the mel out of the lymph nodes, and at the same time I had a lung met. This was in 2006. I underwent 18 months of Biochemotherapy with IL-2. Very tough to get through, but so far I am a success story with this treatment. I am 4 years NED. Feel free to look at my profile.

Please keep us posted and if you have any more questions I would be more than happy to answer,

Suzanne

Hi I am a stage IV survivor and I had a radical neck dissection to get the mel out of the lymph nodes, and at the same time I had a lung met. This was in 2006. I underwent 18 months of Biochemotherapy with IL-2. Very tough to get through, but so far I am a success story with this treatment. I am 4 years NED. Feel free to look at my profile.

Please keep us posted and if you have any more questions I would be more than happy to answer,

Suzanne

I have had the IL2 treatment back in 2005. The treatment was given in the ICU at St.Johns Hospital in Saint Louis,Mo. I was in ICU for 5 days, then went home for one week and then back in ICU for 5 more days. I did this twice. But I'm happy to say that I'm feeling great. That was 6 years ago. I would be happy to answer any of your questions.

I have had the IL2 treatment back in 2005. The treatment was given in the ICU at St.Johns Hospital in Saint Louis,Mo. I was in ICU for 5 days, then went home for one week and then back in ICU for 5 more days. I did this twice. But I'm happy to say that I'm feeling great. That was 6 years ago. I would be happy to answer any of your questions.

I was diagnosed with stage 3 in 2003 and was put on the interferon right away.  long slow process but was cancer free for almost a year.  Melanoma came back to most vital organs in 2005 had a round of dcit then went to edmonton alberta to have il2.  treatment was tough tough, but had great results.  lung tumor was 10 cm and after first week of treatment it shrunk to 5 cm….all tumors disappeared after 4 rounds.  Reoccurence in 2007 tumor in digestive track surgically removed. Then went on compassionate Ippy.  That was 2 years ago and today am tumor and treatment free….

I was diagnosed with stage 3 in 2003 and was put on the interferon right away.  long slow process but was cancer free for almost a year.  Melanoma came back to most vital organs in 2005 had a round of dcit then went to edmonton alberta to have il2.  treatment was tough tough, but had great results.  lung tumor was 10 cm and after first week of treatment it shrunk to 5 cm….all tumors disappeared after 4 rounds.  Reoccurence in 2007 tumor in digestive track surgically removed. Then went on compassionate Ippy.  That was 2 years ago and today am tumor and treatment free….

I went thru 10 days of radiation and the last 5 days I took temodar ( newer sister to DTIC- with less side effects). I then took Temodar July 09 til March 2010 ( however was told it stopped working in Jan or Feb)-  had surgery (thoracotomy) and had melanoma (6.8 cent) removed from  a lymph node by my heart. Went to Mayo Clinic and was surgically made NED March 26, 2010. Currently on vaccine trial at Moffitt using peptides and MDX1106…NED going on 9 months!

Good luck with your treatments!

I went thru 10 days of radiation and the last 5 days I took temodar ( newer sister to DTIC- with less side effects). I then took Temodar July 09 til March 2010 ( however was told it stopped working in Jan or Feb)-  had surgery (thoracotomy) and had melanoma (6.8 cent) removed from  a lymph node by my heart. Went to Mayo Clinic and was surgically made NED March 26, 2010. Currently on vaccine trial at Moffitt using peptides and MDX1106…NED going on 9 months!

Good luck with your treatments!

Given your options, I would side with those who recommend IL-2.  It certainly worked for me.  I was Stage 4 in 1991, and had high-dose IL-2 at NIH in spring-summer of 1992.  I had a complete response and continue to be NED nearly 20 years later.  Yes, the side effects were significant and wide-ranging.  However, soon after each round, I would start feeling better fairly soon.  I would certainly do it again if I were in the same situation.  Best wishes to you.  Rick

Given your options, I would side with those who recommend IL-2.  It certainly worked for me.  I was Stage 4 in 1991, and had high-dose IL-2 at NIH in spring-summer of 1992.  I had a complete response and continue to be NED nearly 20 years later.  Yes, the side effects were significant and wide-ranging.  However, soon after each round, I would start feeling better fairly soon.  I would certainly do it again if I were in the same situation.  Best wishes to you.  Rick