› Forums › General Melanoma Community › Pros and cons of radiation
- This topic has 15 replies, 3 voices, and was last updated 8 years, 4 months ago by
Nanners10.
- Post
-
- December 13, 2015 at 3:30 pm
Hi all,
I am looking for opinions and information on radiation. I am having surgery in two days to remove to a recurrence of melanoma to the inguinal/iliac lymph nodes (following a superficial groin dissection a year and a half ago). I currently have two enlarged lymph nodes that they are going to remove. My question is related to radiation after surgery. From what I have read radiation does not affect long term survival in any way it just prevents recurrence in the regional lymph node basin.Is this correct? Does having radiation in an area that is prone to lymphadema and other complications make sense if long term survival is not affected? Are there any studies that suggest that radiation can positively affect long term survival? Trying to navigate the decisions we have to make in light of this disease. Thanks for any and all help.
Nancy
- Replies
-
-
- December 13, 2015 at 4:41 pm
Nancy,
I am having a similar situation. I am having surgery dec 30th to get a iliac node after a superficial groin dissection. They are doing the surgery laproscopiclly and a complete dissection. I have had doctors tell me both ways but the 4 different oncologist 2 said yes 2 said no don’t do it. I did have a surgeon tell me that if i get radiation that’s it for surgeries to that area because it will destroy all the tissue and will not heal correctly. I have had the radiation doctor tell me he thinks it would work and be beneficial for local control. I have struggled with this exact question. I think if i was going to do a adjuvant therapy such as yervoy or a pd-1 i would try it because the benefits of responding to immunotherapy with radiation increases response rate and that’s a fact. Lymphedema is also a concern as i had a oncologist say the chances of it happening could be up to 70%.and i had another doctor say he thought may 10-15% with my body type i have been lucky to not show any any signs of it yet. But we are looking to survive and lymphedema i dont think can make me say no to radiation. In the end its a roll of the dice.-
- December 13, 2015 at 5:58 pm
Thanks for replying Jamie. My surgeon is just going in to get the two lymph nodes and not doing any further dissection. When you say complete dissection what do you mean? I had asked my surgeon about that option. My surgeon explained that he had already removed all the tissue so he would just have to go in and cherry pick the nodes in question, otherwise, he wouldn't know where to stop or start removing the nodes. I have already done ipi and obviously didn't have any success and am not sure if I will qualify for another study at this point. From the studies I have read my interpretation is that if you radiate all of the lymph nodes then if it recurs, you are looking at a distant recurrence, however, radiation could be beneficial if it is confined to the lymph nodes. I am a bit ahead of myself as I don't have a consult until after my surgery but I just wanted to get some other opinions on people in similar situations. Like you said perhaps in the end it is a roll of the dice. Kind of scary.
Nancy
-
- December 13, 2015 at 6:17 pm
From my understanding the superficial node dissection is just the nodes in the groin area mine was 13 nodes. The deep complete dissection will be the internal and external iliac nodes and pelvic nodes. I believe called a deep groin dissection. The surgeon basically said he’s going in and taking everything he can find in pelvic region amazingly he said about a 40 min process doing it laproscopiclly. He also referred to it as skeletonizing the area. I had one prior iliac dissection that removed 5 nodes and this one that is showing now was there and the one they were after but the surgeon missed it. However some other nodes were microscopically positive. -
- December 13, 2015 at 6:17 pm
From my understanding the superficial node dissection is just the nodes in the groin area mine was 13 nodes. The deep complete dissection will be the internal and external iliac nodes and pelvic nodes. I believe called a deep groin dissection. The surgeon basically said he’s going in and taking everything he can find in pelvic region amazingly he said about a 40 min process doing it laproscopiclly. He also referred to it as skeletonizing the area. I had one prior iliac dissection that removed 5 nodes and this one that is showing now was there and the one they were after but the surgeon missed it. However some other nodes were microscopically positive. -
- December 13, 2015 at 6:17 pm
From my understanding the superficial node dissection is just the nodes in the groin area mine was 13 nodes. The deep complete dissection will be the internal and external iliac nodes and pelvic nodes. I believe called a deep groin dissection. The surgeon basically said he’s going in and taking everything he can find in pelvic region amazingly he said about a 40 min process doing it laproscopiclly. He also referred to it as skeletonizing the area. I had one prior iliac dissection that removed 5 nodes and this one that is showing now was there and the one they were after but the surgeon missed it. However some other nodes were microscopically positive. -
- December 13, 2015 at 5:58 pm
Thanks for replying Jamie. My surgeon is just going in to get the two lymph nodes and not doing any further dissection. When you say complete dissection what do you mean? I had asked my surgeon about that option. My surgeon explained that he had already removed all the tissue so he would just have to go in and cherry pick the nodes in question, otherwise, he wouldn't know where to stop or start removing the nodes. I have already done ipi and obviously didn't have any success and am not sure if I will qualify for another study at this point. From the studies I have read my interpretation is that if you radiate all of the lymph nodes then if it recurs, you are looking at a distant recurrence, however, radiation could be beneficial if it is confined to the lymph nodes. I am a bit ahead of myself as I don't have a consult until after my surgery but I just wanted to get some other opinions on people in similar situations. Like you said perhaps in the end it is a roll of the dice. Kind of scary.
Nancy
-
- December 13, 2015 at 5:58 pm
Thanks for replying Jamie. My surgeon is just going in to get the two lymph nodes and not doing any further dissection. When you say complete dissection what do you mean? I had asked my surgeon about that option. My surgeon explained that he had already removed all the tissue so he would just have to go in and cherry pick the nodes in question, otherwise, he wouldn't know where to stop or start removing the nodes. I have already done ipi and obviously didn't have any success and am not sure if I will qualify for another study at this point. From the studies I have read my interpretation is that if you radiate all of the lymph nodes then if it recurs, you are looking at a distant recurrence, however, radiation could be beneficial if it is confined to the lymph nodes. I am a bit ahead of myself as I don't have a consult until after my surgery but I just wanted to get some other opinions on people in similar situations. Like you said perhaps in the end it is a roll of the dice. Kind of scary.
Nancy
-
- December 13, 2015 at 4:41 pm
Nancy,
I am having a similar situation. I am having surgery dec 30th to get a iliac node after a superficial groin dissection. They are doing the surgery laproscopiclly and a complete dissection. I have had doctors tell me both ways but the 4 different oncologist 2 said yes 2 said no don’t do it. I did have a surgeon tell me that if i get radiation that’s it for surgeries to that area because it will destroy all the tissue and will not heal correctly. I have had the radiation doctor tell me he thinks it would work and be beneficial for local control. I have struggled with this exact question. I think if i was going to do a adjuvant therapy such as yervoy or a pd-1 i would try it because the benefits of responding to immunotherapy with radiation increases response rate and that’s a fact. Lymphedema is also a concern as i had a oncologist say the chances of it happening could be up to 70%.and i had another doctor say he thought may 10-15% with my body type i have been lucky to not show any any signs of it yet. But we are looking to survive and lymphedema i dont think can make me say no to radiation. In the end its a roll of the dice. -
- December 13, 2015 at 4:41 pm
Nancy,
I am having a similar situation. I am having surgery dec 30th to get a iliac node after a superficial groin dissection. They are doing the surgery laproscopiclly and a complete dissection. I have had doctors tell me both ways but the 4 different oncologist 2 said yes 2 said no don’t do it. I did have a surgeon tell me that if i get radiation that’s it for surgeries to that area because it will destroy all the tissue and will not heal correctly. I have had the radiation doctor tell me he thinks it would work and be beneficial for local control. I have struggled with this exact question. I think if i was going to do a adjuvant therapy such as yervoy or a pd-1 i would try it because the benefits of responding to immunotherapy with radiation increases response rate and that’s a fact. Lymphedema is also a concern as i had a oncologist say the chances of it happening could be up to 70%.and i had another doctor say he thought may 10-15% with my body type i have been lucky to not show any any signs of it yet. But we are looking to survive and lymphedema i dont think can make me say no to radiation. In the end its a roll of the dice. -
- December 13, 2015 at 8:33 pm
Nancy, I wish I could post the link to the video, but it never works for me. If you go to youtube and type in " peer exchange Role of Adjuvant Radiation Therapy in Melanoma" you should find a video from Onclive featuring Dr. Omid Hamid, Dr. Jeffrey Weber, Dr.Jeffry Sosman, Dr.Robert H.I. Andtback and Dr. Mario Sznol. It is from 2014 and gets into the pro and cons of radiation for stage 3 melanoma, and they talk quite a bit about morbidy risks in groin region. The series or video have about 15 other topics including Adjuvant treatment options for high risk Melanoma patients. Hope this helps you with your decision making process. Ed
-
- December 13, 2015 at 8:33 pm
Nancy, I wish I could post the link to the video, but it never works for me. If you go to youtube and type in " peer exchange Role of Adjuvant Radiation Therapy in Melanoma" you should find a video from Onclive featuring Dr. Omid Hamid, Dr. Jeffrey Weber, Dr.Jeffry Sosman, Dr.Robert H.I. Andtback and Dr. Mario Sznol. It is from 2014 and gets into the pro and cons of radiation for stage 3 melanoma, and they talk quite a bit about morbidy risks in groin region. The series or video have about 15 other topics including Adjuvant treatment options for high risk Melanoma patients. Hope this helps you with your decision making process. Ed
-
- December 13, 2015 at 8:33 pm
Nancy, I wish I could post the link to the video, but it never works for me. If you go to youtube and type in " peer exchange Role of Adjuvant Radiation Therapy in Melanoma" you should find a video from Onclive featuring Dr. Omid Hamid, Dr. Jeffrey Weber, Dr.Jeffry Sosman, Dr.Robert H.I. Andtback and Dr. Mario Sznol. It is from 2014 and gets into the pro and cons of radiation for stage 3 melanoma, and they talk quite a bit about morbidy risks in groin region. The series or video have about 15 other topics including Adjuvant treatment options for high risk Melanoma patients. Hope this helps you with your decision making process. Ed
-
- You must be logged in to reply to this topic.