Recurrence

You should consider ipi+nivo immunotherapy. In March 2016 Keytruda immunotherapy had failed me. I had melanoma in several bones including in my spine.
Ipi+nivo immunotherapy made my bone cancer disappear. Opdivo is very similar to Keytruda. I am sceptical of mail order medication, unless it is recommended by your oncologist.

I am so very sorry for what you and your husband and family have and continue to endure. Melanoma sucks great big green hairy wizard balls. There are no words to describe having to suffer from two cancers!!!
My first and very best advice is to see a melanoma specialist ASAP!!! It sounds like that is what you are doing by going to Hunstman. So that is very good.

Here is a primer of current melanoma therapies (and covers immunotherapy, targeted therapy and radiation) that you may find helpful: https://chaoticallypreciselifeloveandmelanoma.blogspot.com/2017/08/melanoma-intel-primer-for-current.html

Here’ a quick down and dirty –
Immunotherapy – We know that about 40% of melanoma patients respond to anti-PD-1 drugs like Opdivo and Keytruda. However, when those patients are treated with the immunotherapy combo – referred to as ipi/nivo – responses can be 50% and better. Also, we know that patients who fail Opdivo, can respond when ipi is added. There are tons of articles about that on my blog. However, we also know that immunotherapy can take time to work and works best with a low tumor burden. That can be a problem when there is a lot of disease.

This brings us Targeted Therapy – For patients who are BRAF positive (about 1/2 of melanoma patients) targeted therapy with a combination of an oral BRAF inhibitor with an oral MEK inhibitor – a response rate of about 80% or better can be attained! The best targeted therapy going currently is named Braftovi/Mektovi. Here is a post in which I compared reports on various BRAF/MEK combo’s: https://chaoticallypreciselifeloveandmelanoma.blogspot.com/2019/12/brafmek-combos-for-melanoma-analyzed.html
It is super important to take a combo – as we have learned that single agents of targeted therapy are not advised except for certain other mutations. Additionally, we also know that for most BRAF positive melanoma patients, the response is rapid and miraculous, but can also be expected to last only 6-9 months. BUT – do not despair. Often, once the tumor burden has been diminished, those same patients can do very well when quickly switched to immunotherapy – like the ipi/nivo combo. Alternatively, there are those who do well on targeted therapy for years.

Radiation – Radiation is not effective on melanoma when used alone. However, when combined with other systemic therapies. Here are a zillion reports – https://chaoticallypreciselifeloveandmelanoma.blogspot.com/search?q=radiation

Finally, though there is a slight propensity for melanoma patients to develop other cancers, it is not terribly common. I would certainly ask about a full genetic evaluation of your husband’s tumor. Especially in those whose melanoma does not respond to typical treatment, this has been useful. We have one member of this forum whose husband has been maintained for years on drugs commonly used for HER2 breast cancer, determined by a full analysis of his melanoma.

I hope these articles give you information that will aid you in finding an appropriate treatment plan for your husband at Huntsman. I also hope they give you hope. I was diagnosed with Stage III melanoma in 2003 at the age of 39 with a 10 and 12 year old, advanced to Stage IV in 2010 with brain and lung mets. I was then in an immunotherapy trial – and remain NED for melanoma today. I did manage to have a super weird and rare appendiceal cancer in 2018 for which I was treated with surgeries and chemo. So – I really feel for what you and your husband are dealing with. BUT!!!!!!!!!! I am still here. There is still hope. Ask more questions as you have the need. This board is filled with knowledgeable and caring peeps. I wish you my best. celeste

Edwin and Celeste gave you excellent advice!
I can only share my personal experience. Being diagnosed with stage IV from the start (Oct. 12, 2018), it made no difference how many places nor how many tumors I had at the time. They were in my lungs, liver, back, and numerous lymphnodes throughout my thorax. I was given six months. Desperate times called for desperate measures and so I chose the combo immunotherapy of Yervoy and Opdivo starting Nov. 2, 2018. After exactly two infusions, I was taken off treatment due to a liver injury. Regardeless, within two months from starting treatment, my tumors shrank 50% and then additional 30% within the following two months and this is after only two combo treatments since I never resumed the combo therapy again. So there is no question that the combo immunotherapy works! Eventually, I resumed immunotherapy and now I am on Opdivo only. My point is that with the combo, your husband does not need to get all four infusions in order to possibly see dramatic and rapid results. From your post, I assume he is BRAF positive so he has target therapy as an option as well. I chose to use this as a last resort, back up plan in case the immunotherapy did not work. Your husband may need to have this first to reduce his tumor burden. Of course, you can discuss your options with his melanoma oncologists. I have shared my path just to show you what is possible so although I know you are overwhelmed, please never lose hope and never think that you are alone.
After you see the specialists, things will be much clearer and your husband beat two cancers before, so there is no reason he cannot do it a third time.
Stay strong, remain optimistic and preservere.
My thoughts are with you and best wishes for your husband’s rapid healing.
Melanie