› Forums › Cutaneous Melanoma Community › Seeking advice for metastatic melanoma treatments
- This topic has 19 replies, 8 voices, and was last updated 16 hours, 22 minutes ago by
Dream Hauz.
- Post
-
- July 14, 2024 at 9:39 pm
Hi all,I am new to the forum and here representing my wife, Sara, who was diagnosed with stage IV melanoma this past April and is currently reaching the next stage of treatment options. Just hoping for any advice, words of wisdom, similar stories, hope, etc. I’ll do my best to summarize her situation here, but it’s been quite an unusual rollercoaster and this may get lengthy. FYI she is 38 years old, mother of two (ages 8 and 6), and a contract attorney director for a large healthcare company. We live in Maryland, about 30 minutes outside of Baltimore.
The first sign of something being off was this past winter, starting in Jan/Feb, when her left tonsil appeared to have an infection of some sort. Week-by-week, things worsened as she visited various doctors and all the antibiotics she tried, gradually increasing in intensity, failed to completely get rid of the weird mass growing on her tonsil. Eventually, the ENT she started seeing recommended removing the tonsil, and that was done on April 18th. A week later, analysis of the tonsil tissue revealed that it was malignant, and the ENT ordered a CT scan for the following morning, on the 26th. The results came back by the early afternoon that there were signs of bleeding in her brain and that she should get to the ER at the University of Maryland Medical Center as soon as possible.
Within a few hours of being at UMMC, she had addtional CT and MRI scans conducted (and eventually a PET). There were 2 larger tumors in her brain, one on each side, that were bleeding, along with 3-4 very small lesions that I suppose were so insignificant for doctors to really mention them much. She also had a larger mass near one ovary, and two very small nodules in the lungs were noted, but doctors did not seem concerned given how small they were – could be nothing, they said. She also pointed out two spots on her scalp that had been there for maybe 10 years or so. From her best recollection at her early 2023 dermatology appointment, she remembered the dermatologist saying that they could be removed if they were bothering her, but did not otherwise look concerning. She had noted how they would occasionally bleed when she hit them with a comb, so that was annoying, but I guess the dermatologist did not find anything concerning with them and left them alone (kind of unusual given my experiences, where they seem ready to remove even slightly suspicious spots right on the spot). I honestly can’t remember what these spots used to look like, but at this point the one is definitely large and raised up enough to be very alarming, though it has also been biopsied and may have changed appearance a bit after that procedure.
Being admitted to the hospital on a Friday was not ideal, and I think it wasn’t until Monday when the PET scan was done, but we were sent to the neuro ICU, and gradually doctors from various specialties came to visit and lay out a gameplan. The first priority was brain surgery to remove the larger tumor (4-5 cm) on the right side of the brain, and this was done on May 3rd, with everything going very well. We went home after 11 long days in the hospital on May 6th.
The next stage of treatment was 6 fractions of radiation for the remaining lesions in the brain, as well as the surgical site, and that began on May 20th and concluded on June 5th.
At some point during all of this the NGS advanced sequencing revealed that all tissue samples – from the tonsil, the brain, and the scalp lesion that was biopsied – were cutaneous melanoma and BRAF mutated.
While all of these treatments were occurring, we were also meeting with Dr. Petr Hausner, melanoma oncologist at UMMC, and discussing a plan to begin immunotherapy (Opdualag) once radiation had concluded and she had tapered off of the steroid (Dexamethasone). He wanted a much shorter taper off of the steroid than the rad-onc doctor wanted, which we tried but my wife quickly began having symptoms of pressure in her brain, headaches, and even a little bit of flashes in her eye, so we went back to the original taper plan after a few days off. Dr. H did not seem concerned about this, citing my wife’s very low tumor burden and otherwise healthy situation. I should also mention that by this time she had seen a gyno-oncologist and it appears that the mass near her ovary is not “lighting up” on scans as anything cancerous, and may be a benign cyst. Either way, we are planning to have it removed whenever possible (we are done having kids), and that way we will know for sure.
Either way, Dr. H did not seem in a rush to begin immunotherapy at that point and was okay with the slower steroid taper. The bulk of my wife’s tumor burden really seemed to be the tonsil (removed) and the brain (removed/radiated), and he also wanted to leave the scalp lesion on in order to have an external indicator of how she responds to the immunotherapy. She had another round of CT scans done on June 26th and things appeared stable.
Her last dose of the steroid was July 7th, and we were scheduled to have her first infusion this past Thursday, July 11th. Unfortunately, things did not go as planned. After coming off the steroid, and even a little bit in the week prior when she dropped from 2mg a day to 1mg, her headaches had increased throughout the day. Towards the end of the day on July 10th, she also started having a few issues remembering words, pronouncing things, and making little mistakes when texting. These language issues worsened on the 11th and were becoming very concerning for me, though it would come and go sometimes. We met with Dr. H after her initial bloodwork and described her symptoms and he ordered a CT scan and then later an MRI to get better detail of what the situation in her brain is. A rad-onc doctor also reached out to assist in explaining things. The right side that was operated on looks great, but the other large tumor on the left side has a fair amount of edema and some bleeding (which I believe he said was the original bleeding treated by radiation). This tumor has grown slightly since an MRI that was done on May 5th, but also keep in mind that radiation did not begin until May 20th, and we were told that the effects of radiation often take many weeks to really take place, and that some growing can happen before the tumor actually shrinks following radiation.
Both doctors agreed that she should go back on the steroid immediately in order to get the edema under control. It was also causing a slight midline shift. She did a loading dose of 10mg that evening and is now doing 2 doses of 8mg each until all symptoms go away. Symptoms are much better at this point (typing this on July 13th), with only mild pain (i.e. when standing up) and very subtle and harder-to-notice issues with speech. How long she will be back on the steroid depends on how long it takes for her symptoms to completely subside, but I would imagine about another 2-3 weeks.
At this point, Dr. H has recommended that we go with the standard of care approach and switch from the initial plan of Opdualag immunotherapy and try the targeted therapy tablets (I believe it’s the combo of Braftov and Mertov?). We are meeting again with him next Thursday (July 18th), by which point the tablets should be ready.
Based upon our conversations, my understanding is that these tablets are very effective in preventing the spread of melanoma and can even shrink tumors in the brain and body, but that it only provides a long-term effect for about 10% of patients, and that the cancer cells can figure out a work-around in about 6-7 months, at which point another treatment type will be needed.
He also said that the immunotherapy treatments have not been found to be as effective when done following the tablets, but this was somewhat unclear. I was also confused as to why he would not want to just wait maybe another 2-3 weeks until she could taper back off the steroid to hopefully start the original immunotherapy type then. I understand there’s no guarantee that she’d be able to taper off successfully, and that the steroid interferes with the immunotherapy treatment so they cannot be done simultaneously, but given her relatively low tumor burden that he referenced before when she first had to do the longer taper, why is it problematic now?
One other option – an “experimental” one that he mentioned – was the immunotherapy combo usually used for liver cancers – Atezolizumab and Bevacizumab, the latter of which could take the place of the steroid in decreasing swelling/edema in the brain. It doesn’t seem like he thought this was the best option to try, but I was kind of confused as to why the Bevacizumab could not be incorporated into the originally planned Opdualag.
I suppose the biggest upside of starting the tablets is that we’ll be able to get the next treatment stage started within the next week, can continue the steroid to help with the brain edema as needed, and can also proceed in the near future with the ovary surgery (not possible with the experimental option because Bev. can cause blot clots). One downside Dr. H did mention was radiation recall, but he said we should be far enough away from the radiation window by now that the likelihood would be very small.
This seems like a really pivotal juncture, and honestly the feelings we’re having coming out of this recent visit are nowhere near as optimistic as the previous one when we planned the first infusion, hearing things like “very low tumor burden” and “cure” (a decent possibility with the immunotherapy) repeated a few times, and shared smiles with Dr. H and his nurse. We did also reach out to John’s Hopkins and are going to meet with Dr. William Sharfman this Wednesday, a day before we meet with Dr. H again.
I haven’t done a lot of thorough research up to this point, but have looked through the outline of resources put together by the Chaotically Precise blogger, which were incredibly helpful, though a bit scary given that none of the doctors have explicitly discussed things like survival rates with us yet. Any advice, wisdom, stories, and/or positive vibes that you can send our way would be much appreciated. Thanks just for taking the time to read it you made it through!
Brian (Sara’s husband)
- Replies
-
-
- July 15, 2024 at 12:09 am
Dear BrianAm sorry I cannot really help as I stopped posting long ago as my Stage III melanoma finally cleared and I stopped treatment
The chaotically website is great – Celeste is the author and she used to post here and she’s expert as is Ed Williams. Ed posted recently and he says the forums have moved to Facebook so please try to find him and others there
I think JHU is a great choice – I cannot remember the doctors there but I know Evan Lipson there is great (I saw him in DC) – have heard of Sharfman think he’s good but don’t know him
You could also try my doctor Rapisuwon who is at medstar washington hospital centre in DC. He probably saved my life (I was lucky) and he knows his stuff as do Atkins and Gibney at medstar Georgetown
You have it right in that the Braf medicines get great results but typically don’t last so they buy you time for immunotherapy and better treatments. Then you get the problem of side effects from immunotherapy etc steroids to address them and then go back on immunotherapy
But most important is to get a good doctor- sharfman should be ok but please try out the people I mention too as they know the latest developments
Am sorry for your wife but I hope my advices helps (looked in by chance only and thought should try to help)
Best wishes Mark
-
- July 15, 2024 at 1:56 pm
Hi Brian,I am so sorry for what you and your wife are dealing with. Her story is incredibly reminiscent of mine, not many of us are lucky enough to experience tonsillar melanoma, but I was one.
Am I correct in understanding that your wife has not had any immunotherapy for her melanoma yet? If so, I am very confused. There is absolutely no reason to hold immunotherapy until off steroids. In fact, some patients on immunotherapy are maintained on steroids so they can tolerate said therapy. Further, the ipi/nivo (Yervoy/Opdivo) combo has the best response rates going in melanoma last I heard though Opdualag can certainly be a viable treatment.
If BRAF positive, as about half of melanoma patients are, then a combination of a MEK and BRAF inhibitors can certainly be effective. However, though there are exceptions, the responses to targeted therapy are often not durable. Meaning, they can be super effective in most patients for 6-9 months but then melanoma learns to work around them. I have seen no data that says immunotherapy is not effective post targeted therapy. In fact, targeted therapy is often used to decrease tumor burden in patients and then they are switched to immunotherapy before the targeted therapy loses its effectiveness. Of course, the hard trick is knowing when exactly that is.
The good news for your wife is that many studies show that immunotherapy following or concomitant with radiation can make the immunotherapy even more effective. So, though it is unfortunate that she needed that treatment, it is good in her circumstance that that is the case.
If you have read my blog you may have found these links…but if not…
Here is a primer that unfortunately remains pretty up-to-date: 2022 updated Primer for melanoma treatments
Here is some data re steroids and treatment (lots of articles, lots of links within them) – Steroids and immunotherapy
Radiation and immunotherapy – radiation
And finally, if the doc is now considering your wife’s treatment adjuvant – that’s fine. She still needs it!!!! ASAP!!! In my phase 1 Nivolumab as a single agent trial – back in 2010 – I was status post removal of lung and tonsillar mets (as well as cutaneous lesions in 2003 and 2007) as well as SRS to a brain met. Therefore, at that moment I had gone to a great deal of trouble to remove all measurable disease. So, I was in the Stage IV adjuvant arm vs other patients who were in the Stage IV active disease arm. Folks in my arm did better for obvious reasons. Immunotherapy works best with a low tumor burden!!! Additionally, my study (and others like it) have allowed the FDA to approve immunotherapy (and targeted as well) for melanoma patients who have no current evidence of disease. So, however you choose to look at it. Your wife needs systemic treatment immediately.
Here is a list (not at all comprehensive) of melanoma specialists you may consider seeing: Melanoma Specialists
These are all excellent and Mark gave you some good info as well. I am partial to Dr. Weber as he ran my trial back in 2010 and remains on the cutting edge of melanoma therapy. He will often respond to emails and calls so you may be able to reach out to him yourself.
Some of the data may seem old and this site not particularly well visited. Thankfully, that is because it is now accepted information. Oncologists treating melanoma patients should be fully aware of all these points and have applied them to their practice long ago. While more treatments are needed for those who do not respond to current FDA approved therapies – the ones that are considered basic standard of care – should be implemented rapidly and efficiently. Please reach out to a physician who is aware of what drugs are first line treatment vs second line and understand that steroids are NOT a reason to postpone therapy.
As I am sure you have gathered, melanoma doesn’t play and can do anything at any time. However, you are not without hope. My children were 10 and 12 at my initial Stage III diagnosis in 2003 when I was 39. They were graduating high school and starting college when I dealt with my progression and joined the nivo trial in 2010. I had my last dose of nivo in 2013 and have been NED (no evidence of disease) for melanoma since.
I hope this helps. I wish you and your wife my best. celeste
-
- July 15, 2024 at 10:49 pm
Hi Celeste,Thank you so much for your response and all of this helpful information (and the hope that it provides)! And you are correct – my wife was slated to begin with her first infusion of Opdualag this past Thursday (7/11), with her last fraction of radiation being 6/5. We were originally trying to start earlier, but she did not do well with a very aggressive taper off of the steroid, so we went back to the original taper timeline recommended by her Rad-Onc doctor, and still had symptoms from the edema in her brain and needed to go back on the steroid (currently doing 8mg of Dexamethasone twice a day and symptoms have greatly improved).
I did look through your outline of steroids w/ immunotherapy page and it looks like the studies involving Dexamethasone specifically were in cases where it given to treat side effects from immunotherapy (whereas my wife is using it for side effects of radiation… not sure if that matters?), and there was also the study involving mice, and it’s hard for me to figure out what to make of that. I guess all I can say is that this is what we were told by Dr. Hausner, though he did say (during the earlier meeting when we delayed the 1st infusion to 7/11) that it would be okay – though not ideal – to begin immunotherapy if she was only taking about 1mg of Dex and towards the end of tapering off. The only other thing I can find, though I haven’t dug super-deep, is this:
“Using dexAMETHasone may decrease the effects of nivolumab, which may make the medication less effective in treating your condition. Talk to your doctor if you have any questions or concerns. Your doctor may be able to prescribe alternatives that do not interact or may choose to postpone treatment with dexAMETHasone. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.”
Source: https://www.drugs.com/drug-interactions/dexamethasone-with-opdualag-810-0-4349-20008.htmlI’m definitely glad you mention this though, as we are getting a 2nd opinion on Wednesday, and may even seek a 3rd or 4th given all of these other recommendations for amazing doctors that we’re getting. As of now, still planning to meet Dr. H on Thursday and begin the Braftov/Mertov tablets. We were told the immunotherapy may not be as effective when done after the targeted therapy (or maybe it was that the immunotherapy does better when there is a shorter window between the radiation and immunotherapy?), but it’s reassuring to hear that you have not heard this supported in the research.
Thanks again, and I will keep posting updates here.
-
- July 16, 2024 at 6:57 pm
Brian, you may find the following two video’s informative on the topic. MD Anderson is one of the leading centers in the US for treating melanoma and worth the effort to get 2nd opinion from Dr. Tawbi, or Dr. Davies or Dr. Glitza. Symptomatic brains mets and getting steroids taper down and things stable to be able to starting ipi+nivo (proven track record from checkmate 204 clinical trial) is difficult. Not sue about going Opdualag pathway as brain clinical trials with Opdualag are in early days with no proven track record. Ipi+nivo has several years and two major research clinical trials proving it works, ABC from Australia and checkmate 204. Targeted therapy for short period of time to keep things under control for a few weeks is used often when steroids are an issue. Faster you can get to ipi+nivo immunotherapy combination the better, even with the possible side effects the clinical trials have shown great results. Now, symptomatic patients do not do as well as asymptomatic but they still have good response that can be durable. Radiation, surgery, Immunotherapy and targeted therapy are all in play, which comes first and then what next is also debated with the experts but now that radiation and surgery have already started the next step is how best to get to immunotherapy. Steroids use below a certain level is a general rule before starting with immunotherapy, if on two high a dose it will work against the immunotherapy drugs and will not be as effective. Best Wishes!!!Ed Also Facebook group called “Melanoma stage 4” is the one I use now and it is solid group with lot’s of members with lot’s of experience to help with questions. https://www.youtube.com/watch?v=F8Md7EP_TH8 https://www.youtube.com/watch?v=4cBhvxvHWXk -
- July 16, 2024 at 9:03 pm
Thanks so much for the reply, Ed! Pretty much all of what you’ve said here falls in line with what we heard from Dr. H, and hopefully my wife can get through the edema issues in the brain and this extended period of steroid use as soon as possible. We’ve heard that it just takes longer for some folks and I guess she is in that camp.I have a request in to join the FB group “Melanoma stage 4 support group” and assume that’s the same one you’re mentioning. Will plan to post updates there as well as here. Thanks again!
-
- July 24, 2024 at 10:10 am
Hi Brian,Although my journey is vastly different from your wife’s (I am not Braf+), I want you to know my local oncologist (not a specialist) was not willing to give me prednisone when I was experiencing a myriad of inflammation and joint issues. I emailed Dr. Jeffrey Weber, whom I last saw in 2012! He responded that 5mg of daily prednisone would not decrease the efficacy of Opdivo (I was on Opdivo 2 years). Once on prednisone I was able to return to work and my exercise regiment. I mow have osteoporosis, but a small price to pay for a better quality of life. I’ve been winning many battles with melanoma since 2009.
Prayers to you, your wife and your family. There is hope!
-
- July 24, 2024 at 11:04 am
Thanks for sharing your experience! You’re the second person to suggest Dr. Weber and I think I will try emailing him today to get a 3rd opinion. My wife just took her first full dose of Braftovi/Mektovi today after a 5-day half-dose ramp up period, and we have a tele-visit with her specialist scheduled for tomorrow mainly just to check in. Having just begun this stage of treatment, I don’t know if it makes sense to make any sudden changes, but I know that immunotherapy of some sort will likely follow, it’s just a matter of figuring out what and when. Thanks again!
-
- July 17, 2024 at 6:01 pm
Quick update: today we visited with Dr. Sharfman for the first time to get a 2nd opinion on things, and then had a follow-up with Dr. Hausner as well.Good news is that (1) my wife’s symptoms have pretty much all dissipated with the use of the Dex steroid, (2) both doctors appear to be on the same page with treatment options, at least for now, and (3) we just picked up her Braftovi/Mertovi tablets and are going to begin the targeted treatment tomorrow.
Dr. S hit on the fact that the targeted therapy should also help to speed up the tapering off of the steroid, and he estimated that in about 2 months she would likely be able to switch over to immunotherapy, recommending the ipi/nivo combo (mentioning that this has more of a track record for patients with brain mets). He also felt that it’d be safe to leave the scalp lesions intact to have an external indicator, and if they begin to shrink it would also make removal an easier surgery. He felt it was fine to leave the ovarian mass as is, but he has also not seen the scans (we requested them from UMMC but they were not ready in time).
Dr. H said since my wife’s symptoms have resolved we can begin tapering the steroid tomorrow, going from 8mg twice a day to 8 and 6 for 3 days, then 6 and 6, etc. He did not suggest a timeframe for switching from the targeted therapy to immunotherapy, but I believe he threw out about 3 months as an estimate. We did not discuss which immunotherapy would follow, but the initial plan from a while back was Opdualag (pro’s: less chance of side effects; con’s: less of a proven track record being the newer option). He now also thinks that we should go ahead and have the scalp lesions removed, as well as the ovarian mass after revisiting the scans, just to be sure. Assuming we aren’t able to schedule surgery for the scalp lesions for at least a week or two, I guess we’ll get a little bit of time on targeted therapy to see how they react and then also the peace of mind to have them gone.
My wife is having an ultrasound on the ovarian mass next Friday to get a better feel for what exactly it is. She did also have bloodwork done earlier to rule out ovarian cancer.
That’s about all I can think of for now… it’s been another long day with lots of driving and waiting around. Hoping for a positive response to the targeted treatment and very minimal side effects.
Oh, one general question that I’ve seen mixed answers for: how active should my wife expect to be during this stage of treatment? I know she should generally avoid being out in the sun and the heat of the day. She wants to get back to doing her morning walks and some light bodyweight exercise, going to our daughter’s soccer games (which are in the evenings during the summer), and there’s a concert on Friday that she was hoping to still be able to attend. She’s also hoping to get back to working (from home for now) within the next month or so. I assume the answer is probably “it depends how she’s tolerating all the medication,” but any suggestions/experiences you can share would be very helpful!
-
- July 19, 2024 at 10:44 pm
To put it as politely as I can, there is a very large “divide” among melanoma specialist about steroids and melanoma and many specialists particularly mine absolutely would have treated with the immunotherapy the absolute minute she could physical tolerate it. Because it needs to get in the body working and she would still be tapering. And they will treat while steroids are ongoing as well to manage AE so you can continue the drugs. “Doing well” is pretty meaningless when you have widespread melanoma and multiple brain Mets. And why single agent originally?I am so, so sorry you are going through this situation. I would really suggest you spend time on this board and read through the posts and Bubbles. She and Ed have a wealth of knowledge and it is very important to see a melanoma specialist who treats melanoma exclusively and is running a very busy office/trials.
-
- July 22, 2024 at 2:42 pm
Thank you for replying, Judi. I don’t know what to say about the controversy regarding the steroids, but our 2nd opinion doctor did essentially confirm our first doctor’s stance that starting the Opdualag while still taking Dexamethasone (unless it was down to only about 1-1.5mg per day) would detract from its effectiveness, and at this point we can’t go back and change things anyways. I suppose we could consult another doctor… do you think it’s possible that someone would suggest we stop the Braftovi/Mektovi tablets (currently on day 4 and doing a half-dose for a week to see how she tolerates it before moving up to full dose) – which could hopefully be effective in significantly reducing her tumor burden, and is supposedly going to help with the swelling in her brain and allow her to taper off of the steroid faster?Also confused about your “single agent” question… do you mean Opdualag, which she was originally planning to take? I’m still getting familiar with all the vernacular, but I thought Opdualag was a combo of two immunotherapy drugs – relatlimab and nivolumab?
Sorry for all the confusion, and thanks for any help you can offer!
-
- July 22, 2024 at 10:28 pm
Brian, you are correct Opdualag is mix of Relatlimab plus Nivolumab (LAG-3 +Pd-1 drugs). the idea behind adding in IL-6 drug comes from some research going on with triplets and quadruple combinations with Ipi+nivo plus IL-6 drug and in other also adding in LAG-3. Things are moving forward and new stuff is on the horizon. The IL-6 is not standard of care but maybe off label oncologist might consider it for lowering IRAE’s with combination. You have learned a lot in a short period of time, keep up the good work!!!
-
- July 24, 2024 at 2:33 pm
Brian, just followed a post in the stage 4 group about you having to wait to get into the group. Make sure that you answered the questions and gave information that is required. Matt Glunt asked the admin why you had not been added, and she replied they have to answer the questions. It is her way to keep out spammers as there are a lot of them lately. -
- July 27, 2024 at 10:50 pm
Dear BrianI remembered to log in again to check up – seems you are in good hands now on this Board with Celeste, Ed, JudiAU and others chipping in, and I hope you join the Facebook group too.
I also echo what Celeste wrote – her website was great especially because at that time immunotherapy was taking off but not all doctors were aware. Celestes advice was always to be treated by a melanoma specialist (not just an oncologist). I ended up finding that the ideas on her website and from Ed and other experts on the Board were matching my doctors because they were melanoma specialists. And they also gave me great advice when faced with difficult treatment decisions (judgment is involve) and also general encouragement – that we may get lucky.
That said, I am concerned that your doctor is not exactly a melanoma specialist. Sharfman at JHU is, although I dont know him. I think it’s super critical to have a doctor who is a melanoma specialist. I can recommend Lipson at JHU who I think is in Baltimore and not just DC and who i know has been involved in immunotherapy clinical trials (Lipson is one of the authors of the relatlimab study and he lives near you!). But also my doctor Rapisuwon at Washington Hospital Centre who had the guts to put me on TVEC plus pembro and make it happen (not an easy treatment to administer), and Gibney and Atkins at Georgetown. My advice would be to switch to JHU, if your insurance works.
Then you can also contact the superstar doctors who Celeste mentions, like Weber and others, if you get stuck. But a good melanoma specialist would be a good start, and you want someone like this who has great judgment and who has seen tricky cases before to be taking care of you. SO while I dont think it’s proper for me to do so as your doctor could be great I think there are better melanoma specialists in the area, so I would work with them.
Then others in the facebook group who are more knowledgeable than me and up to date can help you too.
I really hope your treatment goes well, best wishes Mark
-
- July 29, 2024 at 9:27 pm
Thanks, Mark!Overall, we’ve still been very happy with the team at UMMC, and Dr. Hausner is one of the melanoma specialists listed on the AIM website (https://www.aimatmelanoma.org/melanoma-learning-center/find-a-melanoma-specialist/maryland/), along with Sharfman (who mentioned that he knows Hausner very well, btw) and Lipson. I think we’ll still seek out 2nd/3rd opinions from Sharfman and others when important treatment decisions need to be made, and I’m drafting an email to Dr. Weber now (finally!). Hopefully we find reassurance with all Dr.’s being pretty similar in their suggestions and do not feel the need to rock the boat, which I feel would be quite stressful. I should also add that we’ve been very happy with the neurosurgery and rad-onc team at UMMC, and they’re still somewhat involved in the discussion of treatment, symptoms, etc.
Hearing others experiences and making connections in the FB groups has been invaluable, in addition to all the helpful feedback here, and I can’t thank you all enough!
-
- July 29, 2024 at 12:16 am
This reply has been marked as private. -
- September 7, 2024 at 2:56 am
Kitchen Remodeling: The kitchen is the heart of your home, and our kitchen remodeling services are designed to create a space that is both functional and beautiful. Whether you’re looking for a complete overhaul or just a few updates, we can help you achieve the kitchen of your dreams.Bathroom Remodeling: Transform your bathroom into a luxurious retreat with our expert remodeling services. From modern fixtures to elegant finishes, we can create a space that is both relaxing and rejuvenating.
-
- You must be logged in to reply to this topic.