› Forums › General Melanoma Community › SLNB results today
- This topic has 27 replies, 4 voices, and was last updated 9 years, 9 months ago by
Janner.
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- March 9, 2016 at 12:38 pm
Hi All:
I am waiting for the results of my slnb from two lymph nodes taken from my right arm pit area.
I'm currently stage 2a and am concerned about a plan for this "fork in the road" – hear one way and off to stage 3 and get ready to fight this battle now. Or, go the other way and look perhaps to a promising stage 2 adjuvant treatment while waiting for recurrence.
The good news with waiting "10 business days" with lab results is that I've gotten myself ready for any news.
Here's a question. If I stay 2a with a negative slnb – what adjuvant treatment / trial / diet change would you recommend? If I'm found to be stage 3, should I try to get melanoma genetically tested to see what treatment wouldn't work?
thanks,
Neil D
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- March 9, 2016 at 4:31 pm
Unfortunately there isn't much in terms of adjuvant treatment for Stage II and Stage III melanoma.
Interferon is one FDA approved treatment for either of those stages but doctors are shying away from it because it's toxic and has some bad side effects. Plus, if you're going to have a recurrence, it only will delay that recurrence by about a year. Some folks have made it through treatment and have had no regrets while others have had a recurrence while on treatment and have had to stop.
Yervoy is an option for Stage III now. Outcomes for those on Yervoy are better than Interferon. The kicker for Yervoy is that the dosage for Stage III patients is higher than that for Stage IV patients. Go figure! However, Yervoy is kicking butt for Stage IV folks. But before you get all excited, please know that there are some severe side effects to deal with.
There are clinical trials to keep an eye out for if you end up being Stage III. Here's a fairly new one for Stage III where they will be testing Pembrolizumab (Keytruda), which has been kicking butt with tolerable side effects in Stage IV patients. Now, the catch to the Stage III trials is that a drug is tested against a placebo. That is the stinky part.
https://clinicaltrials.gov/ct2/show/study/NCT02362594
As for diet changes, just use common sense. Avoid processed foods, eat plenty of fresh veggies, fruits, etc. Stay away from anything labeled "diet" or "fat free" because of all the chemicals that are added to give it any flavor. You want a diet beverage? Have a bottled water. You want a fat free snack? Have an apple. LOL. You get the picture.
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- March 9, 2016 at 4:31 pm
Unfortunately there isn't much in terms of adjuvant treatment for Stage II and Stage III melanoma.
Interferon is one FDA approved treatment for either of those stages but doctors are shying away from it because it's toxic and has some bad side effects. Plus, if you're going to have a recurrence, it only will delay that recurrence by about a year. Some folks have made it through treatment and have had no regrets while others have had a recurrence while on treatment and have had to stop.
Yervoy is an option for Stage III now. Outcomes for those on Yervoy are better than Interferon. The kicker for Yervoy is that the dosage for Stage III patients is higher than that for Stage IV patients. Go figure! However, Yervoy is kicking butt for Stage IV folks. But before you get all excited, please know that there are some severe side effects to deal with.
There are clinical trials to keep an eye out for if you end up being Stage III. Here's a fairly new one for Stage III where they will be testing Pembrolizumab (Keytruda), which has been kicking butt with tolerable side effects in Stage IV patients. Now, the catch to the Stage III trials is that a drug is tested against a placebo. That is the stinky part.
https://clinicaltrials.gov/ct2/show/study/NCT02362594
As for diet changes, just use common sense. Avoid processed foods, eat plenty of fresh veggies, fruits, etc. Stay away from anything labeled "diet" or "fat free" because of all the chemicals that are added to give it any flavor. You want a diet beverage? Have a bottled water. You want a fat free snack? Have an apple. LOL. You get the picture.
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- March 10, 2016 at 2:16 pm
Great feedback. Very much appreciated.
My oncologist appointment is with Dr. Jang at Fairfax this Wednesday. They said I may be interested in considering the phase 3 trial of pol-103a vaccine as I think I am now stage 2b due to size of tumor exceeding 4mm.
Any thoughts on adjuvant treatments including pol-103a?
thanks!
Neil D
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- March 10, 2016 at 2:16 pm
Great feedback. Very much appreciated.
My oncologist appointment is with Dr. Jang at Fairfax this Wednesday. They said I may be interested in considering the phase 3 trial of pol-103a vaccine as I think I am now stage 2b due to size of tumor exceeding 4mm.
Any thoughts on adjuvant treatments including pol-103a?
thanks!
Neil D
-
- March 10, 2016 at 2:16 pm
Great feedback. Very much appreciated.
My oncologist appointment is with Dr. Jang at Fairfax this Wednesday. They said I may be interested in considering the phase 3 trial of pol-103a vaccine as I think I am now stage 2b due to size of tumor exceeding 4mm.
Any thoughts on adjuvant treatments including pol-103a?
thanks!
Neil D
-
- March 9, 2016 at 4:31 pm
Unfortunately there isn't much in terms of adjuvant treatment for Stage II and Stage III melanoma.
Interferon is one FDA approved treatment for either of those stages but doctors are shying away from it because it's toxic and has some bad side effects. Plus, if you're going to have a recurrence, it only will delay that recurrence by about a year. Some folks have made it through treatment and have had no regrets while others have had a recurrence while on treatment and have had to stop.
Yervoy is an option for Stage III now. Outcomes for those on Yervoy are better than Interferon. The kicker for Yervoy is that the dosage for Stage III patients is higher than that for Stage IV patients. Go figure! However, Yervoy is kicking butt for Stage IV folks. But before you get all excited, please know that there are some severe side effects to deal with.
There are clinical trials to keep an eye out for if you end up being Stage III. Here's a fairly new one for Stage III where they will be testing Pembrolizumab (Keytruda), which has been kicking butt with tolerable side effects in Stage IV patients. Now, the catch to the Stage III trials is that a drug is tested against a placebo. That is the stinky part.
https://clinicaltrials.gov/ct2/show/study/NCT02362594
As for diet changes, just use common sense. Avoid processed foods, eat plenty of fresh veggies, fruits, etc. Stay away from anything labeled "diet" or "fat free" because of all the chemicals that are added to give it any flavor. You want a diet beverage? Have a bottled water. You want a fat free snack? Have an apple. LOL. You get the picture.
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- March 9, 2016 at 4:48 pm
Looks like the bulk of the info is already provided. Unfortuantely, there just isn't much there in terms of treatment. I can definitely appreciate the feeling of not having any options when your dxed with melanoma. It's frustrating because you know there's a potential for cancer to be in your body, you know their are things that could kill it, but you're not given any of it.
The best treatment though is diligent checkups and self-checks, along with appropriate wait/watch procedures from oncologists/related professionals. Even if a recurrence or node involvement shows up eventually, the more vigilant you are, the better you can do if you have to utilize those advanced treatments.
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- March 9, 2016 at 4:48 pm
Looks like the bulk of the info is already provided. Unfortuantely, there just isn't much there in terms of treatment. I can definitely appreciate the feeling of not having any options when your dxed with melanoma. It's frustrating because you know there's a potential for cancer to be in your body, you know their are things that could kill it, but you're not given any of it.
The best treatment though is diligent checkups and self-checks, along with appropriate wait/watch procedures from oncologists/related professionals. Even if a recurrence or node involvement shows up eventually, the more vigilant you are, the better you can do if you have to utilize those advanced treatments.
-
- March 9, 2016 at 4:48 pm
Looks like the bulk of the info is already provided. Unfortuantely, there just isn't much there in terms of treatment. I can definitely appreciate the feeling of not having any options when your dxed with melanoma. It's frustrating because you know there's a potential for cancer to be in your body, you know their are things that could kill it, but you're not given any of it.
The best treatment though is diligent checkups and self-checks, along with appropriate wait/watch procedures from oncologists/related professionals. Even if a recurrence or node involvement shows up eventually, the more vigilant you are, the better you can do if you have to utilize those advanced treatments.
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- March 9, 2016 at 8:26 pm
Results are in: Lymph nodes are clean. I am happy about not moving to stage 3 just yet.
But, pathology report from surgery showed melanoma at .66 mm and after the shave biopsy (2 pieces total result of two cuts) for total depth of 3.5mm. So my t3a resulted in a stage 2a diagnosis. Additional depth apparently puts me into t4a and new slip down to stage 2b. Probably where I was all the time.
im still going to sacrifice our fattest calf – but I'm discovering you have to be cautiously optimistic heretofore.
Thanks,
Neil D
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- March 9, 2016 at 8:26 pm
Results are in: Lymph nodes are clean. I am happy about not moving to stage 3 just yet.
But, pathology report from surgery showed melanoma at .66 mm and after the shave biopsy (2 pieces total result of two cuts) for total depth of 3.5mm. So my t3a resulted in a stage 2a diagnosis. Additional depth apparently puts me into t4a and new slip down to stage 2b. Probably where I was all the time.
im still going to sacrifice our fattest calf – but I'm discovering you have to be cautiously optimistic heretofore.
Thanks,
Neil D
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- March 9, 2016 at 8:54 pm
Typically, you can't just "add" the two depths with any certainty. There is no way to know if the residual .66 matches up with the deepest part from the original biopsy. Usually, you just see it stated "at least" original depth with some residual. If you think about how they slice the biopsy up to view on a microscope slide, you slice it. Then you have the WLE tissue. You slice that. How do you know what slice from the biopsy matches the slice from the WLE? You can't. So I think your bumping to stage IIB could still be debatable, Obviously, if it helps you qualify for a clinical trial, it's better to have a higher staging. But for yourself, you can think that you might be stage IIA because of the uncertain depth. Just my 2 cents.
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- March 9, 2016 at 8:54 pm
Typically, you can't just "add" the two depths with any certainty. There is no way to know if the residual .66 matches up with the deepest part from the original biopsy. Usually, you just see it stated "at least" original depth with some residual. If you think about how they slice the biopsy up to view on a microscope slide, you slice it. Then you have the WLE tissue. You slice that. How do you know what slice from the biopsy matches the slice from the WLE? You can't. So I think your bumping to stage IIB could still be debatable, Obviously, if it helps you qualify for a clinical trial, it's better to have a higher staging. But for yourself, you can think that you might be stage IIA because of the uncertain depth. Just my 2 cents.
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- March 11, 2016 at 10:45 am
Janner:
Turns out – you are correct. The remaining melanoma was adjacent – most likely the rim – that remained after the 2 shave biopsies.
So I remain Stage 2a and am not 2b since adding the .665 mm depth to the 3.5 mm would be incorrect.
So im ineligible for the adjuvant melanoma vaccine pol-103a since it requires stage 2b or beyond.
Thanks again for your response!
Neil D
-
- March 11, 2016 at 10:45 am
Janner:
Turns out – you are correct. The remaining melanoma was adjacent – most likely the rim – that remained after the 2 shave biopsies.
So I remain Stage 2a and am not 2b since adding the .665 mm depth to the 3.5 mm would be incorrect.
So im ineligible for the adjuvant melanoma vaccine pol-103a since it requires stage 2b or beyond.
Thanks again for your response!
Neil D
-
- March 11, 2016 at 10:45 am
Janner:
Turns out – you are correct. The remaining melanoma was adjacent – most likely the rim – that remained after the 2 shave biopsies.
So I remain Stage 2a and am not 2b since adding the .665 mm depth to the 3.5 mm would be incorrect.
So im ineligible for the adjuvant melanoma vaccine pol-103a since it requires stage 2b or beyond.
Thanks again for your response!
Neil D
-
- March 9, 2016 at 8:54 pm
Typically, you can't just "add" the two depths with any certainty. There is no way to know if the residual .66 matches up with the deepest part from the original biopsy. Usually, you just see it stated "at least" original depth with some residual. If you think about how they slice the biopsy up to view on a microscope slide, you slice it. Then you have the WLE tissue. You slice that. How do you know what slice from the biopsy matches the slice from the WLE? You can't. So I think your bumping to stage IIB could still be debatable, Obviously, if it helps you qualify for a clinical trial, it's better to have a higher staging. But for yourself, you can think that you might be stage IIA because of the uncertain depth. Just my 2 cents.
-
- March 9, 2016 at 8:26 pm
Results are in: Lymph nodes are clean. I am happy about not moving to stage 3 just yet.
But, pathology report from surgery showed melanoma at .66 mm and after the shave biopsy (2 pieces total result of two cuts) for total depth of 3.5mm. So my t3a resulted in a stage 2a diagnosis. Additional depth apparently puts me into t4a and new slip down to stage 2b. Probably where I was all the time.
im still going to sacrifice our fattest calf – but I'm discovering you have to be cautiously optimistic heretofore.
Thanks,
Neil D
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