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Starting treatment

Forums General Melanoma Community Starting treatment

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      Well, I just started my treatment yesterday. Had my first monthy dose of Nivo and so far (I know it's early) I'm tolerating it. I also have an appointment with a radiation oncologist next week to begin focal radiation treatment of the single met in my brain. I'm still trying to learn about the different types of focal radiation so I can ask intelligent questions when I meet the oncologist. It's hard to find unbiased comparisons of gamma knife vs cyberknife vs linear accelorator, etc. Any pointers to web resources would be helpful.

      Anyway, currently stage IV with mets in brain, lungs and liver, but the doc says my overall disease load is low, so that's a positive (I'm looking for all I can get at this point). It's been a roller-coaster of emotions since my latest diagnosis, both for me and my wife, but I feel like we have a path forward now, whereever that takes us. Fingers crossed, etc.

      Also, I asked a few days ago about the possibility of getting my treatment locally while getting my scans read and care managed at a more distant cancer center. Thanks everyone for those responses, Opinions seemed to be event divided betwen doing that and doing everything at a cancer center with melanoma experts. In the end, I decided to do everything at Dana Farber in Boston, even though that is a 5-7 hour round trip drive, depending on traffic. I felt it was important to get coordinated care and I hope I'll be getting that at DFCI. There were some mix-ups yesterday that they seemed to be genuinely embarrassed about, so I'll cut them some slack on that. This time.

      Feeling positive today. As my wife has taken to saying, "watch out cancer, there's a new sheriff in town!"



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          Congrats on making a decision re where to attain care and getting started, Rich!!!  There is much benefit at being at a facility that specializes in melanoma care beyond the physcian.  At such a facility you gain access to better versed ancillary services as well – from surgery to lab to radiology.  Basically, any point specific radiation method is pretty much the same.  Gamma knife, cyber knife, SRS (stereotactic radiation) are basically 6 of one – half dozen of the other.  Same with the linear accelorator except that it is a bit more cumbersome.  NOW proton beam and whole brain radiation ARE very different animals and not generally the first line recommendations.  Mostly within the first three I listed….I would go for the one the folks at your facility use the most and are best at!!!  Here are a zillion articles about radiation combined with immunotherapy where you can see the added benefit and peruse them as to type used, if you like:  


          Glad you are on your way.  I wish you my best.  Celeste

            Gosh damn brother! Sounds like you belong here with the rest of us! You should be fine with Opdivo, i mean, theres a 50/50 chance of “something” going south, Thyroid, Pituitary, Colitis, vomiting etc. but, hopefully not..Warrrior Strong man!!, keep yer boots on & continue to fight this crap! I too have it in my lungs, “alotta of em”, to many to count, i to take Opdivo (with Yervoy) and now its just Opdivo (Yervoy is given #4 times only Usually) and will get my 1st scan soon..take care Brother, welcome to MRF (You are new right?) Will leave the light on ya hear?…Mike

              Rich, sorry to hear.  I've been a Stage IV patient for 5 years.  I've had 2 gamma knife procedures for brain mets.  Very easy as procedures go.  Good luck.


                Rich – good luck. I definitely think you made the right choice, to pickone good centre rather than two separate places. there will be mixups from time to time, or things that go wrong like late bloodwork (maybe you can do that ahead of time at home) or delays at the hospital pharmacy or in getting a chair at the infusion centre. You kind of have to factor these in and stay cool. You may want to consider taking the train or overnighting sometimes. But i think you are taking the right approach and i hope very much you will succeed.

                good luck and welcome to the forum



                  Good luck Rich, fingers crossed for good results!

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