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Subungual Melanoma

Forums Cutaneous Melanoma Community Subungual Melanoma

  • Post
    kellygirlsr
    Participant

    hi everyone,

    I have subungual melanoma of a big toe. Surgery was performed and path report came back as 1.01 mm in depth. There is a positive margin at the periosteum.   Also, 2 lymph nodes were biopsy and came back negative.  Because I am in early stages of miminal invasive cancer, I've been searching for medical treatment for the positve margin to avoid amuptation of the toe.  All adjuvant therapies seem to treat only adbance cancer. I'm a stage IB or II.

     

    Any thoughts on possible immuno therapy of early stage patients like myself?

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  • Replies
      Janner
      Participant

      Immunotherapy is not FDA approved for stage 1 or stage 2.   Even if a doc were to prescribe it off-label, insurance may not pay and these therapies are very expensive.  To date, surgery is still the most effective method to remove melanoma and doing a systemic treatment for positive margins is pretty radical. (I understand that amputation is radical as well).  Remember, immunotherapy is only effective for 40-50% of individuals (depending upon treatment)  so you are risking a lot on hoping you are a responder.  Are you being seen at a major melanoma center?  My suggestion would be to go to a large center – they may be the most creative in treatment options.

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      Threefitty
      Participant

      Sorry you are "here", but glad you are here.

      If you are not familiar with the story surrounding the death of the legendary Bob Marley, google it today.

      Wish I had something more positive to say.

      Best of luck.

       

      Dave S.

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      JuTMSY4
      Participant

      I had a subungual melanoma on my left big toe as well.  There was no possible margin control without (partial) amputation.  The short answer is, you can't or at least not covered by any insurance, get any form of immunotherapy.  Not sure a doctor would prescribe it either as standard of care for stages I and II are surgical mostly.  

      My follow up question is…why?  Surgery at early stage melanoma is highly effective or at least a great tool in the toolkit that includes later use of immunotherapy (hopefully you won't have to find out!).  Immunotherapy has made MASSIVE advances but pales in comparison to surgery at your early stage.  I know it sucks to lose a toe (really, half a toe!), but it's far better than the alternatives.  Left between a choice of surgery/amputation and immunotherapy, with their relative results, I would take surgery/amputation 10/10 times.  

      I'm a relatively young person, but I will say that I run, bike and play rec sports w/o issue (and without half my left big toe!).  If your concern is activity, you likely won't have a problem.  If your concern is looks, that's fair, but it's far better than the alternative.  

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        kellygirlsr
        Participant

        Thanks for sharing your treatment history. Cheers! Kelly

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        kellygirlsr
        Participant

        My concern with the amputation is not diminished mobility nor aesthetics.  I am also a diabetic with reduced circulatory and immune systems.  I fear the surgery will put me at greater risk than most patients who have had their toe removed. 

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