› Forums › General Melanoma Community › Very Confused – Newly Diagnosed Stage III
- This topic has 42 replies, 8 voices, and was last updated 8 years, 11 months ago by
amelanomajourney.
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- May 20, 2015 at 11:26 pm
I appreciate all of the input and support that I have found on this site thus far. Yes, I am one of the newly diagnosed patients with melanoma. I had a mole on my back that was considered "no big deal" and then turned out to be melanoma, initially thought to be stage 11b. I have had the wide excision completed with SNL and removal of both axillary nodes in April. My left arm biopsy turned out to be positive so I just had a complete removal of my lymph nodes under my left armpit (axilla) on 05/08. The node contained 0.15 mm of cancer cells and the rest of the nodes were negative. Now I am considered stage 3 with options that are confusing… The choices are : do nothing just observe, interferon and be sick for a year, pegylated interferon and be sick for 5 years or possibly receive ipilumumbab (spelling may be wrong…).
I know that this has to be my decision; however, I was wondering if anyone knew where I could find any statistics on these drugs. I know doing nothing is not an option for me and the 5 year long course really isn't appealing either but I am just so confused at this point in time. If anyone has any help, it would be greatly appreciated.
Thank you!
- Replies
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- May 21, 2015 at 1:23 am
There are some statistics on Interferon in the following article: http://mwdn-richmondva.cadmus.com/elsevier/1082038_117_wtrmrk.pdf
Bottom line is that interferon is not all that more effective that just observation alone.
Some folks make it through treatment while others have had to stop due to side effects. Those who have finished treatment are still disease-free and have no regrets while others have recurred.
A number of folks have done well on ipilimumab (Yervoy). The side effects are no walk in the park but there have been durable responses.
Are you being seen by a melanoma specialist? Melanoma specialists will be the most up to date on treatment options. Interferon is becoming old school so I'm surprised that it was offered. Are you being seen by a melanoma specialist at a melanoma clinic?
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- May 21, 2015 at 1:23 am
There are some statistics on Interferon in the following article: http://mwdn-richmondva.cadmus.com/elsevier/1082038_117_wtrmrk.pdf
Bottom line is that interferon is not all that more effective that just observation alone.
Some folks make it through treatment while others have had to stop due to side effects. Those who have finished treatment are still disease-free and have no regrets while others have recurred.
A number of folks have done well on ipilimumab (Yervoy). The side effects are no walk in the park but there have been durable responses.
Are you being seen by a melanoma specialist? Melanoma specialists will be the most up to date on treatment options. Interferon is becoming old school so I'm surprised that it was offered. Are you being seen by a melanoma specialist at a melanoma clinic?
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- May 21, 2015 at 1:23 am
There are some statistics on Interferon in the following article: http://mwdn-richmondva.cadmus.com/elsevier/1082038_117_wtrmrk.pdf
Bottom line is that interferon is not all that more effective that just observation alone.
Some folks make it through treatment while others have had to stop due to side effects. Those who have finished treatment are still disease-free and have no regrets while others have recurred.
A number of folks have done well on ipilimumab (Yervoy). The side effects are no walk in the park but there have been durable responses.
Are you being seen by a melanoma specialist? Melanoma specialists will be the most up to date on treatment options. Interferon is becoming old school so I'm surprised that it was offered. Are you being seen by a melanoma specialist at a melanoma clinic?
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- May 21, 2015 at 2:31 am
I think you shouldn't do interferon. The side effects are nasty and it is not very effective. My husband initially was diagnosed at stage3c and entered a clinical trial of yervoy (ipi) vs interferon. After a bump in the road, he is NED. He was on high dose ipi and managed the side effects. I read there are clinical trials of ipi vs nivo (both immunotherapy) for stage 3. Definitely check out clinical trials through your oncologist or clinical trials.gov. I think there is a link from the MRF home page. Stay positive .
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- May 21, 2015 at 2:31 am
I think you shouldn't do interferon. The side effects are nasty and it is not very effective. My husband initially was diagnosed at stage3c and entered a clinical trial of yervoy (ipi) vs interferon. After a bump in the road, he is NED. He was on high dose ipi and managed the side effects. I read there are clinical trials of ipi vs nivo (both immunotherapy) for stage 3. Definitely check out clinical trials through your oncologist or clinical trials.gov. I think there is a link from the MRF home page. Stay positive .
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- May 21, 2015 at 3:39 am
Exactly. The ipi vs nivo (ie: pd1) trial is a good option for stage 3 folks. If I was stage 3 that would be the one I would want to be in.
Artie
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- May 21, 2015 at 3:39 am
Exactly. The ipi vs nivo (ie: pd1) trial is a good option for stage 3 folks. If I was stage 3 that would be the one I would want to be in.
Artie
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- May 21, 2015 at 3:39 am
Exactly. The ipi vs nivo (ie: pd1) trial is a good option for stage 3 folks. If I was stage 3 that would be the one I would want to be in.
Artie
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- May 21, 2015 at 2:31 am
I think you shouldn't do interferon. The side effects are nasty and it is not very effective. My husband initially was diagnosed at stage3c and entered a clinical trial of yervoy (ipi) vs interferon. After a bump in the road, he is NED. He was on high dose ipi and managed the side effects. I read there are clinical trials of ipi vs nivo (both immunotherapy) for stage 3. Definitely check out clinical trials through your oncologist or clinical trials.gov. I think there is a link from the MRF home page. Stay positive .
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- May 21, 2015 at 5:00 pm
Just realized I had a typo. The following paragraph:
"Those who have finished treatment are still disease-free and have no regrets while others have recurred."
Should read:
"Those who have finished treatment AND are still disease-free have had no regrets, while there are others who have recurred."
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- May 21, 2015 at 5:00 pm
Just realized I had a typo. The following paragraph:
"Those who have finished treatment are still disease-free and have no regrets while others have recurred."
Should read:
"Those who have finished treatment AND are still disease-free have had no regrets, while there are others who have recurred."
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- May 21, 2015 at 5:00 pm
Just realized I had a typo. The following paragraph:
"Those who have finished treatment are still disease-free and have no regrets while others have recurred."
Should read:
"Those who have finished treatment AND are still disease-free have had no regrets, while there are others who have recurred."
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- May 22, 2015 at 9:14 pm
Thank you for your advice! I appreciate the statistics. I am working with a oncologist but not a melanoma specialist. He consulted the melanoma specialists at Hopkins who indicated that I would not be a candidate for the Yervoy because I did not have multiple bulky nodes and only a small tumor that had 0,15 mm of cancer cells. They are recommending Pegylated Interferon; however, I really do not want to go through a 5 year treatment with this drug. I think I will look for a melanoma specialist and a clinical trial at this point. I didn't think that I had to have multiple nodes to qualify for the ipilumamab.
Thank you again!
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- May 22, 2015 at 9:14 pm
Thank you for your advice! I appreciate the statistics. I am working with a oncologist but not a melanoma specialist. He consulted the melanoma specialists at Hopkins who indicated that I would not be a candidate for the Yervoy because I did not have multiple bulky nodes and only a small tumor that had 0,15 mm of cancer cells. They are recommending Pegylated Interferon; however, I really do not want to go through a 5 year treatment with this drug. I think I will look for a melanoma specialist and a clinical trial at this point. I didn't think that I had to have multiple nodes to qualify for the ipilumamab.
Thank you again!
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- May 22, 2015 at 9:14 pm
Thank you for your advice! I appreciate the statistics. I am working with a oncologist but not a melanoma specialist. He consulted the melanoma specialists at Hopkins who indicated that I would not be a candidate for the Yervoy because I did not have multiple bulky nodes and only a small tumor that had 0,15 mm of cancer cells. They are recommending Pegylated Interferon; however, I really do not want to go through a 5 year treatment with this drug. I think I will look for a melanoma specialist and a clinical trial at this point. I didn't think that I had to have multiple nodes to qualify for the ipilumamab.
Thank you again!
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- May 22, 2015 at 10:26 pm
Why not just go to Hopkins? Both Dr. Scharfmann and Dr. Lipson are excellent. I don't see anything on their web site for trials for Stage III right now but I don't know how often they update their web site.
Don't be afraid of "Observation only". Despite the nomenclature, it actually is a quite agressive treatment approach. If I remember correctly, the first year you see your oncologist every 3 months and you get a scan every visit. The second year, that interval jumps to every 4 months. In the third year is goes to 6 and I'm not sure when it goes to 1 year. But, I would want to do this at a melanoma center because all they look at are melanomas. There are people on this board and on the MIF board who have done Observation only and have been in remission (you'll hear the term NED applied to this, which means No Evidence of Disease) for years.
The fact that Yervoy was not recommended means you don't have advanced disease. So, in its own way, that's not such a bad thing.
Back in 2011 I was offered Interferon, Observation Only, or Clinical Trial. I opted for the trial because it gave me the best of both worlds: 2 out of 3 chances of getting the drug plus an aggressive scan/observation schedule. If I didn't qualify for the trial, I would have gone with Observation Only because the side effects of Interferon just weren't worth it.
In the end, the choice is yours. But please do seek a second opinion at a melanoma center.
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- May 22, 2015 at 10:26 pm
Why not just go to Hopkins? Both Dr. Scharfmann and Dr. Lipson are excellent. I don't see anything on their web site for trials for Stage III right now but I don't know how often they update their web site.
Don't be afraid of "Observation only". Despite the nomenclature, it actually is a quite agressive treatment approach. If I remember correctly, the first year you see your oncologist every 3 months and you get a scan every visit. The second year, that interval jumps to every 4 months. In the third year is goes to 6 and I'm not sure when it goes to 1 year. But, I would want to do this at a melanoma center because all they look at are melanomas. There are people on this board and on the MIF board who have done Observation only and have been in remission (you'll hear the term NED applied to this, which means No Evidence of Disease) for years.
The fact that Yervoy was not recommended means you don't have advanced disease. So, in its own way, that's not such a bad thing.
Back in 2011 I was offered Interferon, Observation Only, or Clinical Trial. I opted for the trial because it gave me the best of both worlds: 2 out of 3 chances of getting the drug plus an aggressive scan/observation schedule. If I didn't qualify for the trial, I would have gone with Observation Only because the side effects of Interferon just weren't worth it.
In the end, the choice is yours. But please do seek a second opinion at a melanoma center.
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- May 22, 2015 at 11:22 pm
Thank you! This has helped me ALOT! I agree that I should be happy about my "non-qualification" and think I was stuck on my alternatives, which is a very long treatment that I am not sure I am ready for. I will get the second opinion as you have suggested. I have been grateful for the doctors who have treated me thus far;; however, I think that I am becoming a little uncomfortable with their lack of current treatment; hence, the reason for the second opinion!
Have a great holiday!
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- May 22, 2015 at 11:22 pm
Thank you! This has helped me ALOT! I agree that I should be happy about my "non-qualification" and think I was stuck on my alternatives, which is a very long treatment that I am not sure I am ready for. I will get the second opinion as you have suggested. I have been grateful for the doctors who have treated me thus far;; however, I think that I am becoming a little uncomfortable with their lack of current treatment; hence, the reason for the second opinion!
Have a great holiday!
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- May 22, 2015 at 11:22 pm
Thank you! This has helped me ALOT! I agree that I should be happy about my "non-qualification" and think I was stuck on my alternatives, which is a very long treatment that I am not sure I am ready for. I will get the second opinion as you have suggested. I have been grateful for the doctors who have treated me thus far;; however, I think that I am becoming a little uncomfortable with their lack of current treatment; hence, the reason for the second opinion!
Have a great holiday!
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- May 24, 2015 at 2:29 pm
You might find this interesting:
ata from a phase III clinical trial has shown some benefits with pegylated interferon alfa-2b in the adjuvant setting; however, Richard Joseph, MD, suggests that interferon is not an appropriate option for most patients. Findings from the phase III EORTC 18991 study demonstrated an improvement in recurrence-free survival (RFS) with adjuvant pegylated interferon alfa-2b compared with observation in patients with resected stage III melanoma, Hamid notes.In the study, the 7-year RFS rate was 39.1% with interferon versus 34.6% with observation. However, there was not a significant difference in overall survival (P = .57). The greatest benefit with interferon was seen in patients with stage III N1 ulcerated melanoma, Hamid notes. In this population, overall survival was improved by 41% with interferon compared with observation. However, 37% of patients in the study discontinued treatment with interferon due to side effects.
– See more at: http://www.onclive.com/peer-exchange/melanoma-treatment/Adjuvant-Immunotherapy-for-Melanoma#sthash.UOi2ijAk.dpufata from a phase III clinical trial has shown some benefits with pegylated interferon alfa-2b in the adjuvant setting; however, Richard Joseph, MD, suggests that interferon is not an appropriate option for most patients. Findings from the phase III EORTC 18991 study demonstrated an improvement in recurrence-free survival (RFS) with adjuvant pegylated interferon alfa-2b compared with observation in patients with resected stage III melanoma, Hamid notes.In the study, the 7-year RFS rate was 39.1% with interferon versus 34.6% with observation. However, there was not a significant difference in overall survival (P = .57). The greatest benefit with interferon was seen in patients with stage III N1 ulcerated melanoma, Hamid notes. In this population, overall survival was improved by 41% with interferon compared with observation. However, 37% of patients in the study discontinued treatment with interferon due to side effects.
– See more at: http://www.onclive.com/peer-exchange/melanoma-treatment/Adjuvant-Immunotherapy-for-Melanoma#sthash.UOi2ijAk.dpufata from a phase III clinical trial has shown some benefits with pegylated interferon alfa-2b in the adjuvant setting; however, Richard Joseph, MD, suggests that interferon is not an appropriate option for most patients. Findings from the phase III EORTC 18991 study demonstrated an improvement in recurrence-free survival (RFS) with adjuvant pegylated interferon alfa-2b compared with observation in patients with resected stage III melanoma, Hamid notes.In the study, the 7-year RFS rate was 39.1% with interferon versus 34.6% with observation. However, there was not a significant difference in overall survival (P = .57). The greatest benefit with interferon was seen in patients with stage III N1 ulcerated melanoma, Hamid notes. In this population, overall survival was improved by 41% with interferon compared with observation. However, 37% of patients in the study discontinued treatment with interferon due to side effects.
– See more at: http://www.onclive.com/peer-exchange/melanoma-treatment/Adjuvant-Immunotherapy-for-Melanoma#sthash.UOi2ijAk.dpufData from a phase III clinical trial has shown some benefits with pegylated interferon alfa-2b in the adjuvant setting – See more at: http://www.onclive.com/peer-exchange/melanoma-treatment/Adjuvant-Immunotherapy-for-Melanoma#sthash.UOi2ijAk.dpufData from a phase III clinical trial has shown some benefits with pegylated interferon alfa-2b in the adjuvant setting; however, Richard Joseph, MD, suggests that interferon is not an appropriate option for most patients. Findings from the phase III EORTC 18991 study demonstrated an improvement in recurrence-free survival (RFS) with adjuvant pegylated interferon alfa-2b compared with observation in patients with resected stage III melanoma, Hamid notes.
– See more at: http://www.onclive.com/peer-exchange/melanoma-treatment/Adjuvant-Immunotherapy-for-Melanoma#sthash.UOi2ijAk.dpuf"Data from a phase III clinical trial has shown some benefits with pegylated interferon alfa-2b in the adjuvant setting; however, Richard Joseph, MD, suggests that interferon is not an appropriate option for most patients. Findings from the phase III EORTC 18991 study demonstrated an improvement in recurrence-free survival (RFS) with adjuvant pegylated interferon alfa-2b compared with observation in patients with resected stage III melanoma, Hamid notes.
In the study, the 7-year RFS rate was 39.1% with interferon versus 34.6% with observation. However, there was not a significant difference in overall survival (P = .57). The greatest benefit with interferon was seen in patients with stage III N1 ulcerated melanoma, Hamid notes. In this population, overall survival was improved by 41% with interferon compared with observation. However, 37% of patients in the study discontinued treatment with interferon due to side effects."
http://www.onclive.com/peer-exchange/melanoma-treatment/Adjuvant-Immunotherapy-for-Melanoma
-
- May 24, 2015 at 2:29 pm
You might find this interesting:
ata from a phase III clinical trial has shown some benefits with pegylated interferon alfa-2b in the adjuvant setting; however, Richard Joseph, MD, suggests that interferon is not an appropriate option for most patients. Findings from the phase III EORTC 18991 study demonstrated an improvement in recurrence-free survival (RFS) with adjuvant pegylated interferon alfa-2b compared with observation in patients with resected stage III melanoma, Hamid notes.In the study, the 7-year RFS rate was 39.1% with interferon versus 34.6% with observation. However, there was not a significant difference in overall survival (P = .57). The greatest benefit with interferon was seen in patients with stage III N1 ulcerated melanoma, Hamid notes. In this population, overall survival was improved by 41% with interferon compared with observation. However, 37% of patients in the study discontinued treatment with interferon due to side effects.
– See more at: http://www.onclive.com/peer-exchange/melanoma-treatment/Adjuvant-Immunotherapy-for-Melanoma#sthash.UOi2ijAk.dpufata from a phase III clinical trial has shown some benefits with pegylated interferon alfa-2b in the adjuvant setting; however, Richard Joseph, MD, suggests that interferon is not an appropriate option for most patients. Findings from the phase III EORTC 18991 study demonstrated an improvement in recurrence-free survival (RFS) with adjuvant pegylated interferon alfa-2b compared with observation in patients with resected stage III melanoma, Hamid notes.In the study, the 7-year RFS rate was 39.1% with interferon versus 34.6% with observation. However, there was not a significant difference in overall survival (P = .57). The greatest benefit with interferon was seen in patients with stage III N1 ulcerated melanoma, Hamid notes. In this population, overall survival was improved by 41% with interferon compared with observation. However, 37% of patients in the study discontinued treatment with interferon due to side effects.
– See more at: http://www.onclive.com/peer-exchange/melanoma-treatment/Adjuvant-Immunotherapy-for-Melanoma#sthash.UOi2ijAk.dpufata from a phase III clinical trial has shown some benefits with pegylated interferon alfa-2b in the adjuvant setting; however, Richard Joseph, MD, suggests that interferon is not an appropriate option for most patients. Findings from the phase III EORTC 18991 study demonstrated an improvement in recurrence-free survival (RFS) with adjuvant pegylated interferon alfa-2b compared with observation in patients with resected stage III melanoma, Hamid notes.In the study, the 7-year RFS rate was 39.1% with interferon versus 34.6% with observation. However, there was not a significant difference in overall survival (P = .57). The greatest benefit with interferon was seen in patients with stage III N1 ulcerated melanoma, Hamid notes. In this population, overall survival was improved by 41% with interferon compared with observation. However, 37% of patients in the study discontinued treatment with interferon due to side effects.
– See more at: http://www.onclive.com/peer-exchange/melanoma-treatment/Adjuvant-Immunotherapy-for-Melanoma#sthash.UOi2ijAk.dpufData from a phase III clinical trial has shown some benefits with pegylated interferon alfa-2b in the adjuvant setting – See more at: http://www.onclive.com/peer-exchange/melanoma-treatment/Adjuvant-Immunotherapy-for-Melanoma#sthash.UOi2ijAk.dpufData from a phase III clinical trial has shown some benefits with pegylated interferon alfa-2b in the adjuvant setting; however, Richard Joseph, MD, suggests that interferon is not an appropriate option for most patients. Findings from the phase III EORTC 18991 study demonstrated an improvement in recurrence-free survival (RFS) with adjuvant pegylated interferon alfa-2b compared with observation in patients with resected stage III melanoma, Hamid notes.
– See more at: http://www.onclive.com/peer-exchange/melanoma-treatment/Adjuvant-Immunotherapy-for-Melanoma#sthash.UOi2ijAk.dpuf"Data from a phase III clinical trial has shown some benefits with pegylated interferon alfa-2b in the adjuvant setting; however, Richard Joseph, MD, suggests that interferon is not an appropriate option for most patients. Findings from the phase III EORTC 18991 study demonstrated an improvement in recurrence-free survival (RFS) with adjuvant pegylated interferon alfa-2b compared with observation in patients with resected stage III melanoma, Hamid notes.
In the study, the 7-year RFS rate was 39.1% with interferon versus 34.6% with observation. However, there was not a significant difference in overall survival (P = .57). The greatest benefit with interferon was seen in patients with stage III N1 ulcerated melanoma, Hamid notes. In this population, overall survival was improved by 41% with interferon compared with observation. However, 37% of patients in the study discontinued treatment with interferon due to side effects."
http://www.onclive.com/peer-exchange/melanoma-treatment/Adjuvant-Immunotherapy-for-Melanoma
-
- May 24, 2015 at 2:29 pm
You might find this interesting:
ata from a phase III clinical trial has shown some benefits with pegylated interferon alfa-2b in the adjuvant setting; however, Richard Joseph, MD, suggests that interferon is not an appropriate option for most patients. Findings from the phase III EORTC 18991 study demonstrated an improvement in recurrence-free survival (RFS) with adjuvant pegylated interferon alfa-2b compared with observation in patients with resected stage III melanoma, Hamid notes.In the study, the 7-year RFS rate was 39.1% with interferon versus 34.6% with observation. However, there was not a significant difference in overall survival (P = .57). The greatest benefit with interferon was seen in patients with stage III N1 ulcerated melanoma, Hamid notes. In this population, overall survival was improved by 41% with interferon compared with observation. However, 37% of patients in the study discontinued treatment with interferon due to side effects.
– See more at: http://www.onclive.com/peer-exchange/melanoma-treatment/Adjuvant-Immunotherapy-for-Melanoma#sthash.UOi2ijAk.dpufata from a phase III clinical trial has shown some benefits with pegylated interferon alfa-2b in the adjuvant setting; however, Richard Joseph, MD, suggests that interferon is not an appropriate option for most patients. Findings from the phase III EORTC 18991 study demonstrated an improvement in recurrence-free survival (RFS) with adjuvant pegylated interferon alfa-2b compared with observation in patients with resected stage III melanoma, Hamid notes.In the study, the 7-year RFS rate was 39.1% with interferon versus 34.6% with observation. However, there was not a significant difference in overall survival (P = .57). The greatest benefit with interferon was seen in patients with stage III N1 ulcerated melanoma, Hamid notes. In this population, overall survival was improved by 41% with interferon compared with observation. However, 37% of patients in the study discontinued treatment with interferon due to side effects.
– See more at: http://www.onclive.com/peer-exchange/melanoma-treatment/Adjuvant-Immunotherapy-for-Melanoma#sthash.UOi2ijAk.dpufata from a phase III clinical trial has shown some benefits with pegylated interferon alfa-2b in the adjuvant setting; however, Richard Joseph, MD, suggests that interferon is not an appropriate option for most patients. Findings from the phase III EORTC 18991 study demonstrated an improvement in recurrence-free survival (RFS) with adjuvant pegylated interferon alfa-2b compared with observation in patients with resected stage III melanoma, Hamid notes.In the study, the 7-year RFS rate was 39.1% with interferon versus 34.6% with observation. However, there was not a significant difference in overall survival (P = .57). The greatest benefit with interferon was seen in patients with stage III N1 ulcerated melanoma, Hamid notes. In this population, overall survival was improved by 41% with interferon compared with observation. However, 37% of patients in the study discontinued treatment with interferon due to side effects.
– See more at: http://www.onclive.com/peer-exchange/melanoma-treatment/Adjuvant-Immunotherapy-for-Melanoma#sthash.UOi2ijAk.dpufData from a phase III clinical trial has shown some benefits with pegylated interferon alfa-2b in the adjuvant setting – See more at: http://www.onclive.com/peer-exchange/melanoma-treatment/Adjuvant-Immunotherapy-for-Melanoma#sthash.UOi2ijAk.dpufData from a phase III clinical trial has shown some benefits with pegylated interferon alfa-2b in the adjuvant setting; however, Richard Joseph, MD, suggests that interferon is not an appropriate option for most patients. Findings from the phase III EORTC 18991 study demonstrated an improvement in recurrence-free survival (RFS) with adjuvant pegylated interferon alfa-2b compared with observation in patients with resected stage III melanoma, Hamid notes.
– See more at: http://www.onclive.com/peer-exchange/melanoma-treatment/Adjuvant-Immunotherapy-for-Melanoma#sthash.UOi2ijAk.dpuf"Data from a phase III clinical trial has shown some benefits with pegylated interferon alfa-2b in the adjuvant setting; however, Richard Joseph, MD, suggests that interferon is not an appropriate option for most patients. Findings from the phase III EORTC 18991 study demonstrated an improvement in recurrence-free survival (RFS) with adjuvant pegylated interferon alfa-2b compared with observation in patients with resected stage III melanoma, Hamid notes.
In the study, the 7-year RFS rate was 39.1% with interferon versus 34.6% with observation. However, there was not a significant difference in overall survival (P = .57). The greatest benefit with interferon was seen in patients with stage III N1 ulcerated melanoma, Hamid notes. In this population, overall survival was improved by 41% with interferon compared with observation. However, 37% of patients in the study discontinued treatment with interferon due to side effects."
http://www.onclive.com/peer-exchange/melanoma-treatment/Adjuvant-Immunotherapy-for-Melanoma
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- May 22, 2015 at 10:26 pm
Why not just go to Hopkins? Both Dr. Scharfmann and Dr. Lipson are excellent. I don't see anything on their web site for trials for Stage III right now but I don't know how often they update their web site.
Don't be afraid of "Observation only". Despite the nomenclature, it actually is a quite agressive treatment approach. If I remember correctly, the first year you see your oncologist every 3 months and you get a scan every visit. The second year, that interval jumps to every 4 months. In the third year is goes to 6 and I'm not sure when it goes to 1 year. But, I would want to do this at a melanoma center because all they look at are melanomas. There are people on this board and on the MIF board who have done Observation only and have been in remission (you'll hear the term NED applied to this, which means No Evidence of Disease) for years.
The fact that Yervoy was not recommended means you don't have advanced disease. So, in its own way, that's not such a bad thing.
Back in 2011 I was offered Interferon, Observation Only, or Clinical Trial. I opted for the trial because it gave me the best of both worlds: 2 out of 3 chances of getting the drug plus an aggressive scan/observation schedule. If I didn't qualify for the trial, I would have gone with Observation Only because the side effects of Interferon just weren't worth it.
In the end, the choice is yours. But please do seek a second opinion at a melanoma center.
-
- May 21, 2015 at 5:40 am
A little over two years ago, I was diagnosed with at least stage 3b melanoma. We couldn't do further testing and staging diagnosis at the time because I was pregnant with my son. Two months later, we began the rest of the process. It was determined that my first surgery while I was pregnant removed all the cancer cells. I was given similar treatment options. Observation, interferon, clinical trials (where I might be on interferon anyway), or advanced bio chemo. I knew that if I was going to do treatment, I'd want to do the hard and fast option of the bio chemo rather than the longer interferon treatment.
ultimately, my melanoma specialist took that option off the table because of the small size of the melanoma in the only positive lymph node. I opted to take the observation route. It was definitely not an easy choice and I spent many nights crying over not knowing what I should do. I still worry about whether I made the right decision.
I don't really have much advice because I'm not well versed in the newest treatments, but just wanted to share my decision to a similar situation.
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- May 21, 2015 at 5:40 am
A little over two years ago, I was diagnosed with at least stage 3b melanoma. We couldn't do further testing and staging diagnosis at the time because I was pregnant with my son. Two months later, we began the rest of the process. It was determined that my first surgery while I was pregnant removed all the cancer cells. I was given similar treatment options. Observation, interferon, clinical trials (where I might be on interferon anyway), or advanced bio chemo. I knew that if I was going to do treatment, I'd want to do the hard and fast option of the bio chemo rather than the longer interferon treatment.
ultimately, my melanoma specialist took that option off the table because of the small size of the melanoma in the only positive lymph node. I opted to take the observation route. It was definitely not an easy choice and I spent many nights crying over not knowing what I should do. I still worry about whether I made the right decision.
I don't really have much advice because I'm not well versed in the newest treatments, but just wanted to share my decision to a similar situation.
-
- May 21, 2015 at 5:40 am
A little over two years ago, I was diagnosed with at least stage 3b melanoma. We couldn't do further testing and staging diagnosis at the time because I was pregnant with my son. Two months later, we began the rest of the process. It was determined that my first surgery while I was pregnant removed all the cancer cells. I was given similar treatment options. Observation, interferon, clinical trials (where I might be on interferon anyway), or advanced bio chemo. I knew that if I was going to do treatment, I'd want to do the hard and fast option of the bio chemo rather than the longer interferon treatment.
ultimately, my melanoma specialist took that option off the table because of the small size of the melanoma in the only positive lymph node. I opted to take the observation route. It was definitely not an easy choice and I spent many nights crying over not knowing what I should do. I still worry about whether I made the right decision.
I don't really have much advice because I'm not well versed in the newest treatments, but just wanted to share my decision to a similar situation.
-
- May 21, 2015 at 8:11 pm
To Keeping your chin up-
On 5/16 a post was made by Never gonna stop…."recently diagnosed stage 3a" with many similarities to your case. You can see the responses that were posted there. I was in a position similar to you both in 2003! At any rate there are many trials available to folks who are Stage III now other than just interferon…anything from trials with intralesional therapies (though you must have a remaining injectable lesion or node), ipi vs nivo (that is anti CTLA4 [yervoy] vs anti-PD1 [Opdivo]), some with vaccines and others even using BRAF inhibitors. Trials are their own challenge, no matter the one you pick. Interferon is a therapy you can attain without trial particepation, but it has long been proven to make NO change in survival and is tough to take. Additionally, observation is the route many in your shoes choose. Here is a link to a post I wrote about NED treatment options: http://chaoticallypreciselifeloveandmelanoma.blogspot.com/2015/03/new-ipi-vs-nivo-trial-for-resected.html
A good deal of excellent advice was also given to the poster "New Stage III maybe IV" on 5/17 that may be of help to you as well. Wishing you my best, Celeste
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- May 21, 2015 at 8:11 pm
To Keeping your chin up-
On 5/16 a post was made by Never gonna stop…."recently diagnosed stage 3a" with many similarities to your case. You can see the responses that were posted there. I was in a position similar to you both in 2003! At any rate there are many trials available to folks who are Stage III now other than just interferon…anything from trials with intralesional therapies (though you must have a remaining injectable lesion or node), ipi vs nivo (that is anti CTLA4 [yervoy] vs anti-PD1 [Opdivo]), some with vaccines and others even using BRAF inhibitors. Trials are their own challenge, no matter the one you pick. Interferon is a therapy you can attain without trial particepation, but it has long been proven to make NO change in survival and is tough to take. Additionally, observation is the route many in your shoes choose. Here is a link to a post I wrote about NED treatment options: http://chaoticallypreciselifeloveandmelanoma.blogspot.com/2015/03/new-ipi-vs-nivo-trial-for-resected.html
A good deal of excellent advice was also given to the poster "New Stage III maybe IV" on 5/17 that may be of help to you as well. Wishing you my best, Celeste
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- May 21, 2015 at 8:11 pm
To Keeping your chin up-
On 5/16 a post was made by Never gonna stop…."recently diagnosed stage 3a" with many similarities to your case. You can see the responses that were posted there. I was in a position similar to you both in 2003! At any rate there are many trials available to folks who are Stage III now other than just interferon…anything from trials with intralesional therapies (though you must have a remaining injectable lesion or node), ipi vs nivo (that is anti CTLA4 [yervoy] vs anti-PD1 [Opdivo]), some with vaccines and others even using BRAF inhibitors. Trials are their own challenge, no matter the one you pick. Interferon is a therapy you can attain without trial particepation, but it has long been proven to make NO change in survival and is tough to take. Additionally, observation is the route many in your shoes choose. Here is a link to a post I wrote about NED treatment options: http://chaoticallypreciselifeloveandmelanoma.blogspot.com/2015/03/new-ipi-vs-nivo-trial-for-resected.html
A good deal of excellent advice was also given to the poster "New Stage III maybe IV" on 5/17 that may be of help to you as well. Wishing you my best, Celeste
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- May 22, 2015 at 9:16 pm
Thank you! I will look at those posts as well!
Kathy
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- May 22, 2015 at 9:16 pm
Thank you! I will look at those posts as well!
Kathy
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- May 22, 2015 at 9:16 pm
Thank you! I will look at those posts as well!
Kathy
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- June 2, 2015 at 1:25 am
Wishing you the best with this tough decision.
The landscape of melanoma treatment is totally different than it was 5 years ago – lots of new therapies! Take care of yourself!
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- June 2, 2015 at 1:25 am
Wishing you the best with this tough decision.
The landscape of melanoma treatment is totally different than it was 5 years ago – lots of new therapies! Take care of yourself!
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- June 2, 2015 at 1:25 am
Wishing you the best with this tough decision.
The landscape of melanoma treatment is totally different than it was 5 years ago – lots of new therapies! Take care of yourself!
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- May 21, 2015 at 11:37 pm
Hi Keepingyourchinup, as far as stats go, looking up on youtube key words (ASCO 2014and Melanoma) with key names like- Dr.Mario Sznol, Dr. Jeffrey S.Weber, Dr. Antoni Ribas, Dr. Jedd D. Wolchok, Dr. Patrick Hwu from Anderson Cancer center in Houston would be a good start. ASCO 2015 is being held in Chicago at the end of the month and new data will be presented on phase 3 trials of PD-1 drugs alone or in combinations with other drugs. Immunotherapy is the hot field in Melanoma today and for the last couple of years. ASCO stands for Americian Society of Clinical Oncologists. You can also look up Melanoma on Onclive, Medscape and Video from " The Angeles Clinic " with Dr. Omid Hamid. Wishing you the best in your quest!!! Ed
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- May 21, 2015 at 11:37 pm
Hi Keepingyourchinup, as far as stats go, looking up on youtube key words (ASCO 2014and Melanoma) with key names like- Dr.Mario Sznol, Dr. Jeffrey S.Weber, Dr. Antoni Ribas, Dr. Jedd D. Wolchok, Dr. Patrick Hwu from Anderson Cancer center in Houston would be a good start. ASCO 2015 is being held in Chicago at the end of the month and new data will be presented on phase 3 trials of PD-1 drugs alone or in combinations with other drugs. Immunotherapy is the hot field in Melanoma today and for the last couple of years. ASCO stands for Americian Society of Clinical Oncologists. You can also look up Melanoma on Onclive, Medscape and Video from " The Angeles Clinic " with Dr. Omid Hamid. Wishing you the best in your quest!!! Ed
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- May 21, 2015 at 11:37 pm
Hi Keepingyourchinup, as far as stats go, looking up on youtube key words (ASCO 2014and Melanoma) with key names like- Dr.Mario Sznol, Dr. Jeffrey S.Weber, Dr. Antoni Ribas, Dr. Jedd D. Wolchok, Dr. Patrick Hwu from Anderson Cancer center in Houston would be a good start. ASCO 2015 is being held in Chicago at the end of the month and new data will be presented on phase 3 trials of PD-1 drugs alone or in combinations with other drugs. Immunotherapy is the hot field in Melanoma today and for the last couple of years. ASCO stands for Americian Society of Clinical Oncologists. You can also look up Melanoma on Onclive, Medscape and Video from " The Angeles Clinic " with Dr. Omid Hamid. Wishing you the best in your quest!!! Ed
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Tagged: cutaneous melanoma
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