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Hello Trent,

It seems that the combo is working. Your scan results are very encouraging. You should ask your doctor about the overall response for this scan. Stable disease in one lesion does not mean overall response “stable disease” if other lesions are no longer the issue. Likely you have partial response. Your doctor cannot push you to take the 4th combo, but if he advises you to take it, I would go for it and tolerate side effects instead of just continuing nivo alone, which was not given you much success in the past. The liver lesion may shrink/disappear with more cycles of treatment. If not, is it something what could be surgically removed? The choice is yours.

Best of luck.

What if you get complete response? If you stop therapy now, all your suffering from the combo to date would be for nothing. Lost thyroid and pituitary function can be managed with hormone replacement therapy. Maybe diarrhea can also be brought under control.
Nobody can make a decision for you, but I think MD Anderson is right advising you to get another infusion/see the scan results before making any decisions. Just my 2 cents.

What does doctor recommend? What is your doctor assessment of your disease status on Opdivo? Something to keep in mind that Yervoy could be added to Opdivo. The combo has more side effects compared to Opdivo monotherapy, but the response rate is much better.

Could it be just a blood blister? It i common to get those on the cheek mucosa.

If your doctor wanted to freeze it, it is most likely not a nevus but a seborrheic keratosis. I would not worry over it but ask your doctor when you have an appointment. If this is indeed a nevus, he/she can remove it for your piece of mind.

Good luck, Mike! Hope you will get an appointment with Dr. Hamid ASAP!
A the same time, I think it would not hurt to inquire about that trial in San Diego, which uses IL-2 plus PD-1 in patients who become refractory to PD-1 9which is your situation). The goal is to overcome the resistance to PD-1 and get response back on truck. At least this is immunotherapy combo and not chemo. It any case, you need to act fast. Hope you will find a plan you are comfortable with!

My mother had the whole nail removed with the lesion excised. There was no Hutchinson sign. Now we are waiting for the biopsy results. Is it possible to have just a nevus and not melanoma??? The dioctor said the lesion looked superficial.

It looks like nevus spilus to me: benign congenital nevus type. You could google it and see similar pictures. For your piece of mind, however, I would make an appointment with a dermatologist to confirm it. 

This is the unusual progression for thin melanoma. Do you know what was your primary melanoma  depth?

I am sorry about your situation. It does not sound like your doctor is using the right approach. MRI, for example, is another option to evaluate your lump and other parts of the body (see the guideline https://www.acog.org/Clinical-Guidance-and-Publications/Committee-Opinions/Committee-on-Obstetric-Practice/Guidelines-for-Diagnostic-Imaging-During-Pregnancy-and-Lactation?IsMobileSet=false). Wonder if they can excise the lump completely since it causes so much discomfort and distress. Have you consulted with a surgeon?
I would seek a second opinion at a major cancer center where the comprehensive care team, including melanoma specialist, are available.

Mike, I would not rule out IL-2. If this drug works, it gives a prolonged remission if not cure. For example, check out this new clinical trial, which is recruiting in San Diego:
High Dose IL-2 in Combination With Anti-PD-1 to Overcome Anti-PD-1 Resistance in Metastatic Melanoma and Renal Cell Carcinoma https://www.clinicaltrials.gov/ct2/show/NCT03991130?recrs=a&cond=Melanoma+Stage+IV&rank=2
I would also request to test your tumor(s) for mutations. You never know, maybe there are mutations for which targeted therapy is available.

Best of luck!

I am sorry about your diagnosis. Wonder if you could describe that “light colored mole” that turned to be melanoma. It is unusual for melanoma not to be dark and it would be good to know how it looked like for awareness. It is great that you caught is so early! Thanks!

Since it is grown and is quite big now (1 cm is not a small lesion), I would remove it for a piece of mind. Maybe it would be worth to let a plastic surgeon to do it: it will be cosmetically better and the whole lesion would be gone. 1 cm is too big for a punch biopsy, while shave biopsy may not remove the whole thing. Best of luck!

Personally, your elbow spot does not look like melanoma to me. Having said that, you should go and see a dermatologist and not GP to figure out what it is. The black line under nail sounds more concerning to me that this spot. Could you post a picture of it? 

Sorry about your diagnosis! Because your melanoma presentation was not very common, could you please describe how your lesion did look like (e.g., size, color, rized, flat, etc.). We would appreciate it!