MPIP: Melanoma Patients Information Page

The MPIP is the oldest and largest community of people affected by melanoma hosted through the Melanoma Research Foundation. It is designed to provide support and information to caregivers, patients, family and friends. Once you have been touched by melanoma—either as a patient or as a family member or friend of a patient—you become part of a community. It is not a community anyone joins willingly. But if you must be part of this group, you will find no better place to find the tools you need in your journey with this cancer, and the friends who can make that journey more bearable.

The information on the bulletin board is open and accessible to everyone. To add a new topic or to post a reply, you must be a registered user. Please note that you will be able to post both topics and replies anonymously even though you are logged in. All posts must abide by MRF posting policies.

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Lyric17's picture
Replies 26
Last reply 10/21/2014 - 6:24pm

Hi everyone,  my name is Lyric and yes that is my real first name. I am 30 years old and I seem pretty healthy except for an issue I have going on with my index finger nail.

 

About a year ago I noticed a small skinny pale light brown streak on my nail. The line is near the side of the nail and not the middle of my name. It runs from the cuticle to the end of the nail. And to be honest I use to smoke and had quit about a month before I noticed this discoloration of a line on my nail. So when I spotted this I thought it was nothing more than cigarette tar stain to my nail and it would slowly go away since I was smoke free.

 

Six months went by and nothing changed. The small skinny light pale brown streak was in the same spot with no changes. My fiance kept telling me I was worrying over nothing and just to forget it and as you age your body changes. At the moment I went along with what she said but at times in the back of my head I didn't feel right about ignoring it. Kind of like it was my body telling me something or a possible warning. 

 

Finally at about a year I got tired of looking at it and after several hours of non stop looking online the only thing I seen remotely was something called Subungual Melanoma. My fiance did her own research and it's all she could come up with as well. She grew a little worried by now and so did I.

 

Next day I called my local clinic and doctor to get an appointment. I was able to see the doctor about an hour later. So the doctor looked at my index finger nail and was speechless. She said she had no idea in all her years of practice had she seen something like this. I mentioned to her what I found online and she left the room to do some searching. She came back and stated she had no idea and she called making a referral and appointment with a Dermatologist Clinic and Cancer Specialist next town over.

 

I had to wait about a month before I went to see the dermatologist. Once the dermatologist looked at my fingernail she asked if I'd like to have a biopsy done that day or later and of course I chose now. So the dermotologist comes back and ssys she is doing a punch biopsy of my nail and the skin area below the nail which is where melanoma/whatever it is is. She does the punch biopsy and not to much discomfort. 

 

Now I had to wait a couple weeks for the results of my biopsy. If I got a letter in the mail it was benign and if the called me it's malignant. Well today my results came by a phone call. But the RN says the results showed nothing but something is there and we need to figure out the cause of it. She said that this time I will be seeing the head main dermatologist next visit who will performing a deeper biopsy sample of the area. The RN stated they knew it was some type of melanonychia but don't know exactly why or what. So they don't know if it's benign or malignant or nothing. So now I have to do a second biopsy of the same spot and a little deeper. And now i gotta wait another month till my next biopsy. This concerns me a lot and has me extremely worried. My fiance keeps saying things will be alright but that people die young everyday - which this is not very helpful.

 

Can anyone give their thoughts and opinions here? I'd really appreciate it a lot. If you know anything about, anyone who has been through or if you have been through this please let me know more information. I feel lost and kind of like it's a type of cancer that many doctors don't know about. Help please!!!

 

BTW I have recently became a member also of Cancer Compass asking for help and thoughts. The people there have been really nice and I have had a couple replies but I would like to see thoughts and help also from those from melanoma.org site here. Please if you've have had experience, know someone who has or any information please let me know. I have included a couple pics as well of my index finger with the supposed issue. In the photo you will see the light pale brown line near the edge of my nail and you will also see where a recent punch biopsy was performed. As stated above that biopsy came back inconclusive and I have to now go in for a second biopsy which will be deeper. 

I'm a 30 year old white male btw just to give a little idea of my age and race.

I'm very terrified and scared. I have cried almost every day over  and can't imagine dying and leaving my two dogs and two cats. I can't imagine leaving my fiance as well who will not discuss or talk about it all. I have no family to talk to as I was adopted and have not talked with my adopted parents in over 10 years. I don't know my real parents and family so medical history and support is not there. I have no one to really turn to and I'm sorry for asking for help and support. But then again this could all come back benign but from what I've read one benign cases are more common in african american but with caucasian it's very rare and more possibly malignant. Plus the life expectancy is horrible. Help me with information or anything if you can.

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Janet Lee's picture
Replies 3
Last reply 10/21/2014 - 2:53pm

It has been months since I've posted something about our roller-coaster ride with melanoma. My Don has had one issue after another since his diagnosis in January of 2013, Stage IV. He finally started on Merck's expanded access to Anti-PD1 in late June, and at this point after five infusions it appears that he is not responding to the treatment. The mets in his lower abdomen appear to be growing and causing even more problems.

It breaks my heart to see this beautiful man suffer so, and to see his robust, healthy 200+ pound body deteriorate to a skeletal 130 pounds. Dr. Hodi at Dana Farber is now saying no more PD1 until he feels stronger. He has been in so much pain for so long, I think it has just sapped too much out of him.

Don has now been in the hospital for one month. He had an epidural catheter placed so that he gets continuous pain medication directly into his spine instead of taking all those pills and being affected by the pain meds mentally. The theory is to get him out of pain so that he can regain some strength to continue treatments.

However, now the catheter is causing him pretty significant discomfort and he is once again in too much pain to move much. And after being bedridden for a month, there's not much strength there at all.

As always, we appreciate any feedback, common experiences, helpful anecdotes.

I started writing an email to our friends and relatives right after Don was diagnosed, more so I knew I what I said to whom. I later started posting on one of those "caring" websites. It occurred to me that some of you may be interested these updates, so I'll give you the link here:

https://www.mylifeline.org/donlee

Keep up the good fight everyone. Good night.

Janet Lee

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Girl52's picture
Replies 5
Last reply 10/21/2014 - 11:33am
Replies by: Janner, Linny, Girl52

Got message from sis tonight: surgeon says BIL's lymph nodes clear (nothing said about WLE tissue yet). Yay! What does it mean to have pathology of metastatic melanoma with clean nodes? What would staging be here? And if primary remains unknown, could this mean there's still something in there somewhere that could pop up? Does anyone know where further testing/treatment/watch-wait goes from here in a case like this? Does this depend on results of WLE (e.g., satellite lesions, in-transit, etc.)?  Thank you for any insight.

Sis-in-law of person just diagnosed with metastatic non-cutaneous melanoma

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BrianP's picture
Replies 10
Last reply 10/21/2014 - 6:03am

Hey Chris,

Was just wondering how you are doing.  By my calculations you should be coming up on your 3rd Ipi soon.  Hope things are going well.

Brian

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RJoeyB's picture
Replies 5
Last reply 10/21/2014 - 12:39am

(Following up to my last radiation necrosis post a couple of weeks ago here:

 
This past week I had my scheduled three-month full-body PET/CT for continued monitoring but also to possibly be used as part of the continuing assessment in determining how to proceed on the question of radiation necrosis vs. tumor regrowth in my brain.  Physically, I think I've continued to improve slightly, perhaps starting to plateau over the last week.  I still need a cane to get around outside the house, but I'm mostly functional within limits again and we haven't had to increase the dexamethasone dose again.
 
The full-body portion of the PET was good.  No sign of any new metastatic disease elsewhere in the body.  The small lung met that was radiated (SBRT) in February didn't even make the radiologist's report and in reviewing the images, neither my radiation or medical oncologists can see it.  An area in my small bowel that's lit up on my past two scans (and periodically on prior scans over the years), but which we were pretty sure was transient GI inflammation near the site of my small bowel resection over three years ago, also didn't light at all.  A spot adjacent to the surgical site from May in my left tibia was noted in the report with a recommendation for follow-up with MRI, but recognizing that there was recent surgery and that the adjacency to the bone cement may make it challenging for MRI to differentiate.  Knowing my orthopedic oncologist (he's operated on me three times:  left humerus, femur, and tibia) and based on numerous prior conversations, the fact that this area is lighting up on PET likely won't be a concern — in the past he's said that there can be inflammation for 6-12 months after a bone surgery.  So we'll check in with him and it's possible he'll say to go ahead with the MRI, but I'm guessing not at this point, which I'm comfortable with.  We see him in a few weeks for a six-month post surgery follow-up anyway.  
 
(The only other items on the radiology report were cutaneous areas on my upper inner right thigh and bottom of my right foot and the only reason I note them here is to point out the finicky nature of PET:  both areas I told my wife the day before, "Don't be surprised if these light up on the PET."  The area near my groin is an infected pore or hair follicle, which I've been prone to since being on the steroid (reduced resistance to infection + increased sweating + weight gain + "chub rub").  And the bottom of my right foot has been a mess of blister, irritated, and dry skin since that leg and foot has been doing a lot of work with my messed up gait over the last couple of months.  The radiologist doesn't know any of these when reviewing the images, so they make the report, and then my medical oncologist has to "correlate".)
 
Which brings us to the big question, what about the radiation necrosis vs. tumor regrowth?  Of course, there is nothing close to an absolute answer without pathology, but both my radiation oncologist and neurosurgeon were influenced sufficiently to think we should continue down the path of this being RN.  First, while the PET isn't all too helpful in looking for brain metastases (remembering of course that the brain already lights pretty brightly on PET making tumor difficult to discern from normal activity), the fact that there was nothing so bright to stand out at all, indicating something more significant, is something they wanted to see.  My radiation oncologist also requested that radiology perform an "image fusion" of my brain MRI from two weeks prior with the brain portion of the PET/CT, and that fused image didn't show anything that stood out either.  Finally, while the steroid would treat either RN or tumor, they are encouraged that I've seen motor control improvement with the steroid.  The plan then is to continue for now managing this as RN with close monitoring, meaning another MRI in probably about a month.  In the meantime, we'll stay at the current steroid dose unless symptoms again worsen.  The goal of the steroid won't be to completely resolve the motor control symptoms (and it doesn't treat the underlying necrosis at all), only to keep me functional while minimizing the long-term dangers of prolonged steroid usage.  I'm told and have read that more often than not, RN can resolve on its own over time, so for now, the approach they want to take is to balance motor control issues with steroid effects and closely monitor as this plays out over the coming few months.  Other options were discussed, including Avastin, surgery, and I brought up hyperbaric oxygen therapy (HBOT), but the consensus is that we're not there yet with any of those.  Any changes on scans or symptomatically would put anything back on the table, of course.
 
It's as frustrating as it sounds, but I'm trying to be patient and live with the continued ambiguity, both skills I've had to work on over these past few years.  More to follow soon, thanks for reading.
 
Best,
Joe
 
 

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Anonymous's picture
Anonymous
Replies 7
Last reply 10/20/2014 - 11:13pm

This horrible disease has claimed another life…

On October 5th my father in law was called home after a lengthy 10 month battle with Melanoma.  I have posted on here anonymously a lot throughout this journey and have come to this board to learn valuable insight and to keep up on how everyone is doing.  It became my way of coping at times.  I want to say thank you to each and every one of you that participate in the discussions and even just come to read the posts. 

A little history…

My father in law was diagnosed in January 2014.  He had complained to his general practitioner that he had felt a lump below his right armpit last spring and the advice was “let’s watch it”.  By the December it had grown, was hard and bothersome so they scheduled a surgery to remove it the first week of January.  By the time they removed it, the tumor was the size of an orange.  The plastic surgeon also removed a mole off of his stomach and determined that was the primary.  He was then sent down to a surgeon who specialized in Melanoma.  She advised at that time he was at least stage 3, but would need to have a PET scan to determine if the melanoma was anywhere else. 

The first week of February we met with his Melanoma Medical Oncologists who gave us the results.  The melanoma had spread to his stomach, spleen, liver, pelvis, spine & right arm.  His LDH was in the 700’s and he was to start IPI immediately and they would test his tumor for the BRAF mutation.  By February 15th he was in the hospital due to the severe pain in his back.  Every doctor we saw gave us the same grim news that this was an aggressive cancer and with his tumor burden the odds were stacked against him.  They did a round of radiation to help try and reduce the tumors on the spine to help with the pain and decided to move him to a rehab facility.

In the beginning of March we learned he had the BRAF mutation.  He was also admitted back into the hospital because of the pain on that same visit.  Around the second week of March he was started on the MEK/Taf combo and was back in the rehab facility.  The doctors at this point are wondering how he is still alive.  By the end of March he is able to sit on the end of the bed and started using a wheelchair. 

In April he had a port placed and we also learned that he had a blood clot so they did the “umbrella filter”.  A doctor’s appointment in mid-April was the first bit of good news we have.  His LDH numbers are declining and by the end of the month he was able to come back home using a walker.  May continued with good news as the LDH was down around a normal range and he was able to walk with a walker, enjoy his grandchildren, spend time with his kids & wife.

The end of June we learned that his LDH number had climbed back up to over 700.  He was weaned down on his steroid and started Ipi two weeks after.  By the end of July his LDH number was still climbing.  We continued with the Ipi and in July had radiation on the tumor on his arm to help levitate some of the pain.  By August he was having so much pain walking, they did a round of radiation on his pelvis to help with quality of life.  His last appointment/Ipi treatment in September his LDH was up to 1800.  He had two tumors on his right side that were the size of oranges.  He was scheduled for another radiation treatment on those tumors and was to start Keytruda as soon as they could get it.  We noticed a cough on Wednesday and by Sunday around midnight it had caused shortness of breath.  The ambulance was called and he was taken to the ER.  At first they said it was pneumonia and transferred him to the cancer hospital he was to have the radiation at an hour away from his home town.  Tuesday when the doctors came in to see us, we were told that his tumors had increased everywhere and that they would finish the planned round of radiation to help with quality of life, but after that no treatment would be given.  They estimated he had weeks to months left. On Wednesday this all changed.  His regular oncologist informed us that his platelets were very low even after a blood transfusion and that he believed the cancer had moved to the bone marrow.  He informed us that at this point we were looking at a time frame of days to maybe a week and he would be moved into a hospice facility. 

As a family we discussed what his wishes were, had many good visits & watched him pass peacefully after 17 days in the hospice facility.  It was a long road and a hard fought battle & it will be a long road getting used to our new “normal” without him.  He was a good father, husband, friend, son & grandfather.  He never once complained or felt bad for himself.  He told his children in the beginning “no more tears, we will play the hand we were dealt”.

I ask that you pray for comfort for the family as they mourn the loss of a great man.  To all the fighters, survivors, & to those that have lost the battle, you will never be far from my thoughts and prayers.

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Anonymous's picture
Anonymous
Replies 0

I am going to chat in a few minutes if anyone cares to join me..  Hope to see some of you there..

Love and Light

Carole K

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Steve2142's picture
Replies 4
Last reply 10/20/2014 - 6:04pm
Replies by: Ed Williams, Anonymous, Steve2142

I had metastatic melanoma in one lymph node in 2012 and had a complete lymph node dissection. I did not opt for interferon.  Have watched it closely and had annual pet scans and all has been good.  I just found two suspicious spots and had them biopsied and they are both new melanoma lesions that the Dr. believes are tied to the original melanoma from 2012.  One on my back was a 6.5mm non-ulcerated lesion and the other was a 4.9mm ulcerated lesion in my scalp above the ear. Going back for a pet scan and will probably need to discuss immunotherapy again.  My question is would this be considered "distant metastases" of the skin and therefore puts me at Stage IV?  Thank you.

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Ashley's picture
Replies 8
Last reply 10/20/2014 - 3:03pm

Hi,

My dad has stage 4, and just started on a combo trial of nivolumab and lirilumab.  Since starting his LDH has been dropping... I don't want to get my hopes up, but at the start it was 400, after the 1st dose it went to 397, then 348, and today 260 (normal range 110-210).  I'm hoping this is a good thing, but just looking for some feedback :-)

 

Thanks,

Ashley

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BrianP's picture
Replies 7
Last reply 10/20/2014 - 3:01pm

I wanted to share this in the event someone else on here finds themselves in a similar situation as a friend of mine recently.  My friend is about 16 months into a 2 year clinical trial for nivolumab.  He achieved a NED status about 4 to 6 months ago.  About a week ago he went in for a regular infusion and got a big surprise. Right before he was heading to the infusion center the clinical trial coordinator came in and told him he was being taken off Nivolumab effective immediately.  Apparently in the protocol there is the following statement, "Discontinuation Due to Confirmed Complete Response:  Subjects with a CR continue to receive study therapy until response confirmation or for an additional 2 cycles (whichever is longer) and then enter the follow-up period."  Being none to pleased with this "surprise" my friend, along with the staff at UVA, appealed to BMS and got them to reverse their decision primarily on the argument that the quote above did not match the paperwork my friend had signed.

I'm curious if this foreshadows what BMS's actions will be at the end of the 2 years for most participants.  From Laurie's post about her trial it seems like Merck may have a different view than BMS.  Time will tell. 

Brian

 

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Hi :)

I have had a mole removed from the sole of my foot today. It was 4mm by 4mm in 2013, after a visit to my GP as it had ulcered & was weeping a clear fluid.

it grew from that to 7mm wide & 6mm high in 13mths.

My question is whether anyone has had a mole this size or bigger? That has evolved & grown so quickly (if that is quick?) & it ticks all the ABCDE criteria, but has come back benign? Or Dysplastic?...

Any advice greatfully recieved thank you! :)

Tori x

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katieherwig's picture
Replies 5
Last reply 10/20/2014 - 11:41am

I was diagnosed with Stage 4 on July 28, 2014. I had anywhere from 10-18 tumors. Mostly in my lungs, liver, and ovaries, it was "widespread melanoma". I also had some in my abdomen, bones, and subcutanous. I had exploratory surger removing my ovareis and some of my small intestine. I started Tafinlar on 08/20/2014 at MD Anderson and had my first round of zometa that day. I went back to MD Anderson on 10/14/14 to get my CT, PET, and MRI scans completed. I got my results on 10/15/14. My doctor was very pleased with the results. Only 2 tumors were shown active in my liver and my left thigh and one dead tumor in my lungs. We are so pleased and happy with the scans. That night I did my first round of Yervoy and my second round of Zometa. I will be continuing the Tafinlar and going every 3 weeks for my Yervoy for a total of 4 rounds. I hope this is just the begining of good news to come! It's hard but I can do it!

I also asked my doctor about diet do's and don'ts. He told me to follow the LCHF diet and also get some information at www.dietdoctor.com.

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SarahW's picture
Replies 15
Last reply 10/20/2014 - 5:17am

I saw a post earlier this week polling people with NED after treatment of stage IV melanoma. So I thought to ask how many of you out there have stable non-progression of Stage IV  on this drug combo. My husband has been on it since February with stable disease as of July's scans.

Prior to that he was treated with stereotactic brain radiation surgery x 8 brain tumors on two occasions, Vemurafenib alone, and Vemurafenib + XL888(pre-clinical trial drug) and dabrafenib alone.

His energy level and skin color have returned to his pre stage 4 level on the dabrafenib and Mekinist combo

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Anonymous's picture
Anonymous
Replies 2
Last reply 10/20/2014 - 5:11am
Replies by: rick1981, Anonymous

Is there anything to look forward to with regard to melanoma being presented at the 2014 European Society of Medical Oncology (ESMO) Annual Congress held September 26-30 in Madrid, Spain?

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Wilbur's_Mom's picture
Replies 6
Last reply 10/19/2014 - 12:37pm

My father had a melanoma on his leg that was removed by wide excision in October 2013.  He was staged at IIa and was told he needed no further treatment because his sentinel nodes were clear.  In late April he noticed three new lesions near the surgical site.  They were all three melanoma and he was referred to a melanoma group in SF.  In June he had another wide excision around the three lesions and three MORE brand new lesions.  He had sentinel node mapping again and three nodes were identified - two superficial and one deep.  His melanoma surgeon chose to only remove the two superficial nodes.  One of the two came back positive with melanoma and he was re-staged to IIIc.

His oncologist told him the group was recommending radical lymph node dissection of the groin - taking all nodes superficial and deep.  When he consulted with the surgeon, the surgeon wanted only to remove the superficial nodes.  He now has to decide whether to to the radical or superficial with not much information.

One concern I have are that there's still a deep node that hasn't been examined with potential for cells.  The second concern is that the surgeon wants to rely on PET scans for evidence of metastasis.  My father has had several clear PET scans but has active disease in his leg and inguinal nodes so I'm not sure how reliable they are for catching movement early.

Following the surgery (either surgery) he will join the clinical trial for Yervoy vs. Interferon.  If anyone has advice or experience about opting for radical or partial lymph node dissection we welcome input.

Thanks,

Stephanie

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