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.

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Hey Friends,

An update on my husband Scott's status:
Scott received 6 doses of Nivolumab, but only 2 of 4 scheduled doses of
Ipilimumab while on the BMS Nivo/Ipi trial at UVA. (The last dose
administered on October 30th, 2013). He was unable to receive the final
two, as his liver AST and ALT levels were vascillating between Grade
2-Grade 4 adverse effect reaction. Corticosteroids (prednisone) were
begun in mid-November 2013 (after a very odd 4-day
hospital-stay-requiring and as-yet-still-undetermined high fever
episode in Los Angeles). We saw results and began tapering (with the
hopes of rejoining the trial protocol as soon as levels equalized).

Scott's scans of December 27th revealed yet another 50% reduction in
his lung tumor size in the two more formidable locations...the largest
of which is now a mere 4.5mm, the smaller 2.5mm! One has resolved
nearly completely...and a few others seem "dead in the water,"
unchanged in nearly a year!

However, his bi-weekly lab work this week revealed his liver levels (at
our tapered down to 60mg a day dose) ascended DRAMATICALLY to nearly
14x the norm. Our fantastic oncologist, Dr. Grosh at UVA immediately
has bounced us back to a full 200mg daily, and Scott consulted (at Dr.
Grosh's behest) today with liver specialist Dr. Caldwell at UVA. We're
looking forward to seeing a perceptible drop in AST & ALT tomorrow when
we do labs. Our fondest hope is to rejoin the BMS trial with two years
of "maintenance" Nivolumab once his liver is "back to normal," as it
clearly is working so well for Scott and so many others.

We wanted to bring you all up-to-speed---as well as to see if you have
any insight/advice into this profoundly stubborn liver reaction to the
sequential Nivo/Ipi combination.

WIshing us all health and happiness and hope-
Cheryl Lage
Wife of Scott, Stage IV since Feb 2012
(Diagnosed in 2005 at 2a, 4 recurrences---surgeries, radiation, 27 bags of IL-2, two clinical trials and scans beyond counting and he's here and FIGHTING and LIVING!)

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Anonymous's picture
Anonymous
Replies 12
Last reply 1/10/2014 - 7:02pm

Anyone else experienced headaches with ipi? I'm going on about 2 weeks now of pretty constant headaches. Started pretty mild but lately I call them more migraine like. Thankfully MRI on Thursday came back clear. Scheduled for my 4th and final ipi infusion tomorrow. Just hoping this headache doesn't get worse with another infusion. 

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Lisa - Aust's picture
Replies 17
Last reply 1/10/2014 - 11:31pm

Hi Everyone,

Just wanted to share our good news and give others hope. My husband Craig started the Merck PD1 trial in Oct 2013 after prolonged success on the BRAF inhibitor trial. The one lymph node in his abdominal region flared up again, so he had to stop the BRAF trial. He had his first set of scans last week since starting the PD1 trial, and the results today were excellent. He had an 80% reduction in the size of his tumour. Although his tumour wasnt very big to begin with, the results are so encouraging, and it is such a relief that he is responding. This drug seems to be doing wonderful things, I hope everyone can have similar positive results.

We are a couple of relieved Aussies tonight.

Good luck to everyone fighting

Lisa

x

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Replies by: BrianP, kylez

http://www.theaustralian.com.au/news/latest-news/blood-test-to-tackle-me...

A SIMPLE blood test could identify those patients whose melanoma - the most serious form of skin cancer - has started to spread to other parts of the body, according to new research.

The test allows scientists to examine DNA shed from cancer tumour cells into the bloodstream, in particular a gene called TFP12.

The gene usually helps stop healthy skin cells growing out of control, which can potentially lead to cancer.

But in melanoma patients this gene is switched off because of the presence of chemical "tags" known as DNA methylation.

Experts behind the test found that higher levels of DNA methylation suggested the cancer had spread around the body.

Early stage tumours had relatively low levels of DNA methylation, while advanced cancers (those that had spread) had much higher levels, suggesting the gene was more tightly shut down.

Measuring levels of methylated TFP12 in DNA in the blood could help doctors work out whether the disease has spread and what treatments may be needed.

Dr Tim Crook, study author and a consultant medical oncologist based at the University of Dundee, said: "Once melanoma starts to spread it becomes far more difficult to treat. But actually detecting whether or not it has started to spread is also challenging.

"By using a blood test, we have the basis of a simple and accurate way of discovering how advanced the disease is, as well as an early warning sign of whether it has started to spread....

"There's increasing evidence that the latest treatments are more effective in these early stages and, if we can identify patients whose cancer has only just started to spread, this would significantly improve the chances of beating the disease."

The same Dundee researchers have identified another potential biomarker - NT5E.

This gene appears to become methylated and switched off as melanoma first develops. But if NT5E becomes unmethylated again, the gene is reactivated and helps the disease to spread more aggressively.

The researchers suggest that NT5E could be a possible target for the development of new treatments to tackle melanoma, particularly for aggressive cancers that have spread to the brain, lungs and other organs.

Professor Charlotte Proby, a Cancer Research UK dermatologist based at the University of Dundee, said: "Using blood tests to assess the landscape of our DNA is a simple way to learn more about what's going on under the skin. The switching on and off of certain genes seems to affect when, where and why the melanoma spreads.

"Our goal is to develop a panel of similar biomarkers that will help us to accurately detect those patients needing extra treatment to fight their melanoma.

I'm me, not a statistic. Praying to not be one for years yet.

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Anonymous's picture
Anonymous
Replies 3
Last reply 1/11/2014 - 12:35pm
Replies by: Anonymous, aldakota22, Richard_K

May be moving to CT. Does anyone have any input on Yale Cancer Center as a melanoma center.Has anyone any first hand experience there.May it be good or bad would appreciate your input.Any doctors should I seek.Thank you.

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Yvonne.D's picture
Replies 6
Last reply 1/11/2014 - 4:23pm
Replies by: Yvonne.D, BrianP, WendyD., Linny

Good morning.

I have a question for anyone who would like to help.

I was diagnosed back in November with Melanoma. I had my WLE done last week. I did not have the SNB done. My surgeon did check my lymph nodes in my groin area that day as the Melanoma is on the left thigh. She did not feel anything. Yesterday I pressing against my vanity when looking in the mirror and felt discomfort in my groin area. Felt on my left side and there is a pea sized lump there. Of course my mind goes right to the worst place. I have been suffering the last 2 months with a tailbone issue and then did something to my lower back/buttock area left side, like I put my back out(I sound like my mother now!) Or pulled a muscle 3days ago. So that side is in bad shape already.

I am just wondering if anyone had lymph nodes swollen in that area that was not melanoma or experienced anything like that? My WLE was on the 31st of december. Could it happen that fast after her just checking my groin and felt nothing? I know it is unpredictable and anything I am sure can happen, just wondering peoples thoughts.

Monday can't come fast enough to call my Dr. Or should I just go to emergency and get someone to check it there. I don't want to be over paranoid all the time but it's so hard not to be now.

Thoughts anyone?

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WendyD.'s picture
Replies 4
Last reply 1/12/2014 - 12:39am
Replies by: WendyD., Janner, Bubbles

I finally got to see a dermatologists and got my skin checked. Well, once the derm seen all of my path reports she suggested that I might have to have MOHS Surgery because she felt my margins weren't big enough. My melanoma was quite thin and the intial biopsy itself had clear margins. Then I had my WLE done and it came back completely clear as well. Why in the world would I have to have MOHS done? Then while she was checking me she marked two more places on my back and done shave biopsies on them. Why would she do that knowing my history with melanoma? Shave biopsies can alter my results if it comes back as melanoma. Grrr!! Well, on another note I did request for them to get my slides and let a derm path look at my intial biopsy which they are going to do. I definitely wanted a second opinion on that. But from my knowledge unless these other biopsies come back melanoma they only want me to come back at 6 month intervals. Is that normal? Also I did finally convince my doctor to excise the abnormal lesion as well and I believe they said everything came back ok on that. I guess I'm just confused on everything. She don't think I need 3 month follow ups but I need MOHS surgery? Has anyone else had this to happen to them before? Also I know Clark's level isn't used a lot anymore, but I am kind of curious what mine was or do they even check that anymore? I know I read something about if it is level iv that AJJC will put it in their system just not on the actual path report. I don't know everything is so controversial on some of these sites you never know what to believe. I want my life back! I have read other people's stories how melanoma was all they thought about once they got their diagnosis, and I understand completely cause I have done the same. It's almost like I'm afraid to be happy because I feel like it could be short lived by a recurrence or by me finding out it had already spread without me knowing it. Oh and by the way every back pain, headache, or any other pain I have now is melanoma( not really but that's what comes to my mind now). Where before I would count these things as oh well I'm getting older and stiffer. Or wouldn't pay much mind to them. Now I'm thinking should I get an x-ray or something? Or just ignore it cause I couldn't handle the diagnosis anyway? When I first was diagnosed and realized the low risk lesion I had I was relieved and felt very optimistic. I mean 95% or higher survival seemed pretty good. But now my thinking has gone to what if I'm the 2-5% that becomes a statisic? Thanks for letting me vent, because I don't feel like I can do this with my family. I have to put a smile on my face as if this never happened and like I'm going to out live Methuselah (which was the oldest living man in the Bible for those who didn't know). Well, I guess I might need some sleep sometime today. Good Night For Now.

In God I Trustsmiley!

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Apologies if I am posting this twice - I don't see my earlier post and so am thinking I may not have done it correctly.

My husband had a melanoma on the bottom of his foot, mestases in lymph nodes, all removed in October. He was in screening for an interferon/ipi randomized trial, but a December PET showed more cancer. He's just had surgery for removal of expansive melanoma in the groin area as well as a new spot on his foot.  I'm not sure if he is still Stage III or is now considered Stage IV.

Our surgeon and local medical oncologist are referring us to a specialist at California Pacific Medical Center in San Francisco.  I can see that they have a clinic that is totally focused on melanoma - does that mean it is a Center of Excellence?

At this point, we don't know what our options are. Ipi looks like the best best (He was tested for BRAF but does not have the gene). But are hoping we are going to a true Center of Excellence and not sure how to determine that.  I see that UCSF also has a melanoma clinic in San Francisco.

We are in Sacramento, and with the problems of lymphedema we are trying to manage, at this point getting on an airplane is not a very viable option.

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ecc26's picture
Replies 16
Last reply 1/12/2014 - 1:40pm

Hello,

It's been a while since I've posted but I've got a question or two.

After winning a fight wiht my insurance company about coverage I was denied access to a PD-1 trial in December because the researchers realized during prescreening that I had not tried the BRAF inhibitors yet. Not that it would have mattered- I would have been denied anyway because after successfully treating 7+ mets in my brain last summer with WBR there were 4 new ones found at prescreening- just about a month after a clean scan. Following denial of enterance to the trial I was placed on the BRAF/MEK combo and have been on those drugs for about a month, give or take.

I had a follow up MRI on Friday and my results appointment yesterday locally. Unfortunately the images from my December MRI did not upload into their system so we were not able to make an acurate comparison (and the written report does not give measurements), but based on what I saw on this new scan I very much expect I will be referred back to a center for either SRS or gamma knife. Hopefully they can get the computer guys on it and be able to more acurately compare the scans later this week, but in the mean time...

I know a little about the basic differences between the two methods of targeted radiation, but I guess I'm soliciting opinions about which may be the better choice and other's experiences with this therapy particularly regarding side effects. 

Thanks

 

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lucy3's picture
Replies 2
Last reply 1/12/2014 - 7:56pm
Replies by: Anonymous, JerryfromFauq

Hello all.  Anyone out there have information of this trial offered at Vanderbilt and MSK?   I have appointment next week in New York.  Have been researching this as well as their trial using attenuated dendrite cells as a vaccine to be used intradermally.  I am stage 3 B and refused the interferon arm of interferon vs ipi in my local area.  Any info appreciated re both therapies would be appreciated.  Lucy3

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Michelem's picture
Replies 4
Last reply 1/12/2014 - 9:40pm
Replies by: Michelem, doro, Anonymous

My husband is being treated for Stage III melanoma in Sacramento, but our doctors here now feel we need to see specialists in San Francisco.  We may be referred to Dr. David Minor at California Pacific Medical Center, or possibly a Dr. Spittler with UCSF. I'm not sure how to determine who's the best, or if there is a particular person we should try to see . . .

Comments and insights on best options in Northern California much appreciated.

My husband has had surgers in October and again in January to remove a melanoma from the bottom of his foot, cancerous lymph nodes.  90 days after the first surgery, a PET scan found more cancer in the groin area, which proved to be more extensive than our surgeon had anticipated.  I have asked if we are now Stage III or IV, but our surgical oncologist said that is open to interpretation - just that it is time to see someone for whom melanoma is a specialty area.

MicheleM

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Pretty interesting article on some neat things going on in cancer research.  There's a lot of press on immunotherapy treatments but there's some other novel treatments such as anti-drug conjugate (ADC) and anti-cancer stem therapeutics (CSC) treatments that are starting to show promise as well.  Encouraging to see that there may be even more options in the future. 

http://www.fool.com/investing/general/2014/01/11/how-researchers-are-waging-war-on-the-most-lethal.aspx

Brian

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JerryfromFauq's picture
Replies 1
Last reply 1/13/2014 - 1:12am
Replies by: JerryfromFauq

Why can I not paste in tshe body what I pasted in the Subject?????

 

I'm me, not a statistic. Praying to not be one for years yet.

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http://www.integrativeoncology-essentials.com/2013/03/is-there-any-other-anti-cancer-botanical-compound-as-exciting-as-curcumin/#sthash.Ab5ttvQf.dpuf

One might want to read the whole article.  MD Andeeron has written on the benefits of Curcumin.

 

One of the interesting findings:  
Curcumin Acts Synergistically With Chemotherapy and Radiation Therapy:

    Increases tumor cell sensitivity to chemotherapy and radiation therapy
    Protects normal tissues (liver, kidney, mucous membranes, heart, etc.) from radiation and chemotherapy injury
        One recent study demonstrated a significant reduction in radiation dermatitis (skin inflammation) in patients who received curcumin during their radiation therapy for breast cancer. Patients received either oral curcumin (2 gram tablets, taken 3 times per day) or a placebo. The authors reported that the patients taking the curcumin had dermatitis reactions that were on average 31% less than those taking placebo. One of the most impressive findings in this study was that the women taking curcumin had a marked reduction in their risk of developing severe skin reactions (called “moist desquamation”) compared with those taking the placebo; 28.6% (curcumin) versus 87.5% (placebo).

- See more at: http://www.integrativeoncology-essentials.com/2013/03/is-there-any-other...
http://www.integrativeoncology-essentials.com/2013/03/is-there-any-other...
 

I'm me, not a statistic. Praying to not be one for years yet.

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Good morning,

The FDA just approved the first-ever combination therapy for advanced melanoma! The combination involves a MEK inhibitor, trametinib, and a BRAF inhibitor, dabrafenib. Both drugs (developed by GSK) were approved by the FDA in May 2013 for use as single therapies. The MRF issued a statement on the approval, which you can read here.

Lauren - MRF

 

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