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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democat's picture
Replies 9
Last reply 11/4/2014 - 1:29pm

Does mitotic rate impact how fast melanoma will return? I was diagnosed as 3A in January 2013, but told that I was more like a 3B because of my very high rate of mitosis. Does that make it more likely that my melanoma will recur (if it does) sooner rather than later?

 

Roxanne

Stage IIIa/IIIb

since 1/2013

 

Roxanne

Stage IIIa/IIIb

since 1/2013

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Randy437's picture
Replies 9
Last reply 11/4/2014 - 10:21am

I'm now 5 years NED.

 

Randy - Stage IV

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Anonymous's picture
Replies 11
Last reply 11/4/2014 - 5:00am

hi ... i'm a Danish guy looking to enter a Bristol Myers Sqiubb phase 3 trial of ipilumimab and/or nivolumab and I was wondering if anyone else in this forum is participating in this trial already and what your observations have been so far - both in terms of tumor effects as well as side effects ... looking forward to your comments !

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JimS's picture
Replies 5
Last reply 11/4/2014 - 2:29am
Replies by: JustMeInCA, JimS, casagrayson, Anonymous

Hello,posted on here a couple weeks ago about my mom having something removed from her arm and her being very nervous about what it was.After talking with the kind folks on here and others,we had her calmed down and waiting for biopsy results.Well,it has been over 10 days and no word so she called the dermatologist today.They said the results would be delayed an extra day or two because the lab wants to do extra tests and stains.The lady said this was neither good nor bad.They just wanted to do extra tests.Well,needless to say,my mom is panicing worse thean ever now."Extra tests?" she told me."That cant be good."She's freaking out bad.

Anyone heard of this?Is it common?Thoughts on what to tell my mom?Thanks,everyone.

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Girl52's picture
Replies 19
Last reply 11/3/2014 - 6:28pm

My brother-in-law had followup visit today with general surgeon who did his WLE and SNB recently; like PET scan, nodes clean. Path report had said, "Diagnosis: metastatic melanoma" of the lesion on his arm. BIL has no plans to see an oncologist, much less a melanoma specialist, though folks here and other research indicate that he's a Stage III.

If staging information isn't cited specifically on your pathology report -- and neither your dermatologist nor surgeon use this precise language -- how do you know you're a Stage III? How do patients normally get this information. Can it happen that no one ever specifies this...that any/all doctors a patient sees assume that someone else has given him or her this info, or that he or she will arrive at this conclusion on their own? 

Surgeon didn't refer BIL to an oncologist, but did say he needed to be very alert for ANY skin changes, and any pain, fatigue, or other body signs that might indicate cancer spread. If they tell you this much, can't they come out and say, "Stage III?"   

    

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

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Gordknight's picture
Replies 15
Last reply 11/3/2014 - 5:35pm

Let me give you a bit of my background.  Also been a hypochondriac.  Well not always, but for at least the past 8 years or so.  Always worried that everything is cancer or something equally as bad.  Well today my worst fears came true.  After a week of waiting in anguish for my biopsy results to come in for two moles I had removed I got the call today.  One of them is Melanoma.  My soul dropped into my shoes and I instantly began to think about my wife and leaving her alone on this earth.  

Im a31 almost 32 year old caucasian male.  I requested my pathology report from my dermatologist.  I am meeting with a plastic surgeon on the 3rd of November since the melanoma is located on my neck.  Here is my pathology.  I dont know how accurate it really is becase he did a shave biopsy.  

 

PROCEDURE: BIOPSY

SPECIMEN LATERALITY: Left Neck

Breslow Thickness: Favor 0.22 MM

Clark Level (not overall tumor stage): Favor II

Ulceration/max width: Not Identified

Mitotic figures: <1 per MM squared

REgression: not identified

Lymphatic Invasion: not identified 

Perineural invasion: not identified

Microscopic Satellitosis: not identified

Tumor-infiltrating lymphocytes: Non-Brisk

Associsated Melanocytic Nevus: Absent

Predominant Cytology: Epitheloid

Lateral Margins: non involved (1mm)

Deep Margins: Not involved (0.5 mm)

TNM Tumor Stage: Favor T1a NX MX

 

I am even more terrified because the other day my wife accidently knicked the scab that had formed after the biopsy and caused it to bleed.  Could this make the cancer cells spread into my blood stream?  I am so scared.  Can anyone help me?

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vicuk's picture
Replies 5
Last reply 11/3/2014 - 12:32pm
Replies by: vicuk, Ginger8888, Anonymous, G-Samsa

So Helen has had latest scan and the melanoma is back. She was diagnosed 2. 5 years ago and was lucky enough to get on GSK MEK trial straight away.  Initially, the mel was in her ovary, her pelvis and her lungs. The trial drugs started work straight away and got rid of everything although her ovary was removed. The mel is back in her pelvis but her lungs and everywhere else are clear. Dr. says next step is Yervoy. Advice needed please. What are success rates with Ipi and where could we turn to after? We are in U.K so understand things will be different. She's my best friend and only 32. Ideas, advice and anything else.

Kind regards,

Vic.

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Jewel's picture
Replies 8
Last reply 11/3/2014 - 12:26pm

Hi there,

   Here is a fast history. 3.7 nodular mole found on husbands left calf 11/2010. Recurrance in 9/2011 on calf, Complete Lymphnode Dissection of left groin 3/19 positive. All clear until 9/2014 Ct scan followed by full body Pet Scan. Showing hot spots in the External iliac nodes & the pop nodes on the knee. Surgery(s) for removal is scheduled for 11/6. Hoping to get back to his NED status. Our oncologist is talking about starting him on YERVOY/IPI. My husband is Braf positive. Catherine from Melanoma Intl tried to look for PD1 trials for us but the closest is 5 hrs away. Ok so here is the question. My husband feels that if he is declared NED after surgery, why put that stuff in his body until HE HAS too. We are way up in the Adirondacks where the nearest hospital is an hour each way. We do have a local health clinic that is open M-F till 4. Is there any Stage 4 people here that have only maintained that way thru surgery? Is my husband crazy?, or am I for wanting him to proceed with YERVOY even though the side effects scare me. Thoughts and experiences PLEASE!

 

Thank you,

Jewel

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chowmene's picture
Replies 7
Last reply 11/3/2014 - 12:04pm

hi, my name is mark and just learning about melanoma. just had mole removed and was told it was superficial spreading melanoma clark lvl ll breslow depth 0.40 mm. i understand i'm lucky it was found when it was. should i use sunscreen even if i'm just gonna be out walking to work about 10 mins. time?

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BrianP's picture
Replies 17
Last reply 11/3/2014 - 9:01am

I mentioned I would post something after returning from the immunotherapy conference so here goes.  Sorry if it’s a little long but I know Joe will appreciate it ;).

I really enjoyed the Immunotherapy Patient Forum Hosted by GRACE and MRA in Chicago on Oct 26.  They talked about having more of these in the future and if they do I highly recommend it.  The presentations will be available online in a couple weeks so I won’t regurgitate all the presentations, nor could I if I wanted to, but I’ll try to list a couple things that struck me as interesting.  I’ll post the link to the presentations when they do become available.  Here’s a link to the agenda:

https://docs.google.com/document/d/1ih75jS0VuZXm2Jqt-E5BbeqG6-fyZbwJly74rGm1or8/edit?usp=sharing&utm_source=Immuno+Forum+-+Pre-Event+Logistics&utm_campaign=2014+Immunotherapy+Registrations&utm_medium=email&pli=1

I think it was Dr. Pardoll from John Hopkins who talked about a renaissance occurring with vaccines partly driven by some success with combining them with anti-inhibitors.  Expect to see more trials in the future.

Dr. Wolchok made a comment that especially struck a chord with me when he said, “Stable disease is OK, in fact it’s good.”  He said this is an indication that the immune system is effectively working.  One of the reasons I went to the conference was to see if I could get any answers on what the future holds for anti-PD1 patients with long term stable disease.  Basically the answer was, “We just don’t know yet.”  Guess I should have anticipated that but I wish every once in a while someone would say what their gut feeling is.  I know why they don’t but it would be nice if they would.  The only Dr. I have met along this journey that has done that for me is Dr. Weber at Moffitt.  I did see a couple case studies presented which showed cases where tumors dramatically shrunk but never went away.  When they were biopsied they basically found “battle field debris”.  Apparently this “debris” is not very soluble and could stay there for a long time.

Most of us know melanoma has a very high mutation rate.  A presenter talked about why some cancers respond to drugs like Anti-PD1 and others don’t.  Each time a cancer cell mutates it expresses a different type of protein which gives the immune system another chance to recognize the cancer as the enemy.  They think this might be one reason why melanoma and other cancers such as lung-cancer are responsive to immunotherapy.  This highly mutative characteristic of melanoma topic also came up in discussing why in some patients some tumors respond while others continue to grow.  They still cannot explain why this happens other than it being a result of the different mutations.  One of the doctors advocated for patients who find themselves in this situation to consider donating their tumors to clinical study in the event they succumb to their disease.  As you can imagine having a patient with some tumors responding and some not and being able to study those tumors to determine the differences could unlock the key to many mysteries.  Apparently this type of tumor donation must occur within 6 hours of death.  If you are interested in participating in something like this I would talk to your clinical study doctors.  They didn’t give much detail about how this is done but if anyone thinks they might be interested and can’t get anywhere with their doctors let me know and I’ll reach out to MRA and see if they can shed more light.  Along the lines of mutations and having some tumors that respond and some that don’t, it was emphasized the importance of repeating biopsies when new tumors grow in order to see what type of mutations and what type of antigens are present.  I think this is more important to the clinical trial doctors than the patients because other than knowing the Braf mutation I’m not sure what we as patients can do with the knowledge of what antigens are being presented.

A couple forecasting stats thrown out by Dr. Pardol I thought were interesting: By 2025 70% or greater of patients with cancer will receive immunotherapy.  Greater than 95% of immunotherapy potential has yet to be mined.  Another quote that was attributed to Dr. Wolchok was that we are at the “end of the beginning of immunotherapy treatment.”  I think what he means by this is we’ve just kinda finished the introduction of this Immunotherapy book and now you can expect things to really start happening. 

Dr. Pardol talked about immunotherapy and the ability to create an immune system memory but stopped short of saying that’s what’s happening with any of the inhibitor blockers available now.  He said combination therapy is the future.  One thing Dr. Wolchok said that I thought was interesting is he never imagined that the Anti-PD1 drugs would be effective as they are.  I think this is a reflection of how complicated and dynamic the immune system is and how surprising it was to him that only blocking one inhibitor would have such a profound influence not only with melanoma but a variety of cancers.

Dr. Hellmann gave a good presentation on the history of immunotherapy.  During the presentation he mentioned a mouse study combining IPI and Tvec that’s had amazing results.  Not sure if human trials have started but I think you can expect to see some in the future if not already.  I learned during his presentation why all these drug names end with “mab”.  “Mab” describes a monoclonal antibody (i.e. Ipilimumab , nivolumab, pembroluzimab)

During question and answer session the panel was asked if there was still a role for Interferon and IL-2.  Panel seemed to agree there still was a role but leaning more toward combination with an inhibitor and more so if we can narrow which subset of patients will respond.

Panel talked about PD-1 and PD-L1 which I think they said are getting similar responses.  I thought PD-1 was getting a little better response.  Maybe  Celeste can verify.  One thing Dr. Wolchok said is we may see PD-1 and PD-L1 combination in the future.  Sounded redundant to me but he said the ratio of PD-1 and PD-1 ligand is not a 1 to 1 ratio so some type of cocktail of anti-PD-1 and anti-PD-L1 at the appropriate ratio may have better results.

That’s all for now.  All and all a great experience.  It’s very uplifting  to see the optimism in person of some of these great minds in the field of immunotherapy.  The forum was first rate all the way from the colored printed binders of all the presentations they gave to all the attendees, the thumb drive they gave all the attendees which contained all presentations, and the amazing food they continued to put out all day.  And all this for just a $25 registration fee.  Amazing. 

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KRob's picture
Replies 4
Last reply 11/2/2014 - 3:23pm

Friends, 

I am a stage IV survivor (10 yrs this Feb) who visits now and again to check in on others, get the latest news, and try to share hope.

For those who have been and those who are new to this world of melanoma, never give up hope and never accept being a statistic! People do survive! 

For you whose battle is not going well, I pray that God our Father gives you strength and courage. Please know that you're always in the prayers of others.

Today I ask your prayers for a fellow melanoma warrior, Danny age 60, who was just diagnosed last week stage IV with metastatic spread to his bones (more tests are forecoming). He is at The James in Columbus, Ohio. Please pray for Danny.

Many thanks,

Karen

"Write it on your heart that every day is the best day in the year." - Ralph Waldo Emerson "Dreary though the path may look to others, it has quiet lights and gentle shades that no other path in life can offer."

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Anonymous's picture
Anonymous
Replies 7
Last reply 11/2/2014 - 8:14am
Replies by: kalisama, SStamps, casagrayson, Anonymous

2 weeks ago we found out my mom's melanoma has returned to her spinal fluid and ventricle of her brain (diagnosed via two separate spinal taps and brain MRI). She has a history of one large brain met, but had that gamma knifed and then a subsequent brain surgery a little over a year ago. Her doctor said she now has leptomeningeal disease, and we're waiting on scans (Fri: PET; Mon: spine MRI, brain MRI) to see if it's elsewhere in her body. Does anybody have anyone I could reach out to for help?? I've been searching through posts and, per other posters, have seen that Dr. Papadopoulos at MD Anderson is someone we should try (since he does intrathecal IL-2 radiation to the spinal fluid). My mom is my everything, and I have never been so scared in my life. She's battled melanoma for the last 5 years and has done interferon, il-2, ipi, gamma knife...She's both Braf and CKit negative. She has completed one round of Temodar and is set to start the second round next week...WBR has also been discussed... I just don't know what to do and I feel like her oncologist has no idea what to do either! :( Any help, resources, uplifting stories, etc. would be greatly appreciated!!! 

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Steve2142's picture
Replies 5
Last reply 11/2/2014 - 1:06am

I am currently being BRAF-tested.  If the results are positive, my onologist will put me on taflinar + mekinist.  If I am negative, he mentioned an expanded access trial with yervoy + keytruda.  I have not been able to find out how anything on this trial or the combo of these drugs.  Any info would be very much appreciated.  Thank you!

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Adrian G's picture
Replies 3
Last reply 11/1/2014 - 11:53am
Replies by: oldblue, arthurjedi007, Anonymous

 

 

Hi,

 

my sister has been diagnosedwith malignant melanoma in 2009 stage 3. She had 3 surgeries to removed the primary and lymph nodes. After that was receiving chimo, interferon and radiotherapy.

This august on the last CT scan a lymph node (between the kidney and spleen) was looking suspicious on the image. 

She had a surgery to completely remove the lymph node (fully encapsulted and tested positive for melanoma). Everything else looks clean. 

Does she need any adjuvant therapy after sugery? 

 

Many thanks

Adrian

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StephyD83's picture
Replies 15
Last reply 11/1/2014 - 4:00am

Hi Everyone-

I was DX with Melanoma In-situ in March of this year. To give you the history I had a severly atypical mole on my forehead that was removed with a shave biopsy in Nov of 2012 & my Derm at that time told me it was begin & no further treatment was needded. I only just found out that it was actually severly atypical & the Pathologiest  recommened that it be removed via completed excision. This was not dont & it grew back. I went in to my new Derm in Feb of this year & she sent me to plastic suregy for removal & 2 surgeries later it was completly removed. I had found a lymph node in my neck on the same side as they Melanoma so I went to teh Dr & they sent me to Oncology PET Scan, biopsy, etc. The 1st PET was completly normal in April 2014. Now I just went yesterday for a follow up PET & this is what was seen. 

Ther are various izes axillary nodes seen with slight uptake the most prominent 13 x 7 mm in the left SUV 1.96 &  the most prominent in the right 9 x 6mm  SUV 1.61. There is increased uptake in the adnexa slightly larger in the right SUV 5.23 then the left SUV 3.40. There is a linear are of slightly higher uptake at the superior endplate of the bodies of the spine, the highest uptake is seen in T11 SUV 4.03. My referance SUV for mediastinal blood pool is SUV 2.09, Liver SUV 3.51, & Spleen SUV 2.83. Also, they did see several lymph nodes in my cervical region & in my jaw & under my jaw with no abnormal uptake.

 

Does anyone know what this means? Thank you in advance!!!

 

Thanks!

Stephanie

 

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