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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nicoli's picture
Replies 12
Last reply 8/11/2011 - 9:56pm

I am NED as of March, when I had my last surgery.

This past week and a half I've had bronchitis and lots of coughing. Then came the neck pains. Fairly painful shooting pains in my glands behind my left ear and jawline.  The right side of my neck had the lymph nodes removed in 2010 and I have had no problems with the left side of my neck. Until now. This was NOT muscle, NOT bone, what else could it be but glands? 

So I said, I will not freak, I will not freak. It could be related to the coughing. (Note: I have had bronchitis at least 15 times in my life and NEVER had any kind of neck pain). Not every ache and pain is the cancer returning. But I was freaked.

Told myself to wait until Monday and if the pains were still coming I would call the onc for an appointment.

WAHOOOOOOOOOOOOOOOOOO. The pain is gone as of yesterday afternoon, as is most of the cough!!!!!!!!!!

My next PET is end of this month. I can do this thing.

Nicki, Stage 3b

Be strong and take heart, all you who HOPE in the Lord. Ps. 31:24

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AZ_Gal's picture
Replies 8
Last reply 8/8/2011 - 2:52pm
Replies by: MichaelFL, Anonymous, mombase, AZ_Gal, lhaley, nicoli

I had my SNB and WLE on Friday August 5th. Things went well according to my husband. I don't remember much.

 

They took out 4 lymph nodes in my axilla. 3 had the radio active dye in them one and tattoo ink. (i have 5 tattoos) I can grantee that I will be getting no more tattoos!

 

They say I should have my results by Wednesday the 10th. Cross your fingers!

 

For now I'm in an Oxycodone daze and sleeping quite a bit.

 

Thanks for all you support guys! I really appreciate it.

 

~Kim

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Combo Therapies Tested to Overcome Drug Resistance in Melanoma Patients

ScienceDaily (Aug. 4, 2011) — About 50 to 60 percent of patients with melanoma have a mutation in the BRAF gene that drives the growth of their cancer. Most of these patients respond well to two novel agents being studied in clinical trials that inhibit the gene, with remarkable responses that are, unfortunately, almost always limited in duration.

In a study published August 2 as a Priority Report in the peer-reviewed journal Cancer Research, scientists at UCLA's Jonsson Comprehensive Cancer Center tested a combination of small molecules that may, when used with the BRAF inhibitors, help overcome this drug resistance and extend the lives of those with advanced melanoma.

The team, led by researcher Dr. Roger Lo, focused on testing only small molecules that are already being studied in various phases of clinical trials in the hope of developing a combination treatment that can be studied in patients much more quickly than compounds that aren't yet being tested in humans.

"These molecules we tested are already being studied in patients with other cancers, and some of them have very good toxicity profiles with few side effects," said Lo, a Jonsson Cancer Center researcher and an assistant professor of dermatology and molecular and medical pharmacology. "The idea was to combine some of these with the BRAF inhibitors and come up with something that we don't have to wait years and years to use in patients. We need to find a way to combine these molecules so the cancer cell cannot get around them."

This study builds on the discoveries from a previous study published by Lo last year in the journal Nature. That study found that subsets of melanoma patients with BRAF mutations become resistant to BRAF inhibitors through either a genetic mutation in a gene called NRAS or the overexpression of a cell surface receptor protein.

It had been theorized that BRAF was finding a way around the experimental BRAF inhibitors by developing a secondary mutation in the same gene. However, Lo determined that was not the case, an important finding because it means that second-generation drugs targeting BRAF would not work and therefore should not be developed, saving precious time and money.

Lo and his team spent two years studying tissue taken from patients who become resistant to try to determine the mechanisms that helped the cancer evade the inhibitors. In the lab, they also developed drug resistant cell lines, in collaboration with another UCLA lab headed by Dr. Antoni Ribas, also a Jonsson Cancer Center researcher. There are still other mechanisms of resistance in melanoma patients with mutated BRAF who are treated with BRAF inhibitors, which UCLA researchers are seeking to uncover and that may provide even more targets for drug therapy. Cancer operates similarly to a criminal seeking to evade his captors, and the small molecule inhibitors are like the police barricades that seek to block escape. When one of the cell signaling pathways driving resistance is blocked, the cancer finds a way to activate another pathway that will drive its growth. If that pathway is blocked, yet another pathway may be activated. The goal is to find a way to block all the pathways helping the cancer evade therapy at once so the cancer cells die before finding a way around the drugs.

In the lab, Lo and his team would apply one drug at a time to the resistant cancer cells and see what route or pathway the cancer used to escape. They then determined what pathway was being used to evade therapy and found an inhibitor for that. In the end, the researchers identified the most optimal combination of molecules to block the pathways PI3K, mTORC and MEK.

"Normal cells have physiologic safety mechanisms to avert death and this is taken to a higher level by the cancer cell to serve its growth agenda, making single agent targeted therapy insufficient," Lo said. "We have to block several roads, which is what is behind our approach to developing combination therapies. The key was to figure out how to combine the molecules so that the cancer cannot get around them. Why wait for the cancer to escape? Let's block all the pathways right from the start."

Lo said this study highlights the need not only to identify mechanisms of acquired resistance to targeted inhibitors, but also to understand the signaling network associated with each mechanism to generalize potential translatable approaches to overcome drug resistance.

Once the right combinations of drugs were used together, the inhibitors "consistently triggered cell death in a highly efficient and consistent manner," the study states. "Together, our findings offer a rational strategy to guide clinical testing in pre-identified subsets of patients who relapse during treatment with BRAF inhibitors."

Lo said a clinical trial could be planned that first examines the patients' cancers to identify the resistance mechanisms at play. Those patients could then be funneled into a study pairing the inhibitors that target those specific pathways. Patients with other resistance mechanisms at work would be placed in studies testing inhibitors specific to their resistance mechanisms.

The next step, Lo said, is to identify all the mechanisms of resistance in this form of melanoma.

According to the American Cancer Society, melanoma incidence rates have been increasing for at least 30 years. This year alone, more than 68,000 Americans will be diagnosed with melanoma, with 8,700 dying from their disease.

The study was funded by Wesley Coyle Memorial Fund, Ian Copeland Melanoma Fund, Wendy and Ken Ruby, Shirley and Ralph Shapiro, Louise Belley and Richard Schnarr Fund, National Cancer Institute, STOP CANCER Foundation, V Foundation for Cancer Research, Melanoma Research Foundation, Melanoma Research Alliance, American Skin Association, Caltech-UCLA Joint Center for Translational Medicine, UCLA Institute for Molecular Medicine, Sidney Kimmel Foundation for Cancer Research, Stand Up to Cancer/American Association for Cancer Research, Fred L. Hartley Family Foundation and the Jonsson Cancer Center Foundation.

Advocate for your own treatment.. Stage 4 Melanoma NED Surgery,Radiation, Temodar 300Mg July 2009-March 2010, then Thorocotomy...now "Phase I Study of Anti-PD-1 Human Monoclonal Antibody MDX-1106 and Vaccine Therapy"

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EricNJill's picture
Replies 4
Last reply 8/6/2011 - 1:53pm

These last two days have been unbelievably painful for me.  I miss him so terribly.  I am glad that he is at peace and rejoicing in heaven.  Now my battle begins...living on without him. 

Thank you all for your prayers and support during our journey.

http://www.legacy.com/obituaries/dayton/obituary.aspx?n=eric-jerome-sizemore&pid=152880705#.TjwMep5G82E.facebook

Because I was asked, here is a link to the Paypal Fund set up for our family.

https://www.paypal.com/us/cgi-bin/webscr?cmd=_flow&SESSION=IZ0He2TpNwyduRqOljgzD5oNqwvN9MgSv7B-Omm-nod2fJ-_O4iSxlrs6fO&dispatch=5885d80a13c0db1f8e263663d3faee8d1e83f46a36995b3856cef1e18897ad75

EricNJill in OH

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Brettuss's picture
Replies 9
Last reply 8/11/2011 - 5:52am

 

My wife has what the dermatologist calls an "extremely high" number of atypical moles. Her father had melanoma, Stage III and is still alive and cancer free after 12 years. She went into the dermatologist on July 19th and they did a shave biopsy (I think) on the maximum number of moles they could do, five. Unfortunately, one of them came back positive for melanoma.

This scared the crap out of us. We have a 4 month old son. I can't imagine a future without her. She just became a nurse. We are finally hitting our stride. We are only in our late 20's.  This is insane.  Fortunately, the dermatologist thinks they got it all with the biopsy. Here are the official stats:

Depth of .75 mm, Clark's Level III, no ulceration, no mitotic evidence, margins clear.

They are going in on August 18th to take an extra 1 cm from around the site of the mole. If the tests there show no melanoma cells, and they have said they think it will, she will be given an 'all clear'. Based on the pathology results, there are no plans to do a sentinel node biopsy.

Is this news as good as we think it is? No melanoma would be better, but aside from in-situ, I think these results are pretty good - or am I grasping for something that isn't there? For those with experience, would you suggest pushing for a SNB even though it isn't officially recommended?

This was a huge wake up call to us. Her making her dermatology visit is also a direct result of the "Dear 16 Year Old Me" video, so THANK YOU to the people who posted that video. You probably saved her life.

Are there any of you who track your moles at home? What method do you use?

I want to make sure that we catch every last one of these bad moles right when/if they start.

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mombase's picture
Replies 10
Last reply 8/6/2011 - 2:01pm

This is just a general question, and this might be a figment of my imagine:

Are there lots and lots of folks who have been diagnosed as Stage IV that were declared free of disease years prior? For example, I had a lesion on my back that was fairly deep (can't remember the actual Breslow rating), it was removed and sentinel galns under both armpits were negative for disease.  I was told "congratulations", sent on my way, and no further treatment was advised. Three years later, melanoma brain tumor and lung tumors.

I know "the beast" is sneaky and resistant, but isn't there anything that dermatologists, nutritionists, etc. could advise to maybe alert a person that a certain lifestyle change might aid in helping the body fight off future melanoma?

I am thinking that there are a LOT of folks who are in the same boat. Not that the disease might always be avoided, but that we might have a better chance. I know this is not a medical judjment,  just a personal one!

Cristy, Stage IV

Getter done!

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fgilbert63's picture
Replies 1
Last reply 8/5/2011 - 5:30pm
Replies by: MichaelFL

Just wondering if anyone has heard of this or used naltrexone.

http://www.lowdosenaltrexone.org/index.htm 

Frank

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Anonymous's picture
Anonymous
Replies 4
Last reply 8/9/2011 - 9:22pm
Replies by: Angela C, Anonymous, Terra, Tim--MRF

Hello.

I am a Stage IV patient and just had a brain MRI this week and the results say, "There is a minimal punctate focus of enhancement along the high anterior right frontal lobe. This measures 2 to 3 mm in maximal size and is on the cortical surface. This is a new finding when compared with the previous exams and is suspicious for a tiny metastatic lesion."

I've never had any mets to the brain before. So, is there a possibility this could be something other than melanoma? I'd love to think that is the case, but I don't want to be unrealistic. A Stage IV Melanoma patient having something show up in the brain is a big red flag. This is very tiny. So, will they just assume it is melanoma or do they ever attempt a biopsy?

If this is melanoma, how will they most likely treat it? Am I looking at Gamma Knife? This is outside of my field of experience with melanoma so far and I'm trying really hard not to freak out right now. I won't see the doctor until next week  to discuss what he thinks needs to be done.

Be kind, for everyone is fighting a great battle. -Plato

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mombase's picture
Replies 2
Last reply 8/5/2011 - 4:32pm
Replies by: mombase, lhaley

I had my consultation with the Chief Radiation Oncologist yesterday at David Grant, who was very up front with me. He said since melanoma cells by their nature are resistant to light, he would need to do a much higher daily dose to be effective than if the tumor had been a primary brain tumor. Along with my sister, I made the decision to forego the WBRT for now and start with Yervoy as soon as possible. That way the Yervoy can act against any melanoma cells that might be hanging around in my brain, as well as start working on my lung mets. The rad onc said that he would be happy to go with WBRT in the future, or SRS, if  I need it.

I thought about this long and hard overningt and woke with a sense of relief. Not looking back!!

Cristy, Stage IV

Getter done!

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Becky C.'s picture
Replies 6
Last reply 8/7/2011 - 4:01pm
Replies by: jimjoeb, Tim--MRF, Anonymous, MariaH, akls, washoegal

Hi, I would appreciate some other people's opinions about this. After having my SLNB, I had microscopic cells in the node, other node that was removed was clear. Both my oncologist and plasitic suregeon recommended removing more nodes. From some of the research I have done, some surgeons may recommend not going forward with the LND. I am afraid of lymphadema, but I also know there is no test to detect microscopic cells. I would appreciate feedback form anyone having a simolar situation as mine. Thanks

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Hi, I would appreciate some other people's opinions about this. After having my SLNB, I had microscopic cells in the node, other node that was removed was clear. Both my oncologist and plasitic suregeon recommended removing more nodes. From some of the research I have done, some surgeons may recommend not going forward with the LND. I am afraid of lymphadema, but I also know there is no test to detect microscopic cells. I would appreciate feedback form anyone having a simolar situation as mine. Thanks

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carol b's picture
Replies 2
Last reply 8/5/2011 - 3:22pm
Replies by: lhaley, Fen

ok here it goes.. i know im a little late but my arm is still super sore.. i can use my arm from elbow down but thats it, one surgeon said they clipped a nerve and one said they didn't. we thought there was only one tumor but when the got in there it was 3 and they had fingers wrapper around everything, They cut out some of the muscle. They couldn't get it all but they did get most of it so we are hoping some more rounds of IL2 will get rid of whats left . i go monday to take out the drain tube hopefully. It hurts all the time. fluid id still pouring out of it so they may leave it in longer. I sure don't want lymph edema. they took off a tumor growing off of the outside of the skin and sent it off for a  biopsy. I get that report Monday too along with a PET scan. I pray the IL2 has worked on the other small tumors and they are gone. they will set up my next rounf of IL2 while i am there. Im starting to really dread those treatments. The last one was so scary cause my blood pressure dropped to 40/20 and had to bring in the crash cart but they give me a shot of something to bring up my blood pressure and it started working before they figured out how to work the crash cart... I Thank God for that... But it was so scary for my husband  and i was on the phone with my daughter when it happeren so she was freaking out too... But as for the surgery it went really well. no stitches except for the drain tube got sewed in so i wouldn't pull it out.. The incision was only about 3 inches long and the just glued it ant put stirrie strips on it but the hole is really deep, its not gonna look very good for a long time.. Trauma from the surgery hit about the second day, OMG was that awful , every muscle from my chest up was so sore, so if anyone has this surgery expect it.. the Dr says they to stretch you and move you head and neck in ways that they stretch all the muscles and it makes you very sore.. i was on morphine every 2 hours except for when i was sleeping so that helped alot. But even after 7 days im still  really sore,, Could be from clipping the nerve cause i cant raise my shoulder still..Anyway thats my story from my surgery,,Its the best i could do with drugs im on,, Now im on to step 3 now, i got to beat this, i cant stand much more. I dont want to give up . but voices in my head are starting to tell me quality is better than quanity... i love all you guys on here and pray for you all the time..I sure wish they would hurry up and find a cure for us...God Bless you all.

 

carol b

Believe all thing are possible, believe faith can move mountains, believe in the healing power of prayer and never ever give up on your dreams

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manu000's picture
Replies 1
Last reply 8/5/2011 - 10:55am
Replies by: lhaley

Hello guys,

Yesterday my girlfriend made ​​a new resonance in the head, is very concerned, now should give you the results.
Tuesday (the day of the resonance) had some degree of fever, but the evening passed quickly.
However, begins to be very tired at any time of day, are the effects of fotemustine or the ipilumumab? or both?

The good news though is that three lymph nodes were visibly reduced almost disappeared.

 

ps.
thanks for the support you give me

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Anonymous's picture
Replies 2
Last reply 8/5/2011 - 9:35am
Replies by: mom3girlsFL, nickmac56

Question for folks with experience with clinical trials.  What affect does the existence of pre-existing health conditions have on your chances of being selected for inclusion in a clinical trial?  Random list:  Seizure disorder/epilepsy (monthly AEDs), pernicious anemia (an auto-immune disorder treated with monthly B12 injections), severe allergies, hypothyroidism, rheumatoid arthritis (also an auto-immune disorder), sub-clinical asthma

Color me just curious.  I currently have some of the items on that list, and it has been suggested I may have some of the others.  I'm very curious what affect these pre-existing existing conditions could have on any clinical trial I may want to be on in the future.   Yes, I realize a lot depends on both on how the clinical trial is designed and the type of drug being tested.  However, I'm looking for general experiences people have had to date.

I would be so disappointed to be prevented from being part of one because of a pre-existing condition.  And not just because of the lost treatment option.  This may sound corny, but I really, truly believe, deep in my heart of hearts, it is my Christian duty participate in any clinical trial I can.  I was so very disappointed when my oncologist told me there were no clinical trials available in our state for which I fit the criteria.  If I ever get a recurrence, I'll be transferring my care to one of the major melanoma centers, and I will be looking not just for treatment trials, but also for the trials that collect information, such as DNA, etc.  I really believe the only way we're ever going to beat this horrible, malicious disease is if everyone who can, does.  And when I'm gone, if they want my body or any portion of it for medical research, they're welcome to it.  (Yes, when the time comes, that will be a discussion I'll have with my medical team.)

Stage IIIb, 2 years NED

"A little ingenuity and a lot of duct tape will solve many problems.", AKC Agility Judges Guidelines

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Phil S's picture
Replies 8
Last reply 8/5/2011 - 9:13pm

While, the month of July proved to be challenging, when Phil's "routine" Pet/Cat and MRI scans at Dana Farber showed a lung nodule that turned out to be melanoma.  Just a quick recap, Phil's case is somewhat unique (mucosal, rectum) melanoma, and he had initial surgery in Feb 2010, then one year of interferon.  He did great on interferon, and we really felt it kept his aggressive melanoma (mucosal, deep primary, very high mitotic rate) at bay for the eighteen months he stayed at stage 3.  Others can disagree, and we will never know for sure, but two months after completing his year of interferon, the lung tumor was found.  Since, he was clean on all scans except for that one lung nodule, he had his right middle lobe removed on July 14th, and they got all the tumor and clean margins, no lymph node involvement. 

Phil is also Braf,C-kit, and HLA 02 negative, so future options are limited.  Stage IV NED, also limits clinical trial involvement, but we aren't complaining, thankful that surgery was an option.  We pushed for Leukine, and he is starting on Monday, praying that this drug can keep him stable for awhile.  We frequent this bulletin daily and get wonderful information and hope from all the people who share their experiences on this Board, especially Jerry (another stage IV mucosal melanoma case) who battles on, despite last year's fight with a horse.  Jerry is a true inspiration to us. 

We grieve with all those who have lost love ones to this disease.  We understand how everyone can and does feel sad, angry, scared, frustrated, disappointed, and hopeless when melanoma once again takes a front seat in their lives.  We truly emphasize with all the familes with young children (our kids are six and eight years old) and how fighting melanoma takes away part of their childhood, or at least part of the summer.  But, one thing I have learned in the past 18 months, is that people are resilient even children, and on a personal note, our kids are doing really well.  Phil is plugging along, lung surgery was fairly easy for him, and he is ready for the next step, hoping leukine boosts his immune system.  And, I have rallied too, after some dark moments especially at night, to again help my husband begin another battle with the beast.  Take Care!  Valerie (Phil's wife)

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