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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Anonymous's picture
Replies 1
Last reply 8/30/2015 - 12:17pm
Replies by: ET-SF

ET seems to be (haven't yet confirmed the exact appointment) lined up with the melanoma center at Inova Fairfax.  They are participating in a Phase III trial of seviprotimut-L (POL-103a) at that center, and ET would qualify for the study, being NED, surgically resected stage IIb.  ET also qualifies for a couple of other vaccine trials.  There are no other trials at this time for which she qualifies, given her stage.  We are trying to figure out which vaccine trial would be most promising for her to undergo.

Option 1:  Phase III seviprotimut-L trial at Inova (NCT01546571):  This vaccine, manufactured by Hong Kong-based Polynoma, was first developed in the mid 80's and has a very small body of research behind it throughout the years.  From what I'm reading, it seems to be somewhat successful at mopping up free melanoma cells in the circulatory system and especially reducing serum CYT-MAA (cytoplasmic melanoma-associated antigen).  Perhaps the CYT-MAA effect is from a reduction of tumor load and therefore shed antigens?  Although the vaccine doesn't work on everyone, it works on some, somewhat extending the duration of recurrence-free survival.  The problem with this Phase III study is that the experimental design uses a placebo control group.  I don't yet know whether they use unequal sample sizes for the experimental vs. control groups.  (Some studies will greatly diminish the size of the control group for ethical/compassionate reasons.)

Option 2: Phase I trial of GVAX, Lipson, Johns Hopkins (NCT01435499):  Compares GVAX of two strains, combining one strain with cyclophosphamide.  GVAX vaccine, developed 1993, manufactured by BioSante Pharmaceuticals, consists of whole tumor cells that have been genetically modified to secrete GM-CSF (granulocyte-macrophage colony stimulating factor).  These whole cells are first irradiated to prevent cell division.  If I understand correctly, the strategy is to use the GM-CSF to stimulate macrophages to engulf them, digest them, and express their component antigens.  I am finding no data so far as to any measure of efficacy, other than immunological findings.  But then again, I suppose that's why it's still in Phase I testing.  Lipson is trying to determine how well the drug is tolerated

Option 3: Phase II trial of CDX-1401 and poly-ICLC, with or without CDX-301, Hanks, Duke (NCT02129075).  I don't know whether this trial is still in progress, as I don't see it listed on the Duke website.  These vaccines are manufactured by Celldex.  CDX-1401 is a MAB specific to the DEC-205 antigen on dendritic cells, activating these cells against the NY-ESO-1 tumor antigen.  (I have no idea whether ET's tumor expresses this antigen.  Could this be tested?)  CDX-301 stimulates production of dendritic cells.  Poly-ICLC (mfgr, Oncovir) is a viral mimic that acts as an immunostimulant.

Any thoughts as to which of these three choices might hold the most promise for ET at her stage IIb?  Note: We have no insurance coverage that would help us with options 2 or 3.  I don't know what sorts of costs would not be covered by the research grant.  Only option 1 is conducted by physicians and a melanoma center covered under our insurance.

Thanks for any thoughts on these vaccine trials!  We continue to be hard at work learning all this stuff!  There's sooooo much to learn!

SF

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PamelaA's picture
Replies 1
Last reply 8/30/2015 - 12:29pm
Replies by: arthurjedi007

I am currently getting Keytruda every 3 weeks. My family knows that I have stage 3c Cancer, they know I am now taking chemo and they know I am in a lot of pain from past surgeries but they still make me feel like I should be attending everything I am invited to, regardless of how I am feeling. Today my whole family went to a birthday party for my cousin, and I stayed home. I'm upset because I feel like am missing memories and because it gets held against me but bottom line, I don't have any energy!

PamelaA

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We heard this morning that Oliver Sacks, famed neurologist and author of the book Awakenings, has succumbed to ocular melanoma at age 82.  Dr. Sacks had a long career as a clinician, educator, and author. Awakenings was made into an academy award nominated movie staring Robin Williams and Robert DeNiro.

Dr. Sacks has been public about his cancer, particularly in recent days after he was diagnosed with metastatic disease. He was treated for ocular melanoma in his right eye, but later developed metastases in his liver.

Melanocytes are well known in the skin but are also found in the uvea, middle layer of the eye. Many people have a "freckle" in their eye that is benign. Sometimes, just as in the skin, those spots become malignant and form melanoma. The genetics of uveal/ocular melanoma are different from melanomas that start on the skin. About half of people diagnosed with uveal melanoma will develop metastases and this almost always happens in the liver. 

I truly believe the old reminder from John Donne that "Any man's death diminishes me..." but somehow when a well-known person dies from melanoma the impact of this cancer becomes particularly real and present.

Let's use his passing, and the news coverage that will accompany it, as an impetus to reach out to our friends and loved ones still struggling with melanoma. An extra phone call, email, or hug is always a good thing.

Tim--MRF

 

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davekarrie's picture
Replies 1
Last reply 8/30/2015 - 12:15pm
Replies by: arthurjedi007

Hello all,

I have mets to lungs, abdomen, liver and small bowel and C7 neck vertebrae. Just started Keytruda/Indoximod trial at Mayo in MN.  Will have infusions every 3 weeks. I feel great but just started on Thu.  Has anyone heard of Indoximod or been on this? I know its in a trial but its supposed to add to the Keytruda affect, at least it should, let's hope!  I will keep everyone updated how I do on this trial. Much love to all out there!

Live life to the fullest and enjoy each day! #noonefightsalone

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Anonymous's picture
Replies 2
Last reply 8/30/2015 - 10:35am
Replies by: Anonymous, ldub

Recently diagnosed as stage 2a.  Dermatologist recommended I use a sunscreen every day on hands and face.  Anyone have a recommendation for something tolerable - light and easy to use, not heavy, tacky or greasy?  Thanks!

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Anonymous's picture
Replies 4
Last reply 8/30/2015 - 1:11pm
Replies by: jpg, Anonymous, jamieth29, Bubbles

Recently advised by dermatologist that LO has sizable (greater than 4mm) melanoma on back. Unknown if it has traveled to lymph nodes yet. Except for the obvious stress caused by the diagnosis, LO feeling relatively fine.  Not a spring chicken.  Referred to surgical oncologist and have meeting coming up soon.  Expect he will recommend SNLB and WLE.  LO is anxious (to say the least) but trying to rally.  Preparing to make some decisions.  Expecting that they will have to be made quickly.

Hoping for feedback/info on the following:

(1) In your experience, is there any medical reason not to have SNLB? (Or WLE, for that matter?)

(2) What is the general recovery time for the surgery?  I know every case is different but, assuming no complications, I was hoping for any ideas about how quickly travel  (airtravel) and driving can commence after the surgery?  Any significant side-effects?

(3) How quickly does the surgery take place related to the consultation meeting, generally?  I suspect they will not want to delay but does it happen that day or the next ?  Will there be time for distant relatives to travel for support?

(4) What are the typical work-ups before surgery?  Are there scans, etc. before surgery takes place?

(5)  Who advises and oversees the next steps in any treatment: the surgical oncologist, the dermatologist or are you referred to a medical oncologist who sets the next course?

(6) If additional treatment is recommended, how quickly does it usually begin?

(7) If treatment includes immunotherapies (not sure if I got this right--ie Yervoy), are those administered by patient or in hospital?.  My understanding is that they are injectables but I don't know if you do them yourself or if you have to have a doctor or nurse administer the injections.  It is my understanding that any targeted therapies are taken in pill form.  Is this correct?

(8) Is there anything you would recommend that is asked of the surgical oncologist (other than the questions that are in the mrf materials....or are there key questions that you found helpful from the materials)

(9) Other than the resources of this website, are there any reading materials you recommend to get ready for the road ahead both for the patient and/or relatives of the patient?

Am feeling quite fortunate to have found this board and website.  Thanks for taking the time to read my questions.  Any advice you have related to 1 or all of the above would be greatly appreciated.

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Thandster's picture
Replies 6
Last reply 8/29/2015 - 9:15pm
Replies by: pookerpb, Thandster, Bubbles, Anonymous

I'm taking Nivolumab. I've had very slow yet steady progress. Currently my liver is inflamed and my oncologist is talking about putting me on steroids Monday to reduce the swelling and take away the liver pain. I realize I should've asked her this question when I was there, but I just didn't. If she puts me on steroids, will she just write the prescription that I'll have filled locally? Or will this involve a hospital stay so they can be playing with the dosage and monitoring me closely?

just trying to make my plan for next week and don't know if I can plan one day for this or if I need to plan a little time in the hospital.

Any info is appreciated.

(1 Peter 5:7 NLT). Give all your worries and cares to God, for he cares about you

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Replies by: Scooby123, dfeng

Morning all hope it's a good day for all. Can anyone give me an idea on if they have had tumors removed on liver lungs. I have 3 on liver 1 on each lung some mel in lymp. I have had ippi with 50 % reduction which probably would put my biggist tumor at about 1.5 cm is this possible  to remove. I see some have had tumors removed with ablation on liver . I am having another scan next week 4 weeks after first scan from finishing ippi . My consultant wanted to scan me at 4 weeks not sure why but he put in a request for keytruda if I did not respond to ippi but was not sure if I would get it. He has managed to get me the treatment but due to response with ippi he waiting to see scans again. He said he could not hold the drug for long so I guess he seeing if any change from last scan but only 4 weeks ago. 

Any thoughts 

regards

scooby

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Anonymous's picture
Anonymous
Replies 2
Last reply 8/29/2015 - 8:48am
Replies by: stars, Linny

Hi

i have a red - light brownish streak on my thumb nail - it is towards left side, not from the cuticle but starts at the curved outer line of the White lunula which is not affected. It's been there for about 4 months I have white skin. Took a while to get dermatologist appointment - finally he said yesterday we need to watch it and to come back in 10 weeks, is he suspecting melanoma? If yes, then 10 weeks seems like a long time...Should I ask for biopsy earlier? He said it was longitudinal something I sadly forgot the exact name. I feel very worried! 

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Anonymous's picture
Anonymous
Replies 0

My husband just finished 3 weeks of Whole Brain Radiation... When we first found out about his more than 20 brain tumors the Dr said, "This is a serious situation, I am suggesting WBR and when you are finished we need to be very aggressive and do Biochemotherapy ... We have run out of treatments so I am afraid it is the Biochemo or hospice" ... We were devastated!

now that the radiation is over... Whole game plan is different, because my husband looks and feels ok????..."let's  do CT  scans first of the neck to pelvis and see if you are stable Everywhere else".... Unbelievable!

For three weeks my husband has been so down and depressed because of our prior conversation....We are so confused.... to go from Biochemo or hospice.... to let's see where we are at.... Do not know how to feel about this...,do not get me wrong, my husband is happy no Biochemo..for now, but just so confused.. 

Anyone have any input on WBR and response rates?

 

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BrianP's picture
Replies 7
Last reply 8/29/2015 - 9:39pm

So this discussion hasn't come up in a while.  Do side effects have any correlation with overall survival?  This abstract says it doesn't.  Also states that taking corticosteriods don't have an impact on overall survival.  Would be interesting to see the whole article.

 

http://jco.ascopubs.org/content/early/2015/08/11/JCO.2015.60.8448

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So this discussion hasn't come up in a while.  Do side effects have any correlation with overall survival?  This abstract says it doesn't.  Also states that taking corticosteriods don't have an impact on overall survival.  Would be interesting to see the whole article.

 

http://jco.ascopubs.org/content/early/2015/08/11/JCO.2015.60.8448

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momof4boys's picture
Replies 2
Last reply 8/28/2015 - 10:42pm

My scan last Thur showed 2 spots on my lungs and my lymph nodes were enlarged. Yesterday I had a brochoscopy to biospy the lymph nodes and preliminary results are saying negative for melanoma. I was wondering if anyone here has ever had histoplasmosis. I think this is what may be going on. Any insight would be appreciated. Thanks, Rachel

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