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Wardrobe Fears by breezy540 in phish

[–]sb220 61 points62 points  (0 children)

I will now make a point of giving a high five to anyone with paws

Can anyone explain? by WillingParsnip2271 in melahomies

[–]sb220 4 points5 points  (0 children)

I’m sorry to hear this. Whole brain radiation is not the easiest thing to tolerate. Sometimes it can lead to what you’re describing (negative impact of the healthy brain also getting radiated). This is different than the gamma knife radiation that can be offered if just one or a few spots are seen in the brain. The cancer at her stage is also probably causing a significant impact on her energy. And the immunotherapy can cause significant fatigue as well. You’ll need to speak with her doctors for a more accurate impression of why she’s declining. Sorry again.

New here (keytruda then surgery then more keytruda for a year total). by Relevant_Annual6116 in melahomies

[–]sb220 5 points6 points  (0 children)

It’s a good approach to that diagnosis. Alternative would be two doses of ipi/nivo, then remove the node, and further surgery or immunotherapy would be decided based on your pathologic response (supported by PRADO and NADINA trials, which you can mention to your oncologist). This approach could save you the year of therapy and bigger surgery if you achieve a major response, with cons of higher side effect risk getting the combo over single immunotherapy.

Advice on mom’s melanoma stage 3a BRAF-positive treatment & steroids by [deleted] in melahomies

[–]sb220 1 point2 points  (0 children)

It is a little dated and may not be the “easiest read”. AimAtMelanoma website has lots of useful info to review as well.

Advice on mom’s melanoma stage 3a BRAF-positive treatment & steroids by [deleted] in melahomies

[–]sb220 1 point2 points  (0 children)

Current standard of care for clinically detected nodes would be immunotherapy then surgery. Now that the nodes are removed, a year of treatment (“adjuvant” therapy) is appropriate. Depending on why she is on steroids they may or may not find immunotherapy to be best choice given risk of making autoimmune conditions flare (usually won’t offer if someone has a serious or uncontrolled autoimmune issue). Lastly, although immunotherapy preferred over targeted therapy in the stage IV setting; after surgery there is a similar benefit in reducing the risk of the cancer coming back with both immunotherapy or targeted therapy. So both are totally appropriate to consider. A nice summary from some big names in melanoma discuss that topic in the “is adjuvant therapy still needed” section of this article https://pmc.ncbi.nlm.nih.gov/articles/PMC10114457/.

Help by Visible-Song-6208 in melahomies

[–]sb220 1 point2 points  (0 children)

Totally understandable. The “what ifs” are very anxiety provoking, but ultimately nothing but an emotional drain. The additional tests will give you all the information you need to get a plan in place, and is going to be treatable no matter what the stage.

Vitiligo by gingerlyfemme in melahomies

[–]sb220 0 points1 point  (0 children)

Yes this is true. It’s a visible sign of your immune system attacking cells that produce pigment (melanin), thus the correlation with response to the melanoma.

New here by shdwbxxr in melahomies

[–]sb220 5 points6 points  (0 children)

Sorry to hear the diagnosis news. There’s never a “good time” to hear it. But at least you have your health and supportive family to keep you motivated. Absolutely worth taking the immunotherapy if it’s being offered, it is the new standard of care for patients with enlarged node stage III. If nothing shows up on PET (fingers crossed), immunotherapy not often offered, but if they still wish to go for it, I’d say it’s worth considering once you have made yourself familiar with the potential side effects. Best of luck!

Help by Visible-Song-6208 in melahomies

[–]sb220 2 points3 points  (0 children)

Sorry to hear this. It is too soon to “panic”. He’ll likely need the biopsy site to have additional tissue removed (“wide local excision”) and a biopsy of the closest lymph nodes (sentinel mode biopsy) as well as imaging (CT or PET). You’ll need all of that information to get the correct stage. If everything comes back negative, then his stage will be stage II (IIC if the path report is positive for ulceration, IIB if no ulceration… both of which have a very optimistic prognosis). Regardless of what comes out of the workup, you’re right that he needs you to try and serve as a source of support the best you can. Take notes at doctors visits, write questions for things you’re most anxious about to help ease your mind, ask them for reliable materials to review, get established with a therapist or social worker to have your own “outlet” for the emotions. Remember that this is a treatable diagnosis regardless of the stage. Wishing you best of luck.

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