Melanoma (internal): What questions should we ask the oncologist?

@marywc Oh, that must have been devastating news to hear!

You ask what you should bring to the melanoma oncologist now. Finding out what stage this melanoma is, is very important. Ask about the possible treatment options and what his/her opinion is as to what will be advisable in your daughter's case. Remember that each patient is different, and what you hear from someone else may not fit her unique situation.

Assemble a team. Social worker to assist with the mental aspect of all this. Her primary care, to be kept in the loop. The oncologist. Any other doctors your daughter sees, so everyone is kept in the loop. Your daughter, of course, as she is the center of all this. Take a deep breath and be there for her and yourself.

Gentle hugs,
Ginger

@marywc, I can imagine that you and your daughter and family are reeling with this news. I'm tagging a few other members who have experience with melanoma and for some melanoma that has recurred internally like @0716 @meg4434 @sunflower319 @gaybinator @jrc3vette @birdman518 @besissy @secondhandrose

See these related discussions:
- uterine & cervix melanoma...
https://connect.mayoclinic.org/discussion/uterine-cervix-melanoma/
- Vulvar melanoma Radiation Treatment
https://connect.mayoclinic.org/discussion/vulvar-melanoma-radiation-treatment/
- Stage 4 Malignant Melanoma internal
https://connect.mayoclinic.org/discussion/stage-4-malignant-melanoma-internal/
Here are a few questions I might suggest as you prepare for the upcoming appointment:
- What stage is the melanoma?
- What treatment options do you recommend?
- What are the side effects and benefits of each treatment option?
- Is immunotherapy effective?
- Should we consider a clinical trial?
- What are our next steps?

What questions do you have and are afraid to ask, @marywc?

Skip the surgery and radiation and go directly to systemic approach. In my husband’s case (spindle cell squamous) we were trying to save his transplanted kidney, so we went for surgery after surgery, radiation after radiation, and it weakened him both mentally and physically. Finally, we tried Keytruda (2018) and it was a miracle. The first scan was clear, though it killed the kidney. Subsequent scans showed cancer which came and went. He lived 3 years after beginning Keytruda - not from the cancer, but just worn completely out. Had he not had dialysis to deal with, he probably could have lived much longer.

Thank you so much Ginger. My daughter - my eldest of 3 - lives in Falls Church, Virginia (just outside of DC) and we live just West of Denver. It's hard having her so far away. I will fly out to help with her kids (5, 3, 1) when it is best to do so. Thank you for your input and counsel.

Thank you so much, Colleen. This is all extremely helpful. A few days before we the doctor called my daughter with the results of the biopsy I was diagnosed with Squamous Cell carcinoma on my Forehead. I have two Moh's procedures scheduled in September AND a breast biopsy in September.

@marywc I am sorry to hear about your daughter's situation. Although I am stage 3, mine has not been found internally, which I am sure is more scary. I have taken the approach to have anything that can be, to be removed surgically. As for radiation, chemo, or immuno-therapy, I suggest that you read as much as you can about their side effects, including personal testimonies on this site and on many Facebook pages (e.g. Melanoma Warriors).
Good luck to her (and you).

I should amend my comments in light of your diagnosis, @marywc. My husband's SCC was not taken seriously by the dermatologist we had here at home. There were many months of "watching" between the appearance of the lesion and any practical treatment. When the doctor turned it over to the Mohs surgeon, it was too late. SCC is common in kidney transplant patients and they don't know why, but all transplant patients should get a diligent and competent dermatologist. Mohs surgery is the most practical and common treatment for lesions on the skin surface. I'm sure your's will go well.

Thank you @gaybinator. At this point I am more concerned about my daughter’s melanoma diagnosis. I will have two Moh’s done on the left and right side of my forehead. And I’ll go in to the dermatologist every 3 to 6 months from now own to get new spots freeze dry removed. My daughter’s situation is far more serious. I shared my cancer just to highlight how overwhelmed we all are. Both my daughter and I are dealing with cancer.

We also are having good results with Keytruda treatments. My wife was diagnosed with stage 3 Metastatic Melanoma. She has two tumors on her upper right arm (subcutaneous) as well as two righty auxiliary lymph nodes. After three Keytruda treatments, the tumors on her right arm are definitely getting smaller. If the trend continues, the Oncologist will order the removal of the tumors on her right arm as well as the lymph nodes following the checkpoint after her fifth Keytruda treatment. (Also removal of a small ER+ tumor in her right breast, caught by chance by the PET scan.) I'm not saying Keytruda will work for everyone, but it does have a high success rate, which we are experiencing.