Should I take Nivolumab for stage 2B nodular melanoma at age 75?

@matt75, how did your appointment with your oncologist go last week? What did you decide regarding treatment and taking nivolumab (Opdivo)?

@colleenyoung ; The meeting went well and I decided to proceed with the Opdivo treatments. Had the first infusion last Wednesday. It went smoothly as of today no side effects at all. I'm scheduled for every three weeks for a year which seems like lot. Just hope the side effects stay away'

Good morning
My name is Jeannie
I had a wide local excision of a nodular melanoma 3.35 mm 14 mitotic rate and ulcerated on April 3rd 2026
I also had a sentinel lymph node biopsy during that procedure
Clean margins for the excision and no metastasis for the three lymph nodes removed
On July 28th of 2026 I received my 4th of a total of 19 infusion of keytruda a very similar drug for immunotherapy
No side effects so far
On Friday August 7th I will be having my second full body scan by my dermatologist who did the original biopsy on the nodular melanoma
My first full body scan after 90 days they found two squamous cell in situ
I hope this information is helpful

@jeannie2222 : Thank you for sharing your experience and joining us here at Mayo Clinic Connect. It's encouraging to hear how well you're responding to Keytruda!

When undergoing immunotherapy, imaging in the form of PET or CT scans are generally performed at set intervals and typically referred to as scans, in addition to having our skin scanned or checked thoroughly by dermatology or other medical professional to assess for potential skin cancers. I'm curious if in your case the squamous cells were detected by a skin evaluation as opposed to imaging? In either case, it was definitely a good catch! How are these being treated?

@grammato3
Good morning
Thank you for sharing this information
The squamous cell were detected on a physical full body scan at my first 90-day checkup by my dermatologist
They're both scheduled for excision in his office in August
Both a full body PET scan and an MRI of the brain were performed before I began my Keytrida
The MRI of the brain was clear no cancer
However on the full body PET scan ground glass appeared in my left upper lobe lung
A thoracic surgical oncologist performed a biopsy and a 2 mm adenocarcinoma was discovered
On Thursday July 30th I finished my 5 SBRT radiation treatments for the adenocarcinoma
The radiation oncologist who is handling this diagnosis will see me again in 30 days
Additional imaging will be done in about 90 days after the last radiation
I remain grateful for my continued treatment provided by the medical professionals
Your response was informative and appreciated

@jeannie2222 Much continued success to you in your treatment of the detected cancers. You have an excellent attitude and that is half the battle!

Will you be having Mohs for the squamous cells? I've been down that road several times myself. Please check back in with me afterwards to let me know how you're doing then.

@grammato3 I want to let you know where things stand with my case. I met a second time with the oncologist. He confirmed that he believed my tumor that was removed had an extremely high risk of recurrence and that Keytruda could reduce that risk to around 50% over 5 years. He also told me again of the possible risks. But he would give his opinion of whether I should begin treatment now. It’s very frustrating because he is my doctor and I want and value his opinion. We meet again in 4 weeks. He said they typically start any infusions about three months after the WLE. I’m still researching(Keynote 716 is the Merck trial for stage IIb and IIc)but need some informed guidance.

@joetex: Thank you for keeping me in the loop on your situation. This is a lot of information to process. Can you clarify what you mean by "He would give his opinion of whether I should begin treatment now"? I'm uncertain if that means he's declining providing his opinion or he is in favor of it? You've indicated your sons have been involved in discussions, have they weighed in on their feelings about the risks vs benefits of Keytruda? Or have you possibly explored obtaining a second opinion to assist with your decision making?

@grammato3 My mistake. That should be “he would not give his opinion”. He seems to be leaving it up to me to choose but I would like to know what he thinks is best. He did say he had confidence in the high risk nature of my tumor. My sons are divided with one in favor of starting now and one favoring wait until something shows up. I’m leaning towards starting soon since it looks like there is a high chance that I will need it sometime. I’m looking at getting a second opinion as you mentioned if I don’t get comfortable with going ahead. I guess he may be seeing my age(84) as a factor and thinking I might want to just live out my time and avoid hassle and side effects of treatment, but I still have things to do and people to see! I’m sure not ready to go yet.

@joetex: I hear you loud and clear! I wonder if one question for your current provider - and one for a second opinion should you choose that - is if a recurrence does indeed happen, would it potentially be more aggressive and not as amenable to treatment? In this day and age, 84 is still spry for many folks and you do seem to be in that category; we shared many happy times with my own dad until his age of over 99 and my father-in-law continued to consult as an sharp minded attorney into his 90's!

In my own situation, I elected to undergo Keytruda that worked well...until it didn't, and by that I mean some adverse effects that required intervention. However, by that point by metastatic lesion had resolved and I have remained without evidence of disease although I continue to be monitored at regular intervals. I, too, focus on the things I want to do and people I want to see yet remain open to the possibility of more intervention I may need in the future. We didn't ask for this wrench to be thrown into our lives but getting the hardware to deal with it is a lot harder than going down the aisles at Home Depot, isn't it?!

Let me know what tools help you along your journey. We can all learn from each other.