Melanoma: What are your tips about immunotherapy (Keytruda)?
It started a year ago, nodular melanoma on my right arm. Had incision to remove. Stated they got it all. Checked two lymph nodes. One negative, 1 small traces of cancer cells. A year later, two pumps come up very near the same spot. Its cancer again. Doctor wants to try Keytruda, Neoadjuvant immunotherapy. Starting the drug before the tumor is taken out. I'm concerned the tumor will grow in 6 weeks and may spread while getting treatment, which could make things worse. She states I'm a good candidate because of my positive TPS 6-10% and my TMB 52.6. After reading up on this drug I'm very nervous about the side effects, many that are permanent and non reversible. Latest stage diagnose is melanoma stage 3C because it recurred. I'm kinda at a loss with direction to go. Any experience using this drug out there?
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Thankfully, my rash resolved after 7 days treatment with benadryl and famotidine. As the rash left severe itching started in my hands and feet. If I was a dog i would be wearing a cone around my head. The hand itch is so intense I hold onto blue ice at times to settle it down. The oncologist prescribed an antihistamine which is stronger than benadryl but it makes you extremely tired, a little dizzy, and shaky. So I am praying the itch resolves like the rash did, time will tell!
@beebe, how is the rash?
Wondering if you still have the Keytruda skin rash. A rash started around my neck 5 days after the first infusion. I've contacted my oncologist and am waiting for a call back. In the meantime I am using 1% OTC hydrocortisone and Allegra. Were you prescribed a special cortisone for your rash and did it ever go away?
Yes I had the biopsy. It appears it had a 10-15% response. Not earth shattering by any means. I go for my 3rd infusion tomorrow. I’m a little concerned about that spot on my arm the pet scan found. Just got back from a wilderness backcountry trip where I hiked 105 miles in a week so I’m still feeling great.
I’ve had two doses. Third coming up in a week. I haven’t had any side effects so it’s no big deal for me. I did the adjuvant treatment, after they took out one tumor on my arm. Another came up a year later, that’s when I decided on the keytruda. After the two doses I went ahead and took the other one out near the same spot. I did get my biopsy back and it appears it had a slight response…but only 10-15% shrinkage, although it grew and grew while I waited for the two doses. I have no idea how it shrunk when it doubled in visual size during those 2 months. I have nodular melanoma it seems.
They suggest keep taking for the whole year. Maybe it is taking longer to work. I dunno. But then I hear it’s a good thing when there are side effects, because it means it’s working. Since I have had no side effects that remark isn’t encouraging. Just leaving my life and getting scanned here and there. Physically I feel fine so I still have a hard time believing I have cancer.
I am recovering well from surgery and start keytruda on Monday the 31st
@charlene9, how are you doing? Have you started Keytruda now?
Thank you for that I hope you continue to improve
Char
I too am receiving Keytruda for kidney cancer. So far I have had about 5 infusions and have had no side effects. My last CT scan showed my lymph nodes had shrunk to half size since starting Keytruda. So far...so good.
Hi Charlene. I hope you're recovering well from your surgery; I see it wasn't all that long ago you'd gone through your biopsy so I imagine you've been grappling with a lot these past few months.
I, too, was diagnosed with metastatic melanoma in my lung back in November when I started on Keytruda. I've had 6 infusions so far and have been doing fairly well. My lung nodule responded very favorably after three cycles but of course I need to remain on the immunotherapy which is not without potential side effects and everyone responds differently.
The best bit of advice I could give you would be to familiarize yourself with the potential adverse effects in the event you should become aware of developing one you can notify your team early on. For example, I had a slight skin rash after my third infusion I immediately notified my oncology team about so I was seen and started on a corticosteriod cream which helped keep it in check. Last week I realized the neck symptoms I was experiencing were related to thyroid issues that can occur as a result of pembrolizumab so again I was seen for evaluation and treatment. My husband had initially warned me I was reading "too much" as he feared I was getting alarmed about possibilities that may never occur - which is true; some might not. But at least I felt prepared and ready to act on those that did without panicking or waiting too long until they may have become more uncomforfortable or difficult to treat.
Be sure to inform anyone who is treating you for any issues - other providers, even aestheticians if you're getting massages or facials - that you're receiving immunotherapy - as you may be more sensitized to fragrances, alcohols, preservatives or dyes as your skin may be more sensitive.
I do give into how I'm feeling on certain days and try not to push myself or feel guilty if I'm feeling fatigued - it's okay to go along with simply "being". A saying I remind myself of on such days is: We're human beings, not human do-ings! Go at your own pace. We'll always be here for you.