What to expect with treatment of melanoma with metastasis?

Hi @uma1, to add to @grammato3's helpful post, you might find the free mindfulness videos from Mayo Clinic here helpful:

Health & Mindfulness Blog https://connect.mayoclinic.org/blog/mindfulness-in-health/tab/resources/#ch-tab-navigation

How are you doing?

Good morning, @uma1. It's @grammato3 here. following up. I'm sorry to hear that you and your daughter both required hospitalizations - that does sound stressful!

I'm glad to you've identified mindfulness program that allow you to participate virtually. I hope that assists with smoking cessation. While I personally never smoked, my mother had and it was a huge step for her to quit - which she had through tremendous will power when I'd informed her I was pregnant with her first grandchild, who will be 45 this coming Saturday! A few months later she showed signs not only of COPD but of a suspicious tumor in her lung. Back then, there was no such thing as a robotic biopsy so her only option was a needle biopsy. In her case, it did confirm a metastatic lesion but I have to tell you: she went on to having surgery and seeing not only my son but four more grandchildren born and see them mature into adulthood!

Again, that was 45 years ago and lots of adavances have been made since then. Personally, I underwent a robotic biopsy on my own lung nodule - which was small - however, still required sedation. Your entire team - from pulmonologist, to anesthesiologists, to nurses and techs - are tremendously experienced. That, combined with the skills you ought to gather from your meditation practice will ideally put your mind more at ease. There are also some online that can help supplement; perhaps someone on this site can recommend one they found helpful. Some months ago, I found and listened to the Honest Boys, a British gentleman with a soothing voice, provide a lovely Hawaain mantra of sorts that provided a great source of comfort for my situation. You can find it here:
https://www.youtube.com/watch?v=eDK8SWCz7fw.
Have you been able to enroll in one of virtual meditation programs yet?

As an add on, I’ve been having regular bi monthly scans.

Colleen, I very much appreciate your reply and apologize for my delay in responding. I was at the hospital with a COPD exacerbation & my daughter had emergency heart surgery. All your points are true, I was doing well with smoking cessation, then my daughter’s surgery got me smoking again. I’m sure I can do it ! I did check Harvard’s mindfulness program, unfortunately it’s not virtual but I’ve found other reputable ones. I guess my main problem is that my oncologist is insisting this be done asap! I’m terrified of the needle biopsy combined with severe COPD. I’d prefer a pulmonologist robotic one but am unable to get my dr. to arrange for it..my research shows it to be much safer. Do you have any information on a regular Interventional Radiologist’s needle biopsy? I have little time and am truly scared. Anything you can lend is so appreciated. And again, I’m so sorry for mt delay in responding. You are very kind. Thank you and will hope to hear back from you.

Quite a predicament you're in, @uma1. It does sound like you're facing some difficult choices. My mother had also been a smoker and had to undergo a bronch many years ago so I can relate on some level. This actually occurred after she had voluntarily stopped smoking a few months earlier.

Perhaps the first place to consider is some kind of smoking cessation program because you are correct that smoking will only exacerbate severe COPD in the long run; although it may soothe your nerves in the short term, you've probably found the results aren't lasting. Perhaps that combined with other techniques to help curb your anxiety? Harvard runs an excellent program in mindfulness meditation which might be worthy of exploring.

There are heart attacks called "silent MI's" or myocardial infarctions. These can occur without any traditional symptoms and only show up on subsequent medical tests. You can ask your doctor if this is the kind you may have had.

As far as I know, a biopsy is the traditional "gold standard" for most accurate diagnosis of a lung nodule. Other imaging tests, such as a PET scan, can determine the metabolic activity of a lesion to see if it "might" be a metastasis but it's far less accurate, And having a clear diagnosis is very important in how one goes about determining how to treat the underlying condition.

So it does seem like you do have some difficult choices to make. You are at an center of excellence and appear to be in capable medical hands. You are armed with good knowledge to make informed decisions. It's tough right now but with support and guidance you'll find the direction you need to take the steps to forge the right path going forward for you.

Thank you, Colleen. Yes, I’ve had several conversations with my oncologist. She’s 99.9% certain it is either melanoma metastasis or lung cancer. She tells me the only way of knowing what to treat is through knowing what the cancer is. I completely understand that. Are you aware of other options? I’d be most grateful if you let me know. I’m extremely scared of the biopsy given the risks, especially with extreme COPD. I have severe anxiety to begin with and no medication helps unfortunately. Brilliant me has turned to smoking as it’s the only thing that calms me a bit…worst thing I could do! This is all at a very well known cancer hospital affiliated with Harvard where I’ve always felt very secure with my doctors but right now I don’t know. Top it off with in reading my last CT scan, it mentions “likely from a myocardial infarction “ in it,
which was never mentioned to me. I asked my oncologist and she replied “well you had a heart attack.” No, not to my knowledge and why was this never mentioned even though it’s not my lungs where the nodules are? It all makes me very Leary yet what choice
do I have?
Any thoughts you have are most welcome and thank you.

@uma1, I can understand your concern. Have you and your oncologist discussed pros and cons of the biopsy or other possible options?

@rblegend50. Hello. I have melanoma and my oncologist has been watching lung nodules get larger in size. She’s recommending a biopsy which I understand. My concern is that I have severe COPD which makes a biopsy much more of a risk. Was your husband’s found through scan observations? I know I must have something done but am wondering if a bronchoscopy would be safer? If there’s anything you could share it would be much appreciated.

Hello @rblegend50

If you want to ask a question of anyone on the forum you can just click on "Reply" below their post. Also, by using their username with an "@" sign, (like I did when I started this post to you), will also get your message directly to the person you would like to chat with. When you respond in this way the member will get a notification that you have responded to them.

By clicking on this link, you can find more information on how to use Mayo Connect,
https://connect.mayoclinic.org/help-center/

Yes the system is busy and overworked. Perhaps we may chat since it is the same cancer center