Melanoma medical info

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Prevention to Stage IV

There is a ton of good information out there about melanoma. In speaking with various doctors and experts, I feel like I have some additional stuff to add to what's out there. I have stage IIIc melanoma, I have a brother and sister that both had stage I. It's in our family, so we have to be extra cautious. I will try to share some of my insights.

• Prevention

This is where the most effective fight against melanoma occurs. There is a great website that talks about UV and you can determine the risks in your specific area (as well as recommendations on what to do based on UV levels) - www.uvawareness.com.

Staying out of the sun at the highest UV times and then protecting yourself at all other times when UV rays are present is your best defense. Believe me, it's a small price to pay - compared to invasive surgeries, interferon hell, biochemotherapy nightmares etc. The sun is not your friend in all circumstances. It can be if you control the terms of your relationship with it.

Stay out of tanning beds. A base tan does not help prevent melanoma. Any UV rays you get are harmful and put you at higher risk of developing melanoma.

Be proud to be pale! It took me going halfway around the world to Asia to realize that tan is not inherently beautiful. In America, all of the commercials are about how to get a tan. In Asia, all of the commercials are about how to whiten oneself. We are all different for a reason. Be proud of your skin color regardless of what it is. Important to teach our children (and hopefully change our culture) about what is handsome/beautiful.

• Early Detection

self checks
doctor (correctly diagnose 25%)
dermatologist (correctly diagnose 84%)
Diagnosis methods
-puncture biopsy
-excision biopsy
-shave biopsy

• Diagnosed

TNM staging

Stage 1, 2, 3, 4 survival rates - do statistics matter?

• Stage I, II, and III treatment options and path

WLE/SLN

Lymph node dissection

Adjuvant Treatment options
-Interferon
-Biochemotherapy
-Wait and see

MRI's/CT scans/PET scans/visual and physical checks (visual and touch)

Treatment options for stage 2 and 3 aren't so great right now.

• Stage IV Treatment options

No new meds approved from 2001 to 2011. 5 new meds since 2011 and a number of promising studies. Stage IV used to be a death sentence, the future shows some bright and promising options.

1) BRAF meds
2) BRAF/MEK inhibitors - response rate? (info from Dr. Patel, but not approved together per insurance guidelines - only pay for one or the other).
3) Johns Hopkins - biotherapy meds (Nivolumab plus Ipilimumab) - 40% response rates, New England Journal of Medicine (June 2, 2013)
4) NCI (National Cancer Institute) - Bethesda - Tcell therapy - 56% response rate (also, shared with MD Anderson for clinical trials): http://youtu.be/yGzJzzGj5Jw