Treatment choice for melanoma

My melanoma was found in my lymph node.  My CT scan is clear and I haven offered immunotherapy or targeted treatment.  I am having great difficulty deciding which to choose.

  • Hello Munshkin

    I'm sorry to hear that you've recently been diagnosed with melanoma. It's naturally a worrying time for you. 

    We do have some information about treatment for melanoma on our website and you may want to consider talking things through with one of our nurses. I know they will be happy to listen and offer any advice, information and support they can. They're available Monday to Friday 9am to 5pm on 0808 800 4040. 

    I also wanted to tag in another new forum member,  who has shared that she has recently been diagnosed with stage 3 melanoma and is about to undergo surgery next week. it may be that the two of you can connect and support each other with your diagnosis. I'm also going to tag in  Angie is a regular here at Cancer Chat and has been living with melanoma for quite some time now. She is a great font of knowledge and hopefully, she will be able to offer you some advice as well. 

    Whatever treatment pathway you choose Munshkin, I hope that things progress well for you. Keep in touch and let us know how you're doing. 

    Best wishes, 
    Cancer Chat moderator 

  • Thanks for tagging me Jenn :) I’ve sent over a friend request! 

    I’m in a similar position (although am about to have a sentinel lymph node biopsy so don’t yet know whether the melanoma has spread to my lymph nodes). But I’m at least stage 3B and luckily my MRIs and CT scans have come back clear which is reassuring! 

    I have to also go on treatment. I am starting targeted drug therapy (dabrafenib and trametinib) at the end of August after my surgery. They have said that this is the best option for me if I can tolerate it okay because there is less risk of lasting side effects compared to immunotherapy. The reason I can have it is because my melanoma has the BRAF mutation - does yours have this?

    My oncologist was very keen that I have targeted drug therapy over immunotherapy because of my age (18) and didn’t want me to have to take hormones for the rest of my life is the immunotherapy caused a gland to stop working properly. However, she said that immunotherapy is plan B if for some reason, I can’t take the targeted drugs. 

    Hope this was a little bit useful? Have you spoken to your oncologist on which one they recommend?

  • Hi Jasmine, sorry to hear you have this at 18 years old.  I am a lot older but have still been in shock as I am not a sun lover. 

    It seems your oncologist has this under control.  My treatment has been a lot different.   Mole removed last November. Wider excision and lymph node taken April. Positive lymph node result came through June and I have only seen oncology doctor once. I haven't decided on treatment yet.

    As you are young I can appreciate that you have different concerns to make your treatment choice.  It is good that the doctor is advising you, as this will help with your decision.

  • Only seen oncologist once and he gave me a choice of 2 treatments and leaflets to read.  I have asked for another appointment as I feel I need to discuss further and I need guidance.

  • Yes it’s a horrible thing at any age - I’m not a sun lover either so just feels even more unfair than it already is! 

    I’m so sorry that your treatment seems to be a bit of a mess - that is the most unhelpful thing when going through something so stressful :(. Yes they should definitely be giving you guidance - maybe if you go asking for pros and cons of both treatments and what they recommend hopefully they’ll be a bit more useful. 

    Really wishing you all the best - it’s all such a nightmare isn’t it !!!

    From my research and what my oncologist has said about general stage 3 cases of melanoma (I am also off to study biological sciences at Cambridge in September so am I bit of a biology nerd), if you have the BRAF mutation, targeted drug therapy does seem to be the usual recommendation. From what I’ve read in scientific journals, the target drug therapy seems to have a slightly higher success rate than immunotherapy. But would definitely ask your oncologist about it for your specific case! 

  • Hi Munshkin, I was diagnosed with stage 3C melanoma last year, I had a lump, not a mole, which had a Breslow thickness of 4.7mm, ulcerated and had spread to my sentinel lymph node.

    I also was given the choice of immunotherapy or targeted therapy. I chose the targeted as if problems occurred such as diabetes, they can be reversed after treatment finishes, with immunotherapy, if you develop for example diabetes, you tend to have it for life.

    Moderator, please correct me if I'm wrong. 

    Luckily I've only had nausea and some diarrhoea. 

    I am on the medication, Dabrafenib and Trametininb, for a year, scans so far have been clear. I will live with the fear of it returning but hope and pray the targeted therapy has done the job of switching off those mutated cells.

    Good luck with your treatment, whatever you choose will be right for you. 

  • Thank you for your reply.  As mentioned I have received no advise on what is best for my diagnosis.  I just feel that if I am having treatment for one year, I want the one with the best outcome.  I have asked to see oncologist again as my husband feels that we have not been able to discuss thoroughly with doctor.  Its like tossing a coin.

  • Have you looked at the Melanoma Focus website. They have fantastic advice along with what treatments are available. They have been great support for me and also have an annual conference which is a great place to meet others in our situation. Good idea to take your husband along, you can discuss your options with him so he understands what the treatment involves. It is like tossing a coin and I still sometimes wonder if I chose the right one but I'm over half way through the treatment now and so far so good. I hope you find enough information to be able to make the choice that is right for you x

  • Thank you.  I think I am leaning towards the immunotherapy and hopefully the doctor can answer my concerns next week.

  • Just be prepared I went through 7 years of this dreadful sick disease.

    I am not her to frighten anyone but always demand scans or treatments don't wait!

    Doctors are great but they chat. We can do this next week we can do this or that. No do it now 

    Melinoma does not wait and it's super fast and aggressive.

    My baby had 7 years of operation after operation to be told she beat it again and again. But it came back worse each time and she passed on the tenth July this month. She was only 25 and left a whole so massive I'm never going to fill it. She was everything