radiation for melanoma metastisis and abscopal effect

[missyrand]

Update: this week my husband will drop to 5 mg prednisone and be off steroids in a week. Hopefully the shaky hands, irritability, and sleep disturbance will also wane

In the meantime, we have been consulting as to how to proceed next with the 3 distant sites of melanoma oligometastis: shoulder, abdomen and shoulderblade. The yervoy course did not seem to help at all, and the shoulder has progressed to spread, larger and deep blue/black lesions right at the surface area of his skin.

We have seen the surgeon who suprisingly says, hey, let's just excise this stuff out! And bring in a plastic surgeon to it is pretty at the end. We've also been reading about use of radiation, which after ipi has been demonstrated as sometimes having an abscopal effect: the radiation on one location can have a weird side benefit over time of also jump starting the immune response in other distant, non-radiated melanomas. There are varying rates of abscopal effect with a 2017 retrospective literature review giving a median abscopal effect of 26%. Science is weird!

So we have a new list of questions, including inquiries about side effects like vitaligo, and are leaning towards radiation of the shoulder, and excision of the other 2 locations rather than waiting for potentially many months of an abscopan effect. Anyone out there with ane experience with radiation and abscopal effect??

Missy

[Crycleo]

Radiation did not help us. If you chose that option, have a already chosen back-up plan that you can set into immediate action.

[missyrand Ambassador in reply to Crycleo]

Crycleo,

Can you tell me more about your radiation experience? Was it a solo treatment or before/during/ after immune therapy? where was the radiation directed and was the total treatment greater than or equal to 3 GY? This location is right at the top layers of skin and has had surgery in that same location previously.

thanks,

missy

[Crycleo in reply to missyrand]

No ours was deep groin radiation. It was before immunotherapy because it was not yet FDA approved back then. I’ve forgotten the dose. It may be higher for you because it’s close to the surface instead of deep inside. We had the internal organs to worry about.

It is a treatment that you have to do everyday for several weeks. The appointments are short, but the treatment is several weeks every day. Hope it goes well for you.

[missyrand Ambassador in reply to Crycleo]

Thank you. Not sure at this point which way we will choose, and good chance we will do some of both but for different sites.

missy

[SGHSweethearts]

Missy,

Yeah. This is awesome news that your husband is down to 5 mg and will soon be off Prednisone. I will pray all goes well for your husband. My husband tried to go down lower than 10 3 times, but he couldn’t do it. We had to go slowly 10, 9,8,7,6,5,4,3,2,1,0 in 2 wk increments and he finally made it. I’m so happy that the surgeon is saying to just remove them as well. I will be following as well to see if anyone has had experience with this abscopal effect, very interesting.

Michele