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Below, week by week, is what OnCo's record of Mucosal melanoma says about the first two months: the order is typical, the timing is yours to ask about. Mucosal melanoma grows on the moist linings of the nose, mouth, anus or genital tract rather than on sun-exposed skin, so it is found late and carries fewer of the mutations that make skin melanoma visible to the immune system. Immunotherapy helps less often than in skin melanoma; a minority of tumours has a KIT mutation that the pill imatinib can target. Sections appear only where the record has something to say. Orientation, not medical advice.
Staging tests establish exactly what and where the cancer is. Everything else follows from the answers.
Ask which of these were tested and what the results were; see the report reader for what each value means.
These specialties appear in the standard of care for this cancer. In most centres they meet weekly as a tumour board to agree each plan; you can ask when yours was discussed and what was decided.
A second opinion from a centre that treats many similar cases is normal, not rude; the standard of care tells you what to compare it against.
Each row is a setting from the standard of care, in the order it usually arises. Not all will apply to you; your stage and biomarkers decide which do. The guideline grade, where recorded, says how strong the evidence is.
Wide surgical excision with the least morbid operation that clears margins; postoperative radiotherapy for head and neck and anorectal primaries to improve local control.
Anti-PD-1 antibody as for cutaneous stage III disease by extrapolation; temozolomide-cisplatin chemotherapy is an option in China on a randomised trial.
Nivolumab plus ipilimumab (higher response than nivolumab alone in the pooled analysis) or anti-PD-1 monotherapy; toripalimab with axitinib in China.
Imatinib for exon 11 or 13 mutations after or alongside immunotherapy; nilotinib is an alternative.
Tunlametinib (approved in China) or MEK inhibitor trials; naporafenib with trametinib in the SEACRAFT-2 trial.
Generated from this cancer's standard of care, biomarkers and open problems. Take the group that matches where you are. To tick, add your own and print, open the one-page appointment sheet.
Trials open now for this cancer in OnCo, largest phase first. Joining a trial is a decision like any other: ask what the comparison arm is, whether a placebo is used, and what happens if you leave. The cancer page searches ClinicalTrials.gov live for more.
Much of what helps in the first weeks is free if you know to ask: testing, helplines, rides and lodging, second opinions, trial travel.
Every term links to the glossary.