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Living with cancer· Appointment prep

Appointment sheet: Acral melanoma

One page to bring and write on: your details, the questions for Acral melanoma plus your own, the words you may hear, what to bring, the treatments the standard of care names, and room for the answers and agreed next steps. What you type stays in this browser. Print it or save it as a PDF. New to all this? Start with the first 60 days. Orientation, not medical advice.

Tick the questions to print

All of this cancer's questions start ticked. Untick what does not apply; ticks are kept in this browser. .

Your own questions

Shared with the prep pack, so questions you add there appear here too.

Print or save as PDF

Use (or Ctrl+P, Cmd+P on a Mac). To keep a copy, choose Save as PDF as the destination in the print dialog. Only the sheet prints; the controls stay on screen. Your typed notes print where you typed them; empty fields print as ruled lines to write on.

Appointment sheet

Acral melanoma

Prepared with OnCo (onco.cc/prep/acral-melanoma/). Orientation, not medical advice; your team knows your case.

My details

Name
Date of appointment
Hospital and clinician
Who is coming with me

What I know, what is unclear, changes to discuss

Saved in this browser
What I know so far
What is unclear to me
Changes since last time

My questions

16 on the sheet
Newly diagnosed
  1. 1.What is my exact diagnosis, stage, and grade, and which tests established them?
  2. 2.Which biomarkers have been tested on my tumour (for example Breslow thickness and ulceration, BRAF V600 mutation, NRAS mutation, KIT mutation or amplification, CCND1, CDK4 and TERT amplification), and what were the results?
  3. 3.Which subtype is my cancer, and does that change the recommended treatment?
  4. 4.Is germline (inherited) genetic testing recommended for me or my family?
Diagnosis
  1. 5.For my situation (diagnosis), which of the standard options do you recommend and why?
Localised disease
  1. 6.For my situation (localised disease), which of the standard options do you recommend and why?
Resected stage III
  1. 7.For my situation (resected stage iii), which of the standard options do you recommend and why?
  2. 8.Am I a candidate for Nivolumab, Pembrolizumab, Dabrafenib + trametinib, and what side effects should I expect?
  3. 9.How do the results of NADINA apply to someone like me?
Advanced disease
  1. 10.For my situation (advanced disease), which of the standard options do you recommend and why?
  2. 11.Am I a candidate for Nivolumab, Ipilimumab, Pembrolizumab or related drugs, and what side effects should I expect?
Any stage
  1. 12.Are there clinical trials I could join, for example of Tunlametinib, Comparing Tunlametinib Capsules and Combination Chemotherapy in Advanced NRAS-mutant Melanoma, Palbociclib, Imatinib?
  2. 13.Would a second opinion at a high-volume centre change anything, and can you help arrange it?
  3. 14.What supportive care (symptom control, nutrition, exercise, mental health, financial help) is available from the start?
  4. 15.I read that “Late diagnosis remains the main cause of poor outcomes and awareness in people with darker skin is low”. How does that affect my plan?
  5. 16.I read that “No trial has been designed for acral melanoma alone outside East Asia”. How does that affect my plan?

The words I may hear

  • Breslow thickness: How deep a melanoma has grown into the skin, in millimetres.
  • Ulceration (melanoma): Loss of the skin surface over a melanoma under the microscope; a sign of aggressive biology that raises the stage.
  • Wide local excision: Cutting out a tumour together with a measured rim of normal-looking tissue around it, so that microscopic spread at the edge is removed too.

Tests and results to bring

Diagnosis: Dermoscopy of the parallel ridge pattern and biopsy of any changing pigmented lesion of the palm, sole or nail; nail matrix biopsy for longitudinal melanonychia with Hutchinson sign.

Biomarker results to ask for: Breslow thickness and ulceration, BRAF V600 mutation, NRAS mutation, KIT mutation or amplification, CCND1, CDK4 and TERT amplification (research), Low tumour mutational burden.

Scans and tests linked to this cancer: Dermoscopy, total-body photography & AI skin analysis, Skin cancer screening (visual skin examination).

Bring copies of scan reports, pathology and blood results, and a list of every medicine and supplement.

The treatments I may be offered

From the standard of care recorded for this cancer; which apply depends on your stage and biomarkers. Ask which the team recommends and why.

Answers and next steps

Saved in this browser
What I was told
Agreed next steps, dates and who to call