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Living with cancer· Appointment prep

Appointment sheet: Melanoma

One page to bring and write on: your details, the questions for 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

Melanoma

Prepared with OnCo (onco.cc/prep/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

40 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 BRAF V600, NRAS, KIT, PD-L1, TMB), 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?
Stage II-III
  1. 5.For my situation (stage ii-iii), which of the standard options do you recommend and why?
  2. 6.Am I a candidate for Pembrolizumab, Nivolumab, and what side effects should I expect?
Metastatic first line
  1. 7.For my situation (metastatic first line), which of the standard options do you recommend and why?
  2. 8.Am I a candidate for Relatlimab + nivolumab, Encorafenib, and what side effects should I expect?
  3. 9.How do the results of CheckMate 067 apply to someone like me?
After PD-1
  1. 10.For my situation (after pd-1), which of the standard options do you recommend and why?
  2. 11.Am I a candidate for Lifileucel, Vusolimogene oderparepvec, Tebentafusp, and what side effects should I expect?
Screening and diagnosis
  1. 12.For my situation (screening and diagnosis), which of the standard options do you recommend and why?
Stage I-II primary
  1. 13.For my situation (stage i-ii primary), which of the standard options do you recommend and why?
  2. 14.How do the results of MSLT-II apply to someone like me?
Stage IIB-IIC (thick or ulcerated, node-negative)
  1. 15.For my situation (stage iib-iic (thick or ulcerated, node-negative)), which of the standard options do you recommend and why?
  2. 16.Am I a candidate for Pembrolizumab, Nivolumab, and what side effects should I expect?
  3. 17.How do the results of KEYNOTE-716 apply to someone like me?
Resectable stage III (macroscopic nodes)
  1. 18.For my situation (resectable stage iii (macroscopic nodes)), which of the standard options do you recommend and why?
  2. 19.How do the results of NADINA and SWOG S1801 apply to someone like me?
Stage III after surgery (adjuvant)
  1. 20.For my situation (stage iii after surgery (adjuvant)), which of the standard options do you recommend and why?
  2. 21.Am I a candidate for Dabrafenib + trametinib, and what side effects should I expect?
  3. 22.How do the results of COMBI-AD and RELATIVITY-098 apply to someone like me?
Unresectable or metastatic, first line
  1. 23.For my situation (unresectable or metastatic, first line), which of the standard options do you recommend and why?
  2. 24.How do the results of CheckMate 067 and RELATIVITY-047 apply to someone like me?
BRAF V600-mutant, after immunotherapy or needing rapid response
  1. 25.For my situation (braf v600-mutant, after immunotherapy or needing rapid response), which of the standard options do you recommend and why?
  2. 26.Am I a candidate for Encorafenib, Binimetinib, Vemurafenib or related drugs, and what side effects should I expect?
  3. 27.How do the results of COLUMBUS apply to someone like me?
After anti-PD-1 failure
  1. 28.For my situation (after anti-pd-1 failure), which of the standard options do you recommend and why?
  2. 29.Am I a candidate for Lifileucel, Vusolimogene oderparepvec, Brenetafusp, and what side effects should I expect?
  3. 30.How do the results of C-144-01 and PRISM-MEL-301 apply to someone like me?
Metastatic uveal melanoma (HLA-A*02:01-positive)
  1. 31.For my situation (metastatic uveal melanoma (hla-a*02:01-positive)), which of the standard options do you recommend and why?
  2. 32.Am I a candidate for Tebentafusp, and what side effects should I expect?
  3. 33.How do the results of IMCgp100-202 apply to someone like me?
Brain metastases
  1. 34.For my situation (brain metastases), which of the standard options do you recommend and why?
  2. 35.Am I a candidate for Nivolumab, Ipilimumab, and what side effects should I expect?
Any stage
  1. 36.Are there clinical trials I could join, for example of Intismeran autogene, Vusolimogene oderparepvec, Lifileucel, Tebentafusp?
  2. 37.Would a second opinion at a high-volume centre change anything, and can you help arrange it?
  3. 38.What supportive care (symptom control, nutrition, exercise, mental health, financial help) is available from the start?
  4. 39.I read that “Primary IO resistance in ~40%”. How does that affect my plan?
  5. 40.I read that “Uveal and mucosal subtypes”. How does that affect my plan?

The words I may hear

  • Major pathological response (MPR): When, after pre-surgery treatment, the removed tumour contains little or no living cancer: 10% or less viable cells.
  • 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.
  • Immune surveillance and cancer immunoediting: The immune system patrols for cells that have turned malignant and destroys most of them; the tumours we see are the ones that learned to hide.
  • Bioelectric theory of cancer (Levin): Cells hold a voltage across their membranes, and tissues share these voltages as patterns that guide growth and regeneration.
  • 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.
  • Cancer vaccines and oncolytic viruses: Cancer vaccines teach the immune system to recognise proteins on tumour cells; oncolytic viruses infect and burst cancer cells while raising the alarm to immunity.
  • Fixed-duration vs continuous therapy: Whether a drug is taken for a set period (say 12 months) and then stopped even though it is still working, or continued indefinitely until it fails.
  • HLA-A*02:01 restriction: Some T-cell-receptor drugs only work in people with a particular immune 'tissue type'.
  • Liver-directed therapy (TACE, TARE, HAI, ablation): The set of treatments aimed only at tumours in the liver, delivered through its artery or by needle, used when the liver is the main or only site of disease: chemoembolisation, radioactive beads, ablation and infusion pumps.

Tests and results to bring

Screening and diagnosis: Dermoscopy, total-body photography for high-risk patients, excisional biopsy with Breslow thickness and ulceration reported; AI decision support emerging.

Biomarker results to ask for: BRAF V600, NRAS, KIT (acral/mucosal), PD-L1 (weak), TMB, HLA-A*02:01 (tebentafusp), Breslow thickness and ulceration (staging), Sentinel node status, BRAF V600E/K (targeted therapy eligibility), NRAS, KIT (subtype and trial eligibility), HLA-A*02:01 (tebentafusp, brenetafusp), PRAME (diagnostic IHC; TCR target), LDH (prognostic in stage IV), ctDNA (investigational for MRD and response), TMB and interferon signatures (research predictors of IO response).

Scans and tests linked to this cancer: Companion diagnostics, Comprehensive genomic profiling, Serum tumour markers: proper use and misuse, SPECT & bone scan, SPECT/CT, Ultrasound.

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