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Living with cancer· Appointment prep

Appointment sheet: Stage IIB and IIC melanoma

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

Stage IIB and IIC melanoma

Prepared with OnCo (onco.cc/prep/stage-ii-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

17 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, Ulceration of the primary, Sentinel lymph node status, Mitotic rate, BRAF V600 mutation), 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 and surgery
  1. 5.For my situation (diagnosis and surgery), which of the standard options do you recommend and why?
Adjuvant, stage IIB or IIC
  1. 6.For my situation (adjuvant, stage iib or iic), which of the standard options do you recommend and why?
  2. 7.Am I a candidate for Pembrolizumab, Nivolumab, and what side effects should I expect?
  3. 8.How do the results of KEYNOTE-716 and Effectiveness Study of Nivolumab Compared to Placebo in Prevention of Recurrent Melanoma After Complete Resection of Stage IIB/C Melanoma apply to someone like me?
Adjuvant vaccine (emerging)
  1. 9.For my situation (adjuvant vaccine (emerging)), which of the standard options do you recommend and why?
  2. 10.Am I a candidate for Intismeran autogene, and what side effects should I expect?
  3. 11.How do the results of INTerpath-001 (V940-001) apply to someone like me?
Surveillance
  1. 12.For my situation (surveillance), which of the standard options do you recommend and why?
Any stage
  1. 13.Are there clinical trials I could join, for example of INTerpath-001 (V940-001), Intismeran autogene, Adjuvant Encorafenib and Binimetinib in High-risk Stage II Melanoma With a BRAF Mutation., ctDNA-guided adjuvant therapy in stage II-III melanoma?
  2. 14.Would a second opinion at a high-volume centre change anything, and can you help arrange it?
  3. 15.What supportive care (symptom control, nutrition, exercise, mental health, financial help) is available from the start?
  4. 16.I read that “Roughly four in five patients would have been cured by surgery alone and cannot yet be told apart from the fifth”. How does that affect my plan?
  5. 17.I read that “No overall survival benefit has yet been shown for adjuvant therapy in stage II”. 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.
  • Circulating tumour DNA (ctDNA): Circulating tumour DNA (ctDNA) consists of fragments of DNA shed by tumour cells into the blood, detectable with sensitive sequencing.
  • Neoadjuvant / adjuvant / perioperative: Neoadjuvant therapy is treatment given before surgery, adjuvant therapy is treatment given after it, and perioperative therapy is both.

Tests and results to bring

Diagnosis and surgery: Wide local excision with margins set by thickness and sentinel lymph node biopsy for primaries over 0.8 mm or with ulceration.

Biomarker results to ask for: Breslow thickness, Ulceration of the primary, Sentinel lymph node status (must be negative for stage II), Mitotic rate, BRAF V600 mutation (trial eligibility), Circulating tumour DNA and gene-expression profiles (under study to select who needs adjuvant therapy).

Scans and tests linked to this cancer: Liquid biopsy (ctDNA), 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