UCLA or Stanford/UCSF

Forums General Melanoma Community UCLA or Stanford/UCSF

  • Post
    cstearns
    Participant

      Wow! This is happening fast. I'm Pharmacist and helping a friend with just Diagnosed Stage 4 Melanoma; He is not medical knowledged and I am not with Melanoma, but reading vigorously to catch up.     We live in area of general oncologist not specialist in Melanona.  I read he has much better chance now to get aggressive with newer immunotherapy treatments.  We are equidistant from La and Bay Area.  We are not familiar with staying at centers focused on Melanoma and looking for how to set him up for aggressive treatments. He has good insurance, FYI.   Thanks for your thoughts….Charlie

    Viewing 8 reply threads
    • Replies
        jennunicorn
        Participant

          I live in the Bay Area, actually close to Stanford, but I go to UCSF Melanoma Center for treatment as they are the best for melanoma specialists in Northern California. So, I highly recommend them from my personal experience. I have heard good things about UCLA as well, so maybe someone with experience down there can chime in about them. Either way, it is good to hear you're helping your friend out in finding a good melanoma center with top notch melanoma specialists as that is the #1 thing to do after being diagnosed. 

          Here is UCSF's site for the Melanoma Center: https://www.ucsfhealth.org/clinics/melanoma_center/

          All the best,

          jennunicorn
          Participant

            I live in the Bay Area, actually close to Stanford, but I go to UCSF Melanoma Center for treatment as they are the best for melanoma specialists in Northern California. So, I highly recommend them from my personal experience. I have heard good things about UCLA as well, so maybe someone with experience down there can chime in about them. Either way, it is good to hear you're helping your friend out in finding a good melanoma center with top notch melanoma specialists as that is the #1 thing to do after being diagnosed. 

            Here is UCSF's site for the Melanoma Center: https://www.ucsfhealth.org/clinics/melanoma_center/

            All the best,

              cstearns
              Participant

                Jenn,

                Thanks much for your post.  I am familiar with UCSF for other medical items.  Good to know they are tops Melanoma's too.

                 

                cstearns
                Participant

                  Jenn,

                  Thanks much for your post.  I am familiar with UCSF for other medical items.  Good to know they are tops Melanoma's too.

                   

                  cstearns
                  Participant

                    Jenn,

                    Thanks much for your post.  I am familiar with UCSF for other medical items.  Good to know they are tops Melanoma's too.

                     

                  jennunicorn
                  Participant

                    I live in the Bay Area, actually close to Stanford, but I go to UCSF Melanoma Center for treatment as they are the best for melanoma specialists in Northern California. So, I highly recommend them from my personal experience. I have heard good things about UCLA as well, so maybe someone with experience down there can chime in about them. Either way, it is good to hear you're helping your friend out in finding a good melanoma center with top notch melanoma specialists as that is the #1 thing to do after being diagnosed. 

                    Here is UCSF's site for the Melanoma Center: https://www.ucsfhealth.org/clinics/melanoma_center/

                    All the best,

                    Patina
                    Participant

                      Hi Charlie,

                      I'd HIGHLY recommend USC in Los Angeles. USC Norris Comprehensive Cancer Center is one of the best in the US. My Mom was is now being seen by Dr. James Hu who is her oncologist, Dr. Eric Chang, who is is radiation-oncologist and Dr. Naveed Wagle, who is her neuro-oncologist. And I feel that she would not be doing as well as she is if we had not taken her there for all of her treatments.

                      At 78 my Mom was diagnosed with stage IV in November of 2013 and she is doing great despite the stage IV diagnosis ending up with 28 brain mets!  99% of everything is gone, which is completely amazing. She's had Yervoy and Gamma Knife Radiation, that got most of it, but is now on Keytruda because she had 1 brain met with a reoccurrence and a new brain met about 12 and 10 months ago…. We were told last month that they can only see 1 treated brain met and the evidince of the other 26 is gone. – 1 was removed by craniotomy.

                      We did have some very bad experiences in the beginning so I'd recommend that he: 1) see only melanoma specialists, 2) be treated a facility that has a team with experience with gamma knife radiation (40% of melanoma patients end up with brain mets), 3) keep all treatment at one facility, 4) always ask about all the options and newest treatments, and 5) get a second or third opinion.

                      My Mom had a MRI done in November or 2013. She was diagnosed as Stage IV. We did not find out that she had brain cancer until we saw a 3rd melanoma specialist. The radiologist missed it and the two  melanoma specialists we saw at a clinic in Beverly Hills and then UCLA never even looked at her scans. They read the reports and it wasn't until we saw the 3rd melanoma specialist that we found out about the brain mets. She was about to go into a clinical trial and we were very lucky to have found out before too much time past or damage was done. 

                      She also had a problem with the doctor who did the gamma knife procedure the following month. He only treated 8 of 9 brain mets and said one was a blood vessel. Even though another radiologist said a month later that the "blood vessel" was a brain met he said it wasn't. 4 months later my Mom had another bad call and we were told that the brain met the neuro-oncologist who read my MRI saw was something to watch not treat. 

                      Since my Mom was being treated at USC (with Yerovy, which was started 4 days after gamma knife radiation treatment) her doctor had her seen by his radiologist the next day. We ended up moving all of her treatment to USC and it was the best decision we ever made. – She was treated for 17 new brain tumors a week later. – And the neuro-oncologist  at Cedars told us to just watch and see!

                      If you are going to be taking your friend to see the doctors I also recommend that you be sure to hand carry all of his reports and scans and make sure that any doctor he choose looks at the images not just the reports. Good doctors will want to look at these images and start testing him for the BRAF gene, which will give your friend more options with treatment. A recorder also helps so you can keep a record of what the doctor said too.

                      Today my Mom is 80, is full of energy, has not known lasting issues and does just about anything she wants. I would not be able to say this today if we had not have sought out other doctors or felt that we needed to when we were told to to watch and wait…

                      Good luck!

                       

                       

                      Patina
                      Participant

                        Hi Charlie,

                        I'd HIGHLY recommend USC in Los Angeles. USC Norris Comprehensive Cancer Center is one of the best in the US. My Mom was is now being seen by Dr. James Hu who is her oncologist, Dr. Eric Chang, who is is radiation-oncologist and Dr. Naveed Wagle, who is her neuro-oncologist. And I feel that she would not be doing as well as she is if we had not taken her there for all of her treatments.

                        At 78 my Mom was diagnosed with stage IV in November of 2013 and she is doing great despite the stage IV diagnosis ending up with 28 brain mets!  99% of everything is gone, which is completely amazing. She's had Yervoy and Gamma Knife Radiation, that got most of it, but is now on Keytruda because she had 1 brain met with a reoccurrence and a new brain met about 12 and 10 months ago…. We were told last month that they can only see 1 treated brain met and the evidince of the other 26 is gone. – 1 was removed by craniotomy.

                        We did have some very bad experiences in the beginning so I'd recommend that he: 1) see only melanoma specialists, 2) be treated a facility that has a team with experience with gamma knife radiation (40% of melanoma patients end up with brain mets), 3) keep all treatment at one facility, 4) always ask about all the options and newest treatments, and 5) get a second or third opinion.

                        My Mom had a MRI done in November or 2013. She was diagnosed as Stage IV. We did not find out that she had brain cancer until we saw a 3rd melanoma specialist. The radiologist missed it and the two  melanoma specialists we saw at a clinic in Beverly Hills and then UCLA never even looked at her scans. They read the reports and it wasn't until we saw the 3rd melanoma specialist that we found out about the brain mets. She was about to go into a clinical trial and we were very lucky to have found out before too much time past or damage was done. 

                        She also had a problem with the doctor who did the gamma knife procedure the following month. He only treated 8 of 9 brain mets and said one was a blood vessel. Even though another radiologist said a month later that the "blood vessel" was a brain met he said it wasn't. 4 months later my Mom had another bad call and we were told that the brain met the neuro-oncologist who read my MRI saw was something to watch not treat. 

                        Since my Mom was being treated at USC (with Yerovy, which was started 4 days after gamma knife radiation treatment) her doctor had her seen by his radiologist the next day. We ended up moving all of her treatment to USC and it was the best decision we ever made. – She was treated for 17 new brain tumors a week later. – And the neuro-oncologist  at Cedars told us to just watch and see!

                        If you are going to be taking your friend to see the doctors I also recommend that you be sure to hand carry all of his reports and scans and make sure that any doctor he choose looks at the images not just the reports. Good doctors will want to look at these images and start testing him for the BRAF gene, which will give your friend more options with treatment. A recorder also helps so you can keep a record of what the doctor said too.

                        Today my Mom is 80, is full of energy, has not known lasting issues and does just about anything she wants. I would not be able to say this today if we had not have sought out other doctors or felt that we needed to when we were told to to watch and wait…

                        Good luck!

                         

                         

                        Patina
                        Participant

                          Hi Charlie,

                          I'd HIGHLY recommend USC in Los Angeles. USC Norris Comprehensive Cancer Center is one of the best in the US. My Mom was is now being seen by Dr. James Hu who is her oncologist, Dr. Eric Chang, who is is radiation-oncologist and Dr. Naveed Wagle, who is her neuro-oncologist. And I feel that she would not be doing as well as she is if we had not taken her there for all of her treatments.

                          At 78 my Mom was diagnosed with stage IV in November of 2013 and she is doing great despite the stage IV diagnosis ending up with 28 brain mets!  99% of everything is gone, which is completely amazing. She's had Yervoy and Gamma Knife Radiation, that got most of it, but is now on Keytruda because she had 1 brain met with a reoccurrence and a new brain met about 12 and 10 months ago…. We were told last month that they can only see 1 treated brain met and the evidince of the other 26 is gone. – 1 was removed by craniotomy.

                          We did have some very bad experiences in the beginning so I'd recommend that he: 1) see only melanoma specialists, 2) be treated a facility that has a team with experience with gamma knife radiation (40% of melanoma patients end up with brain mets), 3) keep all treatment at one facility, 4) always ask about all the options and newest treatments, and 5) get a second or third opinion.

                          My Mom had a MRI done in November or 2013. She was diagnosed as Stage IV. We did not find out that she had brain cancer until we saw a 3rd melanoma specialist. The radiologist missed it and the two  melanoma specialists we saw at a clinic in Beverly Hills and then UCLA never even looked at her scans. They read the reports and it wasn't until we saw the 3rd melanoma specialist that we found out about the brain mets. She was about to go into a clinical trial and we were very lucky to have found out before too much time past or damage was done. 

                          She also had a problem with the doctor who did the gamma knife procedure the following month. He only treated 8 of 9 brain mets and said one was a blood vessel. Even though another radiologist said a month later that the "blood vessel" was a brain met he said it wasn't. 4 months later my Mom had another bad call and we were told that the brain met the neuro-oncologist who read my MRI saw was something to watch not treat. 

                          Since my Mom was being treated at USC (with Yerovy, which was started 4 days after gamma knife radiation treatment) her doctor had her seen by his radiologist the next day. We ended up moving all of her treatment to USC and it was the best decision we ever made. – She was treated for 17 new brain tumors a week later. – And the neuro-oncologist  at Cedars told us to just watch and see!

                          If you are going to be taking your friend to see the doctors I also recommend that you be sure to hand carry all of his reports and scans and make sure that any doctor he choose looks at the images not just the reports. Good doctors will want to look at these images and start testing him for the BRAF gene, which will give your friend more options with treatment. A recorder also helps so you can keep a record of what the doctor said too.

                          Today my Mom is 80, is full of energy, has not known lasting issues and does just about anything she wants. I would not be able to say this today if we had not have sought out other doctors or felt that we needed to when we were told to to watch and wait…

                          Good luck!

                           

                           

                            cstearns
                            Participant

                              Thanks for your story with your Mom.  It is encouraging seeing the remission chance with stage 4.  We have to keep searching, I can see from your post.  We have not done a brain or bone scan yet.

                              Is there a short stay cancer patient living quarters near USC.  I am unfamiliar with that part of California, so not sure what people do that are 3 hours away?

                              Trying to figure our options,

                              Thanks again, Charlie.

                              cstearns
                              Participant

                                Thanks for your story with your Mom.  It is encouraging seeing the remission chance with stage 4.  We have to keep searching, I can see from your post.  We have not done a brain or bone scan yet.

                                Is there a short stay cancer patient living quarters near USC.  I am unfamiliar with that part of California, so not sure what people do that are 3 hours away?

                                Trying to figure our options,

                                Thanks again, Charlie.

                                cstearns
                                Participant

                                  Thanks for your story with your Mom.  It is encouraging seeing the remission chance with stage 4.  We have to keep searching, I can see from your post.  We have not done a brain or bone scan yet.

                                  Is there a short stay cancer patient living quarters near USC.  I am unfamiliar with that part of California, so not sure what people do that are 3 hours away?

                                  Trying to figure our options,

                                  Thanks again, Charlie.

                                  Patina
                                  Participant

                                    We come from the Santa Ynez Valley and make the trip in a day. It's about a 2 hour drive and by the time you see the doctor, do blood tests, get lunch and an infusion we can be home around 5 or 6, unless something goes haywire.

                                    If I were him I'd have my PET and MRI done at USC and asked for a report and disk with images to be picked up or mailed to you. I don't know how long it takes to get into see someone, so I'd make an appointment as soon as can and get a referral to have the MRI and PET scan as soon as possible. If you do this the doctor will know when he or she sees your friend what the results are and you can get a few appointments with doctors in LA at the same time too.

                                    Once your friend is seen and he gets on a schedule this is a day trip and a hotel really isn't needed. We use to stay every time my Mom needed to see all of her doctors on the same day, but now we drive down because she can get her brain MRI a week before her appointments. I haven't stayed anywhere else and there hasn't been a great option right by USC. You can check this map out for hotels in NE Los Angeles.

                                    When we needed to stay at a hotel it was either because of a procedure or we had to see all of her doctors in one day. We stayed at the Hilton in San Gabriel is awesome. The people are just fantastic and it's a 15 minute drive on surface streets if you don't go by the highway. That said, you can find plenty of hotels a short distance away if you need to stay somewhere. Downtown LA is a short drive and you don't really need to get on the HWY. The front desk at USC also has a lit of hotels too.

                                    PS

                                    Be sure to take the images and reports with you for any consultations.

                                     

                                    Patina
                                    Participant

                                      We come from the Santa Ynez Valley and make the trip in a day. It's about a 2 hour drive and by the time you see the doctor, do blood tests, get lunch and an infusion we can be home around 5 or 6, unless something goes haywire.

                                      If I were him I'd have my PET and MRI done at USC and asked for a report and disk with images to be picked up or mailed to you. I don't know how long it takes to get into see someone, so I'd make an appointment as soon as can and get a referral to have the MRI and PET scan as soon as possible. If you do this the doctor will know when he or she sees your friend what the results are and you can get a few appointments with doctors in LA at the same time too.

                                      Once your friend is seen and he gets on a schedule this is a day trip and a hotel really isn't needed. We use to stay every time my Mom needed to see all of her doctors on the same day, but now we drive down because she can get her brain MRI a week before her appointments. I haven't stayed anywhere else and there hasn't been a great option right by USC. You can check this map out for hotels in NE Los Angeles.

                                      When we needed to stay at a hotel it was either because of a procedure or we had to see all of her doctors in one day. We stayed at the Hilton in San Gabriel is awesome. The people are just fantastic and it's a 15 minute drive on surface streets if you don't go by the highway. That said, you can find plenty of hotels a short distance away if you need to stay somewhere. Downtown LA is a short drive and you don't really need to get on the HWY. The front desk at USC also has a lit of hotels too.

                                      PS

                                      Be sure to take the images and reports with you for any consultations.

                                       

                                      Patina
                                      Participant

                                        We come from the Santa Ynez Valley and make the trip in a day. It's about a 2 hour drive and by the time you see the doctor, do blood tests, get lunch and an infusion we can be home around 5 or 6, unless something goes haywire.

                                        If I were him I'd have my PET and MRI done at USC and asked for a report and disk with images to be picked up or mailed to you. I don't know how long it takes to get into see someone, so I'd make an appointment as soon as can and get a referral to have the MRI and PET scan as soon as possible. If you do this the doctor will know when he or she sees your friend what the results are and you can get a few appointments with doctors in LA at the same time too.

                                        Once your friend is seen and he gets on a schedule this is a day trip and a hotel really isn't needed. We use to stay every time my Mom needed to see all of her doctors on the same day, but now we drive down because she can get her brain MRI a week before her appointments. I haven't stayed anywhere else and there hasn't been a great option right by USC. You can check this map out for hotels in NE Los Angeles.

                                        When we needed to stay at a hotel it was either because of a procedure or we had to see all of her doctors in one day. We stayed at the Hilton in San Gabriel is awesome. The people are just fantastic and it's a 15 minute drive on surface streets if you don't go by the highway. That said, you can find plenty of hotels a short distance away if you need to stay somewhere. Downtown LA is a short drive and you don't really need to get on the HWY. The front desk at USC also has a lit of hotels too.

                                        PS

                                        Be sure to take the images and reports with you for any consultations.

                                         

                                        cstearns
                                        Participant

                                          Thanks for you insights into how to get this started and done.  I am leaning towards USC, and mostly via your testimonys.  Actually the southland is closer than Bay Area by 1/2 hour or so.  USC is about 3 hours.  I was under the impression from Sansum Oncology that we needed to be within 1/2 hour of hospital with these new aggressive plans with immunotherapy?

                                          I'm planning to get on the phone Monday morning to see when we can get in.  I can see we need more diagnostic work to rule out other mets.  Hoping the end of next week we can do something.  I appreiate your emphasis on carrying and taking reports, films, etc. with us and to keep detail notes as this gets complicated I can see.

                                          Thanks again Charlie

                                          cstearns
                                          Participant

                                            Thanks for you insights into how to get this started and done.  I am leaning towards USC, and mostly via your testimonys.  Actually the southland is closer than Bay Area by 1/2 hour or so.  USC is about 3 hours.  I was under the impression from Sansum Oncology that we needed to be within 1/2 hour of hospital with these new aggressive plans with immunotherapy?

                                            I'm planning to get on the phone Monday morning to see when we can get in.  I can see we need more diagnostic work to rule out other mets.  Hoping the end of next week we can do something.  I appreiate your emphasis on carrying and taking reports, films, etc. with us and to keep detail notes as this gets complicated I can see.

                                            Thanks again Charlie

                                            cstearns
                                            Participant

                                              Thanks for you insights into how to get this started and done.  I am leaning towards USC, and mostly via your testimonys.  Actually the southland is closer than Bay Area by 1/2 hour or so.  USC is about 3 hours.  I was under the impression from Sansum Oncology that we needed to be within 1/2 hour of hospital with these new aggressive plans with immunotherapy?

                                              I'm planning to get on the phone Monday morning to see when we can get in.  I can see we need more diagnostic work to rule out other mets.  Hoping the end of next week we can do something.  I appreiate your emphasis on carrying and taking reports, films, etc. with us and to keep detail notes as this gets complicated I can see.

                                              Thanks again Charlie

                                              jennunicorn
                                              Participant

                                                Just a thought, something a lot of patients who don't live close to a major cancer center with melanoma specialists do: they have a local oncologist and then they find a melanoma oncologist at a recommended institution like where you are looking. They have their melanoma specialist team up with the local oncologist and the patient can receive their drug infusions close to home without having to make the long trip every time for an infusion. They get scans and things done at the larger hospital where the specialist is. Basically, the melanoma oncologist calls all the shots as far as telling the local onocologist what drug the patient will be doing and how to treat any side effects that come up. It's best to live close to a hospital in general, just in case any major side effect popped up that you'd need to get to an ER for. 

                                                I am sure once your friend gets in to see a specialist and gets the ball rolling for treatment it will all start to go smoothly and not feel as crazy, the beginning of this journey is one of the craziest times. Your friend is definitely lucky to have you in their life.

                                                jennunicorn
                                                Participant

                                                  Just a thought, something a lot of patients who don't live close to a major cancer center with melanoma specialists do: they have a local oncologist and then they find a melanoma oncologist at a recommended institution like where you are looking. They have their melanoma specialist team up with the local oncologist and the patient can receive their drug infusions close to home without having to make the long trip every time for an infusion. They get scans and things done at the larger hospital where the specialist is. Basically, the melanoma oncologist calls all the shots as far as telling the local onocologist what drug the patient will be doing and how to treat any side effects that come up. It's best to live close to a hospital in general, just in case any major side effect popped up that you'd need to get to an ER for. 

                                                  I am sure once your friend gets in to see a specialist and gets the ball rolling for treatment it will all start to go smoothly and not feel as crazy, the beginning of this journey is one of the craziest times. Your friend is definitely lucky to have you in their life.

                                                  jennunicorn
                                                  Participant

                                                    Just a thought, something a lot of patients who don't live close to a major cancer center with melanoma specialists do: they have a local oncologist and then they find a melanoma oncologist at a recommended institution like where you are looking. They have their melanoma specialist team up with the local oncologist and the patient can receive their drug infusions close to home without having to make the long trip every time for an infusion. They get scans and things done at the larger hospital where the specialist is. Basically, the melanoma oncologist calls all the shots as far as telling the local onocologist what drug the patient will be doing and how to treat any side effects that come up. It's best to live close to a hospital in general, just in case any major side effect popped up that you'd need to get to an ER for. 

                                                    I am sure once your friend gets in to see a specialist and gets the ball rolling for treatment it will all start to go smoothly and not feel as crazy, the beginning of this journey is one of the craziest times. Your friend is definitely lucky to have you in their life.

                                                  Polymath
                                                  Participant

                                                    Hello,

                                                    Your friend is lucky to have you in his corner.  Its a tough fight, and having a support network is helpful.  I'm being seen, and sometimes treated at UCSF.  For me, the visit requires a 5-hour plane ride, hotel stays, etc.  But exactly as Jenn noted above, I also receive some limited care, and many of my regular infusions at my local hospital under the direction of a general oncologist.  Once a specialist puts a treatment plan in place, you may be able to avoid the travel for at least some treatments.  On another note, perhaps because of my logistical challenges, UCSF seems to really be efficient for me.  I will get a CT scan in the morning, visit my doctor just hours later with results of the scan, then if due, my regular infusion all in a one-day visit.  I have been so pleased with my care at UCSF I would recommend them highly.

                                                    Gary

                                                    Polymath
                                                    Participant

                                                      Hello,

                                                      Your friend is lucky to have you in his corner.  Its a tough fight, and having a support network is helpful.  I'm being seen, and sometimes treated at UCSF.  For me, the visit requires a 5-hour plane ride, hotel stays, etc.  But exactly as Jenn noted above, I also receive some limited care, and many of my regular infusions at my local hospital under the direction of a general oncologist.  Once a specialist puts a treatment plan in place, you may be able to avoid the travel for at least some treatments.  On another note, perhaps because of my logistical challenges, UCSF seems to really be efficient for me.  I will get a CT scan in the morning, visit my doctor just hours later with results of the scan, then if due, my regular infusion all in a one-day visit.  I have been so pleased with my care at UCSF I would recommend them highly.

                                                      Gary

                                                      Polymath
                                                      Participant

                                                        Hello,

                                                        Your friend is lucky to have you in his corner.  Its a tough fight, and having a support network is helpful.  I'm being seen, and sometimes treated at UCSF.  For me, the visit requires a 5-hour plane ride, hotel stays, etc.  But exactly as Jenn noted above, I also receive some limited care, and many of my regular infusions at my local hospital under the direction of a general oncologist.  Once a specialist puts a treatment plan in place, you may be able to avoid the travel for at least some treatments.  On another note, perhaps because of my logistical challenges, UCSF seems to really be efficient for me.  I will get a CT scan in the morning, visit my doctor just hours later with results of the scan, then if due, my regular infusion all in a one-day visit.  I have been so pleased with my care at UCSF I would recommend them highly.

                                                        Gary

                                                          cstearns
                                                          Participant

                                                            Thank you Patina, Jenn and Gary,

                                                            You have been most helpful getting my planning and path set.  I'll for sure keep the appointment for this week with local Oncologist and hope as you suggest, to eventially do most treatments here.   I was just fearful that we could not do the aggressive protocols unless very close to the Melanoma center.  It does sound like initially we'd better plan some stay time at the center

                                                            I'll call the centers to see when we can get in. 

                                                            Thanks again for your help; this is a great site for education. Have great days!

                                                            Charlie

                                                            cstearns
                                                            Participant

                                                              Thank you Patina, Jenn and Gary,

                                                              You have been most helpful getting my planning and path set.  I'll for sure keep the appointment for this week with local Oncologist and hope as you suggest, to eventially do most treatments here.   I was just fearful that we could not do the aggressive protocols unless very close to the Melanoma center.  It does sound like initially we'd better plan some stay time at the center

                                                              I'll call the centers to see when we can get in. 

                                                              Thanks again for your help; this is a great site for education. Have great days!

                                                              Charlie

                                                              cstearns
                                                              Participant

                                                                Thank you Patina, Jenn and Gary,

                                                                You have been most helpful getting my planning and path set.  I'll for sure keep the appointment for this week with local Oncologist and hope as you suggest, to eventially do most treatments here.   I was just fearful that we could not do the aggressive protocols unless very close to the Melanoma center.  It does sound like initially we'd better plan some stay time at the center

                                                                I'll call the centers to see when we can get in. 

                                                                Thanks again for your help; this is a great site for education. Have great days!

                                                                Charlie

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