Christmas Update

Mark had brain surgery on Wednesday, December 18^th. The surgery went very well. The tumor in Mark’s brain, that the doctors thought was aggressive and growing, and warranted surgery, was black, shriveled, dead, and smaller than expected. Although it was no longer growing, it was causing Mark’s brain to swell and the surgeon successfully removed it. Mark is already feeling better.

 

Mark spent several days in the hospital, 

but as he predicted, returned to work on Monday, December 23^rd. Mark is very grateful for the prayers, phone calls, emails and other expressions of love and support. He sends his love and best wishes to all of you for a Merry Christmas and a happy and blessed 2014.

 

December 18th Update- Surgery Day

As you know, Mark has had a miraculous response to medications and radiation.  The mediation he received last summer activated his immune system to recognize the tumor cells as abnormal and therefore to attack and kill the tumor cells.  His followup brain and body scans have shown that most of the tumors in his body are completely gone or are much smaller. Two tumors, however, are growing, one beside his kidney and another in his brain.

After further MRI testing yesterday, the doctor feels that the brain tumor requires another round of focused brain radiation or surgical excision followed by focused brain radiation.  After considering the pros and cons, Mark and Meg have decided to proceed with surgical excision of the brain tumor on Thursday. Mark anticipates a quick recovery and plans to be kept in the hospital for only 3-4 days.  Subsequently, radiation will begin when the doctors feel appropriate, but this is done on an outpatient basis and causes little or no symptoms.

The tumor near the kidney will be treated with focused radiation after the brain tumor treatment has been completed.

Mark will be busy at work and with the necessary hospital pre-admission procedures until Saturday or Sunday. He expects to be in the office Monday of next week.

Mark and Meg are grateful for your continued prayers on his behalf.  He has felt the Spirit very strongly through this process and feels that everyone's prayers on his behalf have had a huge impact for good.

December 6th Update

I'm so grateful to still be here a year later.  I have felt, as has the family, you’re continued love and prayers. I can’t begin to express how much it has meant to me – thank you.  My PET scan showed minor tumor growth, nothing my immune system can’t handle, but one concerning tumor.  I'm scheduled for radiation on that tumor next week. 

My brain scan showed one tumor causing brain swelling.  Doctors Grossman, Shrieve, and Jensen want to perform another MRI on 12/24/13 with additional tests to determine how to treat it.  With the holidays coming up, I'm not certain when I will see the brain surgeon, Dr. Jensen, to interpret the results.

Good News!

Thank you for your prayers and support—it’s worked!

I had scans this week and learned that all four brain tumors are shrinking and my immune system is fighting body tumors. 

Dr. Grossman says there will be no treatments or appointments before my next scans the week of Thanksgiving. 

6/19/13 update

Brain radiation for four tumors was 6/17/13.  I've had no complications, returned to work6/18/13, and feel great.

Attached is a photo my sister, Diane Bartholomew, took of me in my radiation mask as the procedure began.

June 6th 2013 update

The scan results yesterday were not what I hoped for and expected.

I have been feeling much better recently—gaining enough energy to exercise regularly and having only minimal side effects to Yervoy.

Because of this, I fully expected to hear good news yesterday.

Regrettably, four of the brain tumors that were quite small on my 3/5/13 scan have now increased in size.  One of them has increased sufficiently to cause brain swelling.

These four tumors will be treated soon with targeted brain radiation (not whole-brain radiation like I had in Nov 2012).

There is also a new tumor in my left shoulder and right lung.  A tumor on my kidney has grown.  None of these tumors is perceptible to me (they aren’t painful as other have been).  These body scan results aren’t poor.  If not for the growth of brain tumors, the scans and Yervoy treatment could be deemed successful.

After the brain radiation, Dr. Grossman has three treatment ideas for the body tumors, including a possible return to Zelboraf.  Zelboraf is the drug that gave me the great initial response.

I'm grateful for your continued support and prayers.

March 9th 2013 update

I've been struggling with how to describe the road ahead. Thankfully, my brother Scott attended my most recent MD appointment and summarized it aptly below. Scott asked me how melanoma has changed things (besides the most obvious health affects). First, it brings focus to the moment. Instead of always striving for that future reward (e.g. promotion, possession, vacation), I enjoy the family sitting around the table laughing together, or the delicious electric blanket, or the vibrant sunset. Second, nothing goes unsaid. If a friend travels to visit, and he may not do so again, he lays it all out. Communication is direct, sincere, and precious. Third, you get to see the best of everyone. From acquaintances to long-time friends, all go out of their way to be generous and kind. I'm so grateful for your support. It is a blessing to me.
Mark
Mark Melanoma Update 6 March 2013

Mark continues to do extremely well with his chemotherapy treatment. His radiation side effects have mostly resolved, he is starting to grow beautifully white and fine hair, and the chemotherapy side effects are also improved. He is in virtually no pain and is able to work his 9+ hour workdays, although he is exhausted at the end of each day.

He met today with his melanoma doctor, Dr. Grossman, to review recent test results and to discuss changing his treatment regimen. The PET body scan and MRI brain scan showed that his tumors continue to respond well to the current chemotherapy, Zelboraf, but a few tumors show signs of possible resistance to this medication. Accordingly, the doctor has recommended stopping this medication and switching to an immune-therapy called Yervoy (ipilimumab).

Yervoy works in an entirely different way, and unlike the Zelboraf, holds the potential promise of long term survival, so switching at this time makes a lot of sense, after reducing the amount of tumors and making the tumors more accessible to the immune system with the prior chemotherapy. The Yervoy will be given intravenously on Wednesday, March 13 with an additional dose every 3 weeks for 4 doses total. If all goes well, the final dose will be May 22. Yervoy will help Mark’s own immune system recognize the melanoma cells and destroy them. The immune system will maintain a memory that will allow his own cells to continue to destroy any melanoma cells long after ceasing the Yervoy.

Side effects are generally mild and primarily are bowel related. Severe side effects are possible (10%) and are primarily bowel or endocrine (hormone) related.

The major downside with Yervoy is that only a minority of melanoma patients respond to the medication. In addition, it takes 12-22 weeks to know if his body is responding favorably to the medication, so this will be an anxious time of “waiting and watching.” Were he not to respond, he would be able to go back on the Zelboraf and potentially be treated with other medications still under investigation.

Mark feels strongly that his miraculous response to radiation and chemotherapy has been due to the prayers, fasting, and faith of the many loved ones concerned for him. He invites everyone to continue to exert themselves spiritually for the blessing that he will respond favorably to the Yervoy and receive a long term cure.

Love, Scott

My head and body rash has improved.  The photo of me with Bowen, my 15-year old, was taken one month after the previous photo and the photo of me in my office was taken last week.  The three photos, each about a month apart, show steady improvement in the head rash.

On March 5 I will have another PET Scan and an MRI.  Based upon the results of these scans, Dr. Grossman will decide if I should switch to an immune therapy drug, Ipilimumab, from my current chemotherapy drug, Zelboraf.

If I switch to the drug, and my body doesn’t reject it, it offers the best chance of long term success.  We are praying that Ipilimumab will work for me. http://en.wikipedia.org/wiki/Ipilimumab

I had my PET (body scan) and brain MRI on January 8.  I received the body results January 9 and the brain results January 10.
The doctors say they have never seen a more favorable response to stage IV melanoma treatment than they have seen with me.
To quote them “these are dream scans”.  With two months of chemotherapy there are no active tumors below the brain and all brain tumors are decreased in size.
They’ve seen it before, but never seen it so quickly as this.
I'm truly overcome with gratitude for the tremendous support that I enjoy.  My six siblings from around the country gathered with me for Thanksgiving.  I told them that I would never choose to have cancer, but it is astounding how you get to see the best attributes of your friends and family when you are in such an extremity.
As you know, I believe in keeping the blog concise, so I will close this update succinctly.  I will continue to take the chemotherapy daily.  My side effects from the chemo are vastly decreased.  In fact, my experience has already benefited another.  My body rash was severe and a side effect previously undocumented by Genentech.  it is now mostly healed.  Samples of my skin from scalp, leg, and abdomen were sent to Genentech.  An out-of-state MD recently had a patient with a rash reaction so severe that they were contemplating pulling the patient off the drug.  The MD called my MD.  My MD gave the treatment protocol, and they have kept the patient on the drug.
Again, thank you for your prayers.  I truly believe that I’m blessed by a miracle due to the many pleadings, faith, and hope of my family and friends.  Although I do not feel deserving of such generosity, I'm grateful for it.
Love,
Mark