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
