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Notable News July 2020

It seems like everyone is talking about the Broadway musical Hamilton this month, so let’s take a cue from A.Ham himself and rise up because sitting is proving, yet again, to not be so good for us. Also, not good yet again? Covid-19. It’s especially not good for people with cancer. What is good? Advances in cancer treatment and a blood test that delivers super early cancer detection.

PanSeer

PanSeer is a non-invasive blood test that can detect five types of cancer up to four years earlier than current methods of diagnosis, reports theguardian.com. The blood test is not a cancer predictor, but instead is finding cancers before they cause symptoms or are detected through other screening methods. The test is not able to indicate the type of cancer a patient has, but, with further research, shows promise for early, non-invasive diagnosis. You can learn more here and here.

Photodynamic Therapies

Also showing promise is research regarding skin cancer treatments that could be used to treat other types of cancer, reports medicalxpress.com. Photodynamic therapies (PDT) which use light to treat skin cancers by destroying cancerous and precancerous cells could possibly be used to treat other types of cancers thanks to the development of silica nanocapsules that can be used to convert near-infrared light to visible light. Right now, PDT only works if the tumors are on or under the skin because it works with visible light to activate medications that are injected into unhealthy tissue. However, since near-infrared light can get deeper into the tissues and then be converted into visible light by the silica nanocapsules, the treatment becomes more versatile. Learn more about the process here.

Good Diet Improves Treatment

Speaking of versatile, changing your diet could really help during breast cancer treatment, says cancernetwork.com. Recently reported study findings show that a fasting mimicking diet is safe and effective during chemotherapy in women with early breast cancer. The diet appears to have a positive effect on how well the cancer treatment works, and also reduces the side effects caused by the treatment. Basically, the research found that when fasting, there were less nutrients and insulin for the healthy cells to address, indicating the body should conserve energy and put healthy cells into maintenance mode. Chemotherapy targets rapidly dividing cells, so instead of attacking the less-active healthy cells, it would easily find the malignant cells which don’t pick up on body signals and continue to divide despite the fast. Fasting mimicking diets are low-calorie, low-protein, low-carbohydrate, high-fat diet plans that trick your body into thinking it is fasting. You can learn more about fasting mimicking diets and breast cancer treatments here and here.

Cancer and COVID-19

The sooner we can get a treatment for Covid-19, the better, but in the meantime, cancer patients need to be especially diligent about avoiding the virus. The longer you have had cancer, the higher your risk of a severe Covid-19 infection, says technologynetworks.com. Research has found that people who were diagnosed with cancer 2 years or more ago are more likely to have a severe Covid-19 infection. While there are not a lot of studies regarding cancer patients and Covid-19, one study of 156 cancer patients with confirmed Covid-19 infection showed that 22 percent of the patients died from the infection, and those who had been diagnosed two years or more prior to infection were at a higher risk of dying. Symptoms of Covid-19 can mimic cancer symptoms or the affects of cancer treatments, so it can be hard to diagnose Covid-19 in cancer patients, which could result in more severe infections or higher death rates. Learn more about the study here.

Activity Decreases Cancer Risk

Avoiding exposure to the coronavirus may keep some of us out of the gym, but we still need to get moving, otherwise we increase our risk of dying from cancer, reports medicalnewstoday.com. In a study where patient activity level was tracked through hip monitors, researchers found that the amount of time people are sedentary puts them at a higher risk for dying from cancer. Researchers also found that being physically active for 30 minutes a day decreased the risk of dying from cancer. Vigorous exercise decreased the risk 31 percent and light exercise decreased the risk 8 percent. The increased activity doesn’t have to be all at once, either. It can be as simple as standing for five minutes every hour while you are at work. Instead of thinking you must get out there and exercise for thirty minutes at a time, think, ‘sit less, move more,’ throughout your day. Find more information here.

Tests for Melanoma Skin Cancer

This resource was originally published by the American Cancer Society here.

Most melanomas are brought to a doctor’s attention because of signs or symptoms a person is having.

If you have an abnormal area on your skin that might be cancer, your doctor will examine it and might do tests to find out if it is melanoma, another type of skin cancer, or some other skin condition. If melanoma is found, other tests may be done to find out if it has spread to other areas of the body.

Medical history and physical exam

Usually the first step your doctor takes is to ask about your symptoms, such as when the mark on the skin first appeared, if it has changed in size or appearance, and if it has been painful, itchy, or bleeding. You may also be asked about your possible risk factors for melanoma skin cancer, such as your history of tanning and sunburns, and if you or anyone in your family has had melanoma or other skin cancers.

During the physical exam, your doctor will note the size, shape, color, and texture of the area(s) in question, and whether it is bleeding, oozing, or crusting. The rest of your body may be checked for moles and other spots that could be related to skin cancer (or other skin conditions).

The doctor may also feel the lymph nodes (small, bean-sized collections of immune cells) under the skin in the neck, underarm, or groin near the abnormal area. When melanoma spreads, it often goes to nearby lymph nodes first, making them larger.

If you are being seen by your primary doctor and melanoma is suspected, you may be referred to a dermatologist, a doctor who specializes in skin diseases, who will look at the area more closely.

Along with a standard physical exam, many dermatologists use a technique called dermoscopy (also known as dermatoscopy, epiluminescence microscopy [ELM], or surface microscopy) to see spots on the skin more clearly. The doctor uses a dermatoscope, which is a special magnifying lens and light source held near the skin. Sometimes a thin layer of alcohol or oil is used with this instrument. The doctor may take a digital photo of the spot.

Skin biopsy

If the doctor thinks a spot might be a melanoma, the suspicious area will be removed and sent to a lab to be looked at under a microscope. This is called a skin biopsy.

There are many ways to do a skin biopsy. The doctor will choose one based on the size of the affected area, where it is on your body, and other factors. Any biopsy is likely to leave at least a small scar. Different methods can result in different types of scars, so ask your doctor about scarring before the biopsy. No matter which type of biopsy is done, it should remove as much of the suspected area as possible so that an accurate diagnosis can be made.

Skin biopsies are done using a local anesthetic (numbing medicine), which is injected into the area with a very small needle. You will likely feel a small prick and a little stinging as the medicine is injected, but you should not feel any pain during the biopsy.

Shave (tangential) biopsy

For this type of biopsy, the doctor shaves off the top layers of the skin with a small surgical blade. Bleeding from the biopsy site is stopped by applying an ointment, a chemical that stops bleeding, or a small electrical current to cauterize the wound.

A shave biopsy is useful in diagnosing many types of skin diseases and in sampling moles when the risk of melanoma is very low. This type of biopsy is not generally used if a melanoma is strongly suspected unless the biopsy blade will go deep enough to get below the suspicious area. Otherwise, if it is a melanoma, the biopsy sample may not be thick enough to measure how deeply the cancer has invaded the skin.

Punch biopsy

For a punch biopsy, the doctor uses a tool that looks like a tiny round cookie cutter to remove a deeper sample of skin. The doctor rotates the punch biopsy tool on the skin until it cuts through all the layers of the skin. The sample is removed and the edges of the biopsy site are often stitched together.

Excisional and incisional biopsies

To examine a tumor that might have grown into deeper layers of the skin, the doctor may use an excisional (or less often, an incisional) biopsy.

  • An excisional biopsy removes the entire tumor (along with a small margin of normal skin around it). This is usually the preferred method of biopsy for suspected melanomas if it can be done, although this isn’t always possible.
  • An incisional biopsy removes only a portion of the tumor.

For these types of biopsies, a surgical knife is used to cut through the full thickness of skin. A wedge or sliver of skin is removed for examination, and the edges of the cut are usually stitched together.

“Optical” biopsies

Some newer types of biopsies, such as reflectance confocal microscopy (RCM), can be done without needing to remove samples of skin. To learn more, see What’s New in Melanoma Skin Cancer Research?

Biopsies of melanoma that may have spread

Biopsies of areas other than the skin may be needed in some cases. For example, if melanoma has already been diagnosed on the skin, nearby lymph nodes may be biopsied to see if the cancer has spread to them.

Rarely, biopsies may be needed to figure out what type of cancer someone has. For example, some melanomas can spread so quickly that they reach the lymph nodes, lungs, brain, or other areas while the original skin melanoma is still very small. Sometimes these tumors are found with imaging tests (such as CT scans) or other exams even before the melanoma on the skin is discovered. In other cases, they may be found long after a skin melanoma has been removed, so it’s not clear if it’s the same cancer.

In still other cases, melanoma may be found somewhere in the body without ever finding a spot on the skin. This may be because some skin lesions go away on their own (without any treatment) after some of their cells have spread to other parts of the body. Melanoma can also start in internal organs, but this is very rare, and if melanoma has spread widely throughout the body, it may not be possible to tell exactly where it started.

When melanoma has spread to other organs, it can sometimes be confused with a cancer starting in that organ. For example, melanoma that has spread to the lung might be confused with a primary lung cancer (cancer that starts in the lung).

Special lab tests can be done on the biopsy samples that can tell whether it is a melanoma or some other kind of cancer. This is important because different types of cancer are treated differently.

Biopsies of suspicious areas inside the body often are more involved than those used to sample the skin.

Fine needle aspiration (FNA) biopsy

FNA biopsy is not used on suspicious moles. But it may be used, for example, to biopsy large lymph nodes near a melanoma to find out if the melanoma has spread to them.

For this type of biopsy, the doctor uses a syringe with a thin, hollow needle to remove very small pieces of a lymph node or tumor. The needle is smaller than the needle used for a blood test. A local anesthetic is sometimes used to numb the area first. This test rarely causes much discomfort and does not leave a scar.

If the lymph node is just under the skin, the doctor can often feel it well enough to guide the needle into it. For a suspicious lymph node deeper in the body or a tumor in an organ such as the lung or liver, an imaging test such as ultrasound or a CT scan is often used to help guide the needle into place.

FNA biopsies are not as invasive as some other types of biopsies, but they may not always collect enough of a sample to tell if a suspicious area is melanoma. In these cases, a more invasive type of biopsy may be needed.

Surgical (excisional) lymph node biopsy

This procedure can be used to remove an enlarged lymph node through a small incision (cut) in the skin. A local anesthetic (numbing medicine) is generally used if the lymph node is just under the skin, but the person may need to be sedated or even asleep (using general anesthesia) if the lymph node is deeper in the body.

This type of biopsy is often done if a lymph node’s size suggests the melanoma has spread there but an FNA biopsy of the node wasn’t done or didn’t find any melanoma cells.

Sentinel lymph node biopsy

If melanoma has been diagnosed and has any concerning features (such as being at least a certain thickness), a sentinel lymph node biopsy (SLNB) is often done to see if the cancer has spread to nearby lymph nodes, which in turn might affect treatment options. This test can be used to find the lymph nodes that are likely to be the first place the melanoma would go if it has spread. These lymph nodes are called sentinel nodes (they stand sentinel, or watch, over the tumor, so to speak).

To find the sentinel lymph node (or nodes), a doctor injects a small amount of a radioactive substance into the area of the melanoma. After giving the substance time to travel to the lymph node areas near the tumor, a special camera is used to see if it collects in one or more sentinel lymph nodes. Once the radioactive area has been marked, the patient is taken for surgery, and a blue dye is injected in the same place the radioactive substance was injected. A small incision is then made in the marked area, and the lymph nodes are then checked to find which one(s) became radioactive and turned blue. These sentinel nodes are removed and looked at under a microscope.

If there are no melanoma cells in the sentinel nodes, no more lymph node surgery is needed because it is very unlikely the melanoma would have spread beyond this point. If melanoma cells are found in the sentinel node, the remaining lymph nodes in this area are typically removed and looked at as well. This is known as a lymph node dissection (see Surgery for Melanoma Skin Cancer).

If a lymph node near a melanoma is abnormally large, a sentinel node biopsy probably won’t be needed. The enlarged node is simply biopsied.

Lab tests of biopsy samples

Samples from any biopsies will be sent to a lab, where a doctor called a pathologist will look at them under a microscope for melanoma cells. Often, skin samples are sent to a dermatopathologist, a doctor who has special training in looking at skin samples.

If the doctor can’t tell for sure if melanoma cells are in the sample just by looking at it, special lab tests will be done on the cells to try to confirm the diagnosis. These might include:

  • Immunohistochemistry (IHC)
  • Fluorescence in situ hybridization (FISH)
  • Comparative genomic hybridization (CGH)
  • Gene expression profiling (GEP)

If melanoma is found in the samples, the pathologist will look at certain important features such as the tumor thickness and mitotic rate (the portion of cells that are actively dividing). These features help determine the stage of the melanoma (see Melanoma Skin Cancer Stages), which in turn can affect treatment options and prognosis (outlook).

Testing for gene changes

For some people with melanoma, biopsy samples may be tested to see if the cells have mutations (changes) in certain genes, such as the BRAF gene. About half of melanomas have BRAF mutations. Some drugs used to treat advanced melanomas are only likely to work if the cells have BRAF mutations (see Targeted Therapy for Melanoma Skin Cancer), so this test is important in helping to determine treatment options. Tests for changes in other genes, such as C-KIT, might be done as well.

A newer lab test known as DecisionDx-Melanoma looks at certain gene expression patterns in melanoma cells to help show if early-stage melanomas are likely to spread. This might be used to help determine treatment options. To learn more, see What’s New in Melanoma Skin Cancer Research?

Imaging tests

Imaging tests use x-rays, magnetic fields, or radioactive substances to create pictures of the inside of the body. They are used mainly to look for the possible spread of melanoma to lymph nodes or other organs. These tests are not needed for most people with very early-stage melanoma, which is very unlikely to have spread.

Imaging tests can also be done to help determine how well treatment is working or to look for possible signs of cancer coming back (recurring) after treatment.

Chest x-ray

This test might be done to help determine if melanoma has spread to the lungs, although a CT scan of the chest (see below) is often done instead.

Ultrasound

Ultrasound uses sound waves to create images of the inside of your body on a computer screen. This test might be used to look at the lymph nodes near the tumor, especially if it’s not clear if they’re enlarged based on a physical exam. Ultrasound is typically fairly quick and easy to do, and it doesn’t expose you to radiation.

Ultrasound-guided needle biopsy: Ultrasound can also be used to help guide a biopsy needle into a suspicious lymph node.

Computed tomography (CT) scan

The CT scan uses x-rays to make detailed, cross-sectional images of your body. Unlike a regular x-ray, CT scans can show the detail in soft tissues (such as internal organs). This test can show if any lymph nodes are enlarged or if organs such as the lungs or liver have suspicious spots, which might be from the spread of melanoma.

CT-guided needle biopsy: CT scans can also be used to help guide a biopsy needle into a suspicious area within the body.

Magnetic resonance imaging (MRI) scan

MRI scans use radio waves and strong magnets instead of x-rays to create detailed images of parts of your body. MRI scans can be very helpful in looking at the brain and spinal cord.

Positron emission tomography (PET) scan

PET scan can help show if the cancer has spread to lymph nodes or other parts of the body. It is most useful in people with more advanced stages of melanoma.

For this test, you are injected with a slightly radioactive form of sugar, which collects mainly in cancer cells. A special camera is then used to create a picture of areas of radioactivity in the body.

PET/CT scan: Many centers have special machines that do both a PET and CT scan at the same time (PET/CT scan). This lets the doctor compare areas of higher radioactivity on the PET scan with the more detailed appearance of that area on the CT scan.

Blood tests

Blood tests aren’t used to diagnose melanoma, but some tests may be done before or during treatment, especially for more advanced melanomas.

Doctors often test blood for levels of a substance called lactate dehydrogenase (LDH) before treatment. If the melanoma has spread to distant parts of the body, a high LDH level is a sign that the cancer may be harder to treat. This can affect the stage of the cancer (see Melanoma Skin Cancer Stages).

Other tests of blood cell counts and blood chemistry levels may be done in a person who has advanced melanoma to see how well the bone marrow (where new blood cells are made), liver, and kidneys are working before and during treatment.

The American Cancer Society medical and editorial content team

Our team is made up of doctors and oncology certified nurses with deep knowledge of cancer care as well as journalists, editors, and translators with extensive experience in medical writing.

Last Medical Review: August 14, 2019 Last Revised: August 14, 2019

 

Notable News May 2019

Moving into summertime, for many, means increased sun exposure, so it’s pretty good timing that May, the gateway month to summer, is Skin Cancer Awareness Month. Prevention guidelines can be found at skincancer.org and include staying in the shade, avoiding tanning, and protecting your skin with clothing and sunscreen. More guidelines and tips can be found here. However, as noted in washingtonpost.com, prevention guidelines aren’t exactly universal. It turns out that sunscreen is not effective in preventing melanoma in darker-skinned people. While melanoma is a risk for all skin types, those with dark skin or of African descent, usually develop melanoma known as acral lentiginous melanomas which develops in parts of the body that don’t get much sun exposure, such as the palms of the hands or the soles of the feet. Of course, sunscreen use is still recommended for people with all skin types to prevent other sun-related damage, and it’s important to talk to your skincare professional about whether or not sunscreen is the best prevention option for you. Find out more here.

Summertime also tends to include barbecues and picnics, but you might want to think twice about what food you’re packing for the potluck, according to a new study reported in livescience.com. The study researchers estimated that more than 80,000 U.S. cancer cases diagnosed each year might be related to an unhealthy diet. The diets known to be related to cancer risk are low in whole grains, dairy, fruits, and vegetables, and high in processed meats, red meats, and sugary drinks. The cancers most closely-related to diet were colorectal, cancers of the mouth, pharynx and larynx, uterine cancer, and postmenopausal breast cancer. Adults ages 45 to 64 had the highest rate of diet-related cancer. More information about the study can be found here.

There is also increasing evidence that diet can help with cancer treatment, says theatlantic.com. Doctors are starting to look at how the food we eat could affect the cancer cells in our bodies and how what we eat may assist in treatment or preventing cancer cells from growing. Of course, because cancer is a very varied disease, there is no one diet that is best. Different nutrients, or the absence of them, affect different cancers in different ways. The promise is that doctors are starting to uncover the relationship between foods and cancers and how we can best utilize our diets for good health. More information can be found here.

In addition, straitstimes.com further explores the relationship with food and cancer. Researchers in Singapore found a link between a nutrient known as methionine, often in meat, fish and dairy products, and cancer. They discovered that cancer stem cells use methionine as fuel, but when they “starved” lung cancer cells of methionine for 48 hours, they saw a 94 percent reduction in the size of the tumors. The information is promising for the future of cancer treatment. More information can be found here.

No matter what is in your picnic basket or what kind of sunscreen you use, you can enjoy your summer with the knowledge that you are doing your part in being a hero in your own story — much like a young super hero named Wyatt who, during his fourth round of chemo, learned that his dreams would come true in a music video that involved fast cars, battling the bad guys, and pizza. It’s a feel-good story that feels just right for summer. You can read all about Wyatt here. It’s guaranteed to put a smile on your face as bright as the summer sun.

Staying Safe During UV Safety Month

In honor of July being Ultraviolet (UV) Safety Month, we wanted to share a some information and tips to keep you and your family safe this summer. The goal of this month is to spread the word about how important it is to protect your skin and eyes from the harmful effects of the sun’s UV rays. UV radiation is the leading cause of skin cancer in The United States, and between vacations, barbecues, and parties, summer is the season people spend the most their time outdoors, so by following these tips you can stay safe this summer.

  1. Find the shade – The sun’s rays are the strongest between 10:00 AM and 4:00 PM, so staying in the shade during this time can protect your skin from the harmful effects of UV ray exposure.
  2. Wear protective clothing – Try wearing a wide-brim hat that shades your face, ears, and the back of your neck. When possible a linen long sleeve shirt or pants can keep you cool and protected.
  3. Use broad-spectrum sunscreen – The U.S. Food and Drug Administration’s (FDA) regulations for sunscreen labeling recommend that your sunscreen have a sun protection factor (SPF) of at least 15, and should protect against both Ultraviolet A (UV-A) and Ultraviolet B (UV-B) rays. It’s important to wear sunscreen on even cloudy day because you can be exposed to up to 80% of the sun’s harmful UV rays!
  4. Sunglasses – Unprotected sun expose can cause vision problems and damage to your eyes, so always remember those shades!
  5. Avoid getting burnt – A burn puts you an increased risk for skin cancer and signs of premature aging.

Lastly, do not forget to routinely check your skin for changes, especially birthmarks, moles, and marks from the top of your head to your toes. Look for changes in size, shape, or color. So, have fun, stay safe, and stay out of the sun!

It’s NOT Just Skin Cancer…

Real patient experiences shared privately at www.TreatmentDiaries.com.  Read more, share if you like or join in the conversation.  Making sure you feel less alone navigating a diagnosis is important.  Connecting you to those who can relate and provide support is what we do.

I’m new to Treatment Diaries and since this is my diary, I want to share some thoughts that are now near and dear to my personal experience with this dreadful condition.  Let me start with what I’ve heard more times than I can count over the past decade and most often when sharing my Melanoma diagnosis with those who are uninformed.  It goes something like this – “What kind of cancer did you have?”  My response, “I was diagnosed with stage III Melanoma.”  The exchange – “Oh I think I’ve heard of that, it’s just skin cancer…right?”  In fact, I’ve had people tell me I was lucky to just have skin cancer.  Quite possibly the one thing you should consider never saying to someone with Melanoma.  Not only is it completely untrue it will do nothing to make the individual with the diagnosis feel any better about their situation.  The truth is, Melanoma is one of the deadliest forms of skin cancer.  It’s not just skin cancer.

So now that we are clear on it’s not just skin cancer, a few things I wish I would have known:

  • Research suggests that approximately 90% of melanoma cases can be linked to exposure to ultraviolet (UV) rays from natural or artificial sources, such as sunlight and indoor tanning beds.
  • However, since melanoma can occur in all melanocytes throughout the body, even those that are never exposed to the sun, UV light cannot be solely responsible for a diagnosis, especially mucosal and ocular melanoma cases.
  • Current research points to a combination of family history, genetics and environmental factors that are also to blame.
  • You can read this Melanoma Fact Sheet for more information!
  • Support for melanoma patients is incredibly important and connecting with those who relate brings much needed encouragement along with valuable insight.

Unlike other cancers, melanoma can often be seen on the skin, making it easier to detect in its early stages. Keeping track of the changes to your skin and seeing a dermatologist on an annual basis can be a lifesaving event. If left undetected, however, melanoma can spread to distant sites or distant organs. Once melanoma has spread to other parts of the body (known as stage IV), it is referred to as metastatic, and is very difficult to treat. In its later stages, melanoma most commonly spreads to the liver, lungs, bones and brain; at this point, the prognosis is very poor.  Again…it’s not just skin cancer.

Skin cancer comes in many forms and for numerous reasons.  Your job is to protect your skin.  Our skin is the biggest most vital organ we have to care for.  We can’t live without it nor can it be replaced.  It’s ours for as long as we live so we need to take the vitality of it seriously.  Stay out of the sun, look for changes and recurring issues to your skin even in areas that never see the sun, see a dermatologist on a regular basis and make sure to wear sunscreen all year around.  It’s not just skin cancer especially when it can kill you.  It’s a serious topic and I feel so very fortunate to be able to share my personal experience.  I hope to be a help to others newly diagnosed and an inspiration to those on the journey.  Let’s kick melanoma to the curb together…

Early Detection of Skin Cancer Matters…

Real patient experiences shared privately at www.TreatmentDiaries.com.  Read more, share if you like or join in the conversation.  Making sure you feel less alone navigating a diagnosis is important.  Connecting you to those who can relate and provide support is what we do.

TD logo

I am a 32 year old woman- oh wait- 33 now! 32 is when my life changed forever. I noticed a mole on my chest about 2 plus years ago (and keep this in mind- I consider myself a hypochondriac) and I did nothing…. It was flat…then it wasn’t and I did nothing. I would mess with it because it was odd to me and I thought it started bleeding because I messed with it and I did nothing until a few months later. I went to dermatologist and they excised it. On sept 11th 2012, I received a call from my dermatologist ( luckily I was already home and my boyfriend was about to leave for work) and he said something like ” I’m sorry to tell you but you have an aggressive form of skin cancer called malignant melanoma and you need to call Johns Hopkins immediately to schedule surgery”.

TD Feb 2I was in shock and in tears. The next month of my life was the worst I have ever had. Within two weeks I had all consultations, Pre- op requirements and surgery done and it was time to wait for results. For those of you not familiar with melanoma- they removed the area of mole at dermatology office but then you have to get a wide excision so cancer will not come back in the area and then a sentinel node biopsy which through tests determine where the cancer is most likely to spread if it has already spread to lymph nodes. I was considered stage 1b at this point and I guess if it spreads to lymph nodes then you jump to stage 3. Also, melanoma does not have great survival rates – apparently it does not have an effective treatment like other cancers do so what I thought was just ” skin cancer” can kill me and does kill young people quite often. Needless to say I was scared shitless- facing mortality before even getting married. In fact, I feel like I was just starting my life.

I started dating the love of my life only 2 1/2 years before and we were having the time of our lives. The universe was on my side…. But this changed
everything! The wait was the worst- please don’t spread….. And it didn’t! Now while everyone celebrates I’m cancer free- I know that the beast is a bastard and it can come back in lymph nodes and organs or on the skin again and the fight starts again. I’m waiting for the other shoe to drop and looking for resources and outlets all the time for my anxiety or peace of mind. I’m pissed people think it’s just skin cancer but why would they… I did. Educate! Awareness is where the cure for melanoma is right now. Especially in this jersey shore era

A few months later….

I hate you sun

So this is supposed to be a Pre- valentine romantic weekend in a lovely mountain town cabin we frequent…. So why am I crying while the boyfriend is showering?? Because these melanoma stories are heartbreaking. Young men and women dying while their parents and husbands/ wives are caregivers until the last moment. It’s terrifying that I will never know if all of it is gone- until it comes back. While we celebrate our love this weekend it’s terrifying that we may never be able to have a baby (I’ve been reading a lot about how pregnancy hormones can accelerate any cancer- thanks jackass cancer!). My liver results came back as fatty liver so my diet needs to resume: / but yay! No random melanoma in liver! Now I wait for results from cervical biopsy which I get on Wednesday and if all is well than I can breathe again for 2-3 weeks before foot doctor and dermatology appointments.

Back to the reason I am posting…. Since I was diagnosed in September 2012- I have spent 2 days outside- only 2 in over 4 months- because I HATE the sun! So now we are in a lovely town with woods and walking to be done… And I didn’t even bring sunscreen! Ummmm….. Did I forget the sun and melanoma are evil? Did I think my SPF moisturizer would cover my whole body for a day outside? I hate that melanoma has ruined my typical behavior. Now we have to hunt down a hat and sunscreen because the sun is a beotch to my skin and I always knew that but a little pink never bothered me before… Any who….Now I’m going to read my boyfriend the melanoma blog that had me in tears so he is reminded like I am daily of this cancer crap. Ps I will have a lovely weekend but needed to yell at the sun a little

When a Melanoma Diagnosis Brings Clinical Trial Options

36 year old Female diagnosed with Stage III Melanoma on May 19, 2014

Diary Entry

I’m fairly new to this fight and not exactly sure what to even expect. Since my diagnosis, I had one surgery to cut off the melanoma (it was on my toe) along with a 3 week recovery while unable to work. It took three weeks for the biopsy to come back. I guess hearing the doctor say that the pathologist said that they had never seen anything like it, isn’t a good thing. Next, was an amputation of that toe, along with Lymph Nodes from my groin area. Those results did not bode well either. Out of the 3 that he removed had a tumor in it. So, my journey next took me to Baltimore, Maryland where I met with an oncologist surgeon. I had a complete dissection on my left groin area. During my follow up visit I found out that the doctor removed 11 lymph nodes and two more came back with cancer cells. I was readmitted to the hospital thinking that my incision was infected. It wasn’t, but the drains weren’t working all that well either. The doctor opened my incision and my wonderful husband has become my nurse and packs the incision twice daily. I couldn’t be luckier than having such a wonderful husband. During all this, I learned that I am extremely claustrophobic. That puts a slight crinkle in trying to have all these tests that I need to have. I try to stay optimistic and keep my sense of humor.

Clinical Trial Options

So now I am exploring clinical trial options.  I have asked for more information on Yervoy, with Melanoma and clinical trialseveryone’s advice. In my area, to receive Yervoy for stage 3 melanoma, you have to be part of a clinical study or whatever. My doctor promised I wouldn’t be given a placebo. But, I would have to travel quite a distance. I know that there are quite a few of you on here that have traveled for treatment. But, for me, right now, it’s just not an option. I have teenage children that need me to be home. I could never do this alone. My husband would be with me, which would leave no one at home…. I am starting on Paxil this week and should (depending on my insurance) start treatment next week. I have had two people on Treatment Diaries tell me about Yervoy and I don’t want you to think that I am not listening to your advice. But I have had 5 doctors tell me that interferon is probably in my best interest. I don’t know how this is going to go. I’m hopeful, and again, I won’t be alone. My husband has and will be with me for the duration of all of this.  I am hopeful!

 

Real patient experiences shared privately at www.TreatmentDiaries.com.  Read more, share if you like or join in the conversation.  Making sure you feel less alone navigating a cancer diagnosis is important.  Connecting you to those who can relate and provide support is what we do.

 

Metastatic Melanoma Patient Diary Entry

Diary Entry – Patient With Male Breast Cancer and Melanoma

I’m 72 and have lived most of my life in the Midwest, particularly Michigan, with forays to East Coast and West (New York, California) and two years in Sao Paulo, Brazil with lots of visits afterwards. Profession has been education on middle, high school and college levels as teacher and administrator. I decided when informed of my most recent illness to finally retire from university teaching in a grad teacher education program.

My first cancer was male breast. One of about 1400 a year in the U.S. Stage 2, no recurrence since diagnosis in 2003. Never worried about it returning. Second was metastatic melanoma, Stage IV, this year. Total surprise. I skipped Stages I-III with an unknown primary. Landed in my lung. All removed with a lobectomy (rhymes with my previous lumpectomy). I am now NED to hear this week after PET scan and brain MRI whether that continues to be true. I’m in the watch and wait category for further treatment–probably surgery first, then ipi*.

I don’t know how I am going to do with the program of 3 month scans. I do know I will have to live my life in 3 month chunks, but, of course, do not know how that will work psychologically. I have a very supportive wife, but she worries, too, of course.

April 2013

Had my surgery last Tuesday, back home late Thursday. Watching a good deal of snow out the window. I don’t mind at all not being out driving in it. It’s nice to be snug. We’re a snow belt city, one of the top fifteen or so in the country for total snow fall. I’ll have to look that up. Average winter just about 70 inches. I got into snowshoeing a couple of years ago at a buddy’s place in Sun Valley. Can’t make the reunion of the crowd this year.

Recovery is coming along. No exercise for another week. Then back in the pool, I hope. Can’t even walk around the block (not today, of course). Tomorrow I can drive. MelanomaDiary

“I’m feeling more and more optimistic about the melanoma. I think that’s better than looking around the corner. I have a lot going for me right now, and I’m convinced the ipi is working. Just not sure how well. I heard a doctor on a webinar yesterday say that those for whom ipi really works are like people who win the lottery. Why me? But it is you, and you’re done with melanoma for life. I’d like to be one of those 15%. I’d rather be that person than win the real lottery, no matter how big the payoff.”

As of August 2015 – Still thriving!

 

*”Ipi” refers to ipilimumab, a new monoclonal antibody drug that is being used currently in numerous melanoma clinical trials. Ask your medical team about these trials, or you can browse trials by using various trial finders such as the ones on cancer.gov or Melanoma Research Foundation.

Read more about patients and their experiences with clinical trials at www.TreatmentDiaries.com.  Real people, actual stories, shared in private so you can be more social about your health.

Melanoma Patient in a Clinical Trial

From our partner, Treatment Diaries, this is a diary entry of a melanoma patient who participated in a clinical trial.

Diagnosis: Metastatic Melanoma in 32 year old female.

October 2013

I had a mole removed on my back, turned out to be melanoma stage III. Since that mole I’ve had 5 more removed all positive. I’ve had surgery on the first one and then lymph nodes taken out because they found microscopic cells. September 2014 is when they diagnosed it as metastatic and inoperable.

So a clinical trial is a chance for me to make a difference and potentially beat the beast. I have had two Melanoma Diary
immunotherapy drugs Interferon and now currently on Yervoy. PET scan and MRI are clean for now. I have a lot of side effects from the Yervoy which I’m on right now. Dr put me on steroids to reverse those side effects. I get rashes, colitis, headaches, fatigue, and heartburn from yervoy and muscle weakness; retain water, mood swings, anxiety, emotional from steroids.

I have a four month old baby and recently got married and moved states. A lot of changes in my life the last year and coping the best I can. I have serious moments of a break down but try to hold it together for the sake of my precious baby. Currently I am trying to take lower dosages of my steroids so I can go in for more scans. Dr says we are done with Yervoy because of side effects. But there are other treatments we can look into. That’s my story and please feel free to contact me anytime! I feel the more support I have the better my days turn out! I’m here if you want to talk I’ll listen. Sometimes that’s all I need is to have a shoulder!

January 2015

I go in on Thursday for a treatment called Infliximab.. It’s supposed to stop these side effects from the Yervoy, such as muscle aches and colitis. I’m really nervous because the shot itself has a lot of side effects from what I’ve read. Dr says I’ll only need one shot and it should help me get off the steroids which are a must! I’ve been on steroids since end of August… Right now I’m on 25 mg a day but my highest has been 100 mg. I don’t want to do the shot but I’m at a point it might be my only option. I want to feel normal again with no pills. Will that day ever come, who knows? I pop pain pills like candy and steroids like a race horse.

Starting to think I need a therapist to talk to because mentally I’m not handling things well. My husband says he believes everything will work out, but he’s not giving me the emotional support I need. I don’t think he understands… Takes care of the medical bills but as far as emotional support I’m not sure he can be there for me because he doesn’t understand my fear. Fear of limited days and wanting to enjoy life more. I feel I do the same thing over and over every day… I have a 5 month old so we are stuck in the house a lot and hubby just goes to work and comes home… Same routine everyday… I want to feel alive and excited! I want a date night or to feel sexy and I need affection, ok I’m done rambling I’ll keep an update on how the shot treats me. As far as Yervoy I’m done with it the doctor won’t let me do anymore. Too many side effects! After I get off the roids I’ll have another pet scan. More later…

 

Real patient experiences shared privately at www.TreatmentDiaries.com. Read more, share if you like or join in the conversation. Making sure you feel less alone navigating a cancer diagnosis is important. Connecting you to those who can relate and provide support is what we do.

From the Diary of a Stage 4b Melanoma Patient

I am a male with Metastatic Melanoma Stage 4b. Clinical trials have been saving me. Latest is GSK B-RAF inhibitors. Jan07 Original Site was my left thigh. Removal, sentinel node removal, all clear. Mar09, golf ball in left groin. Removal. Lymphandectomy Jun ’09. Reoccurrence in chest Dec10. Inoperable. BRAF trial Apr ’11, still on trial.

Still thriving as of May 2015!

Diary Entry – Melanoma Patient

Amazing, when I wrote this diary title down – September 2014, I recalled how it was not that long ago that I refused to write dates. For over 2 and a half years, I lived in 3-week blocks. Couldn’t plan anything, couldn’t do anything, because I was so close to being finished. Two stints in a hospice house proved that. Yet here I am today and now I keep track of my entries by writing the date.

So Fall is upon us, the leaves have changed color and are falling in great numbers. The mornings are brisk but the afternoons Treatment Diariesget warm…well, warm for us up here, I suppose. Went for a good walk today through the forests, I just love the colors and the smells of fall. It was great.

My dizziness still eludes myself and the docs. This is good as it means Mr. C is not visiting at this time but all the same I am frustrated at not being able to get “normal” again. I think I am well enough to go back to work…well, I want to anyway but it certainly won’t work if I can’t get there without falling down.

I read another person’s post about their recovery and how the length of time it takes tends to baffle them. That really helped. The only people I know that have been to the edge like myself and have made it back just aren’t the same people they were going in and have conceded to not working anymore. I am bored without the work and being a part of something bigger. These are long days at home, long, especially when the body is working fairly well compared to what it was. Summer is gone and fall is here, next comes winter so I better find a hobby cause winters are long up here.