October 1, 2020 – Today I started a new treatment regimen: immunotherapy. For those of you following my blog, a lot has happened since my last post (
The Verdict Is In). Needless to say, we’ve taken a new path in my melanoma journey; hence, the title of this post.
A Quick Recap
After confirmation that melanoma had spread to my right adrenal gland, we were faced with a couple of options: remain on Gleevec and receive radiation therapy or try something new – immunotherapy (described below).
A New Twist
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| Waiting on treatment. |
Initially, we opted to try radiation therapy. The idea was to target the adrenal gland, which would be – we assumed – less invasive that starting an entirely new regimen. After meeting with the radiation oncologists and consulting with some other folks, we decided against that route. There were too many outcome variables and too many negatives (potential damage to surrounding tissue and organs).
We just couldn’t get comfortable with that option.
Cabin in the Woods
Up until we left on our Blue Ridge vacation (see Facebook), we continued to struggle with our first option. Several online consultations, emails with others in the melanoma community, and, simply, time to reflect brought us to a new decision: no radiation therapy, stop the current oral chemotherapy, and start immunotherapy once we returned from vacation.
I feel good about the decision. Vicki feels better about the decision to go with immunotherapy. And our oncologist assures us that if immunotherapy doesn’t work, we can always go another route.
Immunotherapy Explained
According to the American Cancer Society, immunotherapy medicines stimulate a person’s own immune system to recognize and destroy cancer cells more effectively. Several types of immunotherapy can be used to treat melanoma.
Immunotherapy medicines are given intravenously, so that’s another turn in my treatment. Today, I started Keytruda (pembrolizumab), which will help my body fight the melanoma without destroying any existing, healthy (normal) cells.
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| A new turn in my journey. |
What About Your Lungs?
Another positive aspect of our decision is that Keytruda will also fight the tiny melanoma tumors in my lungs. There’s no guarantee that they will be completely gone, but our hope is that they continue to stay small, or even shrink a little more.
Thanks, Again
Thanks, once again, for your thoughts and support. We truly appreciate it. As my treatment journey continues, there will likely be more frequent updates.
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| Everyone should have a view like this. |
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September 12, 2020 – Bottom-line: melanoma has spread to my right adrenal gland.
While, initially, this news was distressing, it didn’t come as a complete shock. All summer, we’ve been wondering what caused the sizable blood mass in and around my adrenal gland (see Doctor Doctor…). Now we know. Melanoma some how made its way to another part of my body.
Frankly, since early June, I’ve expected this outcome. It’s the reality of living with cancer.
Now, some good news
With this sad news comes several positive developments. First, the PET scan (see The Waiting…) was negative for any additional cancer spread. That’s important because we want to keep the cancer contained as much as possible. In other words, right now, only two places inside my body have malignancy – my lungs and my right adrenal gland.
Second, the metastases around my adrenal gland, according to biomarker testing, contain the same genetic mutation (cKit) as the tumors in my lungs. That’s also important because we’re only dealing with one type of cancer (again, see The Waiting…).
Which leads to another (hopefully) positive development…we will continue my current treatment regimen – daily oral chemotherapy medicine (Gleevec) – with a new component: radiation therapy to tackle the adrenal gland.
More details to come
This post will be short and sweet. Many things are coming together even as I write this. I’ll provide more details in a follow-up post (Another Twist, Another Turn).
This is yet another twist and another turn in my melanoma journey. I’m confident the journey will continue for many years to come.
Finally, thanks!
I want to thank all of you who have made this journey with me. Your thoughts, your prayers, and your concerns are greatly appreciated. I’m absolutely humbled by it. Please focus your thoughts and prayers on Vicki, Emily, and Zach as they have been my guiding light in this crazy storm. In addition, prayers would be appreciated for my dad, my sister, my sister-in-law, and my entire extended family.
Thank you.
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| A thoughtful gift from Vicki’s true friends. |
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Writer’s Note – I’ll continue to update my blog on a periodic basis. No set schedule. So, I want to thank everyone who continues to stop by and check out my blog. Please leave a comment or message; I’d love to hear from you.
September 5, 2020 – Much of our August was spent at the West Cancer Center: blood tests, CT scans, an ultrasound, another CT scan, and, finally, a wonderful needle biopsy. Throw in a couple visits with my oncologist, further lab tests, along with a PET scan, and August was a month I’d like to do without.
Why all the visits? You may recall from my last health update on July 6th (Doctor, Doctor…) that – since early June – my doctors were monitoring a blood mass in and around my right adrenal gland.
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September 3rd sunset: a reminder
to enjoy the beautiful things
life has to offer.
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Here’s an excerpt:
Now For Something Completely Different
There was, however, something completely unexpected on the scan results. A fairly large mass – about 2 1/2 inches – on or around my right adrenal gland. The adrenal gland sits on top of each kidney. The radiology oncologist called it a heterogeneous mainly low density mass. Basically, it looks like I had some internal bleeding either in or around my adrenal gland.
Testing, testing…1, 2, 3…testing…
On August 7th I had an ultrasound to determine if there was any tissue with the blood mass surrounding my adrenal gland. The ultrasound did show tiny tissue fragments, so I immediately underwent a needle biopsy utilizing CT scan technology.
A needle biopsy is exactly what it sounds like. An area of skin is deadened and a (somewhat) long needle inserted into your body at the spot to be biopsied. Unfortunately, you remain awake during the entire procedure. It’s painful and weird – the only way to describe it.
Note: The biopsied tissue samples were sent off for detailed genetic evaluation (biomarkers).
A little over a week later, on August 18, 2020, I had a PET scan. Doctors use a PET scan to determine if any cancer – metastatic melanoma, in my case – has spread to other parts of your body, including your lymph nodes.
PET scans utilize a radioactive tracer that is injected into your bloodstream. To be effective, your body must be completely at rest for an hour or more.
Glowing in the Dark
Here’s a brief description of what a PET scan is like:
I shuffled into a cold room with a hard terrazzo floor. In the room’s middle sits a large scanning machine. Plastic. Metal. Intimidating. At this point, I was exhausted. Ready to go home. I hadn’t eaten in over 8 hours, and I’d had no caffeine today. None! It was almost three in the afternoon.
Plus, I had just spent the past hour sitting in a small dark room doing nothing. Nothing. Just sitting, trying to relax, while radioactive isotopes coursed through my body…I think I slept for 15 or 20 minutes while in that little room.
After being strapped down to the hard plastic “bed” of the scanner, I was inserted into the metal and plastic donut hole several times. Many people refer to CT and PET scanners as donut fillers. Another 25 minutes went by before we finished.
Now the hard part
The waiting game began a few weeks ago and will be over soon. At that point, we’ll know the biomarker testing results and the results of my PET scan. Then we’ll know the next direction in my journey.
Thanks, as always, for listening.
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Writer’s Note – I’ll continue to update my blog on a periodic basis. No set schedule. So, I want to thank everyone who continues to stop by and check out my blog. Please leave a comment or message; I’d love to hear from you.
July 6, 2020 – I finished the last of my scheduled doctor’s appointment this afternoon – annual physical. Everything was fine according to my internist. I’ve been with this same doctor for perhaps 25 years. He knows as much about my health as I do. After last year’s physical he joked, “You’re the healthiest guy with cancer, who had a heart attack, I’ve ever seen.”
Based on the numbers from this year’s blood tests and urinalysis, I hope that comment remains true.
Appointments, Appointments, Appointments
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| At least it’s clean. |
Because of COVID-19, I waited until June to follow-up with most of my doctors. In the past thirty days, I saw just about everyone: cardiologist, urologist, orthopedist, dermatologist, oncologist (we’ll get to that in a moment), and even the dentist (no cavities!). All of these visits we’re either annual checkups, routine appointments, or quickly scheduled due to an issue that came up. I saw my orthopedist after I over did it with exercise, yard work, and pressure washing the back patio.
Note: The patio’s now clean, but I was in some serious back and muscle pain for about a week.
Metastatic Melanoma
In early June I had my scheduled CT scan and doctor’s appointment at the West Cancer Center. As I mentioned previously (see Status Quo and An Early Christmas Gift), I am now scanned about every six (6) months because my tumors remain stable and (for the most part) unchanged. June’s CT results were pretty much the same. Nothing – in my lungs – has changed.
Now For Something Completely Different
There was, however, something completely unexpected on the scan results. A fairly large mass – about 2 1/2 inches – on or around my right adrenal gland. The adrenal gland sits on top of each kidney. The radiology oncologist called it a heterogeneous mainly low density mass. Basically, it looks like I had some internal bleeding either in or around my adrenal gland.
Between chemotherapy meds, blood thinners (to help keep the stent in my heart working), and everything else I’ve been through, it’s hard to know what caused this mass.
Modern-day Torture Device
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You never know what’s
lurking inside. |
My oncologist scheduled an MRI to get a better look. If you’ve never had an MRI, it’s very strange and a bit nerve-racking. The MRI machine is claustrophobic and loud. And weird…I swear I could feel the magnetic force going through my midsection. Yuck!
Unfortunately, the MRI didn’t provide any new clues as to what’s going on inside me. The concern is that this blood mass may be hiding a cancerous tumor (or, the mass was caused by a cancerous tumor). The size has not changed, and I’m not in any pain.
At the end of July, I’ll have another CT scan to see if anything’s changed. Then, the doctors and I will figure out what the next steps will be.
Possibly another twist in my melanoma journey. More to come…
Note: If you want to leave a comment, just choose “Anonymous” from the Profile Selection drop down bar right below the Comment box. (It’s the very last choice.) Sorry for any confusion.
Also, please make sure you leave your name or sign-in somewhere in your comment. Thanks.
Writer’s Note – I’ll continue to update my blog on a periodic basis. No set schedule. So, I want to thank everyone who continues to stop by and check out my blog. Please leave a comment or message; I’d love to hear from you.
