Change of course

I am still in CA. What was originally planned as a one day trip to SF for my 3 month scans and maintenance treatment, turned into a FIVE day trip.

The scan results were good. No cancerous activity, and the one remaining nodule in my right lung was even a little bit smaller from my last scans. Whew. Now...the change of plans. When my doctor spoke to us about possibly considering radiation therapy to get rid of that last nodule, I at first thought the idea was totally out of left field. In the past, we had spoken very little about radiation with much more discussion around surgery. However, surgery was ruled out because of the location of the tumor--which is encircled around a bunch of blood vessels and arteries in a tricky spot--and deemed too risky of a procedure for little benefit.

The reason radiation is now just being brought to the table is this though: Recently an article was published in the New England Journal of Medicine (and headline news on MSNBC) about a patient with metastatic melanoma who underwent radiation to a tumor on her spinal column (which was causing her pain). This patient was also undergoing treatment of Yervoy, the same immunotherapy drug that I am still on. What happened was the radiation to this patient's tumor on her spine ended up having a "systemic"-like effect. It activated the immune system to recognize the cancerous cells and kill them (in combination with the Ipi). Consequently, the tumors elsewhere in the patient's body began to shrink also. The results were astounding.

This news is promising for many melanoma patients and interestingly enough, my own doctor has been doing this with some of his own patients for the last 6 months or so and has had some success. (He said that the other doctor just beat him to the punch at publishing it. ;) My doctor feels that I would benefit from the radiation because not only would it get rid of that last little nodule in my lung (to ensure that it doesn't become "active" again), but it would hopefully activate the immune system (in conjuction with the Yervoy) to reach any other possible cancerous cells in my body and destroy them. I liked this idea. A LOT.

I have to hand it to my doctor. He is always thinking ahead. Even though he has always been pleased with my progress and success, you could tell that the last nodule remaining made him uneasy. And probably because he believed that the nodule would most likely become active again in the future. So, why not, "zap" it now while it's still not active!?

We made arrangements to see the Radiation Oncologist the next day to have a consultation and then the assimmulation on Monday (to do more 3D imaging and fit me for a "body cast"). The actual radiation will take place in a couple of weeks (over Spring Break) and will consist of 3 different treatments.

I feel good about this plan. I am so grateful to have a doctor who knows melanoma and has a vision for each of this patients. A vision that is customized for me. I also feel that it is not concidence that this change of plans is happening all right now. Ultimately, I know that God has a plan for me and is leading me on this course and that knowledge gives me a lot of peace, comfort, and hope for the future.

Thank you for all of your thoughts and prayers!!! It means the world to us!