Monday, June 6, 2011

Surgery Day, Again...

Meagan has surgery to remove a couple skin tumors this afternoon. It sounds sorta easy but it's not that easy. They use local anesthetic but that still means she has to put up with a couple nasty shots on each side before it kicks in. She will end up with 3-4 inch scars on her tummy and back. You'll probably not see her in a two piece bathing suit this summer, not that you would have anyway, hahaha.

She's still a bit fuzzy mentally and I'm not sure whether it's related to the steroids she is taking for brain inflammation or the result of the brain radiation itself, which did have to go into some healthy tissue to assure getting all the cancer. It makes her a bit frustrated and she's not able to do much in the way of usual household tasks, and forgets where things are, like where we keep cereal bowls. But she works it out and I am happy to help while her brain recovers. She spent most of the day reading yesterday, which is good as I think that helps her recover more quickly.

We see Dr. Kaplan first, to have him check out a few suspicious things. It may be that he schedules her for a CT scan later this week, as we also are scheduled to see him next Tuesday.

People have been sending me articles that appeared recently in some of the major new publications, mostly about two announcements made at a recent melanoma conference. Regrettably, the one drug they announced, which is really great news for about 50% of melanoma patients, does not work for Meagan as she does not have the mutation (B-RAF) they are targeting. The other, Yervoy (formerly Ipillimumab), is one she was on and it did not work for her. Both are major breakthroughs, one because it is using genetic profiling as a way of targeting cancer treatment (which is the wave of the future) and Yervoy uses the body's own immune system to attack the cancer.

We do know she has one mutation, HLA-2, which is being used as a pathway for melanoma targeting and treatment in a variety of clinical trials. That was the trial we were headed to in Bethesda at the National Cancer Institute, before the discovery of the brain tumors, stroke, surgery and radiation treatment. That is still a potential option for her. But they require one to be free of brain tumors for 90 days. She has been without any attempt at effective treatment for so long that she really can't wait and do nothing. That's why the game plan is to try to get her to be able to get on the Interleukin-2, an approved FDA immune system treatment (but a brute force one, not targeting any specific mutation) ASAP - which Kaplan says will be in about 7 weeks - because the brain needs to be healed before you can start that treatment. If she does that treatment and she is one of the 5% responders - that would be obviously fantastic. If not, and her brain MRI is clear 90 days from essentially today (and she would have already completed the IL-2 treatment), she would be eligible for the clinical trial back that which targets that HLA-2 mutation. So we have a couple treatment options ahead, now that her head is cleared.

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