Met with Surgical Oncologist Dr. Anthony Lucci.  He recommended another surgery to remove remaining lymph nodes under left arm.  He stated this is standard practice at MD Anderson to remove them all and I only had the lower removed.  His concern is any remaining nodes could also contain tumor, although he felt there to be less than a 10% chance any of them would be positive.  Sort of a better safe than sorry perspective.  I contacted Dr. Crawford (the vascular surgeon that previously removed nodes) and asked him to call Dr. Lucci to discuss the matter.  Dr. Crawford doesn't feel the additional surgery is necessary.  We're hoping the two doctors can agree one way or another so that it will make it easy to know what to do.  Surgery is tentatively scheduled for Thursday April 7th awaiting additional feedback.

We also met with Medical Oncologist Dr. Patrick Hwu.  There is a clinical trial available that has shown very good results.  You must have a certain DNA type to be enrolled (which approx 40% of people have) in the trial for which blood was drawn to test for.  The trial would use pegylated interferon alpha 2-b along with a peptide Melanoma vaccine. In the previous study the same vaccine was used with a stronger drug similar to interferon called interleuken-2.  The new clinical trial using the vaccine with interferon may achieve similar results which hopefully would reduce chance of recurrence much better than interferon alone.  If DNA is not  a match for the trial standard interferon is the only other option.  We mentioned the shorter 30 day regiment of interferon verse the full 12 months and Dr. Hwu felt there's not enough evidence supporting the theory and would fully recommend as much of the 12 month treatment cycle as can be tolerated.  Dr. Hwu also recommended a CT Scan and MRI of the brain.  The MRI is required to be enrolled in the trial.

Both Dr. Lucci and Dr. Hwu are experts in the field of Melanoma research and treatment.  By many they are regarded as the best in the Western Hemisphere.  MD Anderson definitely offers a comprehensive approach.  Going forward they will be consulted for all treatment considerations.  If it's decided to go forward with the additional surgery it will be done by Dr. Lucci at MD Anderson.  If approved, the clinical trial will be administered at MD Anderson every three weeks and would start as soon as possible.

Metastatic Malignant Melanoma was found in one of eight lymph nodes removed during 3/15 surgery.  Metastasis (tumor) measured 0.8 mm.  Sentinel Lymph Node Biopsy performed during previous surgery returned one lymph node with metastasis (tumor) measuring 0.43 mm.  The quantity and size of tumors may give the Oncologists an indication of how extensive the spreading of melanoma cells in her blood is.  Removing the axillary lymph nodes was the last available surgical step in trying to deter distant spreading.

MD Anderson called today to pre-register.  Pathology reports and PET Scan results are being forwarded to them.  They will use that information to determine which group of doctors to shedule her with.  (UPDATE: MD Anderson consultation is set for Wednesday 3/31.  Next local oncologist (Dr. Xiong) appointment is Friday 4/9)

Follow up with vascular surgeon has been rescheduled for Monday 3/22 awaiting drainage to reduce to less than 30cc per 24 hours.

​Erica's second night of rest after surgery was much better.  She described her pain this afternoon as a 5 on a scale of 1 to 10 (she described as 9 in recovery area after surgery), which I must say she tollerates very well.  She had some nausea this morning and was sick one time, probably from the pain pill doses overnight without food.  Drainage remains consistent at 100cc per 24 hours.  Follow up appointment with surgeon will probably be postponed until Monday 3/22 as the drainage needs to be below 30cc per 24 hours to have drain tube removed.  She is eating well and drinking a lot of fluids.

​Axillary lymph node disection was performed this morning by Vascular Surgeon Dr. John Crawford.  The surgery took about an hour and a half.  We arrived at the hospital at 7am and left about 1:45pm.  The doctor reported the surgery went well.  Other than two lymph nodes appearing inflamed everything else was normal.  There's a drain tube installed to drain the fluid from the area.  Pathology report from biopsy is expected by 3/17 and the doctor requested a follow up appointment for 3/18 if drainage is below 30cc in last 24 hour period, otherwise the follow up will be delayed until 3/22.

​In late 2009 my husband noticed a mole on the back of my left arm that he said looked a little funny.  I intended to have the mole checked but several months passed before I realized (time fly's) the mole had become itchy and was bleeding a little when I scratched it.  I showed it to my Dad (Dr. Dennis Lehman) at the end of January 2010 and he said I definitely needed to have it looked at.

I visited a dermatologist where he removed the mole and sent it to the lab for biopsy.  Three days later I received a call informing me the mole was malignant melanoma.  I was devastated with the news.  My Dad was diagnosed with metastatic melanoma about 5 years prior,  so I was already somewhat familiar with what I was facing.

It was recommended that I see a surgeon as soon as possible and I was referred to Dr. Robert G. Anderson.  He's a plastic surgeon in Fort Worth, TX that specializes in removing melanoma from the skin.  Two days after receiving the initial biopsy info I was in Dr. Anderson's office.  He set the appointment for surgery to remove the tumor site and surrounding tissue down to the muscle about the diameter of the bottom of a coke can.  The original tumor was 1.18 MM in thickness/depth and approximately 7 x 6 x 1 MM overall.

Melanoma is one of the most aggressive cancers with no proven or consistent treatment for cure.  We all have cancer cells in our body throughout our lifetime but most peoples immune system can manage them.  For some reason my immune system isn't capable.  Lifetime risk for Americans having skin cancer is currently 1 in 70 people.  Upon my diagnosis in February 2010 the clinical stage of my cancer was stage IIIa.