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.
Harvey & Erica Braden
Journal of our journey with a Metastatic Melanoma Diagnosis. Erica was diagnosed Stage 3 in January 2010 and then Stage 4 in April 2018.