Melanoma Caregivers

How does cancer become metastatic?

Here is a link to an article from the September 2017 edition of The New Yorker. We found it really helpful to review the history of how medicine has approached cancer that becomes metastatic. I have particularly appreciated thinking about the differences between the "seed" of melanoma cancer and how we approach treatment interventions as well as considerations for managing the "soil" of the body/mind/spirit of the person living with cancer and the family "soil" environment, too.

newyorker.com/magazine/2017...

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Missyrand, thank you so much for sharing this article from the New Yorker. It does help me to understand what we're up against! So far, my husband has had no mets of either of the two cancers he has had the misfortune to acquire. As I wrote some weeks ago, he was diagnosed with dedifferentiated pleiomorphic liposarcoma almost four(!!!) years ago and a few months ago he was also diagnosed with desmoplastic melanoma, Stage 4, four months ago. He has had surgery for both tumors, both the fast-growing sarcoma tumor on his back near a shoulder blade - which was quite large (about 7" in diameter) and very deep - and more recently, Moh's surgery to remove the melanoma tumor on the back of his head which was about the size of a quarter or maybe a fifty-cent piece and which went deep toward the skull. (I never expected to learn to care for skin grafts!)

My understanding is that his doctor's (Mohammed Milhem, University of Iowa) main concern for both cancers is that metastases can show up anywhere, and at any time and would be most aggressive, and for each type of cancer the 5 year survival rate is 50%). The article you shared helps me to better understand how this works. By choice, and maybe it helps him worry less, hubby reads as little as possible about all of this and has little concept of metastasis. He does keep very busy in his accounting practice and with his farm.

He had radiation and chemo for the sarcoma. For this new melanoma he is receiving 30 radiation treatments which will be completed soon, on Valentine's Day/Ash Wednesday. The area is an angry red right now.

They have no chemo for this melanoma and because it is so rare there are no clinical studies. If melanoma mets happen, the only trick up their sleeve is Keytruda. I don't know if a sarcoma met would occur, what the doc may have to treat it.

Also, Missyrand, in an earlier note, you mentioned that you are in the DC area. You might enjoy knowing that one of our kids is a Georgetown grad :-)

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Legallygray

I also found the article helpful and it has enhanced our broad thinking about the state of cancer treatment and research

Your husband is a living example of the unhappy stastical increase of risk that if you have one type of cancer you are at an increased risk to develop a second one. As if managing one isn’t enough.

It does help my anxiety that for now there is at least one additional option, like how Keytruda is a possible future option for your husband. We are living in exciting scientific times, even if the science is not a perfect fit for our individual situations. My experience is that there is a practical interface between the science, the heart, the spiritual and the partnership in living with melanoma. It feels like the percentages for each contribution shift over time but it’s the closest idea I can convey conceptually.

Thank you for your note. And your child received an outstanding education as a GT grad😊

Missy

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