01 November 2018

Planning Phase, Halloween

I went to the Big City Big Hospital Real Doctor this week.
It was really good.
It was an actual melanoma expert who was knowledgeable and had a well reasoned treatment plan. I'm enrolling in a clinical trial which is a combination of FDA approved immunotherapy and some additional therapies layered in which make immunotherapy more effective in mice and therefore also hopefully in people. The doctor reasons (and I agree) that given my age I should go for the most intensive treatment available. I'm only 36, so I'm not trying to live for 1 or 2 more years, I'm trying to live for like....40. Maybe. Dare I hope?
He recommends immunotherapy over BRAF/MEK inhibitors because those tend to only be effective for a limited amount of time, which isn't a big deal if you are 80, but is sort of a problem if you're in your 30s and an extra year isn't really that much extra time all things considered.
He could answer all of my questions, including, how does cancer go from stage zero to stage four? Answer: it does not.
My local oncologist hypothesized that "melanoma is really sneaky, and we don't understand it well."
This doctor offered the more logical explanation that the spot on my back was a secondary melanoma site, and the primary site was unknown, either because it is internal, or because it regressed.
Basically, this:
Did you know that you can have INTERNAL MELANOMA?
I did not.
Anyway, I start treatment next week.
Probably I will feel like garbage.
Before immunotherapy, something absurd like 98% of metastic melanoma patients were dead people within a couple years.
Now it's more like 75%.
Which are much better odds, really.
But still terrible.
I had to work yesterday, because it's close week and I have that sort of job.
The kids dressed up though. Gabriel wore a giant inflatable T-Rex costume which coordinates nicely with the baby dinosaurs.

The children remain adorable.