MPIP: Melanoma Patients Information Page

The MPIP is the oldest and largest community of people affected by melanoma hosted through the Melanoma Research Foundation. It is designed to provide support and information to caregivers, patients, family and friends. Once you have been touched by melanoma—either as a patient or as a family member or friend of a patient—you become part of a community. It is not a community anyone joins willingly. But if you must be part of this group, you will find no better place to find the tools you need in your journey with this cancer, and the friends who can make that journey more bearable.

The information on the bulletin board is open and accessible to everyone. To add a new topic or to post a reply, you must be a registered user. Please note that you will be able to post both topics and replies anonymously even though you are logged in. All posts must abide by MRF posting policies.

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Anonymous's picture
Replies 3
Last reply 2/27/2015 - 3:37pm
Replies by: joelcairo, tschmith, Squash

Hi everyone,

A parent of mine was recently diagnosed with metastatic melanoma in Oct of 2014. BRAF positive & currently on Taf/Mek combo, doing very well on both. Tumors have decreased by 20-60% in the brain, liver, lung & adrenal glands over the course of 3.5 months. Super grateful! 

As a family, besides finding a good team of doctors (which we were fortunate to get at Hopkins), we are trying to find other ways to help out. Determined to attack this monster from all possible angles! One thing we've heard many recommend is to change nutrition. We eat very healthy but are def interested in tailoring diet towards a strong, melanoma fighting super-body! 

Along with the taf/mek drugs, and steroids for edema & keppra as preventative for seizures, been giving:

*daily multivitamin

*echinacea

*biotin (for hair growth, post WBR)

In terms of food, we've tried to fuel up on: 

*salmon

*flax & chia seeds

*coconut oil & water

*almond milk (for calcium)

*dark greens (kale, spinach, brussel sprouts)

*turmeric 

*berries & citrus fruits

 

Questions that I'm hoping you all can (please) help with:

(1) Of all the "cancer super foods"  & supplements which have experience shown are *actually* important for adv. melanoma? Any validation for ones I listed above? 

(2) We ran into some trouble with echinacea...high ALT liver # and echinacea may have been to blame...were originally giving this supplement to boost immune system & help prep it for immunotherapy... and now I'm reading mixed opinions on turmeric (some say this interferes with Mek/Taf combo?) and have also read some mixed opinions on calcium. Any seemingly smart choices that actually do more harm than good? 

(3) What foods are taboo & should we absolutely refrain from (heard rumors of red meat, dairy, even carbs?...)

(4) Any other important lifestyle changes? exercise?

(5) Any specific foods/supplements/activities known to help with brain mets/brain recovery?

(6) What have you all taken to prepare for (and power through) immunotherapy? This is the next step for our family so we want to start preparing body now :)

Thanks a million! Any help would be appreciated! This forum is invaluable :) 

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TOKYO -- Anyone who has suffered through a lingering cold has firsthand experience that viruses are resilient, annoying pathogens. But our opinion of viruses might improve a great deal if they could be trained to fight cancer.

Researchers at Tottori University and the University of Tokyo's Institute of Medical Science are doing just that. So far, the results are promising. They have confirmed the safety and effectiveness of genetically engineered smallpox and measles viruses in attacking cancerous tumors in animal trials. The bugs are altered to keep them from infecting healthy cells, then injected into the bloodstream to do their work.

Researchers at both institutions believe the method could lead to new cancer therapies to supplement surgery, chemotherapy and radiation. But first, they must confirm the effectiveness and safety of the new method in humans.

Cancerous tumors grow by creating blood vessels that feed them. When a therapeutic virus is injected into the bloodstream, it circulates through the body until it reaches the tumor. It then infects the cancer cells. The virus kills the cancer cells as it spreads through the tumor, causing it to shrink or disappear. The viruses can also be used to stimulate the immune system to attack the cancer cells.

Targeting cancer

A research team led by Takafumi Nakamura, an associate professor at Tottori University, has come up with a way to target malignant cells in lung and pancreatic cancers using the vaccinia virus, which is used in smallpox vaccines. The team genetically altered the virus so that it multiplies in cancer cells but is harmless to healthy ones.

The researchers injected human pancreatic cancer cells into the abdomens of mice, causing tumors to grow in them, then injected the mice with the virus. They found that more than 90% of the cancer cells had died. "The virus was originally used in vaccinations, so it is very safe," Nakamura said. His team hopes to confirm the safety of the virus in animals closer to humans, including monkeys, and start clinical trials in five years.

Professor Chieko Kai and her team at the University of Tokyo's Institute of Medical Science have developed a method that uses a measles virus to treat breast cancer. The researchers found that the virus infects breast cancer cells by sticking to a protein, PVRL4, on the surface of the cell. As with the Tottori University trial, they genetically altered the virus so that it multiplies only in breast cancer cells.

When the virus was injected into mice implanted with cancerous tissue, the cancer grew little and most cells in the tumors died. When the virus was administered to healthy monkeys and dogs, it had no apparent side effects or safety problems. "The likelihood of the virus infecting noncancerous cells is low," Kai said. She wants to start clinical trials as early as 2016.

Treatment without trauma

Viral therapies are likely to be easier on patients than surgery and chemotherapy. And as the virus moves through the bloodstream, it can attack small malignancies that escape the surgeon's knife, as well as metastatic cancers.

This approach, while promising, is not without drawbacks. The patient's own immune system may kill the viruses before they reach their target. The more they are used, the stronger the body's immune response is likely to be. Devising effective treatments therefore means coming up with bugs that can evade the body's natural defenses.

There are also concerns therapeutic viruses may mutate in the body and attack healthy cells. The safety and efficacy of injected viruses have so far been confirmed only in animal experiments. And the long-term effects of these viruses on humans have yet to be studied. Researchers will have to find ways of dealing with potential side effects.

Tomoki Todo, a professor at the Institute of Medical Science and a leader in the field, started a clinical trial in late December for a brain tumor treatment that uses a genetically modified herpes virus. So far, there have been few side effects and therapeutic effects have been confirmed, Todo said.

Viral therapies offer new ways of fighting disease, but work remains before viral weapons can be deployed in the battle against cancer.

(Nikkei)

Nikkei Digital Media Inc.

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Chemotherapy and radiation failed to thwart Erika Hurwitz's rare cancer of white blood cells. So her doctors offered her another option, a drug for melanoma. The result was astonishing.

Within four weeks, a red rash covering her body, so painful she had required a narcotic patch and the painkiller OxyContin, had vanished. Her cancer was undetectable.

''It has been a miracle drug,'' said Mrs. Hurwitz, 78, of Westchester County.

She is part of a new national effort to try to treat cancer based not on what organ it started in, but on what mutations drive its growth.

Cancers often tend to be fueled by changes in genes, or mutations, that make cells grow and spread to other parts of the body. There are now an increasing number of drugs that block mutations in cancer genes and can halt a tumor's growth.

While such an approach has worked in a few isolated cases, those cases cannot reveal whether other patients with the same mutation would have a similar experience.

Now, medical facilities like Memorial Sloan Kettering Cancer Center in New York, where Mrs. Hurwitz is a patient, are starting coordinated efforts to find answers. And this spring, a federally funded national program will start to screen tumors in thousands of patients to see which might be attacked by any of at least a dozen new drugs. Those whose tumors have mutations that can be attacked will be given the drugs.

The studies of this new method, called basket studies because they lump together different kinds of cancer, are revolutionary, much smaller than the usual studies, and without control groups of patients who for comparison's sake receive standard treatment.

Researchers and drug companies asked the Food and Drug Administration for its opinion, realizing that if the F.D.A. did not accept the studies, no drugs would ever be approved on the basis of them. But the F.D.A. said it sanctioned them and could approve drugs with basket study data alone.

Instead of insisting on traditional studies, said Dr. Richard Pazdur, who directs the F.D.A. office that approves new cancer drugs, the agency will look at the data and ask, ''Is the American population going to be better off with this drug than without it?''

These are the sorts of studies many seriously ill patients have been craving -- a guarantee that if they enter a study they will get a promising new drug. And the studies move fast; it does not take years to see a big effect if there is one at all.

In Mrs. Hurwitz's case, the mutation in her rare cancer is in a gene, BRAF, found in about 50 percent of melanomas but rare in other cancers. She is among dozens of patients with the same mutation, but different cancers, in the new study that gives everyone the melanoma drug that attacks the mutation.

Basket studies became possible only recently, when gene sequencing became so good and its price so low that doctors could routinely look for 50, 60 or more known cancer-causing mutations in tumors. At the same time, more and more drugs were being developed to attack those mutations. So even if, as often happens, only a small percentage of patients with a particular tumor type have a particular mutation, it was possible to find a few dozen patients or more for a clinical trial by grouping everyone with that mutation together.

In a way, this is a leading edge of precision medicine that aims to target the drug to the patient. Unlike previous efforts that looked for small differences between a new treatment and an older one, with basket studies, researchers are gambling on finding huge effects.

''This is really a new breed of study,'' said Dr. David Hyman, a cancer specialist at Memorial Sloan Kettering who directs the study Mrs. Hurwitz is in and two similar ones.

And they are seeing some unprecedented responses, along with some failures. The responses, though, can be so striking that control groups might be unwarranted or infeasible, Dr. Pazdur said.

''Conventional therapy might give a response rate of 10 or 20 percent,'' Dr. Pazdur said. ''The newer drug has a response rate of 50 or 60 percent. Does it make sense to do a randomized trial?'' And even if a trial were planned, he said: ''Who would go on that trial? Would you go on that trial?''

''When you are having a big effect, it is kind of jaw dropping,'' Dr. Pazdur added. ''These are response rates we haven't seen before in diseases.''

But these are still the early days, researchers caution. ''It is a different world we are walking into,'' said Dr. Daniel Costa, a lung cancer researcher at Beth Israel Deaconess Medical Center in Boston. ''And we are learning as we go along.''

The new studies pose new problems. With no control groups, the effect has to be enormous and unmistakable to show it is not occurring by chance. When everyone gets a drug, it can be hard to know if a side effect is from the drug, a cancer or another disease. And gene mutations can be so rare that patients for a basket study are difficult to find.

The rarity of the mutations, in fact, is one reason for the new national effort, supported by the National Cancer Institute. Its study, called Match, is essentially a basket of basket studies. Doctors around the country will be sending tumor samples from at least 3,000 patients to central labs that will examine them for mutations. Those with any of a dozen or so mutations in their tumors can enroll in studies of drugs that target their tumor's mutation.

Dr. Keith Flaherty of Massachusetts General Hospital, principal investigator for the Match trial, said the number of baskets was uncertain -- it would depend on the number of drugs. But he expects 12 to 15 baskets to start, expanding to perhaps 40 or more. There will be 31 patients per drug.

He anticipates mixed results. ''We are exploring an unknown space here,'' Dr. Flaherty said. ''But it is essentially impossible for this whole set of baskets to fail.''

To show what is possible, Dr. José Baselga of Memorial Sloan Kettering points to preliminary results he presented in December for the basket study that includes Mrs. Hurwitz.

Among 70 patients, there are eight types of cancer. Eighteen patients had one of two very rare cancers, Erdheim-Chester disease or Langerhans disease, the cancer that struck Mrs. Hurwitz. Of them, 14 responded to the melanoma drug -- their tumors vanished, shrank or stopped growing -- and the remaining four have not been taking the drug long enough to say.

''Unbelievable,'' Dr. Baselga said.

''This is working in a way that is clear, that is unprecedented,'' he said. ''I don't have enough patients to do a Phase 3 study,'' he added, referring to the large, randomized study traditionally used to test new drugs, ''and I even question the morality of it.''

But others in basket studies have not fared so well.

Eleni Vavas entered a basket study at Memorial Sloan Kettering hoping to stop the stomach cancer that was killing her. The study, said her husband, John Vavas, ''was our last-ditch, Hail Mary effort.'' His wife, who was 36, entered it last spring, the only patient with stomach cancer. But, Mr. Vavas said, ''she just didn't respond.''

She died on July 1.

Erika Hurwitz's cancer of white blood cells is now undetectable, after she entered a trial that uses drugs that block mutations. (PHOTOGRAPH BY GREGG VIGLIOTTI FOR THE NEW YORK TIMES) (A19) 

The New York Times Company

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Rocco's picture
Replies 1
Last reply 2/25/2015 - 7:50pm
Replies by: Janner

Your stories helped me through some rough early years after diagnosis.....just wondering if you were still around.

-Rocco

Luke 1:37

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ashlee12's picture
Replies 3
Last reply 2/27/2015 - 3:17am
Replies by: dmk252003, Anonymous, evleye

Ao cause I've had melanoma am I more likely  to get another type of cancer such as breast or lung?

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Anonymous's picture
Anonymous
Replies 1
Last reply 2/25/2015 - 5:23pm
Replies by: Julie in SoCal

Thinking about you. How did you appointment go with the "Rock Star" doctor?

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dmk252003's picture
Replies 12
Last reply 2/28/2015 - 8:38am

My mom's oncologist is suggesting she has yervoy treatments for her stage IV cancer.

She has not suggested doing any lab work prior to yervoy treatments. I am concerned since my mom was in the hospital a few weeks ago with irregular heart rate and very high blood pressure.

I would like to hear feedback regarding this. Thank you.

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Anonymous's picture
Replies 2
Last reply 2/25/2015 - 8:05pm
Replies by: Anonymous, Janner

I am reading many different experiences of those with early stage melanomas who thought they had the all clear but yet, the melanoma had spread internally.

Standard protocol for early melanoma does not consist of any type of body scan and insurance doesn't cover it.  Not everyone has the luxury of affording it.

What is a patient to do? Each case is different, some patients do get a clean bill of health but others don't.

Should I be concerned?

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I am currently on Keytruda at Johns Hopkins and may be oving to the Hampton Roads area.  Do any of you get Keytruda locally?  Just wondering if I would have to travel to get treatment.  Thanks!!

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AshleyS's picture
Replies 5
Last reply 2/26/2015 - 5:06pm
Replies by: casagrayson, Anonymous, jbronicki, BrianP

I'm starting a trial at MD next week. My husband and I are bringing my 2 year old and  3 month old with us to Texas. We have family in Dallas and considered staying there and driving on the days I need to be in Houston. Some have said this will be too much. Any thoughts? I'm going to call my social worker today, but I thought maybe someone on here would have advice. :)

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Randy437's picture
Replies 4
Last reply 2/25/2015 - 7:29pm

I am stage IV, but have been NED for five years after surgeries to remove mets from both lungs, brain and small intestine.  Currently I get a CT with and without contrast every 4 months and a brain MRI with and without every contrast every six months.  Does anyone similarily situated have a different scan schedule?  I'm somewhat concerned about the cumulative radiation from the CT scans.

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G-Samsa's picture
Replies 3
Last reply 2/25/2015 - 8:45am
Replies by: Anonymous, Mat, Bubbles

Read this morning that BMS has just purchased Flexus' IDO inhibitor assets.  This is likely good news. (I think, hope). Back before anti-PD1 took center stage, early IDO trials were showing great promise. (I remember someone on this site indicating a 48 percent response rate for a trial at the Angeles Clinic) I believe IDO interferes with a whole other pathway than the PD1/PDL1 route, and may therefore offer another complimentary way to tackle the beast.   There is indication that BMS intends to initiate some clinical trials within six months... It's nice to have a heavyweight picking this up--I suppose that's a benefit of the crowded PD1 field.

 

 

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 ASX Release 24th February 2015 

FURTHER UPDATE ON NEW ANTICANCER DRUG, PPL-1, IN HUMAN TRIAL AT ROYAL ADELAIDE HOSPITAL 

PharmAust Limited (“PharmAust”) (ASX: PAA & PAAO) is pleased to report that a further patient analysed for levels of p70S6K tumour marker, has also shown a meaningful reduction following oral treatment with PPL-1. Furthermore, preliminary analysis of pharmacokinetic serum levels of PPL-1 in patients receiving the drug at the Royal Adelaide Hospital (RAH) has confirmed absorption following oral dosing and indicates that PPL-1 is active in the high nanomolar range which is similar to other cytotoxic drugs used during chemotherapy. 

PharmAust’s Executive Chairman Dr Roger Aston said “Even though we are dealing with small numbers of patients in our analyses so far, it is exciting to see that we have achieved a statistically significant drop in p70S6K levels in white blood cells in the 5 patients examined so far (p<0.001 at day 3 of dosing). It is furthermore encouraging that the reduction in the p70S6K tumour marker appears to correlate with blood levels of the drug. The Clinical Research staff monitoring the trial, have not noted any serious adverse events further supporting the low side-effect profile of PPL-1”. 

p70S6K is considered as a promising marker and indicator of the aggressive behaviour and prognosis of carcinomas. Overexpression of p70S6K is generally associated with aggressive disease and poor prognosis among cancer patients. Patients with elevated p70S6K often have poor survival rates and metastases. Reductions of p70S6K in blood cells may reflect blocks to tumour progression. 

PPL-1 is an approved veterinary drug launched in recent years by one of the leading global animal health corporations for the treatment of parasitic diseases in sheep. PharmAust, through its wholly owned subsidiary, Pitney Pharmaceuticals Pty Limited, owns patents on the use of PPL-1 in cancer and malignant disease. The drug will be potentially administered to patients suffering from diverse cancers. Recruitment will include selection of patients suffering from lung, pancreas, oesophageal, gastric, colorectal, ovarian, breast, prostate, liver, sarcoma, lymphoma, and melanoma. In animals and more recently in our studies in man, PPL-1 has an exceptionally low toxicity profile. 

The cancer chemotherapy market (estimated at $42 billion/annum)* is currently the fastest growing sector within the pharma industry, mainly driven by the identification of new potential therapeutic targets. This growth is further fuelled by the magnitude of the disease worldwide, currently estimated at more than 25 million people suffering from cancer globally, and an estimated 5 million people dying each year from the disease. 

*Reference: Research and Markets.com accessed 14th February 2014: http://www.researchandmarkets.com/reports/335548/chemotherapy_market_ins...

For further details please contact: 

Dr Roger Aston 

Executive Chairman 

PharmAust Limited 

Tel: 0402 762 204 

www.pharmaust.com 

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Jewel's picture
Replies 6
Last reply 2/28/2015 - 11:28am
Replies by: Anonymous, Rocco, Jewel

Hi there,

My husband goes for his first set of scans 3/3/15 after completing Ipi/Yervoy. Would love to hear some Long term success stories. Thanks!!

 

Jewel

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