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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Replies by: Jamietk, Mymlan, mlbjab, Janner

Hello all, please tell me this is somewhat typical, I'm scared..

First off, I am high risk for skin-cancer, which is the reason why I visit the Derm every 2 or 3 years for check-ups. I was born in Sweden, of Swedish parents. I'm a 36 year old female, blue eyes, blonde hair, fair skin...I probably have 100+ moles on my body. Spent 5 years in West Africa age 4-9, suffered a few severe sunburns, according to mom. I've been living in the Southern US for the last 20 years. Texas and Mississippi. Never been a tanner but I spend much time outside..Either way, I realize I am a high risk person. Never have had a problem until now.

June 6th I went to a Derm, picked one who is known to specialize in skin-cancer. He spotted a very dark mole on the back of my ear, I had seen it last year but didn't think much of it, I just thought 'wow that's ugly' but I've always hated all these ugly moles on my body. The derm regularly removes them prophylactically. So a week later I got a lovely call from the PA at the Derm-office, she told me the mole on my ear was a 2mm, stage 2 Malignant Melanoma. They refered me to MD Anderson. What the...? I know nothing about Melanoma except its dangerous. 

So I went to my appointment at Anderson, to meet the doctor and have a Sentinel Lymph Biopsy. Well, the first doctor comes in, starts talking about having part of my ear removed. He was, by the way, very unprofessional, I don't think he had even reviewed my records before coming in the room...to make it worse, he basically told me having one ear smaller than the other is really no big deal since " you never really see both ears of a person when you  are looking at them." Really? Wow. So now Doctor Number 2 comes in, with Doctor number 1...she proceeds to tell me that the whole thing may be a mistake and the path-report could be wrong!? At this point my head is spinning...So I ask if I need the Biopsy, she tells me that is up to me. Again. What? Who is the doctor here? I declined. So they tell me they want their people to look at the slides of my lesion and in a few days they will most likely call me and tell me the good news. Ok, great. 

They PA called me today to tell me it will be another 2 weeks because as of right now they have established that the lesion is an 'atypical melanocytic proliferation' but they haven't made a definite diagnosis of Melanoma, yet. They want more tissue from the original lesion to make a diagnosis. What is going on here? They haven't done one test, nothing. I'm scared. Is this typical? Nothing to worry about..?

"The journey of a thousand miles must begin with a single step" - Lao Tzu

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Cracker's picture
Replies 1
Last reply 7/8/2012 - 11:58pm
Replies by: Swanee

I'm new to the forums. My sister is about to start yervoyI'm next week. Some history:45 yrs old, had a brain tumor removed sept.2011. In January was diagnosed with melanoma in the lungs and some inner skin lesions. Started Zelboraf and had been on it since January. She recently had a seizure and a MRI. The MRI showed several brain mets. Was told Zelboraf does not work beyond the brain barrier. So we are going to start yervoy. A could of days off of Zelboraf. Does anyone know how long the sun sensitive side effects last after taking the treatment?

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bikerwife's picture
Replies 5
Last reply 7/12/2012 - 1:37am

Lynn started this medicine 4 pills in morning and 4 pills in the afternoon last Monday so we went for his one week checkup Tuesday. Dr. Shirai was totally overwhelmed he said I told you thuis would happen. The tumors on his body that you can see are visible disappearing. The ones that were the size of marbles are size of peas the one that was golf ball size is now marble size. They all are shrinking.

The blood was at 400 has dropped to 279.

The only side effect so far is a small rash in beard and around nose. Dr gave cream for this. Having bllodwork regular at home go back on 18 for another brain scan. Will have ct. Scan of chest and kidney in five weeks and hopefully that will show shrinkage also.

Our dr was so happy he hugged lynns neck and it made us feel so good. Having a caring dr is one of the main things u need in this fight.

May God bless each of you with strength and courage to continue on each and everyday.

What God leads u to he will. Lead you through

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natasha's picture
Replies 22
Last reply 7/7/2012 - 1:56pm
Replies by: Anonymous, natasha, Janner

Hi!

 What is the difference between severely atypical lesion and melanoma?

Does it mean severely atypical cannot metastize and melanoma can? Where is that border ?

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awillett1991's picture
Replies 4
Last reply 7/8/2012 - 2:11am
Replies by: LynnLuc, awillett1991

http://clinicaltrials.gov/ct2/show/NCT01621490

My onc mentioned this last week. I know it's all about the timingand it won't be for me. Not much info here but interesting they are looking for half the patients to have failed IPI. I do get frustrated with the entire clinical trials exclusion process but at least some can be helped. If I were a candidate, I'd start making phone calls!

~Peace

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Replies by: beatricefromPARIS, LynnLuc, Anonymous

Could anyone advise on where to be followed by melanoma specialists in Hong Kong?

This is for a dear friend of mine who is going to move there this summer  for work purposes.

Bad timing as he is currently awaiting for scan results and there is a suspicion that his melanoma (nodules which were excised) has spread. Which means he would have to start systemic therapy. 

He is in very good hands at one of the best melanoma centers in France right now.

Dilemna is to stay here being sure of an excellent standard of care or to go to Hong Kong with his family  where his new job awaits him but no hospital contacts!

Many thanks in advance for names/adresses and their track record!

 

 

 

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cwu's picture
Replies 2
Last reply 7/4/2012 - 2:46am

Hi everyone,

My dad has stopped treatment for the mel on his leg, his last treatment was Yervoy which he finished late November 2011. His oncologist said dad has a mixed response.  While his existing lesions have gotten bigger and begun to bleed more, it doesnt seem like his lesions have moved upward to his upper leg and there are no symptoms of organ involvement (I cant remember his last scans but they must have been 3-6 months ago and were clear). Since his lesions are continuously bleeding, he had multiple infections and was hospitalized 3 times and was given antibiotics and blood transfusion.  He is weaker now and tires easily although he is mentally very alert.  Each time he was hospitalized, his hemoglobin was in th 8-9 range and after the blood transfusions, it goes up to normal 12 and he gets his energy back. His oncologist said there is nothing they can do to stop/control the bleeding. 

Has anyone had blood transfusions and does it stop working at some point?  

I would really appreciate any ideas, or thoughts or questions that we should ask his doctor.

Thank you.

Chau 

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 Greetings community members,

Enrollment is open for the Melanoma Survivor Panel Discussion that is scheduled on July 26th, 4 – 5:30 pm, at 2333 Buchanan Street, Enright Room, in San Francisco, Ca

This panel discussion will be presented by melanoma survivors who have experienced various stages of cancer and a registered nurse educator. Join us for this unique opportunity to hear personal and inspiring stories and experiences from those who battled melanoma and have gone on to live fulfilling lives. This discussion is the second in the three part Melanoma Educational Series and refreshments will be provided.

Community Health Resource  Center offers lectures that are open to all community members, patients, families, and caregivers to attend. Any contribution is welcome, $10 is suggested. For more information or to register, call 415-923-3155 or email cpmcchrc@sutterhealth.org.

Healthy Regards,

 -Melissa

Melissa Brown

Program Coordinator, Community Health Resource Center

www.chrcsf.org

Community Health Resource Center... the next step to better health

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Though my father passed away Feb 16, 2012 of merkel cell skin cancer, he remained melanoma free from the end of this story for the remainder of his life...

In honor of his first granddaughters 5th birthday tomorrow, I'm reposting this story in hope that it encourages and inspires you in your fight...

“White Brows”, my journey through stage 4 melanoma by Warren Galinat (September 18, 2008)

I am 55 years old. My parents are of German and Irish heritage. I was born with very blonde hair and light skin tones. We are a middle class, well-educated, hard working family. My dad graduated with an engineering degree from M.I.T. My grandfather oversaw carpet-manufacturing plants in the south. I’ve got two brothers who live in the northeast. Wayne is a financial business owner, and Brian is the orthopedic surgeon. I’ve lived in south Florida for the last 15 years. I retired near 50 after working almost 25 years as a regional controller for a division of Marriott International. I’m a very proud dad of Jeremy and his younger sister Nicole. Jeremy, now 26, is the corporate finance manager for Wynn Resorts with operations in Las Vegas and Macau, China. Nicole graduated at the top of her class at Stetson University. While giving the commencement speech at graduation, my dad said to me “could you have imagined this?” While choking up slightly I said “absolutely”. She’s an analyst now for Franklin Templeton Investments in Fort Lauderdale, Florida. You may know it as the 22-story glass building that had 821 windows blown out by hurricane Wilma.

I have been a life long surfer. The beach is my favorite spot. When moving to Florida I also became a decent golfer. I had my current house built on the 18th fairway of a golf course. Upon retirement, I surfed each morning and golfed afterwards. Perhaps too much in the sun time for me you might be thinking? Although I had been very healthy for almost fifty years of my life, today I’d agree with that assessment.

My local skin doctor, Tom Connelly, and I became pretty good buddies. He said the money he made cutting and burning non-life threatening skin cancers off me paid his kids way through college. I got smarter at the beach after each doctor visit. I was using more sunscreen, surfing with a cap, and keeping on a t-shirt. No doubt a bit too little and a bit too late!

In June of 2001 things got much more serious as my life with malignant melanoma began. Dr. Connelly performed an excision of a 1.12 mm melanoma in the middle of my back. It wasn’t very big by all standards and the hope was it would not spread. Two years later, September of 2003, I was dealt what we call in poker a “bad beat” hand. I had nothing visible on the skin itself but under it, and a few inches from my first site, I felt the moveable subcutaneous mass. Tom cut the 3.0 cm’s out and sent it to the lab. He called me into the office when getting the results. When it was over he gave me one of those two handed farewell shakes to my right hand. You know what that means. He is a great guy and his skillful work on me is clearly a reason I had a fighting chance for a future. At this point however there was nothing more Tom could do for me.

Upon giving myself a few days to reflect back and do some reading on my future, I told my family and friends. I wasn’t thrilled about doing it either. Nearly everything I read was just dreadful. You feel more sorry for them then you do for yourself.

I should say at this point that upon my retirement from Marriott I made the blunder of declining continuing medical insurance benefits. Believing my excellent health and fitness of the past would remain in the future was a horrible assumption. Fortunately my brother Brian went into high gear after hearing from me. He arranged meetings with some of his doctor buddies, Dr. Conway of Delaware and the highly respected Dr. Michael Mastrangelo of the Jefferson Medical College in Philadelphia. He also arranged for all the scans and lab work that I needed. His most important contribution to my welfare was researching the division of clinical sciences, National Cancer Institute, at the National Institute of Health in Bethesda, Maryland.

On October 29th, 2003 I went to NIH and met Kathy Morton, RN, for a screening appointment for eligibility into one of NIH’s treatment protocols. I would later tell her, when things turned for the worse, I know for a fact that God had chosen her as my angel on earth. She has been there for me every step of the way for nearly five years now. I can’t say enough nice things about her and her professionalism in such a heart-wrenching job. Through the years people have said to me “you know you’re a hero for going through all this for five years because your efforts might save a bunch of others”. I’m no hero; I’m just a survivor. It’s people like Kathy Morton that dedicate themselves to this cause (added to the fact that her son is overseas protecting the future rights of all Americans), who are our real heroes!

The letter from Dr. Steven Rosenberg, M.D., Ph.D. said I met the qualifications. Thank goodness. On November 4, 2003 I signed their paperwork and my journey began.

Step one was the NCI protocol number 6211, “to test the actions of experimental vaccine(s) on the cells in your immune system to determine if it is effective in “turning on” your immune system to fight against your cancer”. The injections under the skin of my thigh came every 3 weeks. The immunizations, along with blood tests, x-rays and scans, took place over one year. You also make friends with the ladies in the Apheresis lab during this time. Here, using the cell-separator machine, some lymphocytes (white blood cells) are removed and tested to see how the peptides are performing. The hope of course is your tumor would not return. Just what the doctor ordered right? Well for me, not exactly.

Fast-forward a couple of years to March 2006. Back in Florida after playing eighteen holes I took a shower and felt something on my back again. Come on, this isn’t fair! It can’t be, can it? I was planning just to go to Dr. Connelly to have him figure out what it was. Probably just a cyst. But I called Kathy Morton and told her about it. She said in an unusually stern voice, “Warren you have to come up here for that”. Geez, I was so hoping I was done with this melanoma cancer.

In the middle of 2006 I was back on the plane heading north. My older brother Wayne lives just off the two major highways to both Baltimore Washington International Airport and NIH. Through all of this he and his wife have made there home mine and gave me transportation to get around. It’s made things so much easier and I sure appreciate them ‘babysitting’ me. Two of Dr. Rosenberg’s surgeons removed my third melanoma inches away from the other two. They also captured and would later grow the tumor killing cells (TIL) that would play a major role in me being here now.

The new scans also revealed a ‘spot’ in my right lung. Horrible news. I’m feeling I’m in deep trouble now. This nasty cancer won’t leave me alone. The scary things I read are now happening to me. It’s hard not to scream out a string of ‘F bombs’ and ‘Why me’s’ but what’s the use? It’s pointless right?

Shortly it is decided that I should be admitted into NIH as an inpatient on 3NW of the sparkling, nearly new Mark Hatfield Clinical Research Center. The huge center atrium with halls of rooms circling it up for several stories reminds you of a first class Marriott Hotel. The service provided by the doctors and nursing staff is second to none. I’m not a spokesman for NIH but I highly suggest you contact them should the need ever arise. Knowing I did not have, and could no longer acquire health insurance with stage four cancer, they have never asked me for a dime. My accumulated bills would surely exceed six figures, a debt I could never payback. To say that I’m very grateful is an understatement!

My first round of Interleukin-2 began flowing into my veins in June of 2006. It’s the opening step preferred by NIH when you get to my stage. I did eight rounds of it in one week, got a week off, and returned for eight more. The going in part is simple. They don’t tell you too much about what happens to some of us afterward. It totally crushed me for days. This man-made HDIL-2 ‘juice’ is the nastiest thing ever put in a bottle, in my opinion. After recovering for another full week at Wayne’s house, I got three weeks in Florida to think about coming back to do it all over again. I did it. The final results came back, no tumor regression at all. Now I am in for a real struggle.

Things are now moving rapidly. Dr. Rosenberg recommends number 06-C-0136. Weird how one seems to remember study numbers. My memory is horrible but I still can’t get this number out of my mind. This is the big one. A ’Phase II Study Using a Myeloablative Lymphocyte Depleting Regimen of Chemotherapy and Intensive Total Body Irradiation followed by Infusion of Tumor Reactive Lymphocytes and Reconstitution with CD34+ Stem Cells in Metastatic Melanoma’. It’s more than a mouthful.

My doctor brother had his own ideas and we schedule a meeting with Kathy Morton and Dr. Rosenberg. You see Brian is a surgeon and all surgeons favor using their skill, the knife, best. While in a room on 3NW, Dr. Rosenberg explains to us that cutting the lung tumor out is possible but would not ‘solve’ the issue in his opinion. He favored the research study as a more complete approach that just might eliminate the tumor as well as ‘possible lingering microscopic melanoma’ previously undetected in my body. Perhaps a full lifetime cure! To do nothing at all gave me a life expectancy median of just five months. Brian was now convinced and I was totally sold on it.

Dr. Rosenberg has devoted most of his adult life to research, science, and helping people with melanoma. His PhD is from Harvard. I believe he has been with NIH for thirty-five years. He is without a doubt the best there is. Following our meeting my brother Brian said to me “you can just see the passion in his eyes to beat this”. His theory behind this clinical trial is that capturing/growing the tumor-fighting cells taken from a melanoma tumor can more effectively fight melanoma when a patient’s immune system is suppressed and thus can’t attack them before they do enough good. Previously he found some success without the intensified full-body radiation but their final results failed to satisfy him.

I was admitted again on October 11, 2006. I had to pass a series of tests and produce enough stem cells to be able to proceed. For five days I got the filgrastim shots twice a day to pump up my white blood cell counts. The Echo, eye and dental consult, and PFT’s (breathing test) all proved to be without any issue. My stem cell count was among the highest achieved. Following a visit to the radiation professionals, and the placement of a Neo-Star catheter in my chest, I was all set to proceed.

My overseeing physician, Dr. Sid Kerkar, gave me one week off before Protocol Number 06-C-0136 would attempt to save my life. I would be the 6th patient in the country to be enrolled in this study.

The two chemotherapy medicines began dripping into my blood stream via the IV chest catheter on October 26th, 2006. The ‘real deal’ starts now. A lot of things go through your mind. First and foremost, your family and friends. Then all kinds of stuff if you let it in. You need ‘brain control’ to keep things calm, and good sleep is a requirement for your mental health. I have been able to take what’s dealt to me in life. A whiner, I’m not. Nor am I a social butterfly. I stick pretty much to myself. I told everyone not to visit me during this. I knew pretty much what was coming and didn’t want them to see me in misery, hair falling out, and hooked up to 4 wires and 6 fluid bags hung off a rolling steel pole. It’s just not my style. I knew they would pity me, go home and have it ruin their day or week. No thanks. I’ll suck it up. In retrospect I had no clue. The entire thing hit me like a Mack truck. I think us skinny guys really get stung the hardest, especially by the new, higher dose full-body radiation that follows.

On the fifth and final day of chemotherapy I was wheeled down to begin the total body irradiation (TBI). In the lead-walled room I received two treatments a day for three days. There is no pain from this. The completed, combined treatments take three days to eliminate my immune system. You have to be careful not to cut yourself and keep your immediate environment extra clean during this time. November 2nd, 2006 I was given my tumor fighting cells (TIL) back. They had now grown in the billions. They arrive in one bottle. It is special moment for everyone involved. It flows for about thirty minutes. There can be side effects and several staff members keep a close eye on you. It went well.

Remember the nasty HDIL-2 I got several months ago? Well here comes 10 more rounds over the next several days. Ugh! The day after you receive the TIL cells, your Stem cells (CD34) begin flowing back through your IV. Though my immune system came back slowly, the dangerous side effects possible from the entire regimen were nonexistent.

That being said, the next two weeks in the hospital room were very tough on me. I came into this weighing 163 pounds. I was down to about 128. I’ll skip the details but you can imagine what you go through. I had another week of scheduled hospital confinement left when I asked if I could recover at Wayne’s house. My thoughts were those of a change in my environment would surely help me to eat better and begin to move around. The doctors gave me an out pass. One more blunder on my part. Without the hydration constantly flowing from my IV line I could not possibility maintain even the 128 pounds. My stomach was so small I just couldn’t eat much. I fell to 119 pounds in five days when I asked my brother to please bring be back to NIH.

Back in the hospital, plugged up to the hydration IV again things got better. The NIH nutritionist gave me personal service, outside the normal cafeteria, with food prepared especially for me. She also hand delivered it to me. She was a major factor in my ability to go home, once again, in just five days. Thank you very much!

Today is Groundhog’s Day, February 2nd, 2008. Five years from my original diagnosis. Borrowed time? Perhaps. Cherished time? No doubt about that. Last year on July 4th I got a new name, ‘Grand Pa’. Jeremy’s daughter Juliet is picture perfect! I owe my life to the wonderful people at the National Cancer Institute at the National Institute of Health. Sure, my skin pigment is gone. My hair and eyebrows are back, completely in white. Another NIH survivor pal refers to our new look as “powered donuts”.

I have been going back for blood tests and scans/mri’s every other month. My first visit back made everybody very happy. The ‘CBS 60 minutes’ crew was filming Dr. Rosenberg and I when he gave me the good news. My lung cancer was gone completely. “Cured” he said. Thank you and thank the Lord. I have been clean ever since. There are some current kidney issues, and lingering nerve damage from the awful shingles that came later on. The prescribed medications appear to be helping in both areas.

I would like to thank everyone that took the time to read this. I hope it helps you in some way. The NIH website is www.nih.gov. It has current clinical trial information as well as contacts, addresses, and other pertinent information.

In closing I would like to quote the very courageous Jimmy Valvano from his speech during the 1993 ESPN ESPY Awards. He was pleading to his audience to give money for cancer research saying, “it may not save my life, but it may save your children’s life”. Stricken with tumors everywhere he struggled to stand before a huge crowd and the national television audience. As he focused in on the camera he said......

“Don’t ever give up. Don’t ever give up.” “Cancer can take away all my physical abilities. It can not take away my mind, it can not take away my heart, and it can not take away my soul”.

Anything is still possible in my future. I have a good prospective on reality. One thing is for sure. I will never give up. I hope you never do either.

"don't ever give up" "don't ever give up" ( the Jimmy V Fund for cancer research) - my dad's motto

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WendyPam's picture
Replies 3
Last reply 7/4/2012 - 6:45pm
Replies by: Anonymous, LynnLuc
Can anyone tell us of a company that does any type of tumor profiling that maybe can lead us to some treatment plan for my Mother.

Another question being that my Mom is Braf Negative and C-Kit Negative and seems that every other test that we have done we never have the marker. Does this make her besides being Braff Negative is she considered Braf Wild Type?

Currently we are on a chemo cycle,Carbo/Abraxane. Trying to get our doc to bring Avastin into the cycle next round. We completed 2 treatments and holding off today because of low levels and our primary doc was out. In 3.4 years all she has done is Interferon, Yervoy and a Yervoy re-induction. With the re-induction we only complete 2 treatments. I am very interested at this point about the clinical trial E7080. Looking at other options until more Anti-pd1 trials open.

Thanks everyone for your help as always!

Wendy

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ipi in DC's picture
Replies 3
Last reply 7/4/2012 - 12:37am

Hey guys,

I haven't posted in a while but still wander around to see whats going on. Monday I received my second set of scans that showed no eveidence of active desease. They are saying active since my other possible nodule in lungs are still visible. They have never been confirmed melanoma or not.

After going to stage 4 two years ago I am very happy to hear anything other than "we need to watch........" and going to 12 week scans is great.

It wasn't too scary to get results when your in the heat of battle, but to go in and maybe hear that it is active again was kinda scary. Like they were going to take my new toy away.

I know I am not even close to being out of the woods but its nice to slow down and enjoy the trees.

Have a wonderful holiday,

David

Fully rely on GOD & try not to ruin today by worrying about tomorrow

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83 articles were found in the search box containing keyword “melanoma”

at  http://www.clinicaloncology.com/

Live 4 today. Thank God for all he has done for us. Looking forward to enjoying tomorrow.

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Ali's picture
Replies 29
Last reply 8/5/2012 - 6:29pm

I have opened this site a dozen times in the last week, thinking I would share, but found it too difficult.  It is no fun reading bad news, and it is not fun spreading it.

I was diagnosed stage IV in January.  We had a scan last October (three months before) that was clean.  By January there were about a dozen subcutaneous lesions, two spots in the liver, and three in the bones.  We radiated 2 of the bone lesions immediately (one time high dose radiation) and started high dose IL-2 the next week.  The first scan looked great, many subqs gone and bone and liver improving.  The second showed improvements in bone and liver, many subqs gone, but new ones popped up.  We did the last dose of IL-2.  It again shrank many subqs (I could feel them melt as I was in the hospital, very cool).  We waited a month to scan.  I really wanted to have all trials available in deciding my next step.

The scans last week showed the liver and bone mets improved (they weren't lighting up at all on the PET), all the old subqs gone, but new ones (lots of them) popping up.  No organ involvement except the brain.  And major involvement there.  25 small brain mets.  Have you ever heard of that?  Popping up since April?  It seems pretty extreme.

So.  That pretty much kicks me out of trials.  Surgery is not an option.  Can't radiate individual mets yet, as they are not big enough.  Could do whole brain radiation, but mostly we are just hoping that we can get a systemic response out of IPI, as I had a good immune response from the IL-2.

Started IPI Wed., and also Temodar.  Scan again in 6 weeks and will see if any of the tumors get big enough to radiate (at the rate they grow under my skin, I'm thinking that won't be too hard).

I hate this disease. 

But I love that we options now that we didn't have a couple of years ago.  I love that melanoma is getting so much attention in the oncology world and that the things that are coming out are actually working. 

Thanks for all the support I find from this bulletin board!  Keep up the good fights!

ali

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Anonymous's picture
Anonymous
Replies 2
Last reply 7/3/2012 - 6:26pm
Replies by: washoegal, Anonymous

 A week and a half ago my dad went in to get his left lymphnodes removed due to an earlier surgery returning positive for tumors.  The results are back and 2 additional nodes came back positive? Does it mean the cancer has spread to other areas? What happens next? His doctor had initially said he was stage 3a.  

Thank you in advance for any information you can provide.

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