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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chermes55's picture
Replies 5
Last reply 2/3/2012 - 12:38pm

No real updates this week. Went in on wednesday to draw labs and everything looked great. So far im not experiencing any side effect which is amazing compared to interferon. go back in two weeks for more tests. I can"t wait for my first scan, I'm really hoping for the best. Will keep everyone updated when i get more news. As for now i feel better than i have since my surgery in April of last year.Think i might go back to work monday for the first time since June and im actually excited about.

 

Cliff

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Gene_S's picture
Replies 10
Last reply 2/3/2012 - 2:48am
Replies by: mob, Gene_S, EmilyandMike, runnergirl, Lori C, premedy, sedona, Anonymous

            A Surprising Cause of Melanoma

 
 
===================  The complete article is below  =======================
 
Rates of melanoma, the deadliest form of skin cancer, have been rising for at least the last three decades, and this increase has been largely blamed on exposure to ultraviolet (UV) light from the sun.

However, research published in the British Journal of Dermatology shows that the sun is likely nothing more than a scapegoat in the development of melanoma, and the sharp increase may actually be “an artifact caused by diagnostic drift.”

                                   Melanoma Increases Due to Benign Disease, Not Sunlight

Diagnostic drift, according to the study, refers to a hefty increase in disease that is being fueled by non-cancerous lesions.

In fact, during the study period from 1991 to 2004, there were nearly 4,000 cases of melanoma included in the report, with an annual increase of 9.39 to 13.91 cases per 100,000 per year.

The researchers revealed that, rather than being fueled by increasing exposure to sunlight as is commonly suggested, the increased incidence was almost entirely due to minimal, stage 1 disease.

They noted:

“There was no change in the combined incidence of the other stages of the disease, and the overall mortality only increased from 2.16 to 2.54 cases per 100,000 per year … We therefore conclude that the large increase in reported incidence is likely to be due to diagnostic drift, which classifies benign lesions as stage 1 melanoma.”

In other words, people are being diagnosed with melanoma skin cancer even when they have only a minimal, non-cancerous lesion, and these diagnoses appear to be skewing disease rates significantly. Further, adding even more credence to the growing body of evidence showing sun exposure is not the primary cause of melanoma, the researchers noted that the distribution of the lesions reported did not correspond to the sites of lesions caused by sun exposure.

They concluded:

“These findings should lead to a reconsideration of the treatment of ‘early’ lesions, a search for better diagnostic methods to distinguish them from truly malignant melanomas, re-evaluation of the role of ultraviolet radiation and recommendations for protection from it, as well as the need for a new direction in the search for the cause of melanoma.”

                                                   Is Lack of Sunlight a More Likely Culprit?

Despite all the bad press linking sun exposure to skin cancer, there’s almost no evidence at all to support it. There is, however, plenty of evidence to the contrary. Over the years, several studies have confirmed that appropriate sun exposure actually helps prevent skin cancer. In fact, melanoma occurrence has been found to decrease with greater sun exposure, and can be increased by sunscreens.

One of the most important facts you should know is that an epidemic of the disease has in fact broken out among indoor workers. These workers get three to nine times LESS solar UV exposure than outdoor workers get, yet only indoor workers have increasing rates of melanoma — and the rates have been increasing since before 1940.

There are two major factors that help explain this, and the first has to do with the type of UV exposure.

There are two primary types of UV rays from sunlight, the vitamin-D-producing UVB rays and the skin-damaging UVA light. Both UVA and UVB can cause tanning and burning, although UVB does so far more rapidly. UVA, however, penetrates your skin more deeply than UVB, and may be a much more important factor in photoaging, wrinkles and skin cancers.

A study in Medical Hypotheses suggested that indoor workers may have increased rates of melanoma because they’re exposed to sunlight through windows, and only UVA light, unlike UVB, can pass through window glass. At the same time, these indoor workers are missing out on exposure to the beneficial UVB rays, and have lower levels of vitamin D.

Researchers wrote:

“We hypothesize that one factor involves indoor exposures to UVA (321–400nm) passing through windows, which can cause mutations and can break down vitamin D3 formed after outdoor UVB (290–320nm) exposure, and the other factor involves low levels of cutaneous vitamin D3.

After vitamin D3 forms, melanoma cells can convert it to the hormone, 1,25-dihydroxyvitamin D3, or calcitriol, which causes growth inhibition and apoptotic cell death in vitro and in vivo. We agree that intense, intermittent outdoor UV overexposures and sunburns initiate CMM [cutaneous malignant melanoma]; we now propose that increased UVA exposures and inadequately maintained cutaneous levels of vitamin D3 promotes CMM.”

To put it simply, UVB appears to be protective against melanoma — or rather, the vitamin D your body produces in response to UVB radiation is protective.

As written in The Lancet:

“Paradoxically, outdoor workers have a decreased risk of melanoma compared with indoor workers, suggesting that chronic sunlight exposure can have a protective effect.”

                                             Vitamin D Helps Protect You Against Cancer

Vitamin D is a steroid hormone that influences virtually every cell in your body, and is easily one of nature’s most potent cancer fighters. So I want to stress again that if you are shunning all sun exposure, you are missing out on this natural cancer protection.

Your organs can convert the vitamin D in your bloodstream into calcitriol, which is the hormonal or activated version of vitamin D. Your organs then use it to repair damage, including damage from cancer cells and tumors. Vitamin D’s protective effect against cancer works in multiple ways, including:

  • Increasing the self-destruction of mutated cells (which, if allowed to replicate, could lead to cancer)
  • Reducing the spread and reproduction of cancer cells
  • Causing cells to become differentiated (cancer cells often lack differentiation)
  • Reducing the growth of new blood vessels from pre-existing ones, which is a step in the transition of dormant tumors turning cancerous

This applies not only to skin cancer but other types of cancer as well. Theories linking vitamin D to certain cancers have been tested and confirmed in more than 200 epidemiological studies, and understanding of its physiological basis stems from more than 2,500 laboratory studies, according to epidemiologist Cedric Garland, DrPH, professor of family and preventive medicine at the UC San Diego School of Medicine.

Here are just a few highlights into some of the most noteworthy findings:
  • Some 600,000 cases of breast and colorectal cancers could be prevented each year if vitamin D levels among populations worldwide were increased, according to previous research by Dr. Garland and colleagues.
  • Optimizing your vitamin D levels could help you to prevent at least 16 different types of cancer including pancreatic, lung, ovarian, prostate, and skin cancers.
  • A large-scale, randomized, placebo-controlled study on vitamin D and cancer showed that vitamin D can cut overall cancer risk by as much as 60 percent. This was such groundbreaking news that the Canadian Cancer Society has actually begun endorsing the vitamin as a cancer-prevention therapy.
  • Light-skinned women who had high amounts of long-term sun exposure had half the risk of developing advanced breast cancer (cancer that spreads beyond your breast) as women with lower amounts of regular sun exposure, according to a study in the American Journal of Epidemiology.
  • A study by Dr. William Grant, Ph.D., internationally recognized research scientist and vitamin D expert, found that about 30 percent of cancer deaths — which amounts to 2 million worldwide and 200,000 in the United States — could be prevented each year with higher levels of vitamin D.

                                  When Using the Sun to Fight Cancer, the Dose is What Matters

When I recommend using the sun therapeutically, this means getting the proper dosage to optimize your vitamin D levels. This typically means exposing enough of your unclothed skin surface to get a slight pink color on your skin. Your exact time will vary radically depending on many variables, such as you skin color, time of day, season, clouds, altitude and age.  The key principle is to never get burned, while still spending as much time as you can in the sun during the peak hours, as it is virtually impossible to overdose as long as you don’t get burned.

A common myth is that occasional exposure of your face and hands to sunlight is “sufficient” for vitamin D nutrition. For most of us, this is an absolutely inadequate exposure to move vitamin D levels to the healthy range. Further, if you use sunscreen, you will block your body’s ability to produce vitamin D!

And, contrary to popular belief, the best time to be in the sun for vitamin D production is actually as near to solar noon as possible which is 1 PM in the summer for most (due to Daylight Saving Time).. The more damaging UVA rays are quite constant during ALL hours of daylight, throughout the entire year — unlike UVB, which are low in morning and evening and high at midday.When using the sun to maximize your vitamin D production and minimize your risk of malignant melanoma, the middle of the day (roughly between 10:00 a.m. and 1:00 p.m.) is the best and safest time. During this time you need the shortest exposure time to produce vitamin D because UVB rays are most intense at this time. Plus, when the sun goes down toward the horizon, the UVB is filtered out much more than the dangerous UVA.

Once you reach this point your body will  peak at about 10,000-40,000 units of vitamin D. Any additional exposure will only cause harm and damage to your skin. Most people with fair skin will max out their vitamin D production in just 10-20 minutes, or, again, when your skin starts turning the lightest shade of pink. Some will need less, others more. The darker your skin, the longer exposure you will need to optimize your vitamin D production.

                                           Why Not Just Take Vitamin D from a Supplement?

You can get vitamin D3 in supplement form, and if sunlight or a safe tanning bed is not an option, this is a better choice than getting no vitamin D at all. If you do use a supplement, it now appears as though most adults need about 8,000 IU’s of vitamin D a day in order to get their serum levels above 40 ng/ml.

However, sunlight is really the superior source for vitamin D, as when you expose your skin to sunshine, your skin synthesizes vitamin D3 sulfate. This form of vitamin D is water soluble, unlike oral vitamin D3 supplements, which is unsulfated. The water-soluble form can travel freely in your bloodstream, whereas the unsulfated form needs LDL (the so-called “bad” cholesterol) as a vehicle of transport.

The oral non-sulfated form of vitamin D may not provide all of the same benefits as the vitamin D created in your skin from sun exposure, because it cannot be converted to vitamin D sulfate.

I believe this is a very compelling reason to really make a concerted effort to get your vitamin D requirements from exposure to sunshine, or by using a safe tanning bed (one with electronic ballasts rather than magnetic ballasts, to avoid unnecessary exposure to EMF fields). Safe tanning beds also have less of the dangerous UVA than sunlight, while unsafe ones have more UVA than sunlight. If neither of these are feasible options, then you should take an oral vitamin D3 supplement.

                                   What Should Your Vitamin D Levels be for Cancer Protection?

In 2007 the recommended level was between 40 to 60 nanograms per milliliter (ng/ml). Since then, the optimal vitamin D level has been raised to 50-70 ng/ml, and when treating cancer or heart disease, as high as 70-100 ng/ml

I recommend you have your levels tested and regularly monitored to make sure they are in the therapeutic range. Your physician can do this for you, or another alternative is to join the D*Action study. D*Action is a worldwide public health campaign aiming to solve the vitamin D deficiency epidemic through focus on testing, education, and grassroots word of mouth.

When you join D*action, you agree to test your vitamin D levels twice a year during a five-year program, and share your health status to demonstrate the public health impact of this nutrient. There is a $60 fee each 6 months ($120/year) for your sponsorship of the project, which includes a complete new test kit to be used at home, and electronic reports on your ongoing progress.

You will get a follow up email every six months reminding you “it’s time for your next test and health survey.” To join now, please follow this link to the sign up form.

                                       Natural Treatment for Non-Melanoma Skin Cancer

Melanoma skin cancer is the deadliest form, but far more common are non-melanoma skin cancers, which impact millions of Americans every year.

If you or someone you love is affected, a cream containing eggplant extract, known as BEC and BEC5, appears to cure and eliminate most non-melanoma skin cancers in several weeks time. Unlike conventional skin-cancer treatment, which is often surgery, the eggplant-extract cream leaves no scarring and no visible sign a tumor or lesion was ever present. The eggplant extract appears to be exceptionally safe and only kills cancerous cells, leaving healthy cells untouched, and causes only minor side effects, such as itching and burning.

The leading researcher in this area today is Dr. Bill E. Cham, who reported as early as 1991 in Cancer Letters that:

“A cream formulation containing high concentrations (10%) of a standard mixture of solasodine glycosides (BEC) has been shown to be effective in the treatment of malignant and benign human skin tumors.

We now report that a preparation … which contains very low concentrations of BEC (0.005%) is effective in the treatment of keratoses, basal cell carcinomas (BCCs) and squamous cell carcinomas (SCCs) of the skin of humans. In an open study, clinical and histological observations indicated that all lesions (56 keratoses, 39 BCCs and 29 SCCs) treated with [the preparation] had regressed.”

Dr. Cham’s latest study was published in the International Journal of Clinical Medicine this year. The paper includes two impressive case reports of 60-something men who were suffering from large basal cell carcinoma (BCC) or squamous cell carcinoma (SCC), which had plagued them for years.  The results upon treatment with a cream formulation of BEC (eggplant extract) twice a day are astounding, and you can view the pictures here.

Unfortunately, simply eating eggplant, tomatoes, peppers or similar veggies, while beneficial for many reasons, will not induce this same effect because the active components are not able to effectively penetrate your cells. This requires the addition of glycosides, molecules with various simple sugars attached to them that can latch on to receptors found on skin cancer cells.

                                                  Simple Skin Cancer Prevention Strategies

What’s even better than an inexpensive, safe and natural cure for skin cancer is, of course, preventing it in the first place. Your body is made to be in the sun, and, when done properly, sun exposure will be one of the best ways you can help reduce your risk of skin, and many other forms of, cancer. Along with optimizing your vitamin D levels, the carotenoid astaxanthin has also piqued the interest of researchers due to its ability to reduce signs of aging by helping protect your skin from sun damage. I personally take 8 mg every day to help limit any potential damage from sun exposure as most of the year I am able to spend one to two hours a day in the sun.

Consuming a healthy diet full of natural antioxidants is another useful strategy to avoid sun damage to your skin, as fresh, raw, unprocessed foods deliver the nutrients that your body needs to maintain a healthy balance of omega-6 and omega-3 oils in your skin, which is your first line of defense against sunburn.

Fresh, raw vegetables also provide your body with an abundance of powerful antioxidants that will help you fight the free radicals caused by sun damage that can lead to burns and cancer.

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  •   Written by Dr. Mercola on January 29, 2012

     

     

     

     

     

     

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    Dr. Mercola has been passionate about health and technology for most of his life. As a doctor of osteopathic medicine, he treated many thousands of patients for over 20 years. In the mid 90’s he integrated his passion for natural health with modern technology via the internet and developed a website, Mercola.com to spread the word about natural ways to achieve optimal health.

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

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    lna426's picture
    Replies 11
    Last reply 2/3/2012 - 1:31am

    Hi all - 

    In between my first and second treatments I developed really bad colitis (intestinal inflammation that makes me look like I'm pregnant). Four weeks after my last infusion and I'm still the size of a house!

    I'm wondering if anyone treated with Yervoy had a similar experience, and, if so, how long it lasted. I know every person reacts to the drug differently, but any insight would help.

    Thanks!

    I never asked "why me?"...I asked "why not me?". And my answer? Because I knew I could.

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    http://medicalxpress.com/news/2012-02-scientists-molecular-melanoma-resi...

    Looks interesting.  Hopefully this can translate into treatment quicly.

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    Greetings my melanoma clan...I"ve not posted, but I read everyday....I do now have a question...stage IIa diagnosed 9/2011...scalp...2cm around, clean margins, neg SNB...however, felt a hard nodule just on the edge of graft about a month ago...had hit my head there and had a sore, but it cursted, and then here's this...derm is almost positive it's a local recurrence which I understand is so not good...anyone have experience with local recurrence, any encouraging info?? thankyou so much...really

     

    beattiesa

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    Greetings my melanoma clan...I"ve not posted, but I read everyday....I do now have a question...stage IIa diagnosed 9/2011...scalp...2cm around, clean margins, neg SNB...however, felt a hard nodule just on the edge of graft about a month ago...had hit my head there and had a sore, but it cursted, and then here's this...derm is almost positive it's a local recurrence which I understand is so not good...anyone have experience with local recurrence, any encouraging info?? thankyou so much...really

     

    beattiesa

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    KellieSue's picture
    Replies 4
    Last reply 2/2/2012 - 1:29am

    I'm starting cycle 2 of clinical trial,
    I can't seem to paste the trial. It is under the U of Iowa clinical trial cancer page.
    Title 07-08-01-50; Phase I/II Study Epigenetic Modification of Chemosensitivity and Apoptosis in Metastatic Melanoma: Treatment of a Resistant Disease Using Decitabine, Temozolomide and Panobinostat

    I start getting 2 shots of Decitabine week one and week two M,W, F. I got to the Clinical cancer center for the shots.
    Week 2 I also takeTemodar day 2 thru day 5 in the evening at home.
    And I also take Panobinostat at home every 4th for 8 days(i think)
    I am on week 2 of cycle 2 now.

    I am doing good except for am still dealing with some edema from the brain tumor. I'm being weaned from steroids. I have a follow up MRI on Feb. 7. We're all hoping that the tumor has shrunk( from radiation) and there are no new tumors and the edema has resolved. I'm worried about being on the steroida for so long and am hoping the MRI is an improvement from last one.
    The steroids are hard since I don't sleep well so I'm hoping theres good news next week.

    My right side still continues to improve from the stroke. I keep getting more feeling on that side and it makes me feel that I can keep improving. I use a cane now and walk as much as and still practice all mt OT and PT.

    I'm really trying to be positive about the trial. I feel that it could do some good things.

    I guess thats it for now. Thanks for reading and caring.

    Kellie( from Iowa)

    Cancer Sucks. I'm so not done kicking cancers ass! I have a lot of life left to live

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    speckles's picture
    Replies 13
    Last reply 2/1/2012 - 9:56pm

    I was diagnosed w/level 3 malignant spreading melanoma in 2009. I was told after the removal of tumor &lymph nodes, stadge lla it seems that the drs aren' t to concerned about follow up! Should I request pet scan or lab to see if anything is going on that I can't see? why do alot of people act like melanoma is no big deal?

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    Anonymous's picture
    Anonymous
    Replies 1
    Last reply 2/1/2012 - 9:49pm
    Replies by: jag

    We have been interviewed by a drug company because of our the response we have had to their drug for melanoma and they are using it in the news and inside their company for training, etc.  They have asked us to do further interviews with them for the media.  It was suggested to us by one of their crew to make sure that we were given something in return - this was not something we had thought of at all - more about providing hope to others and celebrating our miracle; however, would it be possible or "morally right" to maybe ask for assurance that we would have access to the treatment in the future of we needed it.

    Thanks for your opinions.

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    Ali's picture
    Replies 14
    Last reply 2/1/2012 - 5:47pm

    I was diagnosed stage IIIB in 2007, did interferon for 9 months.   Last February found 2 subQs, surgical removal and watch and wait.  Scans came back today (my 33rd birthday) showing mets in hip bones, femur,  liver, and a subq in the thigh.

    I see my oncologist tomorrow.  I want to be prepared to discuss treatment options.  What trial do we think is having the best response rate?  It seems like I remember (I was on this board a lot a year ago) it was the one at NIH with the T-cell transfer and whole body radiation.  Is this still the case?  What other trials are going on right now with promising results?  I am willing to go anywhere.  I do wonder how long it would take to get started on a trial that is out of state.  I called MD Anderson with my first recurrence and I couldn't even get in for an appointment for 2 weeks.  Is that pretty standard?

    Of the mediacations we have available (IPI, IL-2, Zelboraf) what would a young, healthy (well) mother of three (read-desperate for a cure) want to try first?  I know the IPI sometimes takes a long to time to work, so maybe I should start there so I can give it time.  It seems like lots of trials have a requirement that you don't have an auto immune disease, and would the IPI maybe give me one of those and disqualify me for something down the road?   I am strong now, maybe I should do biochemo while feel good?  I do have the braf mutation, but I am thinking that would be the last, unless for some reason I need to shrink the tumors. 

    Any thoughts?

    Thank you so much.  I am so glad I have somewhere I can talk to people who have been through this and are well read on the latest treatments.

    Ali

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    Replies by: cltml, MeNDave

    Hi,

    I am a Zelboraf/Braf dropout due to scans showing growth,  and now moving to Ippi.  I am waiting for insurance to approve ippi and I will hopefully start next week. 

    One of the areas of growth for me is the lower part of my left lung which is starting to close up.  My oncologist mentioned while I waited for ippi to work (fingers crossed  it does work)  I could have laser or stint done to open airway making it easier to breath.    I wondered if anyone had either laser or stint done and if so did they have any problems with it? 

    Thank you

    laurie from maine

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    Okay here goes....Diaganosed with atypical nodular non-pigmented Melanoma on 1/13/12.  Surgery a week later with SNB, week later path came back negative.  Original in office shave biopsy showed depth of 1.85mm, however in the scope it looked to be very active at the bottom of the shave.  So assumed I would probably move to Stage II.  However the good news is the SNB came back negative and the excision showed no sign of the Melanoma, so due to depth I went back to Stage Ib.  Now my head is still spinning with the wait and see attitude that everything is telling me, diligent skin exams and regular checkups.  Is this it, after reading some posts I feel I have cheated and no big deal, but there is still a strong chance this thing will resurface elsewhere.  Just curious of other experiences and suggestions.  Even different health care professionals have different suggestions.  I really feel kind of crummy for asking due to many others who are fighting this disease much harder than I am.  However I know they are the ones with experience with it so I feel I have to ask, best to all and an advance thank you for any reply.

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    Replies by: LynnLuc

    Hi,

    I'm one ofe the last ones still on BRIM 3 in Sweden. The effect of Vemurafenib does not last forever and I am thinking about the next step. Does any of you have experience to share about PV-10, PD1, Ipi, PI3K plus MEK, TIL, OncoVex or something else?

    Thank you!

    /Marie

    ##Fuck Cancer!##

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    zaccarin's picture
    Replies 1
    Last reply 1/31/2012 - 10:13pm
    Replies by: jag

    IArticle title: "Complete Remission of Brain Metastases in three Patients with Stage IV Melanoma Treated with BOLD and G-CSF

    http://jjco.oxfordjournals.org/content/35/9/507.full

    The above journal article, based on the work of Italian researchers, reports a successful treatment for brain mets. I am posting it because perhaps some of you might wish to discuss it with doctors. I hope this can help someone.

    Complete Remission of Brain Metastases in Three Patients with Stage IV Melanoma Treated with BOLD and G-CSF

    1. Ugo Bottoni1,
    2. Paola Bonaccorsi2,
    3. Valeria Devirgiliis2,
    4. Vincenzo Panasiti2,
    5. Riccardo Giovanni Borroni2,
    6. Guido Trasimeni3,
    7. Rita Clerico2 and
    8. Stefano Calvieri2

    + Author Affiliations


    1. 1Department of Dermatology, University of Catanzaro, Magna Graecia, 2Department of Dermatology, University of Rome, La Sapienza and 3Department of Radiology, General Medicine I, University of Rome, La Sapienza, Italy
    1. For reprints and all correspondence: Ugo Bottoni, Department of Dermatology, University of Catanzaro, Magna Graecia, Via Sinopoli, 9, 88100 Catanzaro, Italy. E-mail: ugobottoni@unicz.it
    • Received April 13, 2005.

    Abstract

     

    Methods: Accidentally, we observed a complete response (CR) in a patient undergoing chemotherapy with bleomycin, vincristine or Oncovin, CCNU or lomustine, dacarbazine (BOLD) regimen for metastatic melanoma including brain metastases, who was also treated with G-CSF to manage a concomitant leukopenia. After this observation, seven more patients with stage IV melanoma with brain metastases were treated with BOLD regimen repeated every 6 weeks with administration of G-CSF in the intervals.

    Results: Three patients presented CR (37.5%). Two patients stopped the treatment after two courses for evident progressive disease (25%). The other three patients showed stable disease (SD: 37.5%). Median duration of SD was 24 weeks. Among the eight patients, six (75%) achieved clinical benefit. Median time to progression was 8.5 months (range 0–74+ months). Median survival was 12.5 months (range 4–74+ months). Two patients are still alive and disease-free after 74 and 57 months, respectively.

    Conclusion: We believe that the brilliant CR, the long duration of the disease-free intervals and the long survival in at least three of eight patients should encourage further research on BOLD with G-CSF for the treatment of advanced melanoma.

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    bruski1959's picture
    Replies 9
    Last reply 1/31/2012 - 7:23pm

    Jackie is scheduled for her first melanoma treatment with Yervoy on Friday morning at St. Catherine's Cancer Center. This is of course dependent on the Yervoy being shipped to the cancer center. The oncologist office called yesterday afternoon and said they had spoken with the pharmacist at the speciality pharrmacy and that the Yervoy was in the process of being ordered and shipped. We will get a call if it looks like the Yervoy will not be there tomorrow. We could reschedule to later Friday or Saturday. Otherwise it would need to be the week after next, as I am commuting to Schaumburg next week for a class for work. They want me to be there with Jackie the first treatment and they don't want her to drive after the first treatment until they know how she will react to the Yervoy. The first visit will take 2.5-3 hours, as they will be taking a picture of her port. Also they will give her some preventative medication prior to giving her the Yervoy, which is apparently standard practice for cancer treatment infusions. Its been over 2 months since Jackie's melanoma advanced to stage 4, and we think its important to get the treatment started, as we have seen the melanoma continue to spread. Jackie seems to be doing okay with the port, just having some minor discomfort which seems to be diminishing with time, and she takes pain medication if necessary. Please continue to pray for us, as we enter into this treatment phase. Please pray that Jackie can tolerate the side effects, that the medications we have to treat any side effects make the side effects manageable, and that the Yervoy shrinks the melanoma tumors!

    Thanks :)

    Bruce and Jackie

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