Father With Metastatic Melanoma

My father was diagnosed in August. He had six lymph nodes under his right arm that tested positive. The largest was 7 cm. He opted to do nothing after the surgery. He went for his PET at the end of November. They found three more tumors under his collarbone. They are recommending radiation, but he is not sure he wants to deal with side effects. He would like to get into a clinical study, and is pursuing that avenue. His surgery was today, so even if he is a candidate, he won't be ready to start any trials for several weeks. I have read all I can get my hands on attempting to determine a reasonable prognosis. As far as I know, the melanoma has not spread to any organs. They were not able to identify the primary site, and his is Amelanotic. Any words of wisdom?

sounds like stage III which has a 30-40% 5 yr survival rate.  What about interferon?  Not great results, but its the standard.

 

On 12/13/2006 Oncrx wrote:

sounds like stage III which has a 30-40% 5 yr survival rate.  What about interferon?  Not great results, but its the standard.

He won't take interferon because of the side effects. His melanoma came back in three months, and his doctors said stage iv after the initial labs. could they have been wrong?

stage 4 implies distant mets.  I thought you said he didnt have mets.  How old is your dad?  He doesnt seem to want treatment because of side effects.  Does he understand the severity of his illness?

 

On 12/13/2006 Oncrx wrote:

stage 4 implies distant mets.  I thought you said he didnt have mets.  How old is your dad?  He doesnt seem to want treatment because of side effects.  Does he understand the severity of his illness?

 

My dad is 78. He came out of prostate cancer treatment in March. I'm not sure he does fully understand the severity. Everything that I've read indicates that melanoma is resistant to any treatment. Interfuron appears to extend disease free time, but not life expectancy. I haven't seen any documentation to dispute that. I asked the oncologist about the fact that the cancer hasn't metastisized further than a secondary lymphatic system, but they said that because of the node involvement, the inability to find the primary site and the tumor under the collarbone initially that it was stage iv.

 

well,  he's been through a lot.  I cant say I disagree with him.  At 78, he's had a pretty long life.  I would say you are right about the interferon.  No increase in survival and lots of side effects. 

 

On 12/13/2006 Oncrx wrote:

 

well,  he's been through a lot.  I cant say I disagree with him.  At 78, he's had a pretty long life.  I would say you are right about the interferon.  No increase in survival and lots of side effects. 

Do you have any experience with what his olife expectancy might be?

with no treatment, I would say 6-12 months.

 

On 12/14/2006 Oncrx wrote:

with no treatment, I would say 6-12 months.

further update: his surgeon has somehow conveyed to him that she 'got it all' even though the lab report states they removed 4 nodes, 1 fully  replaced with cancer. Lab report follows:

"MICROSCOPIC DESCRIPTION: - Sections from the
> right intraclavicular contents reveal four lymph
> nodes.  Three of these show NO EVIDENCE OF TUMOR.  
>   "The largest of the four nodes is completely
> replaced by a metastatic tumor.  This tumor is
> composed of pleomorphoric dyscohesive cells which
> have large hyperchromatic irregular nuclei.
> Numerous areas of necrosis are present within the
> metastatic tumor.  This tumor is histologically
> cosistent with metastatic melanoma."

My father considers this a 'miracle'. The PET showed three cancerous nodes. The surgeon only 'got' one of them. She told my Dad that the PET was wrong. He wants to believe, so he does. I don't know how to advise him, or if I should. I don't think he will have much time.

My father just passed from Melanoma. It's so very hard to distinguish the different recommendations that you will receive. I will just tell you what we were told. Mass General in boston doesn't believe in the IL2 treatement, they think what you go through is not worth the short time it alots. UVA was for the IL2 and said it had the best success. My father was willing to try it, but as you know everything is a waiting game and by the time we were ready to start, they discovered it in his brain. Once it is in the brain, IL2 is no longer an options. So if it something you are considering I would act fast. We would up utilizing the gamma knife and full brain radiation. If that is a path you one day encounter, it was worth the couple of months where my dad's balance did return and his seizures did diminish. I would suggest with all the different opinions you will get. Find a doctor that your father  trusts and invest yourself there, because there will always be differing opinions.