Today we met with Dave's local oncologist. The doctor had reviewed the results of Dave's lymphadenectomy at MD Anderson, and had talked to Chad, therefore was aware of the finding of melanoma in one of the lymph nodes. He spent quite a bit of time talking about options, but was quite clear he was supportive of Dave's relationship with the doctors at MD Anderson. In fact, he was very interested in what recommendations they were going to give Dave. We are grateful he is supportive and not at all put off by the fact we are consulting doctors in another cancer facility.
He said it was possible but not probable that with the removal of the cancerous lymph node, all the melanoma was removed. A PET scan may not pick up on a tumor until it is about the size of a pea, so although Dave had a negative PET scan, there is no way of knowing if there are more melanoma cells floating around that have not yet developed into a pea-sized lesion.
Bottom line: his recommendation for treatment would be radiation and chemo (interferon) which would last 12-18 months. He was careful to give us several caveats, including the fact that metastatic melanoma is not curable, radiation will not be able to kill any cells that aren't in the target area, and interferon is generally recognized to lower the risk of recurrence by only 5 "to maybe" 10%.
There is a question of whether the discovery of melanoma in Dave's lymph node, and only his lymph node, technically qualifies him as having metastatic melanoma. Whether or not he has metastatic melanoma can make a difference in qualifying for clinical trials. Dave has not been eager to participate in the one clinical trial for patients with non-metastatic cancer, but he may be interested in one for patients with metastatic melanoma that has been getting good results. That trial is not being conducted in Savannah, however.
Now we have our local oncologist's recommendations, and we will know what MD Anderson has to say early next week.
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