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When Melanoma Metastasizes
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It was bad enough to
hear that the spot on my back was a melanoma but it really knocked the
wind out of my sails when 3 years after the original diagnosis, a
periodic CT (cat scan) identified a growth in my left lung. The growth,
prior to surgery, could have been the melanoma, a slight chance of being
lung cancer, or potentially the squamous cell cancer that had manifested on the base of
my tongue.
The truth is, melanomas, once they
start spreading can pop up in a lot of places. As of this writing the
metasticized melanoma in my body has spread to:
-Both Lungs
-Small Intestine
-Brain
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Melanoma can spread
through your lymph system--we thought that would NOT be the case
due to the results of the sentinel node biopsy--or through the
blood. |
The
following explains how my medical team addressed the lung, intestinal,
and brain tumors.
Lung Wedge Resection
So, in June 2004 within 9
days of first detecting the growth, a team of thoracic surgeons at
Brigham & Women’s hospital in Boston performed a left lung wedge
resection. I showed no symptoms of this tumor. I was biking and kayaking
in addition to my normal activities each day.
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Really a pretty cool operation that can be
completed with just a single night stay in the hospital. In my
case, the tumor was a single pulmonary nodule of the left upper
lobe of my lung. The doctor performed a left-sided thoracoscopy
with thoracascopic wedge excision.
In simple terms, the surgeon made two slits
in between the ribs on the left side of my back. Into one of the slits he
inserted a camera to locate the tumor and monitor the operation that would
go on inside me. He looked around inside my lung with the camera
and, as expected from the CT, found a single 9-mm subpleural mass
in the pericardium.
Using special tweezers the surgeon grasped
the tumor to stretch it away from the clear tissue and to allow
a cutting stapler to separate and seal the incision. The nodule
was then placed in a baggie while still in my lung to prevent
any of the cancer cells from spreading as the tumor was removed.
They sewed me up and sent me to recovery.
The main surgical concern was that my lungs continued o function
well and I was discharged 24 hours later.
As for the can cancer, the nodule was
tested and confirmed that it was melanoma. Hey, at least we
didn’t have some other type of cancer that we would have to deal
with.
Recovery was quick. I was working out on
our stationery bike just 48 hours after being in surgery and had
one follow-up visit with the surgeon. |
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Intussesception
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Another routine scan at 11:30 AM on Jan 4,
2006 put me on the operating table at Brigham & Women’s at
5:30 that same day. The diagnosis was that I had developed an intussesception in my small intestine.
The normally functioning intestine will
smoothly contract and expand much as a a multi-part telescope
would move. However the presence of an expanded lymph node or a
tumor prevents the smooth telescoping of the intestine which
could lead to a blockage. That is why I ended up on the
operating table within 6 hours of diagnosis and then spent the
next 5 days recuperating in the hospital.
The surgeon removed roughly 2” of my small
intestine which included the melanoma and enough clear tissue to
ensure that the margins were clear. She also looked at the
surrounding areas to determine if there were any other growths
that had not been noted by the scans. |
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Brain Lesions
This was the third manifestation of my
metastasized melanoma and, perhaps the scariest. On February 22 I went
to Dana-Farber for my monthly check-up with my adult oncologist and
reported that I had mild, periodic headaches that came and went and
suggested that I thought an MRI of my brain was in order—the previous
MRI checking for spread of the melanoma to my brain had been in June
2005. On Sunday, February 26, 2006 I had the MRI at Brigham & Women’s.
When we first heard the diagnosis on Monday, February 27, 2006 we were
devastated and believed that I had little chance of living more than a
few months at best.
Within 2 hours our
oncologist had arranged for an appointment with a radiation oncologist
for Wednesday, March 1. At this appointment we learned of two treatments
that could possibly stop the growth of the existing lesions and minimize
the potential of other lesions forming from melanoma cells that were
“floating” around in my brain. The two techniques were:
→ Stereotacticradio Surgery- SRS
→ Whole Brain Radiation
Follow the links below to learn more about these two treatments.
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