Sunday, November 11, 2012

Update and a New Blog

It's been over a year and a half since I last posted. In March of 2011, I had a PET Scan that had my oncologist question that spot deep in my chest, plus one in my right armpit. She ordered a needle biopsy of the armpit lymph node which ended up being too small to determine anything. Determined, in April, she sent me to a surgeon who did a lot of breast surgeries and was quite experienced with associated lymph nodes. That surgeon said that she wouldn't have even ordered the needle biopsy because it was so small that there was a good chance that the PET result was a false positive. By my next oncology appointment, that armpit was clear - the spot miraculously disappeared, and there was no change in the tiny spot deep in my chest.

I changed dermatology practices, and kept up with 6-month oncology scans and appointments with no changes until this past summer. I was at my family doctor when I pointed out two hard bumps in my upper leg. He said that they were calcified bug bites. I questioned him because of the bumps being on the same leg in which I had the melanoma, but he wasn't concerned. I visited him again because of a surface clot in my lower right leg that was causing some discomfort, and pointed out a tiny dot I had been checking daily because it looked suspicious (not like the other freckles I have). He didn't like the dot either, and did a punch biopsy. It only required one stitch to close. Well, that came back as something that couldn't be ruled out as melanoma, but wasn't clearly determined.

In consultation with my dermatologist and my husband, I decided to change from the Lancaster Cancer Center to the Hershey Medical Center's Cancer Institute. It was a tough decision, but I liked the idea of having a skin group (dermatologist, surgeon, oncologist) in one place who consulted regularly, and the location was so much more convenient to work and home. It was difficult to leave the Lancaster Cancer Center because I received great care there.

My dermatologist made me an appointment with the surgery oncologist in his practice. By that visit, I had grown a few more bumps like the two "bug bites" I had discovered mid-summer. The surgeon scheduled a biopsy and took out three of the bumps with the punch tool. They were all positive for melanoma. It was back. I had a CT scan, PET scan, brain MRI (noisy!), and blood work done.

My visit with my new oncologist confirmed the return of the melanoma. It is in transit metastases, which is the "spread of melanoma along lymphatic vessels in the skin which forms nodules either in the skin or under the skin away from the primary melanoma site" (http://www.uphs.upenn.edu/surgery/Clinical/EOS/isolated_limb_perfusion.html). He recommended an isolated limb perfusion (ILP) which should then be followed by a year-long immunology treatment. So, the ILP will be performed at the University of Pennsylvania on November 15th.

Once again, I have not been able to find personal experiences of an ILP except for one performed on an arm (http://chapple.freeshell.org/ilp/). So, I am going to begin a new blog to journal my experience of this procedure in the hopes that it helps others about to undergo it. Feel free to follow me along in my new space at http://isolatedlimbperfusion.wordpress.com/.