Treatment

After my first surgery I was given an option to start a treatment which would help prevent recurrence. Given my situation and outlook, we decided against it and worked more on maintaining a good level of health. It was my choice, which my doctors more or less agreed with me on. They could have gone one way or the other, because I was right on the border. After the cancer returned, they were a bit more adamant about my treatment options.

Adjuvant therapy: treatment which is given in addition to an initial treatment, usually after a surgical procedure. The most commonly used adjuvant therapy is radiation, used after surgery to kill off any remaining cancer cells that might have been missed during the operation, or spread beyond the original site. Melanoma is a bastard in this aspect, because both radiation and chemotherapy seem to have little impact on it. This led melanoma to be a big hassle in the field of cancer research and usually a death sentence in people who had a spread of the disease.

The good news is in the past few years, new treatments have been manufactured to help combat melanoma in different ways. The treatments work in conjunction with your body's own immune system to help fight the cancer, instead of using harmful radiation techniques or toxic chemicals. This new immunotherapy (sometimes called biotherapy) is the cusp of a new frontier in helping to fight cancer. Also, because the treatments use your bodies biological defenses, side effects can often be minimal or easily treated.

In my case, my oncologist suggested a drug called interferon alfa-2b. Interferons are proteins naturally produced by the body which are the result of an immune system reaction, normally caused by viruses attacking cells. Cancer works as a way to get around this system so the immune system will leave it alone. The drug acts as a way to introduce these proteins into the body, to "wake up" your immune system and cause it to fight the cancer.

In my case, I was left with "no trace" of cancer, so the treatment would be used as a precautionary measure in the chance I might have some cancer cells left. If my body responded well to the treatment, the hope would be any remaining melanoma cells would be killed off, leaving me effectively cancer free.

Our choice was to go with a drug called Sylatron, which is the brand name for peginterferon alfa-2b. The difference between the two was how they are taken, as well as how they interact with the body. Sylatron is a pegylated form of the interferon, which causes it to be absorbed more slowly by the body. This meant doses could be limited to once per week instead of three times a week. The bonus is the the side effects will be more subdued, but over a longer period of time due to it's dispersal rate.

The most common side effects are fatigue and flu like symptoms, which makes sense because your body is reacting as if it's fighting something off. There are other serious, but rare, side effects as well. I would need to take an injection once per week, for as long as I could handle it (up to five years).

So how did I do? On a full dose, my blood tests showed a decrease in my white blood cell count, most notably my neutrophils. This would make me highly susceptible to an infection, so I was taken off while my body replenished and then reduced to a lower dosage. As for the side effects, I was fortunate enough to not suffer anything severe. Most of the time, I just felt tired. I'd even sleep much longer than normal, sometimes up to 10 hours and still feel lethargic. I didn't get flu like symptoms very often. Usually the worst it would get is some joint pain and muscle aches, which could easily be combated with a Tylenol and a good nap. My only wish is everyone could be affected the same way. I'd even go as far to say the worst part about the whole ordeal was actually having to do the injection itself, because needles are no fun.

While taking my injections, I would still need to get periodic blood tests done to make sure my levels were within reasonable limits. I was also put on a twice per year PET scan schedule in case the treatment didn't work and my cancer returned. As it turned out, this was for a good reason.