May 19, 2016
As we move through the month of May, Melanoma awareness month, I find myself more keenly aware than ever of the importance of finding a cure.
My story began in April when I received a text from my Dad to "call him when I have the chance" quickly followed by a friend's text to "call ASAP." For those of you in the sandwich generation with aging parents and children you, are always on alert for a middle of the night emergency call. My dad has never been one for drama so I knew immediately with the second message that this was serious. I steeled myself for the call and dialed. Not one to mince words, Dad started the conversation with, "you know how years ago I had that melanoma removed, well it's back."
And so the journey began. He made the initial appointment to check on a small lump under his arm. This was determined to be a mass measuring 8cm at its greatest diameter. Then, after a series of biopsies, scans and numerous tests the oncologist confirmed that Dad had Stage IV metastatic melanoma.
Melanoma accounts for about 1% of all cancer diagnoses; however it is considered the most deadly of skin cancers. There has been a 200% increase in melanoma cases since 1973. This is the most rapid increase from any other cancer. According to the World Health Organization approximately 132,000 cases are diagnosed global each year.1
My dad is strong and stoic. Almost two decades previously when the initial melanoma was removed, doctors told him to get his affairs in order, as he likely had two years before it returned. Treatment for a recurrence at the time was not promising. Following surgical removal, radiation and chemotherapy were options but survival rates were low and treatment side effects could be grueling. It was those options Dad thought he was facing once again.
When I joined him last month to visit an oncology specialist, he had accepted his fate and was prepared to forgo a treatment that would dramatically impact the quality of his life and instead focus his energies on enjoying what time he had left. I had recently become aware of remarkable advances in the treatment of melanoma with immunotherapy through my work with Market Ready Rx. The oncologist offered the new treatment options providing Dad with hope that there was an alternative to radiation and chemotherapy. What a difference 17 years make!
During Immunotherapy, medication is administered that stimulates the patient's immune system so that it recognizes cancer cells and targets them for destruction. The body's immune system has "checkpoints" to control the cells that are involved with an immune response.2 T cells are a specific type of white blood cell that target and destroy infected cells or those that are cancerous.3 These T cells contain checkpoints called PD-1 and CTLA-4 proteins which restrain these immune cells from launching an immune response against normal cells.
In the last two years there have been great strides in drugs approved by the FDA to treat melanoma via immunotherapy. Pembrolizumab (Keytruda® Merck Sharp & Dohme Corp)4,5 , and nivolumab (OPDIVO® Bristol-Meyers Squibb)6 are both drugs that work by inhibiting the PD-1 protein allowing T cells to attack melanoma tumors. While ipilmumab (Yervoy® Bristol-Meyers Squibb)7 targets the CTLA-4 protein.
My dad has started a schedule of Keytruda infusions, which are administered every three weeks. After three months, doctors will review his progress to determine if treatment is working or if adjustments need to be made. In the meantime, the side effects have been minimal and he is going about his daily activities without too much inconvenience. He was even able to work in a local fishing trip. More importantly he is looking towards the future with added hope and optimism, as am I.
Christina Scalise is a Marketing Specialist with Market Ready Rx a boutique consulting agency focused on bringing personalized diagnostics to market.
 "Melanoma Stats, Facts, and Figures - AIM at Melanoma." Accessed May 12, 2016. https://www.aimatmelanoma.org/about-melanoma/melanoma-stats-facts-and-figures/.
 Immunotherapy for melanoma skin cancer. (n.d.). Retrieved May 13, 2016, from http://www.cancer.org/cancer/skincancer-melanoma/detailedguide/melanoma-skin-cancer-treating-immunotherapy >
 Beginners Guide to T cells. (n.d.). Retrieved May 18, 2016, from http://www.tcells.org/beginners/tcells/
 U.S. Food and Drug Administration. (n.d.). Retrieved May 19, 2016, fromhttp://www.fda.gov/Drugs/InformationOnDrugs/ApprovedDrugs/ucm478493.htm
U.S. Food and Drug Administration. (n.d.). Retrieved May 19, 2016, fromhttp://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm412802.htm
 U.S. Food and Drug Administration. (n.d.). Retrieved May 19, 2016, fromhttp://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm427716.htm
 U.S. Food and Drug Administration. (n.d.). Retrieved May 19, 2016, fromhttp://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm469944.htm