Saturday, December 1, 2007

12/01/2007 The results are back from Dr. Brown

The results are back from Dr. Brown and the growth on my shin was benign. It took a load off my mind.
Christmas is approaching very fast and I haven’t begun to shop yet. Dee and the kids went shopping on black Friday. I am not big on crowds, so I’ll shop sometime during the week. We started the Christmas baking and will trying out some new recipes. So look for the mailman this week.

Take care

Jimmy B.

Thursday, November 22, 2007

On this day we Give Thanks for what we have.

1) A Caring Family
2) Wonderful Friends
3) Memories that will last a life time.
4) A God that has given me more time to say Thanks.

Happy Thanks Giving

You Have given me strength in times of need.

Love, Jimmy B. and Family

Sunday, November 18, 2007

11/18/2007 Going to see Dr. Brown the Dermatologist

I have an appointment with Dr. Brown to check a spot on my right ankle. It has been there for qiute along time. I thought it was a scrape but it is now raised a little. I think it could be Basal carcinoma. So I am having it checked out on Tuesday the 20th of November at Strong "Wilmot Cancer Center". Hey you never know. Better safe than sorry.

Jimmy B.

P.S. Thanks Steve B. for the wonderful pics of the fishing trip this summer.

Thursday, November 15, 2007

Novel Treatment Approaches For Patients With Metastatic Melanoma (Page 5 of 5)

Anti-41-BB (CD137) agonistic antibody. Anti-41-BB (CD137) agonistic antibody has just entered clinical testing. Although no clinical data are available yet, there are strong preclinical justifications for its use in patients with melanoma.[34] This antibody is capable of augmenting antigen-specific T-cell responses, and its use with a peptide vaccine resulted in regression of established poorly immunogenic tumors in mice.[35] Of note, the combination of anti-CD137 and CTLA-4 appeared to decrease autoimmune side effects yet increase antitumor effects compared with either antibody alone.The recent explosion of knowledge on immune regulatory pathways and receptor-ligand pairs on T cells has facilitated several innovative phase 1/2 trials and the development of 2 antibodies in no less than 5 registration trials. Patients with metastatic melanoma have never before had access to as wide a variety of promising agents.
As you can see, they are making great in roads in finding a cure or just stabilizing the progression of the disease.

Jimmy B.

Wednesday, November 14, 2007

Novel Treatment Approaches For Patients With Metastatic Melanoma (Page 4 of 5)

New Immunomodulatory Agents in Development

Four types of new immunomodulatory agents are in development for use in patients with malignant melanoma, including STA-4783, a heat shock protein inducer; PD-1 antagonistic antibody; anti-41-BB (CD137) antagonistic antibody; and CD40 agonistic antibody.

Heat shock protein inducer.

STA-4783 is a novel agent that promotes natural killer cell activity and augments levels of heat shock protein 70.[28] It is active as a single agent and with a taxane in human xenografts in mice. In phase 1 studies, STA-4783 appeared to have little clinical activity in kidney cancer or melanoma. In a randomized phase 2 study[29] that included 84 patients, STA-4783 plus paclitaxel were administered weekly intravenously for 3 weeks on/1 week off until progression or dose-limiting toxicity. The primary study end point was PFS. An intent-to-treat analysis found that PFS was 112 days for the combination of STA-4783 plus paclitaxel vs 56 days for paclitaxel alone (P = .035). The RR was 15.1% in the combination group vs 3.6% for the paclitaxel group. Patients in the combination group had a 54% grade 3/4 adverse event rate, compared with 57% for the paclitaxel-alone group. STA-4783 is being studied further in a phase 3 randomized registration trial.

PD-1 antagonistic antibody.

PD-1, a member of the TNF super-family, is another inhibitory molecule present on T cells.[30] PD-1 is increased on activated T cells and can bind to the PDL-1 molecule present on macrophages and dendritic cells as well as many tumors. The PD-1/PDL-1 interaction appears to limit the immune response, acts as a down-modulatory influence on antigen-specific immunity, and may represent a means by which tumors actively suppress immunity.A human immunoglobulin G4 antibody has been prepared that binds to and abrogates the activity of PD-1. In vitro, it can significantly augment the proliferation and functional activity of activated T cells; it is active alone, with chemotherapy, or with CTLA-4 abrogating antibodies in different murine tumor models.[31] This antibody has been tested in a phase 1 trial and thus far has not resulted in any dose-limiting toxicities after single dosing.

CD40 agonistic antibody.

CD40 is a receptor expressed on a variety of immune cells, including B cells and antigen-presenting dendritic cells.[32] It is bound by CD40 ligand expressed on T cells and represents an important axis of stimulation for antigen-specific T cells. An agonistic CD40 antibody, CP-870893, has been tested in a phase 1 single-dosing study, predominantly in patients with melanoma, at doses ranging from 0.03 to 0.3 mg/kg.[33] The reported side effects consist of chills and fevers, with deep venous thrombus and headache being the dose-limiting toxicities. Among 29 patients in the trial, 4 of 15 (27%) with melanoma sustained a PR at day 43 after only 1 dose of CP-870893. All responders received the drug at a dose level of 0.2 mg/kg or above, suggesting a dose-response relationship. Multidose phase 2 trials are pending for this promising agent.

Novel Treatment Approaches For Patients With Metastatic Melanoma (Page 3 of 5)

Abrogation of CTLA-4 in patients produces side effects known as "immune-related adverse events" (IRAEs). IRAEs are auto-inflammatory and may represent a breaking of tolerance to self-antigens.[16,17] The most common IRAEs are rash, colitis, and hepatitis. Other types of inflammation -- hypophysitis, pancreatitis, and sarcoid -- are more rare. IRAEs appear to be associated with tumor regression in patients with renal cell cancer and metastatic melanoma,[12,17-19] and a similar phenomenon may be observed in patients with prostate cancer.[14] There also appears to be a correlation between IRAEs and prolonged time to relapse in patients with resected high-risk melanoma.[12,17-19] The kinetic onset of IRAEs is highly variable and is likely dependent both on peak dosing and area under the curve of the drug. Similarly, the timing of the onset of antitumor responses can be variable and may be prolonged for weeks after cessation of ipilimumab[20]
(J Weber, unpublished data, 2007).

If these immunomodulators and others like them -- CD40 agonistic antibody, anti-41-BB antibody, and programmed death (PD)-1 antibody, which are entering early-phase clinical testing -- are approved for cancer treatment, then understanding the kinetics of antitumor responses, their relationship to IRAEs, and how to manage and minimize IRAEs will take on great importance.

Ongoing and Completed Trials With Ipilimumab and Tremelimumab

Ipilimumab has been used as a monotherapy or in combination with other therapies including chemotherapy, vaccines, and cytokines. In an initial phase 1 trial,[21] 17 patients with malignant melanoma received a single intravenous dose of ipilimumab 3 mg/kg. The drug was well tolerated, and there was evidence of immunologic and antitumor activity. In another phase 1 trial, Hodi and colleagues[13] reported that a single dose of ipilimumab 3 mg/kg may have increased antitumor immunity and induced necrosis in biopsied tumors in patients with metastatic melanoma who were previously vaccinated. No serious adverse events were noted in the 7 patients who received ipilimumab in that trial.
Because of the known mechanism of action of ipilimumab and experience in murine models, an important goal has been its evaluation in combination with antitumor vaccination. Attia and colleagues[12] reported that ipilimumab (3 mg/kg every 3 weeks or a 3-mg/kg initial dose followed by 1 mg/kg every 3 weeks) plus a peptide vaccine resulted in 2 complete responses (CRs) and 5 partial responses (PRs) among 56 patients with previously treated and progressive stage IV melanoma. The CRs were ongoing at 30 and 31 months, and 3 of the PRs continued at 25, 26, and 34 months. The remaining 2 PRs lasted for 4 and 6 months.

A trial is ongoing with ipilimumab plus a multipeptide vaccine in the adjuvant setting,[20] which includes patients with resected stage IIIC/IV melanoma and no evidence of disease. After a median follow-up of 12 months, 6 of 25 (24%) treated patients had relapsed. Patients who relapsed were managed either surgically or with biochemotherapy, and all were alive at the time of the report. Subsequently, 4 patients have died at a median follow-up of more than 2 years, but 19 are still free of disease. Time to progression is associated with development of IRAEs (J Weber et al, unpublished data, 2007).

Ipilimumab has also been administered in combination with cytokines. Maker and colleagues[22] reported data from a trial of ipilimumab 0.1-3 mg/kg every 3 weeks with IL-2 in 36 patients with advanced melanoma. Three patients (8%) sustained a CR and 5 (14%) had PRs, yielding an overall objective RR of 22%. Responses occurred in 1 of each of 3 patients treated with ipilimumab at 0.3, 1, and 2 mg/kg, and in 5 of 24 patients treated at 3 mg/kg. Six of the 8 responders had ongoing responses at follow-up periods of between 11 and 19 months.

Novel Treatment Approaches For Patients With Metastatic Melanoma (Page 2 of 5)

A method to my Madness

As you can see from above I tried Interferon, dacarbazine (DTIC), Then a novel new agent called CTLA-4, and then onto IL-2 (Interlukin-2).

The use of a combination of IL-2, other immunotherapy agents, and chemotherapy, known as biochemotherapy, has been shown to result in high response rates (RRs) in patients with stage IV melanoma, but long-term survival without recurrence occurs in less than 10% of patients.[7] Biochemotherapy has not been shown to prolong survival beyond that seen with chemotherapy alone, which has averaged only 7 to 8 months. Therefore, a reasonable consensus is that patients with unresectable stages III and IV melanoma should be referred to a clinical trial as the first treatment for metastatic disease. More than ever before, those patients have access to a broad variety of agents --both targeted biologic drugs and immunotherapy compounds -- that have shown promise in treating unresectable disease.
The landscape for the development of new drugs for the treatment of patients with metastatic and resected high-risk melanoma is more promising than at any time in recent memory. The understanding of signaling pathways at the biochemical and molecular level and the identification of new immunoregulatory receptor-ligand pairs associated with outcome in patients with metastatic melanoma are paving the way for new drug development. A number of novel targeted and biologic agents (see below) are showing promise. A new biologic agent, as well as 2 new immunotherapeutic drugs now in registration trials, have the potential to be the first agents approved by the FDA for use in patients with stage IV melanoma in over a decade.
Potential New Agents for the Treatment of Melanoma
Human Antibodies Directed Against Immune Regulatory Molecules
Human antibodies directed against immune regulatory molecules such as cytotoxic T-lymphocyte antigen-4 (CTLA-4) induce tumor regression and improve long-term survival in tumor-bearing mice. Early clinical studies in patients with melanoma have shown that disease stabilization and prolonged survival can be achieved by manipulation of the immune system.[8,9] CTLA-4 antibodies are currently being tested in phase 2/3 trials in melanoma and phase 1/2 trials in other tumor types. Currently, 2 human antibodies are in clinical testing: ipilimumab (MDX-010) and tremelimumab (CP-675206). Although the 2 agents have similar pharmacokinetic properties, tremelimumab has a 3-week half-life, which is slightly longer than that of ipilimumab.
As you can see, Dr. Kirkwood and I wanted to induce tumor regression by using my own immune system. If we could get my immune system to recognize the tumors as foreign, then we might have a fighting chance. So we decide to try the CTLA-4 Therapy,
Antitumor response with prolonged time to progression has been seen in patients with melanoma who have received either of the CTLA-4 antibodies,[10,11] and durable antitumor responses have been observed with ipilimumab in patients with melanoma,[12] ovarian cancer,[13] prostate cancer,[14] and renal cell carcinoma.[15] Of note, antitumor responses may be characterized by short-term progression followed by delayed regression.
An important, possibly unique, clinical characteristic of anti-CTLA-4 antibodies is that the duration of clinical response -- and even stable disease -- is often quite prolonged.

Novel Treatment Approaches For Patients With Metastatic Melanoma (Page 1 of 5)

A method to my Madness

* When I first started out trying to figure out what therapies I should try, Dee and I worked with Dr Kirkwood and developed a plan of attack (a flow diagram). We put together if and than statements to create a path forward. Coming from a research environment, this made the most practical sense.
So here is my path.

* Most of information was taken from an article written by Adil I. Daud, MDJeffrey S. Weber, MD, PhD entitled:

* “Novel Treatment Approaches For Patients With Metastatic Melanoma”

* Release Date: August 30, 2007


According to the American Academy of Dermatology, an estimated 108,230 new cases of melanoma will be diagnosed in the United States in 2007, including 48,290 in situ and 59,940 invasive cases.[1] Invasive melanoma is the fifth most common cancer in men and women. About 8000 deaths from melanoma are expected in 2007 in the United States.[1]

Melanoma is a cancer of the melanocyte, a long-lived pigment-producing cell normally found at the dermo-epidermal junction within the skin. During the process of transformation of melanocytes to melanoma, histologic and clinical changes occur.[2] The initial stage of transformation can result in an atypical or dysplastic nevus. The next stage is the so-called epidermal radial growth phase (RGP) melanoma, which involves proliferation of the transformed melanocytes in the epidermis. This is followed by an invasive RGP melanoma wherein the tumor cells invade the dermis. In the next phase, the vertical growth phase, melanocytes proliferate in the dermis and are competent for metastatic invasion. Finally, the metastatic phase is characterized by invasion of lymph nodes and distant organs.

Based on a rigorous statistical analysis of a large sample of patients with melanoma, the American Joint Committee on Cancer proposed revised staging guidelines in 2002. These guidelines are useful for clinical management of patients and for analyzing clinical trial data discussed in this review.[3,4]

Stages I and II are melanomas that are localized to the skin, at varying depths of invasion:

stage III includes patients with regional recurrence and nodal spread of disease, and stage IV patients have distant metastatic spread of melanoma.

Currently, 3 drugs are approved for the treatment of metastatic melanoma:

dacarbazine (DTIC), hydroxyurea, and interleukin-2 (IL-2).

None has ever been tested in a randomized phase 3 trial against a control and been shown to prolong survival. DTIC and hydroxyurea were approved by the US Food and Drug Administration (FDA) more than 20 years ago and would be unlikely to meet current standards for FDA approval. The only approved immunotherapy for melanoma, IL-2,[5] is a toxic agent employed in a complex regimen used by a restricted number of centers in the United States today. Practice guidelines promulgated by organizations such as the National Comprehensive Cancer Network (NCCN) indicate that entry into a clinical trial is an acceptable standard of care for patients with newly diagnosed stage IV melanoma.[6] In fact, the NCCN decision tree for patients with stage IV melanoma with multiple metastases indicates that a clinical trial is the first choice, followed by DTIC or IL-2; lower priority choices include DTIC with other agents in combination. For patients with a small volume of disease, a watch-and-wait plan is considered acceptable, an admission that the armamentarium of drugs for metastatic melanoma is deficient.

Tuesday, November 13, 2007

11/13/2007 Meeting with Dr. Kirkwood

Sorry it has taken so long for me to write. I've been catching up on bills and Health Insurance elections, and Voice your choice on Electricity elections.

If you Rochesterians need to compare suppliers for the cheapest KWHour for your electric needs, you can logon at

I am currently in a holding pattern to see if my immune system will continue to fight off the cancer by itself.

The tumors in my lungs have shrunk to the point that they are undetectable by CT scan. (Praise the Lord).

I still have some at my original site but I am hoping that they too will disappear.
I do have new spot on my ankle that looks like basal carcinoma. I am planning to have it looked at by Dr. Brown dermatologist/oncologist at Strong Hospital. I need to make sure I have a referral first so I don’t get stuck with the bill.

I would like to take this time again to thank everyone for their continuing support. Without you, I could not have survived. You have been the rocks of my seawall. Without you, I would have been swept away into the storm. Thanks for being there for me.
Jimmy B.

Monday, November 12, 2007

11/13/2007 Meeting with Dr. Kirkwood

Sorry it has taken so long for me to write. I've been catching up on bills and Health Insurance elections, and Voice your choice on Electricity elections.

If you Rochesterians need to compare suppliers for the cheapest KWHour for your electric needs, you can logon at

I am currently in a holding pattern to see if my immune system will continue to fight off the cancer by itself.

The tumors in my lungs have shrunk to the point that they are undetectable by CT scan. (Praise the Lord).

I still have some at my original site but I am hoping that they too will disappear.
I do have new spot on my ankle that looks like basal carcinoma. I am planning to have it looked at by Dr. Brown dermatologist/oncologist at Strong Hospital. I need to make sure I have a referral first so I don’t get stuck with the bill.

I would like to take this time again to thank everyone for their continuing support. Without you, I could not have survived. You have been the rocks of my seawall. Without you, I would have been swept away into the storm.

Thanks for being there for me.

Jimmy B.

Sunday, November 4, 2007

11/04/2007 We are off to Pittsburgh to see Dr. Kirkwood

Dee and I are on our way to the Hillman Cancer Center to see Dr. Kirkwood. We need to find out what the next step in the treatment. We will fill you in when we get the details.

Take care

Jimmy B.

Monday, October 29, 2007

10/29/07 Good News !!!!!!!

The CT scan Report came back with “NO SUSPICIOUS PULMONARY NODULES” From 40 + to ZERO Nodules.

That is unbelievable!!!!!!!

This is like winning another lease on life.

THEY ARE GONE!!!!!!!!!!!!!!!!

I am going down to Pittsburgh on November 5th to have a check up and to have a second reading of the Scans to be sure that they read it correctly.
I also will suggest a PET scan to see if there are any hot spots they have missed with the CT scan.
I do have a scab at the original site that bleeds off and on. I would like to know why it won’t heal.

I am not out of the woods yet… but I am on the right path.

Thanks for all your help and prayers.

Jimmy B.

Sunday, October 28, 2007

Melanoma Guide page # 4

Questions you may want answered during your MD visit before agreeing to any surgery or treatments are the following:

Do you (or your group) operate or manage a large number of melanoma patients?
Will you personally be managing my care or will I be followed by residents / fellows ? (Post-graduate MD’s in training)
If you do not have a large experience in melanoma patients, whom do you recommend (or what center) will you send me to?
Are there any alternative surgeries / medical treatments that could be considered besides the one you are offering or suggesting ? (i.e. – what is YOUR rationale for what you are doing)
Should I consider getting a 2nd opinion if the surgery / treatment is complex or controversial?

Possible Outcomes from 3rd Doctor Visit

Agreement on treatment and plan for YOUR therapy Go and have a really nice dinner – then “just do it!” Disagree on treatment and plan Ask about 2nd opinions Ask first from YOUR physician Other resources Other major melanoma centers (post your concerns)


This is not an all inclusive method for determining YOUR stage of melanoma or the ‘right’ treatment. However, this information is can be helpful for the newly diagnosed (“now what”) patient. The hope is that by giving the overwhelmed and frightened melanoma patient an approach to finding information about their disease and treatment options, they will become an empowered and active participant in their diagnosis and treatment.

Special thanks to Gertude Stein for this Summary.

Melanoma Guide Page # 3

Important Tip #2
Before starting any surgical or treatment plans (and ESPECIALLY in more advanced disease in which treatments maybe more controversial) – you need to understand your diagnosis and all the various options for your Stage of melanoma.

In other words, before you undergo ANY treatment, you need to do YOUR HOMEWORK and understand YOUR options before deciding with your physician (usually at a 3rd visit) what the plan for YOUR melanoma treatment will be.

Important Information You want to find answers to when doing YOUR Homework” prior to your 3rd (Treatment Phase) physician visit

What seems to be ‘consensus’ for YOUR stage of melanoma ?
Excision, sentinal node biopsy, lymph node removal, etc
What seems to be ‘controversial’ for YOUR stage of melanoma ?
No therapy, adjuvant therapy, radiation, bio-chemotherapy, etc
How do the major melanoma centers approach YOUR stage of disease ?
What is their ‘rationale’ for their suggested therapy
Are the only options for YOUR stage of melanoma ‘clinical trials’ ?

This may apply primarily to advanced stage patients who have already undergone surgery / therapies and are having recurrence of melanoma

Where to go to starting getting the information YOU need
Websites for Melanoma Information – National Comprehensive Cancer Network – National Cancer Website – NCI site – Melanoma Research Foundation – Melanoma Patient Information Page

This list does not represent an endorsement of any given website or a complete list of all available resources for melanoma patients

How to approach and organize the information YOU obtain

Make a list of the various treatment options for YOUR stage of melanoma
Compare / contrast how the large melanoma centers treat YOUR stage of disease
Look for consensus in their treatment options
Determine how the various treatment options could affect your life
(ie. Determine side effects of treatment, effect on family, work, lifestyle you are use to)
Make a ‘wish-list’ based on the information / decisions you have reviewed and made
YOUR ideal treatment plan (medical / surgical and length)
YOUR ideal place the treatment will take place
YOUR ideal follow up
YOUR ideal outcome

Prepare this and your list of Questions for your doctor and take to the appointment with you (follow Tip #1 as before too). As this appointment is to talk about YOUR treatment plan – warn your doctor that this will NOT be a short appointment (so they may want to make it the first or last appointment of their day!)

Melanoma Guide page # 2

Why do you need to know your melanoma Stage ?

It determines if you need a surgical approach to your melanoma
It determines if you need further testing during your surgery (sentinal node biopsy)
It determines if you will need adjuvant therapy after surgeryIt determines if surgery is not indicated and other therapies (gamma knife / bio-chemotherapy etc) is needed in the place of surgery

Important Tip #1
As it is most likely that you have been in some ‘shock’ given the discovery of melanoma, it is important to bring another person with you to take notes on what is said or suggested during this 2nd physician visit. These can then be reviewed after the visit.

Important 2nd Visit (Diagnosis Phase) Questions for your Physician
What is MY Stage of melanoma ? (and what does that mean)
Given my Stage of Melanoma, what are you recommending will my 1st treatment (or surgery ) be?
Will my surgery / medical treatment be done here or at another center?

Simplified Melanoma Staging / Treatment Plan ChartStages of Melanoma:
Stages of MelanomaTreatment Plan(s)

Stage O (in situ) ExcisionStage I(primary < 1mm) Excision (Some centers will doCXR +/- lab work)
Stage II (deeper invasion) Excision + SNB? * Adjuvant therapy
Stage III (LN involvement) * Excision? * No therapy? * Adjuvant therapy
Stage IV (Diffuse melanoma) * Depends on site(s) Involved? * Surgery vs. Biochemo,? * Radiation, gamma knife, etc

* Note that all the these therapies are somewhat controversial as to which is the “RIGHT” therapy for advanced stage melanoma patients.

Melanoma Guide page #1

Rules of Melanoma as a Disease

1. You have been given a diagnosis – NOT a death sentence

2. Melanoma survival statistics describe a ‘group’ of similar patients…. but they may have NOTHING to do with YOUR chance of survival

3. In advance Stage melanoma, there is NO one “RIGHT” answer (or “BEST” treatment) option for your melanoma

4. The BEST melanoma patient is an ACTIVE PARTICIPANT in his or her treatment (not a PASSIVE RECIPIENT)

"The ‘phases’ that most melanoma patients seem to go through (in this author’s opinion) are:
DISCOVERY, DIAGNOSIS and finally TREATMENT. These ‘phases’ very closely linked to physician visits when the information about melanoma diagnosis and treatment are shared with the patient. While superficial melanoma treatment is fairly straight forward, more advanced stages of melanoma (again in this author’s opinion) require more physician and patient interactions (“visits”) especially in the DIAGNOSIS and TREATMENT “phases”.

The following Question / Answer format will help you find the information you need about your diagnosis and treatment as well as provide you with links to important sites for more information on melanoma.

Important 1st Visit (Discovery Phase)
Questions to ask your Physician
Why do you think I have melanoma?
What is MY melanoma Stage ?
(Has it been determined?)
Do I need more tests to determine MY Stage ?
If I need more tests – what tests are they ?

Possible Tests that you may undergo:

CT Scan - looks for melanoma in abdomen (bowel + liver) and chest (lungs and lymph nodes)
PET Scan – looks for ‘metabolically active’ areas in the body which may be melanoma
MRI Scan – Used (primarily) to determine if the brain has any melanoma involvement
Bone Scan – uses radioactive material to find if any bone involvement with your melanoma
Blood Work – non-specific indicator that melanoma maybe involved in several organ systems
Sentinal Node Biopsy – looks for involvement of lymph nodes that melanoma may spread to from its primary siteUltrasound – use of sound waves to try to make a diagnosis of melanoma (usually in solid organs)

Simplified Staging Guide to Melanoma*

Stage 0
In situ melanoma
Stage I
No ulceration (<>Stage II > 4 mm depth (with or without ulceration)
Stage III- >Lymph node involvement
Stage IV- >Distant mets to skin, subcutaneous or lymph nodes; or mets to any visceral Organs (lung / liver / brain / bone / etc)

* American Joint Committee on Cancer Staging System for Cutaneous Melanoma J Clin Oncol 2001; 19:3548-3636. Lippincott Williams & Wilkins.

Friday, October 26, 2007

10/26/2007 My Reflections

What have I learned?
1. I needed a support group! I told all our friends and family about my situation. I wasn't looking for pity. I was looking for any assistance they might be able to give me, prayers, Internet, medical advice, tell me and my wife that we would be ok. Help if we ever needed any. You are our angels. And we have lots of them. Melanoma is not something you should hide under a basket. Tell the people that are important to you.

2. The Internet is FULL of treatment possibilities. It's important that you understand the medical jargon. Then you can begin to understand the treatments that are out there. There are a number of melanoma and NCI sites you should be following frequently. I'll be happy to share what I followed and picked up on.

3. It's important that you have an oncologist who sees you as a partner in finding and following a course of treatment. This is your life at stake. How you feel and what course of action you think is best for you is most important. If you do not have this kind of oncologist, have a heart-to-heart with him/her, be blunt and make your feelings known. If they cannot work this way - CHANGE ONCOLOGISTS! I did.

4. Select the program of treatment you feel is best for you and sail forth into it. Do not look back! You gotta believe in your plan.

5. At the same time, be on the lookout for a "Plan B." What will you do just in case Plan A doesn't work?

6. I can't say enough about being at peace within yourself. Our bodies are all one huge complicated organism. And all the parts communicate with one another. If one part is under duress, it affects the rest. I really believe my cancer was caused by me getting stressed out about work for a years, lowering the efficiency of my immune system. Whatever reduces your stress level - running, yoga, tai chi, reading, praying, listening to music - do it often. I'm not a doctor, but my experience tells me being at peace is critical to healing.

7. Last... Whatever you believe will happen to you... Probably will. If you believe you will die - you probably will. If you believe - I mean really believe - you will live. You have a good chance of living. This is not pie-in-the-sky believing. It's the hard-nosed belief that you have taken every step you can take and are ready to take others if necessary.
Melanoma is not for the faint of heart. You gotta want to live and do whatever is necessary to live to have a chance. And even that may not be enough...

What good have I gotten from melanoma?

What a crazy question! Good - from melanoma?

Every day is a fantastic gift. A day I didn't think I would get. I can get goose-bumps at a sunrise! Seeing my family grow - seeing my nephews, nieces, friends and family... I remember the days I never thought I'd see, these things. It colors, everything about the world. I'm a huggy sorta guy by nature. But getting and giving hugs is a gift of immeasurable worth to me now. Time is so precious to me.
No one ever promised me tomorrow... I guess I always knew that - but it didn't mean anything like it means now, with melanoma. All we have is today. If I really believe I have only today, how would I live it?

Jimmy B.

Monday, October 22, 2007

10/22/2007 MRI/CT scan coming up.

Wednesday I am slated for another scan. I'm hoping for the best. I been very fatigued this past month.It feels like I am trying to fight off a cold which I don’t have one. I am wondering if my immune system is working overtime trying to keep the cancer at bay. Time will tell. I should get the results early next week and I will surely share them with you. Please keep me in your prayers.I need all the help I can get. Thanks

Jimmy B.

Sunday, October 14, 2007

10/14/2007 The passing of a true friend.

I just got word that Bill Maher had passed away from Melanoma this passed week. We did not know each other well as we crossed paths while waiting to get CAT scans. We compared notes of our trials and tribulations while waiting to be seen. He left behind his wonderful wife, Amy and two daughters, Emily and Megan.
I ask you to prayer for Bill and his family, that their hurt turns into comfort knowing that Bill out of pain and in the Almighty Hands looking down on them. Bill was truly a family man and will be missed by all, but his memory will live forever.


Wednesday, September 5, 2007

From OncoLog, March 2007, Vol. 52, No. 3 Printer-friendly version

New Approaches for Advanced Melanomaby Sunni Hosemann

Dr. Elizabeth Grimm (l) and Dr. Patrick Hwu discuss new avenues in melanoma research.

When a melanoma is found early and properly removed, the outlook is excellent. In fact, patients with early-stage melanoma can have survival rates as high as 95%. But for patients with melanoma that has metastasized, the disease is more deadly: the survival rate for patients with metastatic melanomas involving a major organ is no more than 6%—evidence that today’s clinicians have a challenge in finding ways to better manage advanced forms of the disease.
Currently, only two FDA-approved drugs exist for the treatment of metastatic melanoma: dacarbazine and interleukin (IL)-2. Dacarbazine is a conventional cytotoxic chemotherapy agent. According to Kevin Kim, M.D., an assistant professor in the Department of Melanoma Medical Oncology at The University of Texas M. D. Anderson Cancer Center, the rate of response to dacarbazine in metastatic melanoma is only about 10%, and it rarely produces a durable response. And although combination regimens that include dacarbazine have been investigated, none have improved survival more than dacarbazine alone.
On the other hand, IL-2, which works by stimulating killer T-cells to attack melanoma, produces a response in 15% to 20% of patients; in 7% to 8% of patients, the response is durable.
“We can essentially cure some patients with advanced disease using IL-2, but only a small minority of patients have this remarkable response. We want to know why,” said Patrick Hwu, M.D., professor and chair of the Department of Melanoma Medical Oncology. Knowing ahead of treatment who is likely to respond to IL-2 would spare the majority of patients with advanced melanoma from undergoing a treatment that can be toxic and must be delivered in the ICU. “Beyond that,” said Dr. Hwu, “if we can understand how it’s working, perhaps we can convert non-responders into responders.”
Clearly, other treatments are also needed for those who are unlikely to respond to either of these two agents, both of which are toxic and costly. To that end, investigators are pursuing several promising avenues.

Wednesday, August 29, 2007

8/29/2007 The Trip to Pittsburgh (The Hillman Cancer Center)

I could not sleep the night before my trip to Pittsburgh. Things were racing through my head. Questions after question. “If I am stabilized, how long will it last? How can I get rid of my fatigue? Will I hit any road delays on the way down to the Center?. And so on. It was now 1:38 am and I was planning to get up at 3:00 am to be on the road by 3:30 am. I would do the trip solo again so Dee could bring home the bacon to support the “little ones” in college.

Well , I jumped into the shower at 2:45 am (first turned off the alarm so I would no wake Dee). I was right on time.

At 3:31 am I left the driveway and was on my way. The 292 mile trip went smoothly with no major road construction. I arrived an hour earlier (8:30 am) for my 9:30 appointment.I stopped by Joyce’s office to say hello. She gave me a big hug and asked how I was doing. I said, “fine”. We talked a little and then I excused myself to go to the outpatient receptionist to login.

They told me to have a seat until they could draw some blood. Since I was early there was no rush.They took some vials and then sent me to concourse D. The receptionist sent me to an examination room. This is where I would see Melissa, the physician Assistant to Dr. Kirkwood. She came in with a big smile and asked me how I was doing. I gave her the run down and then she proceeded to check me over. She was amazed that the tumor on my back had shrunk to a small scab with little height to it.
The course of action is to wait another 8 weeks and take another MRI and CT scan.They also wanted some more blood for research, so they took another 14 vials.
I left the center at 10:30 and I was back in Rochester around 3:30/4:00 pm.

That is it for now.

Jimmy B.

Thursday, August 23, 2007

8/23/07 Good News!!!!!!!

Over the last three months there has be no detectable growth in the tumors in my lungs.


Quote from the report:

1.) No evidence of disease progression
2.) No emerging lymphadenopathy
3.) No change or slight decrease in size of subcutaneous nodules
4.) No change or slight decrease in subcentimeter right lung nodules

I am schedule to go down to the Hillman Cancer Center on August 29, 2007.
Melissa Demark also said that they are filing a protocol procedure based on my therapy sequence. It seems that they had another patient follow it and had similar results.
That is it for now.

Time to celebrate the small victories.

Keep in touch
Jimmy B.

Tuesday, August 14, 2007

8/14/07 CT and MRI scheduled!!!!!!!!!!!!!

Well it has been a long couple of months off. Dee and I took a short vacation to the shore to see my family. It was great to see everyone!!!!!! The kids have grown like wild flowers. Chris came along to get some R & R. He ended up catching a giant stripe bass in the inlet and it gave him the fight of his life.
We had quite a few get- togethers while we were there.
Well anyway, I ‘m scheduled this Friday to have a CT and MRI done. I hope everything looks good.
Jess and Chris start college in 2 weeks and we become empty nesters for a while. Where has the time gone to?

Take care and we will post the news as it happens.

Jimmy B.

Tuesday, May 22, 2007

5/22/07 Good News!!!!!!

Good News!!!!!!

The scans show that the tumors have stayed the same size over the last two months. Everything is “Status Quo”. No new ones have developed. Dr. Kirkwood wants to stand down any new therapy at this time. I should get the official word some time soon. It looks like I might have most of the summer off. I will take this time to visit friends and family.

Thanks for all your continuing support.

Take care,
Jimmy B.

Monday, May 14, 2007

5/14/07 CT/MRI scans Scheduled!!!!!!

I am going in for more scans on May 17 2:15 pm. All I can hope for is that the tumors continued to shrink. I should get the results by the following Monday. All is well at the B’s house. Jessica came home from college and Chris is finishing up AP exams. It is nice to have a full house again.

Family is # 1.

Take care and I will see ya on the other side of the scans.

Jimmy B.

Thursday, April 19, 2007

Thanks for the Birthday Luncheon!!!!!

It was great to see everyone at the luncheon. I miss you guys. I am still not used to having so much time on my hands, but I seem to fill it in somehow. Dee, keeps adding to my honey to do list so I am never out of things to do.
Thanks again

Take care
Jimmy B.

Thursday, April 5, 2007

4/02/07 Saw Dr. Brown about the Lesion.

Sorry it took so long to update. Dr. Brown took a look at the suspicious spot on my back and determined that it was a scab from the lesion. It was not raised, so he was not so concerned. I did tell him that it bleeds once in a while and I do get a deep pain in the area every so often. It could be that my immune system is still fighting the cancer. We won’t know that until I have another CT scan at the end of April.

I have my fingers crossed!!!!!!
Until then, take careJimmy B.

Wednesday, March 28, 2007

/28/2007 A suspicious Lesion on the Trunk of my Back

A couple of days ago, Dee noticed a spot on my back and asked me if I had been picking at it. I said “No!!!” it is reddish in color and looks like an open scab. So, here we go again. I called the Dermatologist, Marc Brown, and will be seen Monday April 2. I’ll let you know if it is the big C has returned.That is it for now.

Jimmy B.

Tuesday, March 6, 2007

3/6/2007 Why Interlukin-2 Therapy is so important to me

“Interleukin-2 (IL-2) — IL-2 is a form of immunotherapy. It has been found to help some patients with metastatic melanoma when given in high doses. Although significant benefit is seen only in a minority of patients, long-term follow-up of patients treated in early high-dose IL-2 trials confirms that this benefit can be long-lasting. As an example, in an analysis of 270 patients treated in all trials involving high-dose IL-2 conducted between 1985 and 1993 and subsequently updated with follow-up through December 1998, 16 percent (about one in six) of all treated patients had a shrinkage in the size of their tumors with treatment, and the average duration of benefit was about nine months [2,3]. However, sixty percent of those who achieved a complete response (that is, no remaining tumor was evident after IL-2 treatment) remained progression-free at seven years. In addition, no patient responding for longer than 30 months had progression of their melanoma, suggesting that some patients may actually be "cured".These encouraging results, though limited to a minority of patients, led to the approval of high dose IL-2 for patients with metastatic melanoma. However, because high dose IL-2 can produce serious and toxic side effects, it is generally reserved for patients who are otherwise healthy (with good heart and lung function) are treated in centers that specialize in its use.”

Take Care
Jimmy B.

3/06/2007 Update: Response from Pittsburgh!

Just wanted you to know that we shared the good news of your CT scans with Dr. Kirkwood. He was equally excited as well. He wants you to have repeat CT scans in 2 months and return to see us at that time. Given the cardiac events that you encountered during and after your last admission, he does not want to do more IL-2 at this time.

Hope you are having a great week!
Take care,Heather
So it looks like I have 2 months off for good behavior. I would rather be continuing some sort of treatment. Be a little bit more proactive. But, He is the expert.

Take care
Jimmy B.

Sunday, March 4, 2007

3/2/2007 Good News!!!!!!!

I got good news late Friday afternoon. I got a call from Heather Blair. She had gotten the results from the CT Scan and the MRI. The decease is regressing. The 40 + nodules in my lungs have decreased to 2. And the other ones on my back and side have shrunk in half. It was such great news that I took my wife and son out to dinner to celebrate. Things are starting to look up. I hope they continue to shrink and disappear. I have to wait and find out what the next step is. Dr. Kirkwood and staff will review my case either Monday or Tuesday.

I got a late e-mail from Melissa DeMark, my Physician Assistant down in Pittsburgh. Here is what she said:

YUIP YIP YIPPPPPPPEEEEEEEEEEEE i'm so happy I almost cried!!!

Melissa DeMark, PA-C, MPAS
Hillman Cancer CenterDept of Hematology/OncologyMelanoma
Centerpager: 412-958-4287

I can’t wait until Monday!!!!!!!!!!!!!!!!!!
Take care,
Jimmy B.

Thursday, March 1, 2007


Dear Friends and Family,
I wanted to take a moment to let you know that I’ll be leaving my position at Eastman Kodak Company as of March 9, 2007. I will be starting a new phase of my life trying to win this battle of cancer. My short term disability ends and the long term starts.
I have enjoyed my 25 years there and I appreciate having had the opportunity to work with each and every one of you. Thank you for the support, guidance, and encouragement you have provided me during my time at Kodak. Even though I will miss my colleagues and the company, I am looking forward to this new challenge and to starting a new phase of my life. Even though the paths are many, I must go down each one to find the “Yellow Brick Road.” With your support and encouragement we can beat this disease together.

Please keep in touch,

I can be reached at my personal email address ( or at home, 585-467-2851. I will try to maintain my carepage as long as I can.

Thanks again for everything.

Yours truly,
Jimmy B.

3/1/2007 Waiting to hear the results of the CT and MRI scan

When I went to Science Park to have my scans done, I met a couple that is going through the same ordeal. Their names are Bill and Amy and they have two little girls. In talking to them, I found out that Bill is seeing Dr. Kirkwood and lived a few towns over where I used to live on Long Island. I guess we both had to much fun in the sun at the ocean.
Anyway, what a small world. I hope we both have good reports coming from our scans. I will contact my PCP, Dr. Marino to fax me a copy of this report on Friday if it has been dictated.
All we can do is wait and wait and wait.

Take care
Jimmy B.

Tuesday, February 13, 2007

2/13/2007 2:43 pm Appointments scheduled

Well I got the appointments that I needed to make done. I am scheduled to see the cardiologist on Thursday the 22nd of February at 12:40 pm. The doctor that I will be seeing is Dr. Arazzoa. The last time I saw him was 1992.
The other appointment that I needed to schedule was for the MRI of the brain and CT scan of the chest, abdomen and pelvis. This will be done on February 28th at high noon.
So, I think I am all set.
That is it for now.

Take care
Jimmy B.

2/13/2007 Path Forward>>>>>>>>>>>>?

Yesterday I went and saw my PCP and I gave him the cardio Report from Pittsburgh. He sent me home with more scripts( Nitroglycerin tablets ) Just in case. He also set me up with a cardiologist at Rochester General. I think with all the prescriptions I am taking, I should buy some stock in the pharmaceuticals.
Also last night around 8:00 pm I got a call from Melissa DeMark, the best Physician Assistant you could have. They (Dr. Kirkwood and company) have decide to end the IL-2 therapy for good. Yeh!!!!! They want to have CT scan to see how far the therapy has helped. If the tumors are totally gone, they will put me on a holding pattern with CT scan every 4 weeks. If the therapy has leveled off and no improvement has been seen from the last CT scan, they will start me on another therapy they have up their sleeve. So I am waiting for the script so I can make an appointment for the scan.

I will keep you posted.

P.S. Keep warm during the up and coming Winter Storm. Snow 12”+
I would rather be in Florida with the B’s .
Jimmy B.

Friday, February 9, 2007

2/9/2007 The decision is to abort the forth Cycle of IL-2

The decision was to stop the treatment. So I am going home. We need to regroup and figure out what went wrong with this cycle. I started this cycle with being on antibiotics, but we don't know if that was the cause. I am happy just to go home and sleep in my own bed. These trip are staring to ware on me.

My ride should be here by 5:00pm and we should be back in Rochester by 10:30 pm if weather permits.

Take care

Jimmy B.

2/9/2007 Saw the Cardiologist

Saw the Cardiologist and there seems to be some blockage to some veins. No ballons for me. The damage to the heart is very minimal. Atleast that is the take I got. Dr. Smith said there were two small veins that was blocked. He would recommend some drugs plavax, asprin and lopresser.Plavax is a prescription medication used to help prevent heart attacks, strokes and other problems caused by narrowed blood vessels (hardening of the arteries).

I still don't have the path forward.
Jimmy B.

2/9/2007 Hey! what's Up with more Layoffs at Kodak?

I heard on the news down here that Kodak is laying off another 2 to 3 thousand more workers. Who is going to turn off the lights?

Please send info. thanks
Jimmy B.

2/9/2007 Waiting to hear from the Doctors

It is now just a waiting game to see where we go next.Do I continue the IL-2? Do I go home and get a MRI or Pet scan? Do I start a new thrapy? Only the doctors and direct me. My weight went up to 232 lbs and is now starting to drop off again (229.6) There is no visiable swelling in my legs but I am getting the headaches.
Am I missing all the snow and cold weather? Here, it is in the low double digits with a dusting of snow.
Anyway, when I get some information, I will pass it on.
Take Care and keep up all the support. I could use some friendly e-mails sinse I am flying solo here on this trip.
Jimmy B.

Thursday, February 8, 2007

2/08/2007 The Heart Catherization went well!!!!!!!!!

There was no need to get an angioplasty. Angioplasty is a medical procedure in which a balloon is used to open narrowed or blocked blood vessels of the heart (coronary arteries). I did not receive the offical report yet but I think it was good. There were no clogged arteries or they would have put the ballon stents in.

I will keep you informed.

Jimmy B.

2/8/2007 Heart Catherization

The heart catherization will be done around 10:00 am.

"Cardiac catheterization is a diagnostic procedure in which a long thin tube called a catheter is placed in a blood vessel and then guided to the heart. The catheter may be inserted into either arteries or veins, depending on the information needed, in either an arm or leg. A contrast medium (commonly called "dye") is injected through the catheter to determine whether narrowing or blockages are present in the coronary (heart) arteries, and to measure precisely how well the heart valves and heart muscle function. Several specialized procedures may be performed, each tailored to the patient’s special needs.

Why is this procedure necessary?

While stress tests, electrocardiograms (EKG), echocardiograms, and physical examinations provide considerable information on heart muscle function and the status of the valves and surrounding tissue, these procedures do not yield all the answers. Cardiac catheterization allows the specialist to see an outline of the coronary arteries and more precisely determine the extent of blockages in these vessels.All of the above procedures are used together to obtain as much information as possible so that an accurate diagnosis can be made and proper treatment provided."

So I will see you on the other side of the procedure.
Jimmy B.

2/8/2007 Heart Catherization

The heart catherization will be done around 10:00 am.

"Cardiac catheterization is a diagnostic procedure in which a long thin tube called a catheter is placed in a blood vessel and then guided to the heart. The catheter may be inserted into either arteries or veins, depending on the information needed, in either an arm or leg. A contrast medium (commonly called "dye") is injected through the catheter to determine whether narrowing or blockages are present in the coronary (heart) arteries, and to measure precisely how well the heart valves and heart muscle function. Several specialized procedures may be performed, each tailored to the patient’s special needs.

Why is this procedure necessary?

While stress tests, electrocardiograms (EKG), echocardiograms, and physical examinations provide considerable information on heart muscle function and the status of the valves and surrounding tissue, these procedures do not yield all the answers. Cardiac catheterization allows the specialist to see an outline of the coronary arteries and more precisely determine the extent of blockages in these vessels.All of the above procedures are used together to obtain as much information as possible so that an accurate diagnosis can be made and proper treatment provided."

So I will see you on the other side of the procedure.
Jimmy B.

2/08/2007 Can't Sleep

I am having trouble sleeping due to all that has transpired over the last 24 hours. And I can't seem to get rid of my headache.

Let see what tomarrow brings.
Keep in touch.
Jimmy B.

Wednesday, February 7, 2007

2/7/2007 Three strikes and your out!!!!

Well, I missed my last three doses. It is due to the elevated enzymes.The cardiologist wants to do heart catherization to see if the is any damage from the intial dose of IL2. I will be having the procedure tomarrow morning. I will keep you informed. I might be going home earlier than expected.

Take care

Jimmy B.

2/7/2007 update

Had an echo cardiogram this morning. Waiting for the doctors to make a decision if it is a go or no go. I don't want damage my ticker.

I hate waiting!!!!!!!!!

jimmy B.

2/7/2007 Minor Setback!!!

I was unable to take my second and third dose due to some complications. My second dose was called off due to high blood pressure. And the third was also called off due to high enzymes level for the heart. If the enzyme level is above normal, it could be a sign that we are putting too much stress on the heart.
One more strike and I am out. I will be see a cardiologist this morning.

Take care

Jimmy B.

2/6/2007 Got the first dose!!!! ( Interlukin-2)

I got the first dose at 4:30 pm. My blood pressure is running high so I don't know if I will be receiving the next round. Time will tell.

Jimmy B.

Tuesday, February 6, 2007

2/06/2007 The PICC Line is in Yahoo!!!!!!!!!!!!!!!

This time the PICC line only took two tries and 45 minutes. The doctor that put in the PICC line recommended that they leave it in after this cycle of threapy. They are running out of good veins to use. The previous veins have thrombosis.(clotted)
I am now waiting for my first dose of the 4th cycle. I should receive it around 3:30 pm today.

P.S. I will keep you posted

2/6/2007 The trip continued!!

We watched the weather channel and decide to take a chance of Dee driving back our normal route along the lakes. We also checked the NYS Thruway and the was no closings posted on the web.
So Dee left about 2:00 pm and arrive in Rochester at about 7:00pmThe roads were OK except for a small stretch from Erie to the NY state line.
So now it is about 7:45 am and I am ready to go to the Hillman Center to get my blood drawn and to get my marching orders. I believe the PICC line is scheduled to be put in at noon. Also I need to check out of the Family House by noon also.
P.S. I also met a very nice women (Donna Ridgeway) at the house. Her husband has Melenoma. But I will have to save that story for another time.
I also missed Mary Coyne. She was off Monday Night.
That is it for now.

Jimmy B.

2/6/2007 We made it to Pittsburgh!!!!

We left Rochester at 6:30 am for Pittsburgh. We decided to take a new route because of the Lake effect snow in Buffalo and Erie Pa. So we jumped on 390 south to Dansville exit 4. There was blowing and drifting snow across the highway. I had to keep my speed in check.We then took route 36 south to route 17 (interstate 86). We headed towards Jamestown. It was about an hour and a half into the trip when Dee got a phone call on her cell phone. It was our son Chris. We had forgot to leave the keys to the car so he could drive to school. We thought about turning around but decided to keep going. We told Chris to stay home and take the day off. Half of the schools in Rochester were off anyway due to the very cold weather.
So we continued to exit 23 to 219 south through the mountains near Alleganey National Forrest. The roads were quite clear. We then took intersate 80 west for approximately 20 mile to exit 78. we then tookroute 28 all the to Pittsburgh. The whole trip took about 6 hours. An hour longer than our usually route.
We ate lunch and checked in.

Dee decide to make the trip back to Rochester.

To be continued

Jimmy B.

Monday, January 29, 2007

2/29/2007 New date for Cycle 4

New date for Cycle 4 of Interlukin-2 is set for next Tuesday 2/6/2007.

Jimm y B.

1/29/07 Cycle 4 postponed!!!!!!!!!!!!! (IL-2)

Cycle 4 postpone due to nasal infection/head cold. I am going on antibiotics today. I hope to reschedule for next week. I will keep you informed.

Jimmy B.

Thursday, January 25, 2007

1/25/07 Round 4 with the Devil!!!!!!

Well, I got the word that round 4 will start next Tuesday January 30th . Dee and I will drive downMonday and stay at the Shady House if they have an opening. I am not looking forward to this cycle of interlukin. I am still trying to recover from the last cycle. Fatigue has really hit me hard. I feel like I aged ten years.

Well enough complaining. I just hope that the therapy is continuing to shrink the tumors. Then it will be well worth the pain and agony.

Take care, and I will try to stay in touch while I am in the hospital.

Jimmy B.

Monday, January 22, 2007

1/22/07 I am still here!!!!!!!!!

The headaches finally subsided!!!!!!!!! I‘ve been resting. Fatigue has set in. It is the worst bout of it to date. I sleep 8 to 9 hours but wake up very tired. It is like I have never slept. It doesn’t help that I have to go to the bathroom every two hours too. My skin is flaking and is causing me to itch all over. My skin feels like a reptile with scales. I have tried Lubriderm but it only last for a couple of hours. Tonight I am going to try an oil bath. This should be fun.
I am not complaining, things could be worse. Like going back down to Pittsburgh for another cycle. I am now waiting to hear when this is going to happen.

That is it on my end.
Take care
Jimmy B.

Monday, January 8, 2007

01/06/2007 So I am Going Home …. Yah Hoooooooooooooooooooooo!

So Saturday morning I got myself packed and ready to go home from Shadyside. I had called Dee the night before and to get ready for a road trip. I knew I would get release sometime Saturday. The Doctors usually make their rounds in the morning and then write their scripts and then sign release forms. I guess I have the system down. So Dee left Rochester around 8:30 am and would arrive around 1:00 pm. Well the timing worked out just right that I got released at 2:00 pm and we were on the road by 2:30 pm. We arrived back in Rochester a little bit passed 7:00 pm. Round three is now over and I must gain my strength back.

01/05/2007 Eight Is Enough !!!!!!

8 Doses were enough for me. I started experiencing great swelling and sharp pain in my chest every once in a while. So threw up the white flag and gave in. I said to myself “Stop now and there will always be another day to fight this terrible demon.” It was Friday and I would need to recover at least 24 hours before I would get my release papers.

1/09/2007 Off to donate some blood.

I hope they can find a good entry point to draw some blood. When they put in the PICC line, they made a mess if my arm. With my arm bruised and battered, it looks like I am doing drugs. My soars in my mouth are going away and my appetite is coming back. My body weight is just about the same weight as before I was admitted. The 24/7 headache has been a challenge. Tylenol is taking the edge off of it.
Well I am off
Take care,
Jimmy B

Friday, January 5, 2007

01/05/2007 I started my 8th dose of interlukin-2

I started my 8th dose of interlukin-2 and all is going well. I feel I may be able to handle on one or two more doses. I didn’t have the swelling to bad. I think I will be going home Saturday or Sunday. Time will tell.
Take care
Jimmy B.

Thursday, January 4, 2007

01/04/2007 I start my 6th dose at 3:30 pm.

It is a go to get my 6th dose. So far they seem easier to handle. It looks like my belly has bloated up. My legs so far are in good condition. They are using blood pressure medication to keep my pressure in check.

I guess, no news is good news.
Take care,
and I will write after the next dose.
Jimmy B.

Wednesday, January 3, 2007

1/3/2007 Working on my Fourth Dose!!!!! (Interlukin-2)

The third dose went pretty well. I just had the chills so I was given Demerol. The next dose (4th) is slated for 11:30 pm. To keep me entertained, I am watching the ND vs LSU ( I believe it is the Sugar Bowl.)
That is It for now
Jimmy B.

1/2/2007 The first dose

I received my first dose at 3:30 pm and it went off without a hitch. About an hour and a half into my treatment I got the chills so I received some Demerol. Sometime during the 8 hours cycle my blood pressure began to elevate. This is not good. They need to maintain it or I would have to skip the next dose. Well the pressure did not stabilized so I was off the hook for the next dose. I missed the 11:30 pm dose. During the off hours they gave me some blood pressure medicine to get my pressure under control. By 5:00 am everything was back to normal and I am slated to receive my second dose of interlukin-2 at 7:00 am.
That is it for now.
Jimmy B.

01/2/2007 A funny thing happen along the way to getting a PICC Line!!!!!!

Everything was going so smooth until I was to have the PICC line put in. Shadyside is a teaching hospital so I was going to have a resident put the line in under the supervision of the doctor on duty. Usually the Physician Assistant, Dave would be doing the procedure but they lost the PA supervisor to another job opening. The PA supervisor gave 6 months notice, but the hospital administrator staff never replaced him and the PA cannot practice without working under a PA supervisor (an MD).

To make a long story short, the resident had major trouble finding a vein to work with so the doctor took over. Since the doctor didn’t do this PICC line procedure very often, it was like the blind leading the blind. The 20 minutes procedure turned into an hour and half. The doctor used two PICC lines. The first one got damaged while trying to find a working vein. All the while Dee was in the waiting room. I had told her that the procedure took about 20 minutes. She was climbing the walls. I think she was able to finish knitting the baby scarf in that amount of time.

It was now 1:30 pm and we headed up to my room (718) main.

Tuesday, January 2, 2007

1/2/2007 The Next morning. I am in BIG Trouble

I had set my alarm for 6:45 am, I thought but I forgot to set back the time on the clock (Fall Back) so I woke up at 5:45 am. Boy, did I hear it from Dee. She could not sleep to well because I had the windows a cracked to let in some fresh air and plus the room was quite warm. The city traffic never stopped and the bus stop on Centre Ave was right below our window. You could hear the Bus’s air brakes each time they stopped. It reminded me of the old steam locomotives with all the hissing sound. I was waiting to hear the conductor to say, “All aboard”. You also could heard the bus take off. I got use to it, but Dee was a different story. She said she woke up every 10 to 15 minutes all night.

Anyway, we got ourselves together and headed over to Ritter’s Diner for some breakfast. We had our usual, eggs and home fries with a side of bacon, and a coffee to wash it down. After breakfast we went back to the Family House and checked out and were at the Hillman Center by 8:30 am. We were ahead of schedule. I checked in and had my blood work done. We then went to terminal D where I had a once over from Jan the physician assistant. I asked for an official copy of my CT scan for my files. I always like to see things in writing.
My next appointment was at Shadyside Hospital to have my PICC Line put in. This was my ultimate test to see if I knew the right procedure for admission to Shadyside. The last two times things got all screwed up.

So, we are off to Shadyside using the internal bridge to get there. I hope there are no trolls along the way.

Jimmy B.

1/2/2007 We’re Here!!!!!!!!!!!!

Well we made it in record time. It took about 4 hours and 15 minutes to get down to Pittsburgh. The roads were pretty empty on New Years Day. I was driving like a bat out of hell. I don’t know why. We were in no rush. I guess I wanted to catch some bowl games on ESPN. We left around 11:00 am and got there about 3:15 pm. Mary Coyne greeted us at the Family House. Dee And I proceeded to check in to room # 406. It is in the front of the house facing Shadyside Hospital. We could see the helipad on top of the hospital.

To kill some time before dinner, we decided to take a walk to the local market. This helped to stretch our legs after the long drive. We did some sight seeing in the store. We didn’t need any groceries because we brought our dinner from home. On the menu was pepper steak over a bed of white rice. Too much to our surprise, when we returned the Shadyside Family House, they had a great spread in the kitchen. It was leftovers from the New Years Eve party. So, we had H'Orderves and sparkling juices for our appetizers from 4 to 6 pm. Dinner followed.

After dinner we returned to our room and I watched the bowl games and Dee knitted or read a book.

We crashed about 10:30 pm.

Monday, January 1, 2007

1/01/2007 Happy New Year!!!!!!!!!!!!!!!!!

Well, we are on our way back down to Pittsburgh (Interlukin-2). We decided to travel a day early because they want me at 9:00 am. So we are trying to get a room at the Family House across the street from Shadyside Hospital. I will be there for 5 to 6 days. I am not looking forward to this visit.

Anyway, I will try to stay in touch while I’m down there.

Take Care

Jimmy B.

Greetings to One and All

This Blog is dedicated My Brother Kenny B. who passed away in the late 1970's with Cancer before the Internet.

It was he, who showed me How to live and give back. He was wise beyond his years.

Kenny B

Jimmy and Dee

Carepage: Jimmybreitfeller
Jimmy Breitfeller

My Profile as of 2009

My photo
Last July (2005)I was riding my bicycle to work at the Eastman Kodak Research Labs about 3 miles from home. I was wearing a knapsack to carry my things to and from the labs. I started noticing an ache on my back. So I decide to go to the dermatologist. To make the long story short, it was cancer. I knew from my research that I would be needing adjuvant therapy. So I started communicating with Sloan Kettering, University of Pittsburgh Cancer Center, and a couple of others including the Wilmot Cancer Center at Strong. I realized that by telling my story, I might help someone else out there in a similar situation. So to all who are linked by diagnosis or by relation to someone with melanoma, I wish you well. Stay positive, read as much as you can (information helps to eliminate the fear associated with the unknown), and live for today, as no one can predict what tomorrow may bring. Jimmy B. posted 12/15/08


The information contained within this Blog is not meant to replace the examination or advice of your Oncologist or Medical Team. The educational material that is covered here or Linked to, does not cover every detail of each disorder discussed.

Only your physician/Oncologist can make medical decisions and treatment plans that are appropriate for you. But, An Educated Consumer is a Smart consumer.

As Dr. Casey Culberson Said:

"The BEST melanoma patient is an ACTIVE PARTICIPANT in his or her treatment

Melanoma and the “Magic Bullet” (Monoclonal Antibodies)

Just to let you know I posted the first draft of the Melanoma and the “Magic Bullet” (Monoclonal Antibodies). on Melanoma Missionary In the Shared File Section. you can download it for 19.95 (Only kidding) it is Free for the taking.

It is 33 pages long and may help you in your quest for the Yellow Brick Broad. Just to let you know it is only the first draft. Revisions are sure to come. I wanted to get it to the people that need it the most, the Melanoma Patients.


So, where does Interluekin-2 (IL-2) come into play? According to Byung-Scok et al and recent reports, IL-2 is not needed for developmental CD4+ CD25+ Treg cells in the thymus but does play an important role in the maintenance and function in the peripheral.18 Peripheral is defines as secondary system outside the bone marrow and thymus. It entails the site of antigen, immune system interaction. IL-2 is required for the peripheral generation of Tregs based Abbas’s and colleagues research.19

IL-2 prevents the spontaneous apoptosis of the CD4+ CD25+ Treg cells. It has been reported that patients with multiple advance-stage tumors have elevated levels of Tregs within the tumor microenviroment.20 Interluekin-2 is the survival factor for CD4+ CD25+ Treg cells.21 If the addition of IL-2 is on or before the maximum propagation of the CD4+ T cells, the Tregs population can increase 5-fold in a 96 hour period based on certain growth mediums.

By controlling the addition of the endogenous IL-2, one has a knob to turn and can lead to the control of the expansion of the Tregs. When you combined this control with the anti-CTLA-4 blockage, you can shift the balance of the immune response.

Now here is the catch. The maintenance and function of the CD8+ T-cells require CD4+ cells which secrete IL-2. So we don’t want to deplete the CD4+ cells, we want to control the expansion of the Tregs which are a subset of the CD4+ cells. It has been postulated by some researchers that the Anti-CTLA-4 blockage also suppresses the Treg function in a different mechanism. By using IL-2 as the rate limiting factor, we can suppress the CD4+ CD25+ Treg cell expansion by controlling the concentration and timing of the Inerluekin-2 at the tumor microenvironment.

The Interluekin-2 plays another role in this Melanoma Maze. In a study by Janas et al, Il-2 increases the expressions of the perforin and granzyme A, B and C genes in the CD8+ T-cells. This increase expression causes the CD8+ T-cells to mature into Cytoxic T Lymphocytes (CTLs). The exogenous IL-2 is required for the granzyme proteins. As stated previously, CTLs have cytoplasmic granules that contain the proteins perforin and granzymes. A dozen or more perforin molecules insert themselves into the plasma membrane of target cells forming a pore that enables granzymes to enter the cell. Once in the tumor cell, these enzymes are able to breakup (lyse) the cell and destroy it. This is the beginning of the end for the cancer cells. The tumors begin to shrink and the rest is history,

On the other hand, prolong therapy with Il-2 can result in causing apoptotic death of the tumor- specific CD8+ T-cells.23

Clearly in a clinical setting, timing, dose, and exposure to these drugs play a major roll in the immunotherapy, and can have dramatic effects on the outcome.

All it takes is that one magic bullet to start the immune reaction..

Melanoma And The Magic Bullet (Monoclonal Antibodies)

Public Service Announcement

A call for Melanoma Patients by Dr. Steven A Rosenberg

"We continue to see a high rate of clinical responses in our cell transfer immunotherapy treatments for patients with metastatic melanoma", Dr. Rosenberg said.

"We are actively seeking patients for these trials and any note of that on a patient-directed web site would be appreciated."

If you would like to apply for his trials, here is the website and information.

Dr. Rosenberg's information

Dr. Rosenberg's Clinical Trials

For the Warriors

The Melanoma Research Alliance has partnered with Bruce Springsteen, the E Street Band, and the Federici family to alleviate suffering and death from melanoma. Please view Bruce Springsteen’s public service announcement inspired by Danny Federici. Danny was the E Street Band’s organist and keyboard player. He died on April 17, 2008 at Memorial Sloan-Kettering Cancer Center in New York City after a three year battle with melanoma.

Source Fastcures blog

Join the Relay for Life!!!


Dear Family and Friends,

I’ve decided to take a stand and fight back against cancer by participating in the American Cancer Society Relay For Life® event right here in my community! Please support me in this important cause by making a secure, tax-deductible donation online using the link below.

To donate on line now, click here to visit my personal page.
Jimmy B AKA Melanoma_Missionary

Relay For Life® is a life-changing event that brings together more than 3.5 million people worldwide to:

CELEBRATE the lives of those who have battled cancer. The strength of survivors inspires others to continue to fight.

REMEMBER loved ones lost to the disease. At Relay, people who have walked alongside people battling cancer can grieve and find healing.

FIGHT BACK. We Relay because we have been touched by cancer and desperately want to put an end to the disease.

Whatever you can give will help - it all adds up! I greatly appreciate your support and will keep you posted on my progress.

Keep the Fire Burning!!!



Jimmy Breitfeller
Turn off Music before you "Click to Play"
Signs of Melanoma Carcinoma Skin Cancer

How Skin Cancer Develops by " : Dermatology"

Call for Patients with Unresectable Liver Metastases Due to Melanoma

Delcath Systems Granted Orphan-Drug Designations for Cutaneous and Ocular Melanoma

Delcath is actively enrolling patients in a Phase III clinical trial testing its proprietary drug delivery system, known as Percutaneous Hepatic Perfusion (“PHP”), with melphalan for the treatment of ocular and cutaneous melanoma metastatic to the liver.

This NCI-led trial is enrolling patients at leading cancer centers throughout the United States. Commenting on these orphan-drug designations, Richard L. Taney, President and CEO of Delcath, stated, “These favorable designations are important steps in our efforts to secure Delcath’s commercial position upon conclusion of our pivotal Phase III trial for metastatic melanoma. We remain steadfast in our commitment to become the leader in the regional treatment of liver cancers and we continue to enroll patients in this study, and advance our technology and the promise that it offers to patients with these deadly forms of melanoma and other cancers of the liver, all with limited treatment options.”

Orphan drug designation, when granted by the FDA’s Office of Orphan Products Development, allows for up to seven years of market exclusivity upon FDA approval, as well as clinical study incentives, study design assistance, waivers of certain FDA user fees, and potential tax credits.

Current Trial Centers

Phase I Study of Hepatic Arterial Melphalan Infusion and Hepatic Venous Hemofiltration Using
Percutaneously Placed Catheters in Patients With Unresectable Hepatic Malignancies

James F. Pingpank, Jr., MD, FACS
Associate Professor of Surgery
Division of Surgical Oncology
Suite 406, UPMC Cancer Pavillion
5150 Centre Avenue
Pittsburgh, PA 15232
412-692-2852 (Office)
412-692-2520 (Fax)

Blog Archive

Call For Melanoma Patients!!!!

Call For Melanoma Patients!!!!

Dr. Rosenberg Has a New Clinical Trial.

Our latest treatment has a 72% objective response rate with 36% complete responses.

We are currently recruiting patients for our latest trial.

Is there some way to post this “Call for Patients” on the web site?

Steve Rosenberg

Dr. Rosenberg's Clinical Trials

(For a copy of the research paper.. see My Shared files)

The news headlines shown above for Melanoma / Skin Cancer are provided courtesy of Medical News Today.