Initial Diagnosis: May 2003
Current Stage: Stage 4
Depth of Primary: Up to 1 mm
Treatment Stats
Doctor: Mario Sznol MD
Treatment Center: Yale New Haven
Clinical Trial(s): Ipilimumab
Treatment History
February, 2003 my wife noticed a dark spot on my balding head.
April 2003 Punch biopsy read asmelanoma, 0.76mm deep.
May 2003 Wide Local Excision
May-Sept - Multiple dysplastic nevi excised
Sept 2003 - Second primary, this time in situ, on my chest
PET scan, MRI and CT all negative
Oct 2003 - University of Pennsylvania Pigmented Lesion clinic in Philadelphia they reread my slides and reclassified it to a Breslow's depth of 0.86 and Clark's level 4 and told me I have Stage 1B with a specific note that there appeared to be no immunologic response by my body to the melanoma.
October 2003 - October 2006 Derm exam every 3 months. Many dysplastic nevi excised. Doing well, no more primaries, no problems.
October 2006 coughed up blood CT, PET showed a 5cm mass in my L lung. MRI negative for brain mets. No other lesions found.
October 30, 2006 - Thoracotomy at St. Peter's Hospital in Albany NY with removal of the lower lobe of my left lung. Did well after surgery.
November, 2006 - Local oncologist offers interferon but suggests I look into trials
December, 2006 - Accepted into University of Pennsylvania trial of Anti-CTLA4 if my scans remain clear
December 12, 2006 - Had MRI and CT for study and found I has a previously undiagnosed.
met to my brain
December 13, 2006 - Radiation oncologist suggests neurosurgery unless it is not safe to resect. Also heard I may have micro-mets in the lungs. Put on decadron. Seeing neurosurgeon on 12/14
December 14, 2006 - Neurosurgeon says "take it out"
December 20, 2006 - Craniotomy. Second major surgery in 7 weeks! Another stint in the ICU. Woke up unable to move my left leg
December 24, 2006 - One week in a rehabilitation hospital. Intense physical therapy and I walk out
January 2007 - Planned on SRS but more brain mets found. Underwent 15 sessions of WBR
March 2007 - More lung mets found - multiple, disseminated in both lungs, tiny
April 2, 2007 I start IL-2 at Deaconess Beth Isreal in Boston
June, 2007 Brain tumors bleed - emergency craniotomy
July, 2007 - Stereotactic radiation
Sept, Oct waititg for a trial...and waiting...and waiting
October 2007 Accepted in compassionate use trial WITH Ipilimumab (MDX-010 at Yale New Haven Hospital under the care of Dr. Sznol
October 31, 2007 First dose of Ipilimumab at Yale-New Haven Hospital.
November 20, 2007 Second Infusion of Ipilimumab
December 11, 2007 Third dose of Ipilimumab
December 18, 3007 Severe reaction to IPI
Admitted to YNHH with uncontrolled vomiting, dehydration, hyponatremia and weakness. Discharged December 23, 2007 to home. Began 4 mg oral steroids.
January 22, 2008 began to notice double vision, nausea and vomiting as steroids were tapered from 3mg to 2 mg. Steroids increased to 2.5 mg
January 23. , increased to 3mg
anuary 25, increased to 4 mg
January 28, 8 mg January 29 . Nausea and vomiting disappeared. Double vision improvement noted
February 4th…Have lost all peripheral vision.
March 2008 increased weakness noted in lower extremity resulting in confinement to
Wheelchair and walker. MRI noted area of increased swelling on right parietal lobe at site of June 2007 surgery. Not metastatic disease.
April 2008 prescribed high dose (40mg) oral steroids to reduce swelling and manage side effects until planned surgery May 2008.
May 8 2008 planned craniotomy (#3) to remove necrotic tissue iAfter 5 day inpatient stay, walked out of hospital without assistive device. Began taper of steroids.
May-June 2008 unable to tolerate steep taper, steroids increased and taper resequenced at much slower rate.
December 2009 Tumors still visible on scans in brain and lungs but no growth since 2008, Stable. No evidence of active disease.
UPDATE written October 7 2010
October 7, 2010. Four years after my diagnosis with Stage IV Melanoma I continue to show no evidence of active disease. I do have problems elated to treatmens: Simple Partial Seizures, Visual problems (Double and blurred) Short term memory loss, Episodes of fatigue. Symptoms that remind me about what I went through these past four years, but definitely things I CAN LIVE WITH. A hell of a lot better than I thought when I started to fighting the beast/
Mark, Catskill, NY
Activating the Danger Signal with Anti-CTLA-4 Blockade
Was it the combination Radiation, IL-2 plus the Anti-CTLA-4 blockage?
“It is not the strongest of the species that survives, nor the most intelligent, but the one most responsive to change.”
~Charles Darwin~
Take Care,
Jimmy B
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