No End In Sight

Three weeks after my eye surgery I was healing well and ready to discuss returning to school with my instructor. We had a meeting in her office where we went over my options. I could take the rest of the year off and return next September to finish with the class below me, or I could try to push through. I had a lot of make-up work to do, and I would have to work really hard to be ready for the board exams coming up. I chose to push through and graduate this year for two reasons. One was because it gave me something healthy and positive to focus my energy on, and the other reason was because honestly, I had no idea what things would look like in a year. Would I still be here? Would I be sick and not able to ever return. In my eyes if I was going to become a hygienist it had to be now.

I left her office and walked to my car feeling confident about my decision. I sat in the drivers seat and felt something painful in my lower back as I leaned into the seat. It felt like a painful marble sized lump under the skin. You have got to be kidding me! I called my doctor and went right over for a needle biopsy, but both him and I knew what it was.

A few days later we received the results of the biopsy. It was indeed more melanoma. We decided it was appropriate to do another PET scan, even though my last one was only just over a month ago. This time the scan showed three more tumors. One in my lower back, one in my lower abdomen, and one in the tip of my scapula (inside the bone).

Yervoy- April-June 2015

After much deliberation we decided to return to the operating room to remove all three tumors. We knew that this would not end the problem, but what it would do is buy me some time. After surgery I would start an immunotherapy called Ipilimumab (Yervoy). At this point in time, Yervoy was the only drug approved for first line stage IV melanoma. Meaning you have to try this drug first before you can move on to the drugs with better success rates.

Yervoy was administered through an IV in my arm once every three weeks for a total of four doses. A lot of times this treatment comes with very dangerous side effects, so they monitored me very carefully.  During this treatment I felt GREAT! I was working out again, back at school making up everything I had missed and even taking my state and regional board exams (which I passed!). I attended my class pinning ceremony, and celebrated with all of my friends.

Dental Hygiene pinning ceremony

At the winery celebrating

My sweet husband Corey, my person, my rock.

The three months of treatment flew by and before I knew it the 4th of July was here. I had plans with friends, but spent the whole weekend in bed instead. I was feeling so sick on the holiday that I had my husband call my oncologist at 6 am on the 4th of July (sorry doc!) We described the issues to my doctor and he agreed it was time to go to the emergency room. Well I was definitely ill. My CT scan and MRI showed numerous tumors throughout my abdomen and back (roughly 8 or 10), ascites, which was most likely where my abdomen pain was coming from, and a tumor in my brain. It was safe to say my treatment was NOT working.

The new game plan was to have a craniotomy to remove the brain tumor, followed by gamma knife radiation at the site to kill any remainder cells so that the tumor does not grow back. Immediately following my surgery I would begin my next treatment; a drug combination called Tafinlar and Mekinist. These drugs are only useful if you have a certain gene mutation in your melanoma (B-RAF), which I had. These drugs can work amazingly, but generally stop working for the majority of people. The melanoma learns to mutate, and grow around the medication. The average amount of time before that happens is 10 months, but can be up to several years (still not long enough).

Tafinlar and Mekinist

Brain Surgery and Gamma Knife- August 2015

Brain surgery was a piece of cake! The easiest surgery I've had so far. The brain tumor was only 10 mm and was close to the surface, with no inflammation. The incision on my scalp was only about an inch long. I stayed the night in the hospital so they could monitor me and went home early the next morning.

 My Neurosurgeon, we will call him Dr. Mcdreamy (yes I'm a huge Grey's Anatomy fan and I believe if Izzy Stevens can beat late stage melanoma with only a 5% chance of survival then I can too!), most likely wasn't able to remove all of the cancer cells, or there was a satellite tumor right next to the original. When I returned two weeks later for my gamma knife treatment we did a new MRI, and some of my tumor was not only still there, but had grown and was now BIGGER than it was before surgery. This information was extremely disappointing. It made me feel that the brain surgery and everything I had just went through was totally unnecessary.  For the first time throughout this journey I felt defeated. The tumor was now 19 mm. They performed the gamma knife treatment as planned, just on a larger area.

After the rough morning of radiation I told my husband that we needed to get out of town. We decided to head to Bend the next morning and spend the weekend. We stopped in the Cascades on the way and did some hiking. The outdoors has always been an escape and stress reliever for me, and today was no different. Although I probably should have been at home resting, we spent the morning hiking around the trees and amazing waterfalls.

The incision site from my brain surgery

The good news is that I had a follow-up MRI just six weeks after the gamma knife and it showed my tumor was drastically smaller! I've had several MRI's since then (four I think), and now my brain is showing completely clear. The tumor is gone! All of my CT scans since then have been clear as well which means the combo therapy pills are working.

Just after hearing the news my brain tumor was back, just before my gamma knife procedure. Topical anesthesia on my forehead.