By Bill - A Description of Cancer Progression

Bill hiking in ColoradoI am a 36-year-old male. Married, father of two a five year old and a 1-year-old. I am a non-smoker. I do not consume alcoholic beverages (at the most 1 beer a month). Up until recently, I was very athletic. I had been in numerous bike and running marathons, and participated in volleyball and basketball leagues.

When in high school and college I was a lifeguard in Daytona Beach, Florida. This was in the late 70s and early 80s when not much emphasis was placed on sunscreen.

January 1995

I was diagnosed with malignant melanoma, Clark Level IV. The lesion was on my left shoulder measuring Breslow's thickness 2.4mm.

The lesion was excised wide area excision with flap. Dr. Jennings in Denver was the surgeon.

March 1995

I began immunotherapy at John Wayne Cancer Institute at St. John's Hospital in Santa Monica, Ca. Monthly injections were administered until March 1996. (Dr. Leland Foshag my physician there).

March 1996

Immunotherapy injections decreased to every 3 months.

February 1997 - July 1997

Lesion detected on lingular left lobe of lung, measuring 8mm on CT scan. At this time the brain was MRI'd with no lesions detected.

July 1997

CT scan of lung showed lesion increased to 1 cm.

July 28, 1997

Excision of lesion (malignant melanoma) on left lung by Dr. Leland Foshag at John Wayne Cancer Inst. Measuring 1.4cm.

November 2, 1997

Had onset of very painful headache. Relentless. Over-the-counter pain meds not helping. Finally, during night, headache subsided.

November 6, 1997

Back to John Wayne Cancer Institute for monthly immunotherapy injections. Reported to Dr. Foshag of the headache and confusion of thoughts and difficulty reading. Dr. Foshag requested I receive an MRI of brain on my return to CO.

November 12, 1997

MRI of brain in Ft. Collins, CO at Poudre Valley Hospital.

November 14, 1997

Dr. Merrill (oncologist) in Ft. Collins informed me of a 4 cm. Tumor on my left brain with 3 small tumors scattered deep within the brain.

November 20, 1997

Dr. Kindt of the University of Colorado at Denver removed 4 cm. Tumor (the melanoma had ruptured causing the tumor to be 4 cm).

November 21, 1997

Full body scan at University of Colorado at Denver. Possibility of adrenal gland and lung lesions noted.

November 25, 1997

Dr. Breeze of the University of Colorado at Denver performed the Gamma Knife stereo tactic procedure on the three smaller tumors. Fourth tumor noted, but outside the range of helmet. Decided to re-scan in six weeks and take care of any new ones then as well.

January 12, 1998

Dr. Breeze of the University of Colorado at Denver performed the Gamma Knife stereo tactic procedure on the fourth tumor from above and two new tumors.

January 15, 1998

Chest and abdomen CT at St. John Hospital in Santa Monica, CA showed slight growth (from 2.0cm to 2.4cm) in tumor on adrenal gland, and suspicious spot on liver noted. No change in lung lesions, suspect post-operative sites.

January 21, 1998

Started low-dose interferon (3 mil units) injections, 3 times per week.

March 10, 1998

Brain MRI at University of Denver showed two new tumors on right side of brain.

March 12, 1998

Chest and abdomen CT at St. John Hospital in Santa Monica, CA showed slight growth (from 2.4cm to 3.0cm) in tumor on adrenal gland, and suspicious spot on liver confirmed as tumor. Still no change in lung lesions.

April 6, 1998

Gamma knife on the two new tumors. Also, six more small brain lesions were seen. Five of them were treated with the gamma knife - the sixth one was outside the helmet's position.

April 20, 1998

Had MRI of brain - no significant changes.

April 29, 1998

Started a three week treatment of a monoclonal antibody in Philadelphia, administered by Dr. Luther Brady and Dr. Curtis Miyamoto. Finished treatment on May 13, 1998.

May 24, 1998

CT of chest, abdomen and pelvis showed growth in the adrenal gland to 6.0cm. Several small, suspicious nodules appeared in the kidneys along with a larger spot on the pancreas. Also, there were suspicious looking lymph nodes in the lungs.

June 6, 1998

MRI of brain showed growth in lesion in left occipital region.

June 11, 1998

Started whole brain radiation. Started at a lower dose (200 rads per treatment), and finished on June 26, 1998. On June 14, started treatment doses of 300 rads after vision symptoms worsened (blind spot became larger - to the point of affecting my reading). Total rads after completing full treatment was approximately 3,000.

June 23, 1998

Entered Halifax Hospital in Daytona Beach, FL after the largest of the two occipital tumors, hemorrhaged. Remained in hospital for 9 days while brain was being monitored with regular CT scans and MRI. These showed stable progression. On July 3 released from hospital. Have since been making steady improvement. Vision has improved but not yet normal.

August 15, 1998

Started thalidomide treatment at New York Medical Center with Dr. Gruber. This involves taking 200mg of the drug once a day in the evening.

September 25, 1998

Scans of abdomen and a MRI of brain each showed they were stable, so it was decided to stay with the thalidomide treatment. This was Bill's last entry before he passed on November 18, 1998.