Updates!

Just a few quick updates. I will start with the best news. My brain MRI came back CLEAR!! This is awesome news because a pet scan can see almost every little thing lurking in your body, except for your brain. The most common areas for melanoma to metastasize (after the lymph nodes) are the liver, the lungs and the brain. My liver & lungs were clear, so that only left the brain. Such a huge relief. I have to admit, every single inkling of a headache I've had the last week had me convinced there was something going on there.

Next, surgery went well on Monday. The basically went back in where they removed the tumor last Monday and just made wider margins. I joked with the nurses that I BETTER not be back again next Monday...enough is enough already! We also had a multidisciplinary conference with a TON of doctors on Friday. My old doctors from NIH and my current doctors from Walter Reed were both there. We basically flipped through all my scans and discussed every nook and cranny of the inside of my body...fun times. So just two more tests scheduled (pelvic ultrasound & liver MRI) and then it will be decision time. There are basically three different options for "treatment" and I have been told that if you asked 100 oncologists, their recommendations would be split in thirds equally. Here's a quick run-down of the three options...

1) Combo Immunotherapy for a year. This would be the exact drug that I had for a year before, but adding a second one called Ipilimumab. Adding this second drug definitely makes the treatment not as easy breezy as the last time. It has A LOT of scary side effects and a lot people have to stay on a steroid regiment most of the year to get through it. Also - the side effects can be life long, which is really scary to me. :(

2) Targeted therapy for a year - This is a fairly new treatment that is taking pills instead of having infusions. It is a lot of pills...12-15 a day. Where as immunotherapy teaches your own immune system to "find" and destroy the cancer, the targeted therapy works differently. The drugs go into your body looking for a certain type of cell mutation that my particular type of cancer has. The mutation is called BRAF V600+ if anyone was wondering! ha! All I can say is thank GOD there are smarty scientists in this world that figured this stuff out..I mean it's seriously amazing! Side effects of targeted therapy are flu like symptoms, most specifically fevers & fatigue. Do these symptoms sounds familiar??? I foresee many COVID tests in my future if we go with this plan. The good news is that supposedly, it is usually pretty hard for the first 4-6 weeks, but then starts easing up.

3) Final option is to just do strict surveillance and not start any treatments unless something grows again that we can see. This would mean scans every 2 months. My doctors at NIH suggested this option. They make the argument that if we don't have a tumor to monitor then how will we know if treatment is working....and how do we know we aren't going through all the side effects for nothing. VERY good questions in my opinion. :)

If you know me well, you know I am a procrastinator. I will put off decisions as long as physically possible. I also hate fighting and confrontation. So as soon as someone threw out option number three, I was SOLD. I almost stood up, grabbed Jerome, and said, "alright, sounds good to me, peace out, and see you in two months!" Jerome was not as convinced though. We do both agree that option one is not even on the table though. We both feel it's just too aggressive at this point, making the choice either targeted therapy or "wait and see".

Once I get these final two tests done, and meet with one more doctor we will decide. I am getting a 3rd opinion from a Melanoma specialist (vs. a general oncologist) at Georgetown University soon. If we decide to go with targeted therapy, it will most likely start in the next month.

Thank you for for all the prayers and well wishes this past week. Just like last time, it blows my mind how many people from all stages of my life are supporting us again...I can't even explain how much it helps me to know this. Love you all and stay healthy...and just wear the dang mask! ha...had to throw that in there for Jerome. ;)

XOXO,

Lacey