Thursday, May 7, 2009

Dude, what's wrong with your mole?

Oh it's nothing. My barber had clipped it a few months back no worries.

Wow, what a mistake that was. Turns out that my mole which was healthy just three months prior had converted to Malignant Melanoma and started bleeding.

It was getting a bit worrisome how it would not heal so I decided to schedule an appointment with a plastic surgeon. I had three moles removed on December 10, 2008. I was feeling good about the process, I have always had a decent number of moles and several on my neck and head. The plan was to over time have them all removed. My follow up appointment was scheduled for December 17, 2008, one week later. This is when I first learned that mole that was located on the left side of my neck had converted into Malignant Melanoma the deadliest form of skin cancer.

Dr Praful Ramineni, the plastic surgeon made a few phone calls and got me in to see Dr Marc Boisvert at the Washington Hospital Center that same day. I walked back to my office where I called my wife Amy and met up with my business partner and best friend Steven Buxton. Steve and I hopped into a cab and started on my first trip of many to this hospital.

At that point, the plan was to excise the area on the left side of my neck where the original mole used to call home. My first surgery was set for January 16, 2009. The wide local excision was combined with a sentinel node procedure to identify the first lymph node that would be the first target reached by metastasizing cancer cells from a tumor.

The pathology report showed that the 2 centimeter margin that had been excised was negative for melanoma. It did, however say that the sentinel lymph node was fractured upon removal. Meaning, that the melanoma had apparently started breaking apart walls of the lymph node and began to escape.

I was then referred to go see Dr Ziad Deeb. The lead Otolaryngology Head and Neck Surgeon at Washington Hospital Center. The plan now is to be a bit more aggressive and remove the other lymph nodes in the chain in a procedure called a left neck dissection.

This time the pathology report came back and showed that melanoma had existed in the soft tissue just outside the sentinel node but that there was a margin. Yeah! We also learned that of the other 40 lymph nodes that were removed, zero tested positive for melanoma. This was great news!

Now all I had to do was undergo a little targeted radiation on my neck and go meet with Dr William Sharfman at Johns Hopkins and talk to him about other medical and drug options that had to prevent this thing from coming back.

Just prior to this meeting I had noticed a new mole appear on the right side of my neck with a very dark center. I was back in Dr Peck's office within a few days where it boggled him.

"It's not melanoma, it looks vascular", he said.

I insisted that we remove it anyway. I remember the phone call. April fools day and I'm sitting at work. My pal Bob Flanders had just pranked me. Dr Meyer was calling to tell me that the path report came back and the sample had test positive for melanoma. The melanoma has reached the end of the sample and they needed to take a deeper sample to determine if this was a new primary tumor or if this was a satellite tumor from a spread.

This time the pathology report came back and showed that no more melanoma was found and it was determined that we should move forward with the thought that this was a new primary tumor. I would move forward with another round of surgery and then follow up with radiation to burn away any remaining cancer cells that may have gotten away but are still hanging out in the vicinity of the left neck. Then it is all about observing my body and reporting any new suspicious spots or recurrence immediately.

Notable: Cramps are a bitch. On Wednesday, April 29, 2009 I had to sit out a my kung fu class due to some cramping that I had been feeling. I joked with Dan, one of my teachers about it just being gas that I would be back in no time.

Notable: That Saturday night, I could not sleep due to extreme pain in my stomach. I didn't visit the hospital. The pain was gone by morning and pre op testing was coming up.

Surgery is set for May 15, 2009. I go in Monday, May 4 for my pre op testing. I had complained about the cramping feeling to the nurse performing my physical. She was very nice and seemed concerned. She wanted me to have an ECG, where everything came back normal.

I called Dr Boisvert again the next day to talk about the pain that I felt had gone unresolved from the day before. Melanie Goodman is the nurse for Dr Boisvert that has been extremely helpful in getting my case expedited through all the different doctors. She and I discussed the possibility of appendicitis. Probably knowing the entire time that this was not appendicitis the doctor decided that we should still run another round of CT Scans of my abdomen to rule it out. -- Great, more contrast!

You know its bad when the tech comes over to you after the scan and says, Mr Brockey can you hang out for a minute? I need to call the doctor.

"Uh... That can't be good", I said.

He relied, "oh no no, it uh appears that the contrast you drank for the study has filled the entire colon so I want to make sure it's a good picture."

Filled my colon? wouldn't I feel that? ;-)

"Oh okay ... maybe I just need to wait another hour and let the contrast work its way through?", I asked.

"Correct.", said the tech.

Riiiight! How about, dude you have cancer on your liver! He comes back a few minutes later and is like, we're finished here. On my drive home I receive a voice mail Melanie.

"Mr Brockey, Dr Boisvert would like to meet with you tomorrow at 2 o'clock. You should bring your wife along, I know how you like to bring her with you."

"Sh!t.", I thought.

I now have Stage IV Malignant Melanoma. The cancer has already formed about 30 tumors on my liver and a few on my spleen and left adrenal gland. This explains the pain.

Melanie and Dr Boisvert setup another appt for me to meet with Dr Sharfman on Monday May 11, 2009 to talk about further treatment.

It will be interesting to speak with Dr Sharfman about treatment. It seems like chemotherapy is the only real treatment for cancer that has metastasized to distant organs as it is designed to leverage the whole body in it mission to search and destroy cancer cell.

I plan to fight this thing. There are other options. I think that I owe western medicine a chance, but alone I don't think it will help. As radical as chemotherapy is on the body with chemicals and drugs, I think you have to be equally as radical in your way of life and nutrition. A new way of life.

Follow me as I blog about my fight with cancer. My goal is to raise awareness and share information that my friends and family and I think will help the next person in search a better answer.

1 comment:

Anonymous said...

My daughter had melanoma removed from her thigh in September. Surgery showed no signs in the sentinel node. She has an appointment coming up with Dr. Sharfman in 4 weeks because the local oncologist can never answer any of her questions and she went off of the interferon because of the side affects so her insurance company is sending her to Dr. Sharfman for his opinion. I hope you're doing well.