Gary’s history with "The Beast" (Melanoma)

My husband Gary was an avid gardener who loved doing anything with lawns. In the spring of 2010 we noticed his left groin area was swollen. We thought it might have been a muscle pull from lifting the lawn mowers in and out of the bed of his truck. After a while the swelling went down and we forgot about it.

In the spring of 2011 I noticed a mole on his left side was bleeding a little. Since he did lawn maintenance he thought maybe something from one of the lawns had been kicked up and cut him. It stopped bleeding and we thought everything was okay. In the beginning of august the spot was darker, a little larger and was bleeding again. I begged him to go to the dermatologist.

In September he had a biopsy done. It was positive for melanoma. We knew a little about it, but not enough for us to be alarmed.

After we got the results of that biopsy the dermatologist wanted him to have a biopsy of his left groin area since the swelling was back. The biopsy was done in October. This also was positive for melanoma. This put him at stage II. The dermatologist wanted Gary to have a PET scan. The appointment was set up, but when Gary saw the PET machine he had an anxiety attack and was unable to go through the machine. Another appointment was scheduled for a CT scan. This scan was done just before Thanksgiving 2011. The results showed the melanoma was only confined to the left flank and left groin area. The dermatologist referred him to an oncology surgeon.

December 8, 2011 he had a 6 hour surgery to remove the melanoma tumor from his left flank and lymph nodes from his left groin. In total, 15 lymph nodes were removed, only two were positive. During the surgery Gary received ‘tape’ burns (second degree burns caused from tape being torn off too soon). The surgeon said he ‘got clean margins’, so we thought Gary was in the all clear. We knew he’d have to follow up with radiation, but he had to wait until the burns healed. During this time he went back to the surgeon for follow-up appointments every two weeks. Three weeks after surgery I noticed little black dots just under the skin all around the surgical scar. I took pictures and emailed them to the surgeon.

The melanoma was lurking just under the skin, waiting for a chance to pounce. And pounce it did!

On February 7, 2012 he had his first appointment with the oncologist. On February 10, he had another CT scan to be mapped out for radiation treatment. He began the first round of radiation treatments on February 20, 2012. The treatments were Monday through Friday. On March 01, 2012 he had another CT scan. The results showed “possible” melanoma lesions on his right lung.

He continued radiation and on March 19, 2012 he began taking 140 mg Temodar. This medication is supposed to make the cancer cells more susceptible to radiation.

On April 02, 2012 the radiation oncologist began ‘superficial’ radiation treatment. This type of radiation targets the ‘superficial’ layers of skin. He had 5 treatments like this, ending on April 6, 2012. The Temodar was also stopped on April 6, 2012.

Due to the type of radiation Gary had, he received 2^nd degree burns. The radiation oncologist told him to ‘put some lotion on it’ and it will be fine.

On April 16, 2012 he began taking 300 mg Temodar for one week. The burns were really hurting him so he was referred to the wound clinic at a local hospital. After that visit, the burns had almost healed within a week.

By April 27, 2012 Gary had more melanoma skin metastases on his left side. The oncologist said the Temodar and radiation combo didn’t work. He was scheduled for another CT scan on May 1, 2012. This scan showed progression in his lungs, lymphadenopathy and cutaneous metastases. His brain scan was clear (the only good news so far).

On May 05, 2012 he started 960 mg Zelboraf. By May 7 he had already developed extreme sensitivity to sunlight. He continued on the Zelboraf full strength until June 5, when the oncologist reduced the dosage to half. All the while, the cutaneous metastases are still growing and spreading.

Zelboraf can cause squamous cell carcinomas to erupt prematurely; meaning if you were going to have them in the future Zelboraf brought them out early. On June 11, 2012 he went in for his first round of squamous cell removal. They removed 6 this first time. On June 15, the oncologist resumed the Zelboraf at 300 mg daily. On July 18, it was increased back to the full dose. On July 19 he had another CT scan. This scan showed. “Overall worsening of disease. Enlarging pulmonary nodule, new liver lesions, new right renal lesion, new left perinephric lesions, new and enlarging nodules within the abdominal wall on the left. A right inguinal lymph node is necrotic and decreased in size.”

On August 1, 2012 oncologist spoke about other options, suggested Yervoy. He had to have a CT scan of his brain on August 3, 2012 before Yervoy could be started. This scan still showed no sign of melanoma.

On August 10, 2012 he started his first Yervoy infusion. On August 24, 2012 he started radiation on his groin and upper left thigh. On August 31, 2012 he had his second Yervoy infusion. The last radiation treatment was September 11, 2012. He was due for the next Yervoy infusion on September 21, 2012 but the oncologist wanted to have another CT scan done to see if the first two infusions did anything at all.

The next scan was on September 18, 2012. The results of this scan were, “Consistent with disease progression with increasing number and size of metastatic lung nodules, liver lesions, right renal metastasis and worsening chest and pelvic adenopathy. New metastatic left adrenal nodule. Innumerable areas of skin thickening and nodularity, predominantly along the anterior left abdomen and pelvis highly concerning for metastatic melanoma.”

On September 28, the oncologist decided to go another route and use a combination chemotherapy. This was to be three weeks on and one week off. He started the first infusion on October 09, 2012.

We renewed our wedding vows on my birthday, October 11, 2012 (the best birthday gift I could ever receive).

October 16, 2012 infusion number two. So far Gary is doing very well with this combination chemo. He has had very few side effects. The day after the infusion he has a lot of energy, but it dissipates rather quickly each day after that.

October 23, infusion number three.

He did well with the first round, so round two began on November 06, 2012.

November 13, 2012 round 2 infusion 2.

November 20, 2012 round 2 infusion number 3.

On November 30, 2012 he had another CT scan to see if this combo chemo was doing anything at all. By the skin lesions, it looked as if the chemo wasn’t working at all. The skin lesions were growing at an alarming rate, spreading and breaking through the skin.

The results of this scan were, “Continued progression of disease involving the lungs, liver, skin, right kidney and lymph nodes. Increasing dermal metastases along the anterior and posterior left side of the chest, abdomen and pelvis.”

I want to add here that Gary developed lymphedema shortly after surgery back in December 2011. The lymphedema got progressively worse. The oncologist explained that since the melanoma was now confirmed to be in the lymph nodes of Gary’s abdominal cavity it would be of no use to do any type of massage therapy. They had to get rid of the cancer in order to shrink the nodes so the lymph fluid could flow through the nodes. His lymphedema was from his toes on his left foot to the bottom of his left abdominal wall across to his right thigh, including his entire groin area. This made it very hard for him to walk, sit or stand.

On December 04, 2012 the oncologist said he had run out of options, but he would check into any possible clinical trials. We knew the chances were slim, but there is always hope.

On December 11, 2012 the oncologist officially took Gary off all treatments, said there was nothing left for him to offer.

On December 19, 2012 at appx 10:30 am, Gary was put on hospice. The hospice nurse said she didn’t think Gary would last to the end of the week. I scrambled to get the lawyer at the house for Gary to sign his Will (which we had to redo the day before). After the lawyer left I had to go pick up my sister from the airport. Seeing my sister was one of Gary’s last wishes. While at the airport, I was also trying to get a priest to the house for Gary. The priest got there a few minutes before we did.

When we walked in the priest had said he was amazed at how in tune Gary was with God. The priest talked to us then said some scriptures from the Bible and blessed Gary. The priest left at about 3:00 p.m. At 4:40 p.m. my beautiful Gary began his walk with Jesus.

From the beginning of September 2012 until December 17, 2012 Gary kept a journal. The last entry in that journal Gary write he knows his time is up, that people just have it inside them. He thanked everyone that had touched his life and he wrote how much he loves me and will always be with me.