Mel pays another visit

I was in Portland yesterday to see my oncologist about some new metastases that I've detected. There are three of them, all easily resectable. This is obviously disappointing news, but their appearance is a fairly predictable part of the natural history of the disease. I had five subcutaneous mets last year, and will likely have more in the future. The mets are small—no bigger than a pea—but can be seen and felt just beneath the skin.

Because of this change in my status, I will move my next PET/CT scan up from April. Melanoma is notoriously unpredictable, but given the indolence of my disease, it’s unlikely the mel will have spread to internal organs. That’s obviously my hope. Assuming a negative scan, I’ll have outpatient surgery with the redoubtable Dr. V at OHSU shortly after the scan—probably early March. He's done more carving on me than a holiday turkey.

My oncologist once again brought up a clinical trial that’s available for a drug that’s injected directly into the lesions, but this vaccine (OncoVEX) has side-effects and, frankly, not much upside for patients in a holding pattern like mine. Because my tumor burden is very small at this time, surgery is the obvious choice. I'm determined to avoid a decision about systemic therapy for as long as possible.

Meanwhile, I feel as good as ever—no symptoms. I ran five miles this morning under the prettiest bluebird sky you'd ever want to see. Yesterday was a tough day, but I’ve cycled through this routine enough times now that I can reset emotionally pretty quickly. I know I’m under God’s care and that his love prevails over everything, including an unwelcome visitation by melanoma.