SOS from a Melanoma 4mm patient in China

ShiMian · New User Joined: 13 May 2009 Posts: 3

My father in China was recently diagnosed with Melanoma under left feet sole thick with 0.4cm (4mm), ulcerated and penetrated to reticular dermis. Because Melanoma is relatively rare disease in China, the doctors there lack the experience and skills. We are desperate and would like to seek your help.

Our Story:
The surgery of the original Melanoma area was performed in mid March 2009 in a top hospital in local province without any lymph node exam. Then my father flew to Beijing to seek further consultation. The doctor in Beijing concluded that the margin of surgery was not wide enough (1cm short) and the stage was IIB T3bN0M0. We doubt the stage is correct. Given that currently the sentinel lymph node procedure is not available in China, the doctors count on Ultrasound to determine if Melanoma has spread to nearby lymph nodes (accuracy was said about 70-80%). Although Ultrasound shows lymph node enlargement* in left knee and groin areas, the doctor in Beijing somehow concludes no sufficient evidence supporting any lymph node spread. The treatments he prescribed included large dose Interferon-alpha and CIK-DC (cytokine induced killer- dendritic cell). My father is now back to local province for large dose Interferon-alpha treatment. But he needs to be back to Beijing for CIK-DC for three weeks a quarter.

Question

My father is going through ordeal physically and emotionally. And the family members have been stressed out. My father feels extremely tired and weak. He has serious headache, toothache (old problems) and throat ulceration. The blood work shows the current treatments have caused damage to the liver function. What is more, a small lump at size of thumbnail recently developed at the edge of the surgery area under the left foot since May11. The surgeon who performed the surgery 2 months ago thinks the lump results from walk.

Our Questions:

1. Is it necessary to surgically remove any affected or suspected lymph nodes for 4m thickness? If yes, can we still do this now after almost one month large dose Interferon-alpha treatment?

2. The Interferon-alpha was given at 18MIU daily for 5 days a week for a month. Then Interferon-alpha 9MIU will be given three times a week for 11 months. Is the dosage and frequency OK? Given the serious side effects, we wonder if the follow up 11-month Interferon-alpha is necessary.

3. How do we rule out the small lump developed recently is not reoccurrence of Melanoma? If it turned out to be reoccurrence, can we remove them at wide margin only 2 months after the first surgery?

4. CIK-DC* (cytokine induced killer- dendritic cell) is a new treatment in China. We are not sure of its efficacy and long term effect. Anyone tried the similar treatment before?

5. Any particular food/ out of counter medicine might be good for my father?

* Ultrasound result: Left groin hypoechogenicity lymph node, 0.8*0.4cm; several shooting-circle shaped lymph nodes at both groins, partial skin thickness, left groin max 1.2*0.4cm, right groin max 0.8*0.4cm; Left knee hollow shooting-circle shaped lymph node, 0.8*0.6cm, right knee hollow no obvious lymph node

* CIK-DC introduction:
{Links deleted by admin}
_________________
Thank you for offering hope.

Regards,
ShiMian

brainman

Hi ShiMian, I am very sorry about your father’s melanoma. Will I do not know much about melanoma’s I will try to answer your questions as far as possible.

1. Is it necessary to surgically remove any affected or suspected lymph nodes for 4m thickness? If yes, can we still do this now after almost one month large dose Interferon-alpha treatment?

If they find that a node looks suspicious, they can always go back in and remove it. I do wish he had access to the SNB but now that is too late.

2. The Interferon-alpha was given at 18MIU daily for 5 days a week for a month. Then Interferon-alpha 9MIU will be given three times a week for 11 months. Is the dosage and frequency OK? Given the serious side effects, we wonder if the follow up 11-month Interferon-alpha is necessary.

The information that comes with the Interferon says:

"The recommended daily dose of INTRON A in induction is 20 million IU/m2 as an intravenous infusion, over 20 minutes, 5 consecutive days per week, for 4 weeks"

So the dosage your father will receive is correct except that he would get 20 MIUs and not 18.

3. How do we rule out the small lump developed recently is not reoccurrence of Melanoma? If it turned out to be reoccurrence, can we remove them at wide margin only 2 months after the first surgery?

As with question 1, if he has a local recurrence, surgery is still the best option. However, if it metastasizes to another organ, then the only thing they can do is some form of chemotherapy.

4. CIK-DC* (cytokine induced killer- dendritic cell) is a new treatment in China. We are not sure of its efficacy and long term effect. Anyone tried the similar treatment before?

I do not know anything about CIK-DC. However, the first hit on Google is from the Cancer Therapy China site announcing its availability Very Happy

5. Any particular food/ out of counter medicine might be good for my father?

You might find some advice at http://www.rxlist.com/intron-a-drug.htm … this is the site I look at when answering medication questions Wink

You and your father are in my thoughts and prayers.
_________________
Jim
Administrator and long-term cancer survivor
1992 Astrocytoma grade 2, left motor strip
2005 Recurrence this time said to be an Oligodendroglioma grade 3, same location.
http://cancerforums.net/viewtopic.php?t=2405
My Story Part 1: http://cancerforums.net/viewtopic.php?t=2528
My Story Part 2: http://cancerforums.net/viewtopic.php?p=7350
My Story Part 3: http://cancerforums.net/viewtopic.php?t=8029
Twitter: @JimHawkins54
FaceBook: http://www.facebook.com/James.Hawking54?ref=profile

ShiMian · New User Joined: 13 May 2009 Posts: 3

Hi, Jim

Thank you for your response. I really appreciate all the info and support offered through your site. I wish the similar site available in China to offer some support and hope to the growing Melanoma patients in China. Most of them live in the dark by themselves.

The doctors in China have different opinions about if lymph nodes dissections of suspected lymph nodes are necessary in my father's case. I don't have much faith in doctors' decisions here. But I guess we have to follow their intructions for now.

Thank you.

ShiMian
_________________
Thank you for offering hope.

Regards,
ShiMian

ShiMian · New User Joined: 13 May 2009 Posts: 3

I have read a lot of your stories through this site. I salute all of you who have either bravely fought Melanoma or supported your loved one going through this. Compared with many of you, his case is not that serious yet. But little experience and low skill levels of local doctors add a lot of complexity to his case. We can't complain as Melanoma is relatively rare compared with other cancers in China.

My father is undergoing the forth week of high dose Interferon. And he feels very misrable. . Is it necessary for my father to continue 11 more months' interferon? Any harm/risk if we discontinue after 1 month's high dose?
_________________
Thank you for offering hope.

Regards,
ShiMian

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