[Jamesalaos]

Melanoma with multiple myeloma

by Jamesalaos on Thu Oct 22, 2015 10:15 am

I was diagnosed with melanoma 3 months ago. With more than 200 moles (many growing and all sorts of wonderful coloured) on my legs and torso, total surgical removal is impossible. The worst ulcerated and I have a 15 cm (6 inch) hole in my foot. The only treatment available to me in Lao is interferon alpha 2b, which I started 6 weeks ago.

This week I have been diagnosed with myeloma. Unfortunately there is a complete lack of any specialist knowledge. As a teacher in Lao in Southeast Asia, any further treatment is beyond my budget. What I want to try to discover is should I stop the interferon treatment?

[Little Monkey]

Re: Melanoma with multiple myeloma

by Little Monkey on Fri Oct 23, 2015 6:49 pm

I don't know if anyone here can answer that, what has your doctor said ?

[Little Monkey]

Re: Melanoma with multiple myeloma

by Little Monkey on Sat Oct 24, 2015 12:54 pm

I know you said costs of treatment are an issue, however did you look at how much treatment would be at a public hospital in neighbouring Thailand (Thailand has the highest standard in hospitals in the area)

[Kathode]

Re: Melanoma with multiple myeloma

by Kathode on Wed Oct 28, 2015 6:22 pm

Hi James,

Sorry to hear of your dual diagnosis.

My husband has both multiple myeloma and metastatic melanoma too. We live in Queensland, Australia, where melanoma is common.

His history dot points are:

• February 2011 - Diagnosed with multiple myeloma, IgG kappa 35 g/L (3.5 g/dL) with many lytic lesions. (Bloods were investigated as he was 'falling off the back of his road cycling group'.)
• 6 months of thalidomide + high dose steroids.
• Complete response with M-protein undetectable.
• 24 months of Aredia and IV Intragam (IVIG) monthly.
   
• April 2015 Multiple myeloma relapsed. Started Revlimid + steroids.
• July 2015 Melanoma detected in a lymph node. No primary detected.
• Following whole body PET + brain MRI, small melanoma in right frontal lobe identified.
• July 2015 neurosurgery to remove brain tumour. Melanoma determined to be BRAF mutant type.
• August 2015 Started targeted therapy with BRAF and MEK inhibitors. Severe side effects early on.
• September 2015 resumed Revlimid / dex as protein at 30 g/L (3.0 g/dL). (This was paused for neurosurgery and recovery plus establishment of targeted therapy.)

Both regimens seem to be working and not interacting adversely. Bloods are a bit low but he is as active as possible. He has always had a healthy life style – cycling, jogging, gardening, art, cooking.

He even 'escaped' hospital prior to the neurosurgery and ran 4 km (2.5 miles) along the Brisbane river!

He has two brilliant oncologists! All specialists (and there have been many, including a brilliant neurosurgeon) have spent valuable time explaining treatment regimens / surgery / pathology and advances in options to us both and we realise we are very fortunate to live where we do.

My advice is to hot-foot it to a 1st world medical destination, if at all possible, for thorough assessment and treatment. (The interferon sounds right too – I'm no expert). These are seriously bad guys and need to be hit hard and fast!

All the very best with your treatment!

[Kathode]

Re: Melanoma with multiple myeloma

by Kathode on Wed Oct 28, 2015 6:38 pm

Hi James,

On reading my post I realised, I omitted the fact he had an autologous stem cell transplant (ASCT) following high dose melphalan in October 2011 and the complete response followed this. He also had a deep vein thrombosis (DVT) and pulmonary embolus while on the thalidomide regimen as a side effect.

We have traveled often overseas and in Australia over the last few years, including to Laos in January 2013, cycling in Vietnam in November 2013, cycling in China in October 2014 and Europe. We loved Laos and its people.