Andrew (Andy) Messinger: Beating Advanced Melanoma since 2005
Short Hills, New Jersey
When I was diagnosed with melanoma eight years ago, I was shocked: I had never been a sun worshipper. In 2007, scans showed that the cancer had spread to my lungs, and in 2009, it spread to my brain. As a result of the brain lesion, I became eligible to participate in a clinical trial testing ipilimumab (Yervoy). I have been receiving ipilimumab through the clinical trial ever since and I am thankful every day that it has worked for so long.
It was 2005 when I first noticed a mark on my chest and went to see my dermatologist. He thought it was a blood blister so we were both very surprised when the biopsy revealed that it was melanoma.
My dermatologist referred me to Memorial Sloan-Kettering Cancer Center in New York, where I had the lesion surgically removed. I also had a sentinel lymph node biopsy. Unfortunately this showed the cancer had spread to my lymph nodes and I had to have a second surgery to have lymph nodes removed. Although scans showed no sign of metastases in my body, the fact that the cancer was in my lymph nodes meant that my diagnosis was advanced disease.
At that point, there were limited treatment options available to me. It was do nothing and observe or treat with interferon. Although the use of interferon was very controversial, after speaking with multiple doctors to get their opinions, I decided that it was right for me. Psychologically, I just felt I needed to be treated.
Fortunately, I was able to get the initial interferon treatments locally, in suburban New Jersey. That helped a lot. After that, I continued with self-injection of interferon every other day for a year. During that time I recuperated from my surgeries and resumed my life.
About a year after stopping interferon, scans showed tumors in my lungs. During the surgery to remove the affected parts of my lungs, the surgeon also removed several lymph nodes that were obviously cancerous. In an effort to slow the disease, I was treated with granulocyte-macrophage colony stimulating factor, or GM-CSF. It helped me for a few months, but then scans revealed more tumors in my lungs.
At that point, early 2008, I was not eligible for clinical trials testing a new therapy called ipilimumab that was being talked about on all the patient information blogs. So, I began four rounds of interleukin-2, or IL-2. The tumors shrank measurably. However, IL-2 was tough on my body, and then, in 2009, scans showed new tumors in my lungs and a lesion in my brain.
The brain lesion was a turning point, and if anyone can ever say they are lucky to have cancer in their brain then I was very fortunate. I became eligible for a two-year clinical trial to study the effectiveness of ipilimumab on brain metastasis. I immediately enrolled. I experienced side effects and actually missed a round of treatment as a consequence, but my lung metastases disappeared. Ipilimumab was ineffective against my brain lesion, but this was successfully treated with radio-surgery. I also had radiation therapy to eliminate some lingering cancer in my humerus.
At the end of the two years, I had expected to stop ipilimumb treatment. After all, I had been receiving ipilimumab for two years, and the standard treatment for melanoma patients is four doses over the course of a year. However, the trial was extended for a number of individuals, including me, who had responded well to treatment. Because the goal is to determine whether continuing ipilimumab treatment provides benefit, I still receive ipilimumab quarterly.
Because I am benefiting so much from a clinical trial, I do everything I can to help move clinical research forward. In fact, I participated in clinical trials testing new advances in radio-surgery and radiotherapy during the course of my treatment.
I wish I had not had this experience, but I have, and I want people to understand that cancer is manageable, even deadly cancers like mine, and that there are reasons to be optimistic, even in the face of tough prognoses. The speed of progress in cancer research is such that the situation for patients can change very quickly. But to keep up the momentum, government needs to step up and fund cancer research in a much bigger way.
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