Skin Diaries This is Brave

This is Brave: Steve Hamilton

October 8th, 2006. I remember the day quite vividly. A week prior, I had been to my dermatologist to have a small bump on my head looked at. Not overly concerned since it didn’t have any of the typical signs of melanoma. My doctor scraped off enough for a biopsy and I went back to work. Then, on October 8th, I was in a conference room and my phone buzzed. It was my dermatologist’s office calling. I excused myself from the meeting and stepped into the hallway to take the call. It was my actual doctor and not the physician’s assistant. After an exchange of pleasantries, she paused, “I got the results of your biopsy. It’s cancerous. You have melanoma”. I was stunned by the gut punch. The rest of the day was a blur. At that moment, my cancer journey had officially begun.

Two months later in December, a surgical oncologist removed the tumor along with some adjacent lymph nodes on both sides of my neck. The tumor was deeper than expected and diagnosed as stage III melanoma, but it was removed. Margins were clear and I had no cancer activity in my lymph nodes. I felt fortunate and believed that I dodged a bullet.

In 2008, after two years of being NED (no evidence of disease), a follow-up routine chest X-ray showed shadowing and spots on my lungs. The melanoma had returned and had reached a stage IV diagnosis. Over the next 18 months, I had three lung surgeries to remove new tumor growths and wedge resection surgeries that took away 25% of my lungs. I tried to stay positive and committed to outrunning the cancer, literally. I took my exercise to a higher level, enhanced an already good diet, and made a conscious effort to mitigate the stress in my life.

After my third lung surgery, I completed 30 days of Interferon treatment (a form of chemo). It was challenging and I’d never felt worse in my life. Despite the steps I’d taken, by May of 2011, a CT scan revealed that I had tumors on both lungs, pancreas, liver and behind my heart. My stage IV diagnosis became more severe.

I met with my oncologist to map out a treatment plan. I wasn’t going down without a fight. Unfortunately, another surgery was not an option and my doctor didn’t know of any clinical trials. Basically, there was no plan. My doctor looked at me and said, “there is nothing more I can do for you”. Those words pierced the air. Emotions ran rampant, but reality had a way of setting in quickly. I had stage IV melanoma and there is no stage V.

After trying to fully comprehend the odds I was up against, I promised myself that I would find someone, somewhere to help. I wanted to give myself the absolute best chance for survival, so I sought out arguably the best place for cancer treatment – MD Anderson in Houston, TX. They are ranked No. 1 in cancer treatment year after year and are known for advanced cancer treatment options.

My wife and I flew from Atlanta to Houston and met with Dr. Patrick Hwu, a highly respected oncologist specializing in melanoma (today he is the Division Head of Cancer Medicine). When we met, it was clear that he had already reviewed my case as he said, “We’ve got a growing number of options in the melanoma treatment toolbox and I think we can help you. It’s never a good time to be diagnosed with melanoma, but if ever there was a time now is it”.

Amongst the options available, we talked a lot about a relatively new treatment category at the time called “immunotherapy” – training the cells of your immune system to seek out and destroy the cancer cells. After weeks and weeks of various testing, certain treatments were ruled out since my cells did not respond. Ultimately, the best option was a clinical immunotherapy trial that combined high dose IL-2 interleukin (a standard of care treatment option for melanoma at the time) with the Mage 3 vaccine. IL-2 by itself had a pretty low rate of response, but the clinical trial was to see if tying it to a vaccine would improve the response rate. The treatment had drawbacks – side effects, physical hardship, mental challenges, a long duration, and of course, the fact that the trial was new and nobody had completed it at that time.

To fulfill the inpatient treatment requirements, I would travel to MD Anderson in Houston for a week at a time, then return home for one to three weeks. I did this for about eight months. The biggest criterion of the trial protocol was that after each week of treatment I underwent a full CT and a brain MRI. If tumors were stable or shrunk, I continued with the trial. If they grew, then I was removed from the trial.

I started the first week of October 2011. The treatment was tough. Each time I was in intensive care hooked up to multiple machines monitoring every vital you can think of. I gained about 40 pounds of water weight each week and then would have to lose it before I was discharged. I experienced uncontrollable chills and muscular spasms. My heart rate would spike into the low 200’s after each dose of IL-2. My taste buds all but disappeared and I hardly ate. Somehow, in the haze of it all, my immune system responded, and my tumors began to slowly shrink. Week after week, month after month, my CT and MRI results showed progress and I kept going back to Houston for treatment.

I finally completed the inpatient portion of the trial over the eight-month period. Although extremely happy to finish, I wasn’t done. I continued head, neck, chest and pelvic CTs and brain MRIs immediately prior to each return trip to Houston. Every three months, then every six months to get lab work done, meet with my research nurse to answer a litany of questions about how I was doing physically and mentally, meet with Dr. Hwu and, of course, get my vaccine. On February 14th, 2014, in Houston for my checkup and scan results, I received the news I had been dreaming about. My scans and MRI showed no tumor activity. I was in remission. 

After that landmark day, I continued getting CT scans, MRIs and the vaccines for another year. In July 2015, after 4+ years of countless hours in the ICU and flying back forth from Atlanta to Houston for the vaccine, I become the first patient to complete the IL-2 & MAGE 3 clinical trial.

It’s now May 2020 and I am 13+ years removed from my original melanoma diagnosis. I’ve had a combination of 16 major and minor surgeries. But most importantly…I’ve been cancer-free for six years.

My advice to you after all of this is to accept the facts and realize that no one is immune. More people are diagnosed with skin cancer each year in the U.S. than all other cancers combined.

Melanoma is the third most common cancer among men and women ages 20-39, and on age-related cancers, melanoma is the #1 most diagnosed cancer among 25 to 29-year old’s in the United States. So be smart! PLEASE wear sunscreen and sun protective clothing, check your entire body for changes in your skin and see your dermatologist regularly. Most importantly…enjoy life and take care of your body – it’s the only one you get!

For those still battling cancer – keep the faith, keep fighting and don’t ever give up. Above all, always believe that miracles are possible.

Peace!

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