28 years old Madison had just arrived from her honeymoon and wedding, she decided to get tests done on the hard marble-like lump that was present in her left inner arm.
It was only after an excision was sent and a result confirmed that it was melanoma on Friday, 13th October 2023. The dermatologist called her up, informing her that it was metastatic melanoma. All Madison had experienced before was a skin mole when she was 18 years old and she had undergone a biopsy of the left forearm. Around that time, they told her that there was nothing abnormal to fear for. The crazy thing was that as a physician assistant she’s been diagnosing patients throughout her career for cancer! A punch biopsy is an instrument that is sharp, hollow and circular used to remove a small, round tissue piece. It turns clockwise and then anti-clockwise to reach the fatty tissue beneath the skin, cutting up to 4 millimetres in the process. For chronic diseases that are unpredictable in nature like melanoma, the term ‘no evidence of the disease’ is used. Abbreviating to NED. Tumour markers do not demonstrate any disease findings.
There was NED on the follow-up to having scans after every 6 months. She narrated as to how she could’ve had an immunotherapy done at that time, the hospitalists thought that it was odd that there’s no malignant spread to the lymph nodes nor the other body parts and organs yet. There was confusion on how the cancer needs to be monitored. Should she go for chemo? Or should a scan be sufficient enough? She had completed her immunotherapy on March 2024. It was a matter of time, before she found another mole on her upper right-side of her back, where the same marble-hard lump was present. Her mood was dampened by the appearance of the cancer again, she and her husband planned a visit to Florida to visit her grandparents. She found out another mole as she was massaging her entire body. She opens up as to how unimaginably difficult it was to convey the news to her husband and family, telling them 2 or 3 days after.
She had shifted her MRI scan from April to another successive month. Doctors discovered a 1.2cm tumour on her right temporal lobe. There was also another mole on her right hip area. Again, she would go through a dual immunotherapy regimen that is scientifically proven to slow down cancer on a 2021 research conducted by John Hopkins. The first session of immunotherapy was on April 29th. Her body responded well for the most part except for one side effect that was itchiness. She recalls that the itch was ten-fold the normal. She had a fever as well. Then she wasn’t feeling great that day. So, they recommended her to follow-up with the oncologist. She admits to taking Tylenol to cope up with the fevers. The next day, her fever was more higher than the previous day, her heart rate was up 140 and this was extremely unusual. Her oncologist got back on the call; she had to be admitted back for treatment. Extensive testing was carried to rule out other potential diseases that could’ve arisen from immunotherapy. Eventually, autoimmune hepatitis was reported. MRI and PET scans were performed, her PET was negative. Apart from a culture of cells that had to be taken, radiation was the treatment option for her brain tumour.
Source: The Patient Story.
Credit: http://www.cancer.gov, http://www.lifespan.org, http://www.hopkinsmedicine.org.
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