Definitely Not Better

Monday's PET scan results indicate that Keytruda, the immunotherapy infusion, is not working. The SBRT radiation obliterated the two tumors that Mark previously had, but now there's a new crop. We haven't seen the images, but the report indicates multiple lesions in the liver, a cluster in the lymph nodes at the base of the spine (which is likely the reason for the recently increased pain in the lower back), one in the hip, and a small nodule in his lungs. This is definitely not better! We read the report Monday evening and shared it with our children. While sleep was sparse, we continued cousin camp with three grandsons - ages 9-11. Distractions are helpful, and grandchildren are good for that. 

Tuesday, Mark talked with Dr. Taylor on the phone, and while he admitted that this is not good news, he was still optimistic. 

• There is a clinical trial that may be available with a different immunotherapy drug. So he is looking into that possibility and will let us know today or tomorrow after talking to Dr. Urba and others. 
• The targeted therapy that Mark has used multiple times - first Zelboraf, next the combination of Tafinlar and Mekinist --has a third-generation BRAF inhabitor, that may be more effective. These medications do not eradicate cancer but can shrink tumors, sometimes causing them to go away completely, which happened the first several times Mark used it.  Recently, though, they have not been as effective, as the last two tumors grew while he was on Tafinlar and Mekinist. Perhaps, this third-generation drug will have better results.
• Another option involves surgery to remove a tumor and find the T-cells that are already present. They are the immune system's warriors. They would be reproduced and reintroduced into the body. This is similar to the T-cell harvest, but these T-cells are already fighting, so they don't have to try and find the needle in the haystack.

We are amazed that there are any other options, but research continues, and Providence Portland is on the cutting edge with melanoma therapies. 

Mark's pain continues to increase, and pain meds are less effective, so we are anxious for something to shrink the tumors ASAP! 

Your faith and prayers have worked miracles. Now is a new opportunity for another miracle. Thank you for your love, faith, and prayers. Heaven is listening.