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Last week Shane had a brief phone meeting with the oncologist, and I missed it while on a call with a client. Because I'm not satisfied with hearsay I called the oncologist the next day and got the scoop. Basically at that point after biopsy, bloodwork, and PET scan we knew conclusively that Shane had Stage 4 Melanoma (origin unknown though skin is likely). Stage 4 means that the cancer has metastasized (spread) to distant areas of his body. And having that much knowledge prepared us for today's visit.


Nothing to do with our doctor's visit, but Shane said the best part of his day was listening to the kids play as he lay upstairs in bed. It made him cry.


We met our prospective cancer team at Stanford (doctor, nurse practitioner and RN). Everyone was very kind and generously gave us two hours of their time. I asked a lot of questions (the advocate doula in me coming out) and got a head to toe tour of Shane's CT scan results. While I knew what I would be seeing it still felt so very stark to see the dark cancer spots all over his torso. I immediately asked the oncologist if "widespread" would be a fair word to describe what I was seeing, he replied yes.


Their suggested line of care (in order of preference):

  1. Immunotherapy-drugs that "turn on" the body's immune response to cancer. Cancer is a sneaky son of a gun and "turns off" the body's natural immune response so that it can grow uncontrolled. Treatment would take 1-2 years to complete, every 3 weeks, some gnarly long-term side effects to consider (while rare they still give me pause). Right now I'm digging into all the research on these immunotherapy drugs. If indeed we choose this path I want to understand them inside and out. Funny to note that while watching a baseball game last week, Shane saw BOTH potential immunotherapy drugs advertised. Why the heck does direct to consumer advertising for cancer drugs exist?

  2. Targeted therapy- Shane has a BRAF mutation in his melanoma (points to it originating in the skin) and targeted therapy (what else?) targets the BRAF mutation. Apparently it's less effective than immunotherapy

  3. Chemo-no details on that since it's a last choice.

We plan to get a second opinion from UCSF and possibly another local hospital. We don't anticipate hearing anything new from those other facilities (the Stanford team told us that recommendations will be standard across the board), nevertheless we want to gather all the information we can about conventional treatments. We will also pursue all the possibilities that CAM (complementary alternative medicine) offers, and there are many. Shane and I would like to blend the best of both worlds.


We'll continue to carefully consider our options this week.

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