Expert: Claes-Gustaf Nordquist, M.D. - 11/13/2008

Question
My best friend was diagnosed this spring with Stage IV Melanoma.  He is in a Clinical Trial of Genasense w/Dicarbazine and has had three rounds of two treatments.  Last week he lost the use of his left side and when we went for his treatment they did an MRI of his brain and spinal column.  This morning they called and said he has a 1.5cm tumor in the right lobe of his brain.  Presently he has lesions/tumors in his lungs, chest, and upper cavity some of which have shrunk and some have grown but very little either way.
What are we looking at here as far as his chances.  A little honesty would be greatly appreciated at this time.

Thank you,
Deborah

Answer
I always try to be honest here! Unfortunately he has a stage 4 (worst) malignant melanoma that now also has spread to his brain. In this situation surgery is I'm sorry to say not much of an option. Malignant melanomas are usually not very sensitive to chenotherapy and to radiation therapy either. Some promising and interesting experiments in immunotherapy are going on but they are still experimental. So unfortunately I have not much to offer. Since it has spread to his brain I estimate that his survival time can be measured in months at most. I'm sorry I have nothing better to tell you! His brain lesion may be treated with intense radiation from the so called GammaKnife. His lesion is small enough for that. That may help him in his present situation but it will unfortunately not change my prediction.