Expert: Claes-Gustaf Nordquist, M.D. - 2/22/2008

Question
QUESTION: 15 years ago my friend was diagnosed with skin cancer, this came back as milinant melamoma in her leg, this was removed, it has now appeared in her ovaries, she had a hysterectomy, and 4 weeks later has found a lump in her breast. while waiting to be seen for this she has developed severe headaches, she has been for a brain scan has has a tumour in her head 3cm wide. i dont understand what is going on and nd to honestly what is going to happen to my friend and what i can do to help.

ANSWER: Malignant melanoma is a very tricky skin cancer that can reappear again after MANY years. In this case it has reappeared in / spread to her ovaries, her brain and perhaps her breast. So it has reached other organs. That means that it is now a stage IV (4) cancer with a very bad prognosis. Malignant melanoma is usually not very sensitive to radiation therapy or chemo therapy. Experiments in immuno therapy are going on but they are still experiments. Unfortunately your friend will probably  have a survival time that can be measured in months rather than years and there is unfortunately nothing you can do about it except by giving her support. I'm sorry I have nothing better to tell you!


---------- FOLLOW-UP ----------

QUESTION: thank you for your honesty. Is there no way that my friend can beat this? what is the percentage of survival rate for beating this?
I was not clear before because she has got cancer of the breast, the doctors have decided to leave the breast for the time being, because the biggest risk is her brain not her breast. she starts radium on monday for ten days, when will she know if this is working? and what if it doesnt work?
the tumour in her brain is at he back of her head,is there no way that they can remove it? will the cancer spread anywhere eles or is the brain the last stop?
this all seems so unfair my friend is only 30 years old and has two young children, she is a very strong positive person can this help to beat it?
she appears to be fine at the minute, she doesnt even look ill so  i dont understand how she could not be here in just a few small months? how and when will she detiriate? what side effects will the treatment give her? i thank you so much for your time and help.

Answer
No, unfortunately not, survival rates in situations like this are 0 (zero)%. Ok so she has probably another cancer too! I agree with her drs. that in this situation it is useless to tackle any breast cancer but that does not mean unfortunately that any treatment of her melanoma will be successful. Even if her brain daughter tumor is removed it will most probably just reappear somewhere else just as it has already done in her leg and ovaries. If it has spread somewhere it is also most probable that it has spread elsewhere too even if not detected or even detectable yet. Her personality and attitude are unfortunately of no help in her ability to survive this. It is impossible to predict survival times etc. with any accuracy. I can only give you the general idea. It can spread to ANYWHERE in her body. There are no fixed time tables or position charts. So it may spread anywhere at any time.  If radiation does not work - and unfortunately I doubt that it will - surgery can be considered again. But I have not much faith in that either here. Radiation to her brain may cause brain swelling (like an internal sun burn). That can be countered by giving her corticosteroids but they have side effects themselves.

With 2 cancers at such an early age and with children I think some gentic counseling may be important.