Expert: Claes-Gustaf Nordquist, M.D. - 5/15/2008

Question
My wife has melanoma on the left side of the brain. She had two surgeries to remove this the best they could. The surgeries were in Dec 07. She went through radiation that ended in Mar. She now has a spot near her kidney that has not been biopsied but they are concerned about it and have started temador for 42 days. She has also had a another MRI done and they have found a spot on the right frontal lobe. Could you please tell me what is going to happen next what to expect? I have very scared and all the doctors are feeding her false hope should i be planning for. From the time frame of Dec 07 until now how fast spreading does this sound and what kinda of time frame am i looking at. Im tired of not knowing. Thank you for giving me the hard facts.

Answer
OK, the HARD facts! Your wife now has a stage 4 malignant melanoma. That is unfortunately incurable. Especially as it has spread to her brain. Surgery can not cure her and malignant melanoma is usually not very sensitive to radiation therapy or chemo therapy. Some interesting and promising experiments are going on with immuno therapy against this kind of tumor, BUT they are still experimental. It is impossible to predict survival time with any accuracy but in her case it can probably be measured in months. An educated guess would be that it would at most be around one year, probably somewhat shorter. That is as close as I can come. I'm sorry I have nothing better to tell you! Her brain symptoms will dominate the picture. Over time she will be more and more confused. There may be stroke like symptoms and even epileptic fits. She will sleep more and more, eventually drift into a coma and then pass away! There will be very little pain - if indeed any!