Expert: Claes-Gustaf Nordquist, M.D. - 9/24/2007

Question
My 34 yr old partner was diagnosed w/ stage IIIa Nodular Melanoma last November.  His treatment was a removal of lymph nodes, mole and one month of Interferon as he opted not to take the drug for the 12 months prescribed.

He has been off Interferon since the spring.  Lately he's mentioned being dizzy, trouble seeing out of one of his eyes when watching tv, lightheadedness (e.g., During mildly strenuous activities such as hiking, he complains of being 'off' and has to stop and rest), off and on chest pain and very tired.  

He sees his oncologist for his second post Interferon checkup.  His doctor doesn't believe in sending his patients for CT scans unless he feels a lump or if the patient is blatantly showing symptoms of progression.  I was wondering if these symptoms could mean a spread to his brain or a result of the drug?  

Many thanks,

Michelle

Answer
Interferon usually gives flu like symptoms but hardly the neurological signs you describe. Tell him to let a neurologist check him. An MRI scan of his brain (better than CT scans and no radiation) should quickly exclude or confirm if his melanoma has spread.
I'm sorry you are not satisfied! But from my reply it should be rather obvious that 1. I do not think the most disturbing symptoms of his are caused by his drug and 2. It is possible that his symptoms are caused by a spread of his melanoma to his brain. But to be sure if that is the case or not a brain scan must be done. MRI is in that respect superior to CT. Since his dr. probably will not send him to a scan - as I understand it from your own description - I instead suggested a neurologist since his most important symptoms seem to be neurological. Have I managed to make myself better understood this time?