Expert: Karen Brawner - 7/28/2004

Question
Thank you so much for your answers. The problem is that a very very close person to me has the cancer and I'd like to learn as much about it as possible. Thanks!


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Followup To
Question -
Hi
Thanks so much for offering this service. I'm going to get straight into the questions because this is very hard for me
1) What's the average survival rate for someone with metastatic malignant melanoma stage 3?
2) What kind of treatment is there and is the response to treatment usually positive?
3) Can the treatment completely eliminate the cancer?
4) How long is the treatment, how often does one have to get it and how long are the hospital stays/if any?

Answer -
Dear Eileen,   Since you were straight forward with your questions, I will try to be straight forward with your answers unless I need more information and then you will have to provide it, so I can be more specific....

I would really like you to tell me if this melanoma originated from a skin lesion or did this melanoma originate from an internal organ such as the colon....  This usually makes a difference not only in treatment, but also prognosis...  I also want to tell you that malignant melanoma is one of the most rapid spreading types of cancer there are....  The fact that yours has been diagnosed Stage III, means that it has already spread to CLOSE lymph nodes and very possibly other organs as well....  I also have to assume that you have had surgery to remove as much of the cancer as possible (depending on where the original cancer site was)...
I also HOPE that your doctor has ordered ct-scans of the brain, chest, abdomin, pelvic area and the bones.... I say this because cancer travels through the entire blood stream and the entire lymphatic system...  Stage III already tells me that cancer has been detected in SOME lymph nodes somewhere (you did not say where).... Cancer cells travel through the blood stream and are NOT DETECTABLE until they have formed a tumor/mass....  Also, there are 2 different tables that doctors can use to stage a cancer... If your doctor's pathologist is using the WHO, then stage III means that DISTANT metastasis is already present (this would mean like the lungs, brain and distant lymph nodes).... If the pathologist is using the AJCC for staging then stage III means regional lymph nodes are involved and in-transit metastasis is present....  Either way, prognosis is not good..

Now to your questions....

1.  The maximum average survival rate for someone with metastatic malignant melanoma Stage III is 2 years... However, if the WHO staging is being used, then average survival rate is from 6-15 months... If the cancer has spread to MULTIPLE organs, survival is 6-9 months.. If the cancer has metastasized to the skin, subcutaneous tissue or distant lymph nodes, then the average survival rate is 12-15 months..
If the cancer has already spread to the lung, then the average survival rate is 11 months and if the cancer has already spread to the liver, lungs, brain or bones, the average survival rate is 3-4 months...

2.  This question really depends on WHERE the cancer has spread to and how wide spread the metastasis is... Chemotherapy is NOT very helpful in treating melanoma, and immunotherapy drugs have seen the best life-extension rate.   In either case, the prognosis is NOT positive usually...

3.  At stage III it would almost be impossible to eliminate the cancer... As of yet, there has not been a so called "cure" for metastatic malignant melanoma...

4.  Length of treatments depends again on where all the melanoma has spread... For instance, if the melanoma has already spread to the brain, the probable only treatment would be radiation to try to shrink the tumor(s) and relieve some of the symptoms, but it is not a cure...  Using immunotherapy drugs, injections could last as long as months-years depending on the drugs used... With immunotherapy drugs the patient may or may not have to be hospitalized, again this depends on the advancement of the cancer and if other drugs besides immunotherapy drugs are going to be used and also the overall health of the patient..

If you can give me more information like exactly where the primary melanoma was found (internal organ or skin lesion) what tests were done to diagnose metastasis, age of the patient etc,  I will try to help you more...

I am here for you so do not be affraid to ask ANYTHING or talk about anything....     Karen

Answer
Dear Eileen, I understand your wanting to know as much as possible about this cancer since it is a deadly form and not much hope for curing...

However, I need you to get me the information I stated above, find out if the cancer started as a melanoma SKIN cancer or if it actually developed in an organ like the colon etc....

I am here for you and will answer your questions with honesty, but YOU need to tell me everything your know or can find out...

Thank you,   karen