My delayed date with NED

For those who were looking for an update from Robert’s first follow-up appointment – sorry, it will come a little late. That’s because he is hoping to enter the GVAX vaccine trial at Johns Hopkins, and the earliest appointment when they can do all the screening on one day is October 18. I’m happy that we know what’s next, but unhappy about the delay – I was looking forward to another date with NED long about now!

With the “watch and wait” follow-up, patients are screened quarterly with a Wood’s lamp. In this screening, the dermatologist examines the patient’s skin with a special light that highlights any contrast in pigmentation that indicates melanocytes have been destroyed by an immune response, indicating an early-stage melanoma. They also have follow-up PET/CT scans twice a year. Following that schedule, Robert would have been screened and examined (poked, prodded, etc.) last week, and at least we would know that there is no skin metastasis and none of his lymph nodes are enlarged - in other words, he would still be NED. The PET/CT would have been ordered in December.

So, we’ll wait until October 18 for his first follow-up exam. The good news (to me, at least!) is that he will also have a full complement of other scans and tests that day – including the PET/CT scan that otherwise would be given in December and an MRI of his body, including his brain. We expect these scans to be much more detailed and inclusive than the tests he otherwise would have 90 days after surgery.

The screening that day will repeat many of the tests he had during his pre-surgery physical, including standard blood tests and kidney and liver-function tests, an EKG, and blood tests for Hepatitis B and C as well as HIV. Bad results on any of these tests could knock him out of the study, even if none of the scans turn up evidence of melanoma.

But we’re fully expecting everything to go smoothly from here on out. And assuming all goes well, his first vaccine injections will likely be scheduled for the first or second Tuesday in November.

Guess who might make good use of early voting in D.C. this year?!

Call or email if you have questions. We’ll answer them if we can.