Did I luck out getting melanoma this year?

Change and losing what I love might not be all bad for me

Yesterday I handed Parsley off to her new and I hope more-permanent-than-me owner.

In the short week that Parsley lived with us, I was surprised how quickly she bonded with me. I was even more surprised at how strong my connection was to her. I was shockingly sad to see her go and started thinking about change and losing what I love. 

December is an odd month for me. In addition to all of the holiday busyness, I have a bunch of personal milestones that remind me of change and loss:

• I visited the ER last year on December 4, which launched my foray into Big Medicine

• My mom died on December 6, 2004

• My dad died on December 7, 1997

• My birthday is December 9

Another milestone was saying goodbye to our beloved golden retriever in 2010. She was with us for over ten years, so it was natural for me to be sad. What surprised me then was that her death prompted me to reflect on the deaths of my parents from years prior. What was the connection, if any, between our pet’s death and these other losses?

A dear friend used an apt metaphor:

It’s like fish on the line. When you add a newly caught fish to your line on the boat, they all come up. 

These days I'm primed for thinking of loss. Overshadowing everything is my mortality. Metastatic melanoma is not a disease to trifle with. Before immunotherapy, if a melanoma traveled to a distant internal organ, treatment options were limited and not effective. The five-year relative survival rate for patients whose data were collected from 2004-2010 was 16%. (Source)

Immunotherapy using nivolumab — approved for adjuvant melanoma therapy in 2017 — changed the odds landscape for melanoma patients. Five-year survival rates are 22.5% and reaching 50%, depending on the research. 

Of course, odds are not simple to calculate and since the therapy is new,

survival rates are only beginning to reflect these advancements

Most important: 

They are not “your” numbers

I guess I lucked out in getting this disease at this time.

My task then is living with the fear and sadness that accompany the specter of this disease. I want to always be familiar with my fear and sadness so that I don’t let those feelings overtake me, unbeknownst to me. I also want to get on with things and not reflect forever. 

In the spirit of living and enjoying today, here’s a Parsley palate cleanser. 

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An earlier version of this post incorrectly stated that the FDA approved adjuvant immunotherapy using nivolumab for melanoma in 2014. The correct year is 2017. Clinicians use adjuvant therapy after a complete resection to reduce the likelihood of reoccurrence.

The FDA approved nivolumab in 2014 to treat patients with advanced stages of the disease: stage III unresectable and stage IV metastatic.