A few months after my breast cancer diagnosis, Bill and Maty Hallcroft visited me after chemotherapy. Their presence was comforting; they are like family.
Bill had a nice tan and looked healthy. The couple had been travelling to Italy and were very positive. Bill survived prostate cancer a few years ago. But he said his fear of cancer began when he was a teenage boy and his grandfather died of bone cancer. For a while, every time he felt a pain, he wondered if it could be cancer.
“Cancer in those days was a death sentence,” said Bill, 72. “There was so much we didn’t know then. But things are much different now.”
I wasn’t the only one with cancer in my apartment that day. Melanoma, the most dangerous form of skin cancer, had been spreading in Bill’s body, but he didn’t know it yet.
Months before our conversation, a doctor had noticed a mole on his chest near his clavicle. There are high rates of melanoma in Florida, due to our strong sun and its ultraviolet rays. Warning signs in a mole include blurry edges, uneven color, redness, tenderness or bleeding.
While in Italy, Maty noticed the mole was beginning to look like a sore. It was “coming out of the skin” and had started to bleed so badly they had to cover it.
“It was pretty awful,” Maty said. “When we came back, the doctor took a step back when he saw it.”
Bill had a biopsy, surgery and some good news — the cancerous cells had not reached his lymphatic system.
“Up to that point it looked like everything was good, but a couple of months later it started to grow again right under the incision where he had the surgery,” Maty said.
The results of a scan showed the melanoma had spread to Bill’s liver, meaning it was now metastatic melanoma. They turned to the University of Miami’s Sylvester Comprehensive Cancer Center and Dr. Lynn G. Feun, who specializes in malignant melanoma, liver and brain cancer.
Feun said that since Bill had tested positive for BRAF, a genetic mutation found in about 50 percent of melanoma patients, he was eligible for a targeted therapy that inhibits the mutation.
The drug is Zelboraf, also known as Vemurafenib. The U.S. Food and Drug Administration approved it last August. Bill began to take it about three months ago.
“I have to wear gloves because the drug is so toxic I can’t even touch it,” Bill said. “Can you believe that? Some times I feel so sick I just want to stop taking it.”
The side effects: fatigue, skin rashes, nausea, hair loss, joint pain, eye sensitivity to light and a less dangerous skin cancer called Squamous Cell Carcinoma (SCC).
“His dermatologist, who is a young and very caring doctor, has never seen anything like it,” Maty said. “Imagine popcorn popping everywhere.”
Last week, there was good news. Despite the side effects, the drug is working.
“We visited Dr. Feun for our monthly visit. He is a man of very few words,” Maty said. “He comes in with a big smile and sits in front of the computer with his back to us and talks very fast.”
Feun told them the melanoma was no longer in Bill’s chest or his liver. Feun will continue to watch Bill, and in a couple of months he will decide if the dosage can be lowered.
Researchers of the drug have not been following patients long enough to know how it might affect long-term survival. But Maty and Bill remain hopeful.
“You need to be flexible enough to expand whichever way the circumstances take you, because if you resist you can break,” Maty said.