Living in the Here and Now
A metastatic melanoma survivor is hopeful but realistic as new treatments become available.
By Jenny Song
Substitute teacher and metastatic melanoma survivor Martha Bishop gives some individual attention to Charlotte Turner in their second-grade class in Marana, Arizona | Photo by Steven Meckler
Martha Bishop welcomes what most women would consider unpleasant signs of aging, including every strand of gray in her reddish-brown hair and each crease on her freckled face. “I worked really hard to get here and get these,” says the 36-year-old resident of Marana, Arizona, outside Tucson.
Diagnosed with stage III melanoma in 2009 and stage IV disease in 2011, Bishop considers each passing day an affirmation of her determination in the face of a grim statistic: Only 15 to 20 percent of people with metastatic melanoma live past five years.
Seven new drugs have been approved for use in patients with metastatic melanoma since Bishop learned she had stage IV disease in 2011. These advances have been a windfall for Bishop, offering pathways whenever a roadblock obstructed her way.
A Strange Mole
In 2009, Bishop went to a dermatologist to get treatment for acne and asked the doctor to check an asymmetrical mole on her lower back that had increased in size. The doctor didn’t seem worried about it, but he removed it and had it biopsied. Two days later, he called to tell the 29-year-old wife and mother of two that she had melanoma, the most serious form of skin cancer.
“Somewhere in my mind I knew it was the bad skin cancer, but that was the extent of my knowledge,” she says, adding that she thought melanoma was something that could just be cut off with surgery, not realizing the cancer was inside her body and could spread to other organs.
In the month following her diagnosis, Bishop had surgery to remove the tumor and the margins around it and a sentinel node biopsy, in which the lymph nodes closest to the original tumor site were removed and analyzed for cancer cells. Lymph nodes located in her groin tested positive for very small tumors, known as micrometastases. At the time, she was diagnosed with stage III melanoma, but the doctors were hopeful that the surgery had removed the cancer.
Bishop started on interferon, which helps to keep any undetected cancer cells that might be somewhere in the body from growing. The regimen left her feeling like she had the flu for the entire year she was on treatment. “I remember my husband practically dragging me out of bed, and [I remember] going to the cancer center in tears,” she says. “I had a complete breakdown … but I made it through the year and thought, ‘That’s it, I’m done with cancer.’ ” Looking back, she realizes how naive she was.
Less than a month after Bishop stopped using interferon, tumors appeared on her lower back. She had surgery and underwent radiation therapy in November 2011. However, a new tumor appeared on her groin, which meant the cancer was spreading and she now had a stage IV diagnosis.
A Long Road
As Bishop talks about her treatments, she starts with an apology: “Forgive me,” she says, “because I have a long history.” She has had four surgeries to remove tumors from her back and her groin, and has taken three newly approved drugs for metastatic melanoma.
She has dealt with a plethora of side effects—some so taxing that she was thankful when she learned her tumors weren’t responding to certain treatments. For example, a side effect of high doses of interleukin-2 (IL-2), a drug that helps the immune system fight melanoma, was “capillary leak,” which made her blood pressure drop. She was given intravenous fluids to bring her blood pressure back up. “I gained between 30 and 40 pounds of fluid each week I was hospitalized,” she recalls, noting this medication is administered in the intensive care unit because of its known toxicity. She was almost relieved when follow-up scans showed tumors were growing in her lungs, which meant she could move on to the next treatment.