The following is an account of Ben Medley's experiences with MM:

Early history of lots of sun exposure in childhood in Texas. No family history of any kind of malignancy but both paternal grandparents were red haired.

In 1987 while fishing, I took my shirt off in the sun and one of my doctor friends asked "Is that a melanoma on your back?" I answered that I didn't think so but I can't visualize that area without a mirror. I saw a plastic surgeon who said it needed to come off and that was done and it was a Clark's II tumor, superficial spreading, stage one. The original resection was adequate by standards then and also today, but the surgeon said he wanted to do a wider resection which was almost certainly unnecessary but he would feel horrible if the tumor recurred or spread and he hadn't done it. That was performed and careful looks by my pathology colleague showed no tumor. I was appropriately told that there was a 98% chance of cure. The literature said that about 90% of recurrences appear within 5 years.

Ten years later almost to the day I noticed multiple tiny black spots in the skin of my neck, chest and on my lower back. I was dumbfounded and wondered immediately if it could be recurrence but I had no experience or knowledge of this type of recurrence, and, after all, it had been so long. The only difference in my life was that I was under a lot of work pressure and stress, the most ever. A visit to an excellent dermatologist resulted in two biopsies, one on my chest and one on my forehead, both positive for malignant melanocytes. All of these were minute, two to five millimeters, and only one was raised up from the skin (palpable).

The day after the results were given to me I saw an oncologist, a colleague of many years and in two days I was seen by a melanoma expert in Tucson, Dr. Evan Hersh. My wife and I immediately liked and trusted Dr. Hersh, and soon thereafter I began the Legha protocol of biochemotherapy. Dr. Hersh said he could promise two things, that I would be very sick and that I would lose a lot of weight; he also said the goal was a "durable remission" (which is one of five years or greater) or a cure but the response rate was not optimal. I should say here that when I was in medical school we were taught that stage IV or recurrent melanoma was a death sentence and nothing could be done, so in spite of new techniques it was hard to be optimistic, knowing what I knew.

But being optimistic or at least having a positive attitude is critical in fighting disease. At a time when all seemed darkest, my doctors started the chemotherapy which put me in a black hole of hopelessness, and then everyone picked that time to tell me that if I think in a positive manner, I can win. The hardest part of any of my therapy was to will myself to believe that winning was a possibility. But thanks to a number of "angels" - persons who are truly gifted in understanding (nurses, friends, relatives and acquaintances) - this goal was finally reached.

I was hospitalized several times in early 1997 for the therapy - a few days of chemotherapy on the oncology floor, then transfer each time to the ICU for four days of IL-2 infusion. Fairly dramatic stuff, with lots of things happening; some of the people who took care of me were people I had worked with in the hospital, and now I was gratified and sometimes amazed at how terrifically they performed their jobs. I specifically asked not to be told about side effects unless I needed to know and this worked out well for me. Quite frankly, I don't remember all of things that happened.

Then we took a break. I weighed very little and had lost most of my hair, and had been unable to keep anything down for quite a while. I was on Total Parenteral Nutrition (TPN), with a two liter IV bag and a pump I carried in a backpack and I was dependent on this for a few weeks; the PICC line (central venous catheter) got a lot of use for chemotherapy, blood sampling and TPN. I welcomed interferon as a therapy and got subcutaneous injections daily for six months which I tolerated well.

The oncologists had me start vaccine therapy at that point in late 1997, and I continue it to this time and will take as long as it is offered. I've been in the low percentage group twice - a low percentage chance of a problem and a low percentage chance of a solution. I have no evidence of active disease at this time.

Ben Medley, M.D.