big pills to swallow

For this solar powered girl, Hawaii was just the thing. Walked into the Dr.'s office today feeling hopeful and resilient.

Walked out feeling weak and defeated.

I wanted to go to this particular Dr. again because last time when we found out the 50/50 chance of life he gave me a great pep talk on how to "fight hard" and keep a "positive attitude" and how I "can do it", etc. So I was kind of hoping for that today again, as the previous appointments haven't been exactly cheery and inspiring.

First thing he says after hello: "Well, I'm sure you have done some research and know this is a bad thing to have come back."
I looked at him strait in the eye. "How bad?"
Silence. Finally: "This is likely....fatal."
That last l hung in the air. A capital L.

I hope I'm making things up, and that I'm blowing things out of proportion, and that I am wrong in all my research. But here's what I'm finding: Although technically a stage IIIc (bad enough, 27% 5 year survival and 19% 10 year survival), I think I am more in the class of recurrent melanoma (melanoma which has come back after initial treatment), which is awful and usually grouped with stage IV when researching treatments.

This is the kind of thing I am reading on cancer center websites:

Patients with metastatic melanoma who have failed initial systemic therapy are infrequently cured with additional therapy. There are many choices of therapy and access to newer treatment strategies in clinical trials. These therapeutic choices may prolong survival, reduce symptoms of progressive cancer and/or offer the chance of cure. Patients need to assess their treatment options and consider their individual goals for receiving additional treatment.

Treatments that are part of curative and palliative strategies include: single agent and combination chemotherapy; biological therapy with interferons; interleukins and vaccines; combination chemotherapy and biologic therapy; external beam radiation; isolated limb perfusion techniques and surgery.

MY individual goal is cure. Don't read into this that I have given up hope, or think this thing can't be beat. It does happen, so why not happen to me? I have lots of things going for me. My cancer is only in my limb as far as they can tell. That is great. I found it relatively early, and only have one known spot now. This means my tumor burden is low, which gives whatever I'm going to do a better chance at working. I have Dr.s who can perform all the procedures and offer clinical trials. I am young and healthy. I can handle the more rigorous treatments. I am surrounded by people (many virtually) who pray for me.

So...I'm meeting with one more Dr. on Tuesday. Hopefully surgery the end of next week. The two major options after excision seem to be the isolated limb infusion (ili, chemo put directly into the leg during surgery) or the biochemotherapy (imunotherapy combined with chemotherapy). The surgeon today was thinking ili might be the better choice. The Dr. I am seeing next week has the reputation as best in the state, so I hope he has an idea which would be better. Or as things have been shaking down lately, he might suggest something totally different. Wow, I just need a plan. This is draining.