Since returning from Australia mid March and being thrown into a national lockdown, my treatment has remained the same as it has been from the very beginning. I’ve been receiving Nivolumab immunotherapy treatment every 4 weeks through IV drip, administered at Velindre Hospital in Cardiff. I’ve had a multitude of mostly CT scans over the past 7 months, all showing a slight fluctuation in the 3 nodules left over in my lungs.

July came around and my scans were still showing no new spots (most importantly), but slight growth in some of the lung nodules. Decision time, as even though it is likely the treatment was (and probably still is) working throughout the rest of my body, these lung nodules couldn’t be left to continue to grow and potentially spread. Dr F and I decided it was probably a good time to switch treatments – to a targeted therapy specific to a genetic mutation common in melanoma patients called the BRAF gene, and which luckily I have. This would be a tablet treatment, meaning I wouldn’t have infusions at the hospital anymore. This treatment works in almost all patients and it works really quickly, however the majority of patients become resistant after a couple of years.

I’ve always felt that I wanted to keep this treatment up my sleeve, as an almost guaranteed buyer of time if ever I needed it. I also feel anxious about what comes next after targeted therapy, once I become resistant. There are a few other less successful treatment options out there, but really it’s all about the snazzy new drugs, and combinations of drugs, that are going to be on the market and soon. There are at least 2 new treatments (involving immunotherapy agents) that are going to be licensed by the FDA in America within the next 12 months. The UK will hopefully follow suit pretty quickly after, and I need to be here at that time in order to have access to them. Therefore, it’s a very carefully thought out game plan to get to that point, with choosing which options I need to use and when so that I am alive when they find a cure for melanoma. Which they will – I have full confidence. They’re getting closer and closer every day.

So, with the aim of saving targeted treatment for the future, I asked Dr F about surgery – would I be eligible, and is it something he might put me forward for? My melanoma is contained to one organ, and therefore potentially operable. At first he said no, which I totally get. Surgery doesn’t tend to cure stage 4 melanoma on it’s own, it would be a hefty operation, plus and probably most importantly, we still had an extremely effective (and less risky) treatment to play – the BRAF targeted therapy mentioned further up the page. However after a couple of weeks, he called me to say that he had been thinking about my surgery request and was going to refer me to the lung MDT (multi disciplinary team) to see if they would consider me for an operation, or perhaps a surgery/radiotherapy combo. All of a sudden I felt like I had options, which, if there are any other cancer patients out there reading this will know, is all we ever want in life. Options, options and more options!