Metastatic Melanoma – Mother In Law

I am writing on behalf of my Mother In Law. In June of this year she was diagnosed with Stage 4 Metastatic Melanoma. She had a melanoma previously removed from her back in July of last year and were told that the margins were clear. It was not a surgical Oncologist that did the removal/biopsy.

Fast forward to the end of May this year and she noticed that she had a golf ball size swelling in her right supraclavicular lymph node. She had that partially excised at the end of May and she was diagnosed in early June with Metastatic Melanoma.
Prior to the surgery she had a chest/neck CT and upper abdomen CT. When I read the results I cried. My Mother In Law is 82 years old and cares for her 55 year old Autistic Daughter. My Father In Law passed away in 2011 after an awful
struggle with diabetes, amputation and infections.

I have been helping out my Husband and her other children as they are either working or live in another State. Her CT results show that she has masses in her lungs, chest wall, adrenal glands, paraspinal region, orbit and others. The impression
on the CT scan also showed that she has a mass in her pancreas that is suspicious for primary pancreatic carcinoma and less likely metastatic disease.

She currently has an HMO Insurance plan where all of her required visits need to be approved by her PCP. I have fought tirelessly with her Insurance Company and PCP to see if they would approve for her to be seen at
Moffitt Cancer Center in Tampa which is 5 minutes from our house. Unfortunately both the referral and appeal were denied and she is not being seen by a Metastatic Melanoma Specialist. She is currently being treated at Florida Cancer Specialists but I am not happy with the care she is receiving or the answers we are getting. When we initially met with her Doctor two weeks ago I asked him politely if he is a Melanoma Specialist. He replied “NO, and maybe this isn’t a good fit, some patients don’t gel with Doctors”. I explained that I was asking for my benefit. I also questioned as to the other masses noted on her CT imaging reports. I asked if he is certain that the other masses in her body are from the metastatic melanoma and he said “We are assuming they are”. I am concerned that she may have another Cancer that is not being treated, especially with the note about the Pancreatic Cancer. We asked him about Clinical Trials and he said they don’t offer any because most of the
time they don’t work. The more I spoke to him, the more I was concerned.

I am writing to see if anyone can offer me any guidance. My Mother in Law started her immunotherapy treatment this past Wednesday. She will be treated with Yervoy and Opdivo every 3 weeks. In the past month her health is declining. She can barely walk without getting out of breath, she is covered in bruises (neither her PCP or Cancer Doctor) were overly concerned with his. Her Oncologist even asked if she was falling down and we know that she isn’t. Her Right Eye is completely red in the white of her eye and it has been that way for over 3 weeks with a bruise underneath and on her cheek. (she does have a mass behind her right orbit – when we asked her PCP about this he said last week – couldn’t show a mass behind the eye as that wasn’t what was imaged, it’s on the NECK/CHEST CT report and he told her about it initially). She has lost her appetite but we’ve told her that she needs to make sure she eats and drinks to keep her strength up. She has her Granddaughter and Great Grandchildren living with her but we live over an hour away. Not sure how she will manage when they go back to School. She is also not sleeping well so we’ve ordered her a power recliner/lift chair that she may be better sleeping in.
She may need to move in here with us with her Daughter when my Oldest Daughter goes back to College in August.

We are concerned that there may be a secondary cancer that is not being addressed. We are concerned that she hasn’t had a PET scan, Dr told us that it’s a waste of money and not needed. We are concerned that she is not being seen
by a Melanoma Specialist. She had to go for Fluids yesterday as her blood work showed that she has high Uric Acid so that was another thing.

I am doing the best I can to research and research about this horrible disease. She has been in great health up until this past year and it is so hard to see her like this. Any guidance is greatly appreciated and thank you for listening.

Faith (Daughter In Law).