Help If you have a clue, respond! Please?

My husband has Melanoma cancer stage 2b. We have been given treatment options...melanoma vaccine or interferon.

IF you have a story that might help in the decision making process or know of a chat room or bulletin board that is good let me know.

Thanks

Help If you have a clue, respond! Please?

BELOW ARE TWO ARTICLES ON MELANOMA INJECTIONS AND INTERFERON

Cancer Vaccine Ups Melanoma Survival

Experimental Vaccine Also Fights Kidney, Colon, Other Cancers

By Daniel J. DeNoon

WebMD Medical NewsReviewed by Louise Chang, MDOct. 12, 2005 - A personalized cancer vaccine extends survival for some late-stage melanoma patients, research shows.

Melanoma is very dangerous skin cancer. Advanced stage IV melanoma kills about 90% of patients within five years of diagnosis. Patients with advanced melanoma are advised to seek clinical trials of experimental treatments.

Now one of those trials seems to be helping the healthiest of stage IV melanoma patients. These so-called stage IV M1a patients are those whose tumors have spread just below the skin or to distant lymph nodes but haven't yet penetrated other organs.

The study tested a vaccine treatment -- Oncophage, from Antigenics Inc. -- in stage IV melanoma patients. Oncophage is made from a patient's own tumor cells. It stimulates powerful immune responses that attack tumor cells remaining in the body after surgery. Two out of three patients got the vaccine; the other third of patients got whatever current treatment their doctors thought best.

Antigenics released early results from the study this week. Oncophage, the company says, did not help patients whose melanoma already had spread to the lung (stage IV M1b) or to other organs (stage IV M1c).

It was a much better story for the stage IV M1a patients. These patients lived at least 50% longer than those in the doctors'-choice-of-treatment comparison group. The comparison group survived a median of 12.8 months. The M1a patients treated with Oncophage survived a median of 20.9 months.

That's exactly the patients one would expect to respond to a cancer vaccine, says researcher John M. Kirkwood, MD, director of the melanoma center at the University of Pittsburgh Cancer Institute. Kirkwood leads the melanoma committee of the Eastern Cooperative Oncology Group, one of the largest clinical cancer research organizations in the U.S.

"A quarter or so of patients with advanced melanoma have this manifestation of soft-skin-tissue disease that does not involve internal organs," Kirkwood tells WebMD. "In that group we saw the impact of this vaccine."

Earlier Treatment, Better Results?

Based on these findings, Antigenics is designing a new clinical trial to target stage IV M1a patients. The new trial may also include patients with earlier-stage disease whose melanomas have been completely removed by surgery.

Such patients -- who run a high risk of having their cancer come back -- may be the ones who benefit most from Oncophage.

"The most rational application of this and all cancer-vaccine modalities will be the use of this vaccine for surgically treated patients who do not have any tumor remaining at all," Kirkwood says.

That may very well turn out to be the case, says Garo Armen, PhD, Antigenics Inc. chairman and CEO.

"If we can make a fundamental improvement in melanoma treatment, it would be terrific," Armen tells WebMD. "It is our opinion that Oncophage would be most effective in patients who are slightly earlier in the course of disease than traditional end-stage patients. This particular trial gives us an indication of that. We tested the vaccine in late-stage melanoma, in patients with an expected survival of six to 12 months -- but the healthier patients did much better. That is pretty much as our scientific information has told us it should be."

As a melanoma vaccine, Oncophage is still experimental. The next clinical trial -- the one on which FDA approval would depend -- is still in the planning stages.

However, since Oncophage is made from a patient's own tumor cells, it can be used in nearly any kind of cancer. The only limiting factor, Armen and Kirkwood say, is whether there is enough tumor to make the vaccine. About 3 to 7 grams are needed, as multiple injections work better than just a few.

A clinical trial in patients with late-stage kidney cancer is drawing to a close. If the vaccine works in these patients -- and earlier trials suggest that it may -- the trial could be used to apply for FDA approval.

How Oncophage Works

Oncophage takes advantage of a sticky kind of protein called a heat shock protein or HSP. The body is full of HSPs. HSPs do a lot of things. One thing they do is to chaperone cellular proteins by helping them form correctly and moving them from one place to another.

When a diseased cell dies, HSPs carry little snips of the dead cell's proteins to the immune system. Some of these protein snips are antigens that help the immune system seek out and destroy other cells with the same disease.

To make Oncophage, Antigenics takes tumor cells removed from a patient and breaks them open. HSPs carrying tumor antigens are removed and used to make the vaccine.

Making an individualized vaccine isn't cheap. Antigenics thinks a course of treatment will cost $10,000 to $20,000.

Currently, researchers are studying the use of Oncophage vaccines for kidney cancer, melanoma, pancreatic cancer, non-Hodgkin's lymphoma, colorectal cancer, and gastric cancer.

THE NEXT ARTICLE IS ABOUT INTERFERON:

Most skin cancers are detected and cured before they spread. Melanoma that has spread to other organs presents the greatest treatment challenge.

Standard treatments for localized basal cell and squamous cell carcinomas are safe and effective and cause few side effects. Small tumors can be surgically excised, removed with electric current, frozen with liquid nitrogen, or killed with low-dose radiation. Applying an ointment containing a chemotherapeutic agent called 5-fluorouracil to a superficial tumor for several weeks may also work. Larger localized tumors are removed surgically.

In rare cases where basal cell or squamous cell carcinoma has begun to spread beyond the skin, tumors are removed surgically and patients are treated with chemotherapy, radiation, or immunotherapy. Some patients with advanced squamous cell carcinoma respond well to a combination of retinoic acid (a derivative of vitamin A) and interferon (a type of disease-fighting protein produced in laboratories for cancer immunotherapy). Retinoic acid also seems to inhibit cancer recurrence in patients who have had tumors removed.

Melanoma tumors must be removed surgically, preferably before they spread beyond the skin into other organs or glands. The surgeon removes the tumor fully, along with a safe margin of surrounding tissue and possibly nearby lymph nodes. Neither radiation nor chemotherapy will cure advanced melanoma, but either treatment may slow the disease and relieve symptoms. Chemotherapy, sometimes in combination with immunotherapy -- using interferon -- is generally preferred. If melanoma spreads to the brain, radiation is used to slow the growth and control symptoms.

Immunotherapy is a relatively new field of cancer treatment that attempts to target and kill cancer cells by manipulating the body's immune system. Some of the most promising developments in the field of immunotherapy have sprung from efforts to cure advanced melanoma. Some researchers are treating advanced cases with vaccines, while others are using drugs such as interferon and interleukin-2 in an effort to stimulate immune cells into attacking melanoma cells more aggressively. Genetic manipulation of melanoma tumors may make them more vulnerable to attack by the immune system. Each of these experimental treatment approaches aims to immunize a patient's body against its own cancer -- something the body cannot do naturally.

People who have had skin cancer once are at risk for getting it again. Anyone who has been treated for skin cancer of any kind should have a checkup at least once a year. About 20% of skin cancer patients experience recurrence, usually within the first two years after diagnosis.

Alternative and Complementary Therapies

Once skin cancer is diagnosed, the only acceptable treatment is medical care. Alternative approaches may be useful in cancer prevention and in combating nausea, vomiting, fatigue, and headaches from chemotherapy, radiation, or immunotherapy used to treat advanced skin cancer. Be sure to discuss any alternative treatments you are considering using with your cancer doctor.

Nutrition and Diet

Skin experts know that the mineral zinc and the antioxidant vitamins A (beta-carotene), C, and E can help repair damaged body tissue and promote healthy skin. Now, researchers are trying to determine whether these and other nutrients might protect skin from the harmful effects of sunlight. To test the theory, selected skin cancer patients are given experimental supplements of these vitamins in the hope of preventing cancer recurrence.

Help If you have a clue, respond! Please?

My mothers boyfriend has been on interferon for 2 years, most people can't stand it that long and give up. It makes him puke up most of what he eats, lose weight, lose hair, he has constant fevers and chills. He is definitely NOT happy being on it but he needs to be, theres no other way. If there is any other options i would pick that one, interferon looks to be a horrible experience from my view point.

Help If you have a clue, respond! Please?

Is it not possible to receive both? Or - expenses?

I'd go for the interferon to boost immunity, but sammie's description gives second thoughts. There's therapy out there called "Proleukin" that helps with the interferon business, but it only works in a small percentage of people.

If his melanoma is topical, the cream "Aldara" might help. It's worked for about 70% of its patients.

I don't know how melanoma vaccine would work, but if the chance of failure is low and things usually end up right, then you can give it a shot.