When Judith Edmonds discovered an itchy, raised freckle on her leg, she knew something was wrong. At that time, she didn’t realize how important this was going to be to her life.
Edmonds, who now lives in Bullock, N.C., was diagnosed with melanoma, a potentially deadly form of skin cancer, and she had the cancer surgically removed.
Fifteen years later in 2008, the cancer returned. This time, her doctors told her the cancer was more advanced. Her daughter, Teresa Dean, called after the appointment to see what the doctor said.
“She says, ‘I’ll take the bad news first,’” Edmonds said, recounting the conversation with her daughter. “‘The bad news is that the melanoma is back after 15 years lying dormant in my body,” Edmonds replies. “‘The good news is I’m stage IV, but there’s a stage V.’ Teresa says ‘Mom, there is not a stage V.’ I knew I was really in trouble.”
Edmonds, 78, is now a 25-year melanoma survivor, including more than 10 years as stage IV cancer survivor. She shared her experience with having melanoma and the lessons she’s learned from her journey with cancer at the Melanoma Patient Daysymposium on May 6. The afternoon of talks featured updates on melanoma treatment, about the work UNC Lineberger researchers are doing to address the financial toxicity of cancer treatment, nutrition and other topics.
The day also included a presentation from UNC Lineberger’s David Ollila, MD, the James H. and Jesse E. Millis Distinguished Professor in the UNC School of Medicine Division of Surgical Oncology and co-director of the melanoma program, on advances in treatment for metastatic melanoma. With treatments like immunotherapies that can “release the brakes” on the body’s immune cells to fight cancer, Ollila said he’s seen major improvements in survival for stage IV disease since he was in training. He’s also seen changes in the role of surgery amid other treatments.
“For those of you in this room who are without your spouse or loved one [due to melanoma], I’m sorry,” he said. “For those of you in the room that have benefited from the advances and treatment of metastatic melanoma over the last eight years – it’s going to continue.”
Ollila said talimogene laherparepvec, or TVEC, has been effective in treating some melanoma cases. UNC Lineberger researchers were involved in the clinical trial that led to the U.S. Food and Drug Administration’s approval of the drug in 2015. TVEC uses a genetically altered virus to infect cancer cells, destroy them, and recruit the immune system to help fight the disease.
UNC Lineberger’s Frances Collichio, MD, professor in the UNC School of Medicine Division of Hematology/Oncology, said TVEC may be an option for patients who have in-transit disease, or locally advanced disease that can be injected, especially if they cannot tolerate other treatments that have greater side effects.
Patricia Long, MSN, FNP-C, in the UNC School of Medicine Division of Surgical Oncology, said researchers will be studying use of this treatment in combination with others for the disease, and touted the benefit of receiving TVEC from a center of excellence.
In addition to these advances, researchers have investigated ways to optimize radiation treatment for melanoma that has spread to the brain, said Kevin Pearlstein, MD, a resident in the UNC School of Medicine Department of Radiation Oncology.
It’s estimated that as many as half of patients who develop advanced melanoma will have brain metastases, Pearlstein said. These patients may experience headache, weakness, numbness, or seizure. Sometimes brain metastases are asymptomatic, he said.
Pearlstein said whole-brain radiation was the traditional treatment approach. As technology has advanced, doctors have been able to target specific areas with precise radiation beams, a treatment known as radiosurgery.
When her cancer returned in 2008, Edmonds had multiple surgeries to have the cancer removed. In 2012, she had additional surgeries to remove the cancer that had continued to spread. She also started a clinical trial at the N.C. Cancer Hospital. That was just after the trials opened for a combination of targeted treatments, which directly attack overactive proteins in melanoma. Targeted treatments were part of the revolution for advanced melanoma treatment, Collichio said.
Edmonds received the treatment for more than two years. But when she experienced considerable treatment side effects, Collichio changed her treatment.
“I am just thankful to God that I’m living – I think he’s taking care of it,” Edmonds said. “At UNC, I’ve got so many people working on my case that I’m comfortable with, and that are really looking after me.”
She said that Collichio told her that in addition to her treatment, three things helped her survive her cancer: her faith, her travels, and her attitude.
The mother of two, grandmother and wife of nearly 60 years said she plans to live until she’s 101, and she wants to encourage others to have hope.
Regarding her attitude, Edmonds said she’s not going to be waiting “sitting in a chair at home, waiting for anything, much less death, to come get me.”
“Enjoy life while you can,” she said. “All I can say now is I keep on ticking just as God has promised me. It’s been a long journey. I can depend on these people here at UNC, and you can, too.”