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Centerpoint Fall 2009 (PDF)

Battling Melanoma A Second Time Around

Paul Buchanan was just 35 years old when he was diagnosed with melanoma. After having a mole on the back of his leg biopsied, he learned that it was cancerous and that it had spread to the lymph nodes in his groin. The mole and lymph nodes were removed and after four and a half years on a clinical trial in New York, Paul was in remission.  He remained in remission for ten years before noticing a lump beginning to grow on his right thigh; the same leg where the melanoma had been before. 

When Paul met with Dr. Mario Sznol, Professor of Medical Oncology at Yale Cancer Center and Co-Director of the Melanoma Program, the disease had spread so quickly that he could barely talk.  Paul had lost 50 pounds within two weeks and had to shuffle his feet to walk.  He was diagnosed with advanced stage melanoma for the second time, and this time it had spread to his bone marrow.

“I didn’t know it then, but Dr. Sznol later told me that my condition was so bad that my only two options were treatment with interleukin-2 or hospice care.  I had to gain more strength to even be able to survive the treatments with interleukin-2.  Five days later I received my first dose,” Paul explained.  “The entire staff at Yale Cancer Center was wonderful and provided support to my family and me during this time.”

Interleukin-2 is a type of signaling molecule that is instrumental in the body's natural response to microbial infection.  Treatment with interleukin-2 activates a certain kind of cell in the body, a lymphocyte, which then attacks the tumor specifically. Interleukin-2 can be a difficult treatment for many patients to tolerate, as the increase of interleukin-2 in the body can cause severe flu-like symptoms. 
 
After his first diagnosis ten years ago, Paul was told that if the melanoma were ever to recur, it would attack his body and there would be no chance for survival. He lived with that knowledge in the back of his mind, and when the second diagnosis came, he had resigned himself to the outcome he thought was inevitable.  He quickly became very sick and was admitted to Yale-New Haven Hospital.  When his 6-year-old daughter and 3-year-old son came to visit, he resolved to fight.  “I took one look at my two young children and realized that dying wasn’t an option.  I was going to focus all the strength I had left to battle this disease so that I could be there for them and watch them grow,” Paul said.

Paul continued to receive treatment with interleukin-2 on and off for five months and was in bed from September to November.  At some points he became so weak that he was only able to receive half of a treatment session.  He couldn’t hug his children unless they climbed into his bed.  His mother, a retired nurse, and his brother came to live with the Buchanan family for three months while Paul was receiving his treatment and recovering.

Eventually Paul began to feel better and started to regain his strength.  When Dr. Sznol saw him for his next appointment he commented on how much he had improved, and Paul was beginning to feel better himself; he was able to do things that were impossible only five months earlier.

At that point, they had to decide whether or not to keep administering interleukin-2.  After five months, Paul did not want to endure another dose.  His care team tested his bone marrow and amazingly he showed no trace of the cancer.  Despite the harsh side effects, interleukin-2 had worked and Paul was once again cancer free.

Four years later he remains in remission.  Paul still enjoys going to the beach and golfing, but he is sure to cover up and to protect his children from the sun as well.  “Melanoma is not a ‘today’ disease.  You don’t go out in the sun and then an hour later you are diagnosed with melanoma.  You need to protect yourself and your family as early as possible in order to protect their future,” Paul said.  “Through this experience I have learned that melanoma can hit you at any age.” 

Paul attends a regular melanoma support group at Yale Cancer Center and says that it is a great way to tell his story, and hear other people’s experiences as well. Dr. Sznol continues to share Paul’s story of survival with other patients in order to give them hope and as an affirmation to them that melanoma can be overcome.

It was the support of family and friends that Paul said was the true miracle of his experience. “I can’t express how thankful I am to my family, friends, and neighbors for all the help and support they gave me during this time. They shopped for our family, did yard work, and numerous other things.  The small things like a phone call or a visit were also always appreciated,” Paul said.  The Buchanan family was new to the neighborhood when Paul was diagnosed, but everyone came together to lend them a hand. 

“My wife tells me that I haven’t changed at all through this experience, and she has been there with me from the beginning.  I feel that I have changed somewhat internally.  As it is for most of us, work has always taken up more of my time than it should.  I now try my best to schedule my travel time around my children’s events and take time out to play with them.  I also do my best to not let the small stuff in life get to me.  I have already faced the worst thing imaginable and come through to the other side,” Paul said.