When Health Canada announced last month that a breakthrough treatment for metastatic melanoma had been approved, making it the first new treatment in 30 years for melanoma, Meloney Edghill couldn’t keep the smile off her face.
It wasn’t always that way for Edghill, who owns Serious Coffee in Port Alberni with husband Clay.
In 2006 the Edghills were living in Edmonton and Meloney had just lost her boss and her best friend to breast cancer. She and her boss’s husband were working overtime to keep the business afloat.
Meanwhile, an egg-shaped lump on the front of Meloney’s shoulder appeared, irritating her underneath her bra strap. A mother of three with a four-year-old son, she was too busy to have it looked at until Clay insisted she go to the doctor.
She didn’t think much of it.”My doctor said our bodies produce lumps and bumps all the time. Most of them are cysts,” she said.
“He thought it was calcified blood vessels that had built into this bump.”
Once she had the lump removed, pathology tests took nearly three weeks. Then the news from her doctor wasn’t good: she had stage 4 metastatic melanoma. Her prognosis was bleak.
Melanoma is a rare but deadly form of skin cancer, characterized by the uncontrolled growth of pigment-producing cells (melanocytes) in the skin. Unlike other cancers, melanoma is clearly visible on the skin. Ninety per cent of melanomas are caused by exposure to UV light, including tanning beds.
Edghill’s cancer originated in a palm-sized mole or birthmark over her right scapula.
The day she was told she had cancer, she was sent to the Cross Cancer Institute in Edmonton, where one of Canada’s foremost melanoma oncologists works.
“Clay and I didn’t understand,” she said. “We went home and Googled (melanoma) and were just stunned with what we were reading.”
She was given three choices for treatment: a drug that was only three to five per cent efficient; risky and expensive treatment in the United States; or a clinical trial. The decision was “a no-brainer”, she said.
In October 2006 she started taking a drug called Yervoy, by Bristol-Myers Squibb Canada. By this time the lump the doctors had removed had started to grow back, and the cancer had spread to her pancreas, lymph nodes and liver. “They couldn’t do surgery; there was no point,” she said.
By January 2007 though, “almost all of the cancer was gone.” She had the lump removed again, and this time the doctor removed the mole from her back and gave her skin grafts to cover up the hole it left behind.
She remembers the day well: April 2, 2007. “That’s my new birthday,” she said. “My cancer-free day.”
Two months after her surgery, Bristol-Myers Squibb asked if she would enter a maintenance phase of the Yervoy drug trial “so they could gain some long-term survival data. To me, it was the least I could do,” she said.
She has been going back to Edmonton every 12 weeks since then to receive her maintenance dose. Last month she took her final dose, and was told she no longer has to see the oncologist.
Her cancer is gone.
Yervoy (ipilimumab), a cancer immunotherapy, is the first treatment approved for advanced melanoma in Canada that has been proven to extend survival in a phase 3 trial.
The news is particularly exciting for oncologists, who have not seen a change in treatment for metastatic melanoma in the last 40 years.
“Once diagnosed with metastatic melanoma, a patient’s average life expectancy is about three to 18 months, depending upon the extent and location of disease,” said Dr. David Hogg, a medical oncologist with a large melanoma practice in Toronto.
“With approval of Yervoy we now have the chance to offer some patients with advanced melanoma real hope for long-term survival. With its unique mode of action, it is also an important step forward in the use of immunotherapy to treat cancer,” Hogg said.
“It activates a patient’s own immune system to better identify and kill the melanoma cells.”
Bristol-Myers Squibb is working with federal, provincial and territorial authorities to ensure patients in Canada will have access to Yervoy through provincial and private drug plans as quickly as possible.
Edghill is proud to have played a part in the clinical trial, knowing that what she did may ultimately help others to survive their melanoma.
“For the last couple of years I’ve been calling myself a guinea pig. I didn’t think that way in the beginning,” she said. She was only thinking of survival.
Edghill’s clean bill of health, and the approval of Yervoy, come at a poignant time for her. Edghill’s mother has breast cancer, and is undergoing radiation treatment at the Cross Cancer Institute.
Edghill hopes one day soon immunotherapy will be available to fight her mother’s type of cancer.
“Surely, if it works for one type they’ll be able to make it work for others.