What is chemotherapy like for a young man with melanoma?
November 8, 2011 1:05 PM   Subscribe

What is chemotherapy like for a young man with melanoma? Can anyone direct me to a good primer, fiction or nonfiction, on what it's like to have this kind of cancer?

I'm a fiction writer, and my character is a 30-something male undergoing treatment for skin cancer. I'm thinking this is his second round -- either he's suffered a relapse or is simply going through a planned "phase 2" of chemo treatments, not sure which -- and he's fed up with being sick/scared of going through all the awful side effects again, and is ambivalent about treatment, maybe going a little nuts. And I need to know the nuts & bolts of melanoma, chemotherapy, and all the ugly stuff that comes with it.

Fwiw, Lionel Shriver's "So Much For That" is a fantastic and intense novel about a middle-aged woman with mesothelioma, and Lorrie Moore's "People Like That Are The Only People Here" is an incredibly moving short story about parents caring for a child with cancer. I recommend both highly, and am hoping to find something as good about a man with cancer. Nonfiction resources would be useful, too.

Thanks in advance.
posted by theletterfour to Writing & Language (11 answers total) 3 users marked this as a favorite
Cancer.gov & mayoclinic.com both have really good lay descriptions of disease & treatment. I also read an article about two young men (I think cousins?) who were both receiving treatments for melanoma (it had to do with a randomized clinical trial), but I'm having a hard time remembering exactly where I read it. I'll see if I can dig it up.
posted by oh really at 1:13 PM on November 8, 2011

& here is the article.
posted by oh really at 1:14 PM on November 8, 2011

Response by poster: This Times article is great -- just added it to my Instapaper queue. Browsing the other two sites now. Thanks!
posted by theletterfour at 1:19 PM on November 8, 2011

Best answer: There is a blog called Adventures in Skin Cancer that followed a young woman with melanoma (she is now cancer-free so the blog ended in 2007). There's a lot of great first-person detail about what treatment is really like (what's scary, what's painful, what's not so bad). Even though the writer is not of the same gender or age group as your character, maybe it will help with some details of your story.
posted by dayintoday at 2:17 PM on November 8, 2011

I've had my share of skin checked and removed and even a few borderline cases along these lines, but this is still a layperson's understanding: melanoma is quite different than the "usual" cancer rigmarole.

Most cases are caught early enough to only dictate surgery (perhaps an exploratory lymph node dissection), and those people survive quite nicely. However, the cases that aren't caught early enough drop off very, very rapidly in survival rate.

Moreover, the usual chemotherapy route doesn't quite work - some people respond to Interlukin-2 (IL2) and some respond to interferon alfa2b (IFN). The former is generally for more serious metastatic cases and the latter for adjuvant use in less-serious cases. Neither is a chemotherapy drug per se.

If you are able to change the type of cancer the young man has, I might think about it, because melanoma is fairly distinct and not yet understood, and once it's "interesting" it's not the most realistically treatable. IANAD, etc.
posted by kcm at 2:31 PM on November 8, 2011 [1 favorite]

Response by poster: That blog is great, dayintoday -- I'm reading through it now and getting all teary-eyed. It may be just what I need to get a sense of day-to-day life with cancer. She's a great writer, too.

kcm -- thanks for this as well. My reason for giving my character cancer is a bit backwards -- I know he's suffering from intense nausea, but that's about it. I considered a few illnesses that can lead to nausea, and everything I learned pointed to cancer (chemo especially) as the most likely scenario. So as long as there's a not-too-uncommon treatment for skin cancer that causes nausea, I think this will work. Also, he's from Florida, so melanoma seemed like the way to go.

(Fwiw, I'm trying to write about this character with cancer by narrating related events in his life -- a reunion with his sister and some trouble she gets him into, plus whatever else comes up as I write. It's hard to write about someone who has cancer without making it a "cancer story," but that's exactly what going for. So, I need to know a few things about what cancer is like, but only just enough to make the whole thing seem true. I think.)
posted by theletterfour at 3:26 PM on November 8, 2011

Melanoma is thought to be less UV-related than other skin cancers, less so than most people would think on the face of it anyway. I'd suggest that people in Florida get all kinds of cancers, and that testicular cancer is both highly treatable (with chemo if you desire!) and very common for that demographic.
posted by kcm at 4:18 PM on November 8, 2011

The "day-to-day life" of your character will depend on the current stage of your character's cancer, and perhaps the stage at which the cancer was first discovered.
posted by Napoleonic Terrier at 7:50 PM on November 8, 2011

My mother did a bout with melonoma, and when it came back the second time, she did the Interferon treatment. I remember taking her to the treatments, she was fine until I got her home, and then BAM! It took her down so quick she was bed-ridden and in lots of pain. The thing I remember the most about it was that she said "I would rather be dead than go through any more of this." I tried to encourage her, but she shut me down pretty quick. Apparently I didn't understand (of course I didn't, I was just trying to be encouraging). She stopped about halfway through the treatments, and I commend her for making it that far. It must have done something for her though, because she has been cancer-free for about 12 years.
posted by XhaustedProphet at 3:22 AM on November 10, 2011

Response by poster: Xhausted -- this is really moving story. Thanks. The more I read about it, the more powerful and frightening cancer and its treatment both seem.

To add to the list of fiction about cancer (above): Amy Hempel's "The Cemetary Where Al Jolson Is Buried," about visiting a friend with (I think) cancer. I re-read it last night and cried again -- the ending about the gorilla is so beautiful and sad.
posted by theletterfour at 5:31 PM on November 15, 2011 [1 favorite]

Response by poster: (also, to anyone who's interested, I decided to give my character testicular cancer instead)
posted by theletterfour at 5:33 PM on November 15, 2011

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