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After discovering a cancerous melanoma tumor on her scalp in Sept 2016 and having it removed, Emma was diagnosed with melanoma, but tests after surgery showed no signs of the disease having spread. However, Emma began having trouble breathing in June 2017 - a cough she couldn't get rid of, lack of energy, generally icky. After several doctor visits and many tests ordered by both her primary care physician and her dermatologist, we got definitive news on Aug 8th that the dermatologist's fear had proven correct, that the cancer has metastasized. Emma, with her father Mark, met with her new oncologist, Dr. Savage, on Aug 11th, followed by a PET scan on the 15th along with an MRI. Emma's mother Sally was able to join Emma and Mark for those appointments. The results were not good.
Emma has Stage IV metastatic melanoma, which means the original melanoma has spread to other organs beyond the skin, in Emma's case, to her liver, lungs, pleural lining, right shoulder, and brain. She also has two visible tumors outside her body. None of the treatments they have for this are "curative," just management and maintenance, so she will be dealing with this for the rest of her life. We do not have a timetable, nor does Emma want to ask at this time.
Because melanoma doesn't respond to chemo or radiation, she'll be receiving immunotherapy, equipping her immune system with all the latest weaponry to "kick some cancerous butt" (Emma's words.) Of course, cancer cells are genetically identical to one's own cells, so the immune system does not normally attack them. This technique is designed to deliver monoclonal antibodies which should bind to the tumor cells and act as flags or markers to convince Emma's immune system to go to work. This is what is considered a "Level 1" treatment for metastasized melanoma. Our oncologist has been in contact with a specialist in Portland who concurs with this course of treatment. Melanoma is a very specialized field, in which the doctors are always communicating with each other. There is still no cure for Stage IV melanoma, but as our doctor explained, this is such a new treatment that there is just not enough data yet to make such claims. Emma's dermatologist reminded us of the case of Jimmy Carter, who at age 93 was diagnosed with the same stage IV cancer as Emma, and basically given a death sentence, but they tried this immunotherapy on him and they say he is "cured" now, at least in remission or complete remission. Our hope is that Emma's result will be the same. At this time, the oncologist's plan is for Emma to have four treatments of two drugs, every 21 days, then another drug every 2 weeks. We will not know for some time if it is indeed working and shrinking the nasty cancer tumors.
In addition to this treatment, Emma needs a procedure to reduce the dramatic buildup of fluid in the pleural cavity (left lung) that was causing her constant cough and low energy throughout the summer. The only thing to treat this is to get it drained over and over and over again. Emma has a procedure (thoracentesis) twice a week to drain 1.5-2 liters of fluid from her collapsed left lung - about the weight of a big 2-liter bottle of soda that her lung is having to carry around!
Emma has stopped working indefinitely on doctor's recommendation-- the less stress the better, apparently. In fact, the oncologist was shocked that she had been working full-time (until mid-August) considering how poorly she felt. All the more time for writing, says Emma, though she is sad to leave her sous-chef job and the friends she has there, as well as the routine it affords her.
Mark's mom and Emma's beloved Grandma, Marilyn, are here (Ashland) and handling this with as much quiet dignity and grace as any Salter can muster. In an effort to be with Emma as much as possible, Mark and Sally have done a ton of flying (to Sacramento or Medford) and sometimes driving (Sacramento - Ashland - 4.5hrs!) in the last month. Emma's siblings are trying their best to get to Emma and support her, as well. To ease the financial burden of all this travel, please see the "Ways to Help" section of this website for a GoFundMe site to contribute to Salter travel expenses.
We are heartbroken, but this is our new "normal," and we will deal with it with as much strength as we can and as Salters do. Emma is, understandably, upset, and finds it hard to talk about. We appreciate all of our dear friends. Your hope and positive thoughts keep us stronger. Emma's doctor said we have to be realistic in that it is dangerous, but be hopeful in that some treatment may work. We especially ask for your help in supporting our children, as well as Mark and Sally, in this latest trial. As well, if you feel moved to do so, please consider donating to the Melanoma Research Foundation, link is in the "Ways to Help" section.
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