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"An exciting time for the treatment of melanoma," says Dr. John McCann

May 02, 2016

Nobody likes to hear the word “cancer.” But Tracy Mastorakis has heard it several times.

 First diagnosed with melanoma in 2007, Mastorakis had a recurrence of her cancer in 2014 and found herself on the doorsteps of the Baystate Regional Cancer Program.

“I felt a lump in my groin and knew exactly what it was. My dermatologist got me an appointment with an oncology surgeon the next day. I was so scared that my cancer had recurred,” said Mastorakis.

That surgeon was Dr. Richard Arenas, chief, Surgical Oncology, Baystate Regional Cancer Program.

“Dr. Arenas and his assistant were phenomenal. They were very understanding and caring, and they tried to calm my fears the best that they could. Dr. Arenas told me that the fact it had been seven years between my cancers was a good sign,” said Mastorakis.

When the biopsy came back positive, Mastorakis, 56, had surgery to remove the melanoma along with several lymph nodes. Surgery – the main treatment for most cases of melanoma – can often cure early-stage cancers before they metastasize and decrease the likelihood of a cure.

Physical and emotional support

“But it wasn’t just the surgery, the physical side of medicine that was offered to me. Dr. Arenas and his assistant provided me with emotional support and everything else that goes along with your diagnosis from nutritional advice to helping me with my anxiety,” said Mastorakis, who also saw oncology social worker Marlene Quinlan, LICSW to deal with the stress that often accompanies a cancer diagnosis.

Mastorakis, who moved to the area some 16 years ago from sunny Southern California, had been a sun worshipper for most of her early life.

“The speculation is that my extensive sun exposure resulted in my two melanomas. I was outdoors a lot and loved having a tan. My first visit to a dermatologist was at age 14 when I was diagnosed with basil cell cancer. The doctor told me that I was way too young for this, but I was young and didn’t heed his words,” Mastorakis said.

Skin cancer isn’t something just sun seekers are at risk for. Anyone can get skin cancer from sun worshippers to outdoor workers to those who frequent tanning booths. And, it doesn’t matter whether you are light or dark skinned.

According to the American Cancer Society, skin cancer – the most common of all cancers – accounts for nearly half of all cancers in the U.S. More than 5.4 million cases of basal and squamous cell skin cancer are diagnosed each year. Some 76,380 cases of melanoma, the most serious type of skin cancer, will be diagnosed this year. It accounts for more than 10,130 of the over 12,000 skin cancer deaths each year.

Some good news

Despite those dire figures, there is good news.

“Many skin cancers can be prevented by simply refraining from being a sun worshipper and staying away from tanning beds, to which there is a definite link for an increased risk of melanoma from the ultraviolet radiation they give off. Early detection is one of the best ways to cure melanoma,” said Dr. Arenas.

According to the Baystate oncologist, people should examine their skin from head-to-toe every month and see their physician every year for a skin exam. Melanoma is most often found in men between the shoulders and hips, and on the head and neck. Women often develop melanoma on the lower legs. Look for changes in moles – those that are larger than normal, variable in color, and have irregular borders – as well as warts and other blemishes on the skin, especially those parts exposed to the sun.

While the mainstay of treatment for melanoma is surgical removal, for some patients whose cancer has spread to the lymph nodes like Mastorakis, they may require additional treatment such as interferon drugs. Interferons are a family of naturally-occurring proteins that are made and secreted by cells of the immune system. While interferons do not kill cancerous cells, they do boost the immune system response and reduce the growth of cancer cells.

The use of interferons

“Interferon has benefits in terms of preventing the recurrence of melanoma, but it can be a very difficult medicine to take with quite a few side effects, such as weakness and fatigue. Tracy had these side effects, so much so that we had to end her treatment early. However, she was on interferon long enough to benefit from its treatment,” said Dr. John McCann from the Baystate Regional Cancer Program, who treated Mastorakis after her surgery.

In addition to the side effects of the interferon treatment, Mastorakis developed lymphedema, or a swelling of the leg, as a result of the removal of her lymph nodes. The condition is similar to many women who develop lymphedema in an arm after lymph nodes are removed as part of their breast cancer surgery. The lymph system drains fluids from the leg and pelvis and passes the fluid through the groin lymph nodes. If the drainage system becomes blocked or damaged, the fluids can collect resulting in lymphedema.

A longtime flight attendant for Delta Air Lines, Mastorakis retired from flying when the lymphedema made it impossible for her to maneuver in comfort in the close quarters of an airplane.

“I feel very fortunate to have flown with Delta and traveled across the country seeing places I might never have otherwise visited and meeting so many different people. Despite traveling so far from my home here in Palmer. I also feel very fortunate to have received the medical care I needed so close to home,” said Mastorakis.

An exciting time for treatment

According to Dr. McCann, it is an “exciting time” for doctors and their patients in the treatment of melanoma.

“Today we have newer treatments to help improve the survival rate for those with advanced metastatic melanoma. We can look for specific genetic abnormalities and there are now pills available that can benefit those patients with certain mutations in the melanoma cell. We also have medicines that can activate the immune system to attack the melanoma cells,” said Dr. McCann.

“We are currently looking at new medications that activate the immune system and that hopefully are going to be more effective in preventing the recurrence of melanoma by specifically targeting one part of the immune system,” he added.

Baystate Medical Center recently opened a clinical trial evaluating one of these newer medications in patients with resected melanoma. Baystate also offers other clinical trials for advanced melanoma, testing the newest immune therapies with other medications targeting the biology of the melanoma.

For more information about these clinical trials, and to learn if you qualify, contact Betsy Lopez in Oncology Clinical Trials at Baystate at 413-794-4154.

As for Mastorakis, who is scheduled for a CT scan in June to make sure she remains cancer free, she said she has other more pressing worries than herself right now.

“My husband was diagnosed and treated for prostate cancer recently at Baystate and my mother has terminal lung disease. So, my plate is full,” she said.