Dr. Spitler,
I am at the stage of deciding between DTIC or Temodar. May I have your opinion? I have multiple melanoma metastases to the brain(over 10 lesions), liver(4 lesions), and pancreas(2 lesions). I just finished a 10-course WBRT.

As I understand so far, Temodar is a newer form of DTIC, but why it is still NOT approved by FDA to treat melanoma?

And, what is the efficary difference between these two drugs?

Thank you very much,
Angela

THe difference is that Temodar can penetrate the blood-brain barrier and attack any cancer cells in the brain. I belive that it is now FDA-approved for melanoma.

Last year I had a mass removed from my right side and it turned out to be a weird type of melanoma - "clear cell" melanoma. I had an enlarged right inguinal lymph node, which they biopsied and later removed when it came back positive...then I had a PET scan done (with that glucose stuff) that detects increased glucose intake (cancer cells are basically eating machines, so they use a lot of glucose), and it showed a hot spot in my breastbone. A needle biopsy confirmed it positive, so they started me on targeted radiation therapy for a month. When that finished they started me on Temodar, 300mg/day for 5 days, then off for 24 days, then another 5 days, and repeat...

Just finished my third course of Temodar, and have had no side effects at all. They will schedule another PET scan in May, to give the rad-treated area a chance to "cool down" and not show up as a false positive.

All my docs say I am a "weird" patient - I have had absolutely no symptoms at all - I don't look sick or show any typical signs of a Stage IV cancer patient. The original mass did not come from a mole or spot on my skin. The only side effects I have had from my treatments were fatigue from the radiation, and of course a cherry-red burn area on my chest, which is almost healed by now.
I keep reading all these horror stories about having only months to live - my docs won't tell me how long I have because they say that it doesn't look like I have an "end date", as the treatments should have taken care of everything.
I guess the only thing to do for now is wait (on pins & needles) for the next PET scan...