The 4th infusion

I went to Tsukiji hospital with a cold. I felt quite terrible with a swollen throat, and bad night rest and all. I did bring Marika all the way to school which was so sweet and relaxing. It was 15° or so and really weather for jeans and a sweater. Without turbines in my left nostril, the cold air went straight up my sinus and caused a kind of brain freeze. Seeing Marika turn and wave made me fill with fatherly pride and love. What a girl!

Refreshed with completely new energy I was ready for a day of blood tests and infusion. The results were quite good. Except for minor stuff like anemia (low red blood cells) and high lipase (fat burning enzyme) all was normal. With a beaming smile I felt elated, so powerful. The doctor and nurse smiled  listening to my new found research on the web and plans. He said: ‘It’s too early to decide..’ I countered instead that it’s a positive development and smiled. Nothing would get me down today.

The rest of the day was waiting and drowsy infusion, followed by a bus ride and train ride. The diner planned by Marika in town was less of a success. She wanted to meet me in the station and I was visibly tired and not really in the mood. Her expecting smile changed everything and we celebrated a little with pizza. I went to sleep early after enjoying the cold autumn evening.

NLR indicator

The neutrophil-to-lymphocyte ratio (NLR) is an independent factor for overall survival (OS) in patients with metastatic melanoma, whether they receive targeted therapy or immunotherapy. In a retrospective analysis performed in patients treated at a single institution, Overall survival was markedly improved in patients with an NLR <5 at a median of 14.8 months compared with those who had an NLR >5, in whom the median OS was 5 months, according to research presented by Elizabeth Blackley, MD, at the 2017 ESMO Congress.

My NLR was 3.4 when my treatment started and is now 2.2. 

As there is nothing written about results of immunotherapy for Mucosal Melanoma with metastasis in the bones (stage IV-C) patients like me, this is one of the first really tangible positive indicators. Yes!

Reference article.