Alessandra's Medical History and Current Status

[Cherrycola]

I, Alessandra's mom, will be keeping you updated here on Alessandra's current status and I also plan to post past surgeries and treatments in detail. Please forgive me as I get all this organized and posted. In the meantime here is a very brief history and what she is currently going through. Alessandra is a 27 month old girl with melanoma. She was born in November of 2006 with a congenital nevus (large mole) on her lower back and developed melanoma within the nevus at 18 months old. Since she was diagnosed in August of 2008 she has had 6 surgeries and gone through 3 different intense treatments. She is currently at the National Cancer Institute of National Institutes of Health in Bethesda, Maryland. She is on her 4th treatment and we are very positive that this treatment and the Lord are going to cure her. Please keep her in your prayers and thoughts always.
Love,
Carla

[Cherrycola]

Here is a brief medical history that is also on the main page at http://www.SupportAlessandra.com.
BRIEF HISTORY OF ALESSANDRA'S FIGHT AGAINST MELANOMA CANCER
- 11.2006: Alessandra was born with a congenital nevus on her back.
- 07.2008: Family members noticed changes in the nevus and immediately seeked medical attention.
- 07.2008: A biopsy was done of the area that began to change within the nevus. Melanoma Cancer was confirmed.
- 08.2008: Tests were done to determine the possible areas in which Melanoma Cancer could have spread to within her body. Doctors identified that there was a potential for the cancer to go into the lymphatic system. Utilizing a specific test, doctors identified that the area where the initial tumor manifested itself lead to the lymph nodes under each arm. Surgery was scheduled immediately.
- 08.2008: Alessandra underwent initial surgery to remove the cancerious area within the nevus and as much of the nevus as possible. The procedure also included the removal of any lymph nodes, beneath the arms, that could potentially have Melanoma Cancer in them. The removed lymph nodes were sent to the lab to test for cancer.
- 09.2008: Test results come back confirming that 6 of the 8 lymph nodes extracted had Melanoma Cancer in them. A second surgery was scheduled to remove all lymph nodes from under each arm and to try and remove the remaining nevus from her back. During this surgery a Port-A-Cath was installed.
- 09.2008: Alessandra began cancer treatment with high dose Interferon Alpha 2b.
- 12.2008: Alessandra was taken to the emergency room because the family discovered a new "lump" on her back, underneath the incision scar that resulted from her previous surgeries. A third surgery is immediately scheduled for 5 days later.
- 12.2008: Alessandra undergoes her third surgery. This time to remove the "lump". Biopsy results came back positive for Melanoma Cancer. Interferon treatments continued thereafter.
- 12.2008: Brain, chest and abdomen CT scan as well as a PET scan was done. No detectable cancer in Alessandra's major organs but the scans showed three new lesions on her back under the skin. A fourth operation was scheduled for January 2nd.
- 01.2009: Surgery four was very invasive. All lesions were removed and a plastic surgeon was involved to assist in closing the incision.
- 01.2009: Alessandra experienced very high fever. Alessandra was rushed to the emergency room and doctors discovered that she had a staff infection that got into her blood, a very serious condition. Alessandra spent 3 days in ICU of the 6 days hospitalized. During the period in the ICU, additional lesions were found and doctors deemed that the Interferon treatment was not effective and opted to cancel treatments. Alternative treatment options were discussed.
- 02.2009: Alessandra is admitted into the ICU to commence IL2 (Interleukin 2) cancer therapy. She spent 11 days in ICU. Doctors continued to monitor the tumors to see if any change occurred.
- 03.2009: Alessandra was scheduled for a 5th surgery. Doctors cancelled the second cycle of IL2 as they deemed the therapy ineffctive (see the forum for a father's opinion and observations about this). A tumor under her right arm became large and was causing pain and discomfort. The tumor was removed. Discussions continued for additional cancer treatments.
- 03.2009: Alessandra was accepted into the NIH (National Institues of Health) in Bethesda, MD. She's enrolled into anti CTL4 treatments. The family discusses the treatment and makes preparations to fly to Maryland.
- 03.2009: Alessandra and family fly to Bethesda, MD to commence with anti CTL4 treatments. Alessandra received the first cycle of the treatment with no complications. After 12 days in Bethesda for cancer care, the family flies home to Texas.
- 04.2009: Alessandra and family fly back to Bethesda, MD for a second cycle of anti CTL4. Doctors postpone treatment because of the continued tumor growth. At this point one of the tumors has broken through the skin and special care is required. Alessandra is enrolled into another alternative trial treatment (not exactly but very similar to the following treatment - link http://bethesdatrials.cancer.gov/clinic ... -07-C-0176) and plans began. A 6th surgery is scheduled and done to remove a tumor for the treatment. Unfortunately it's not the tumor that has broken through the skin. Because the tumors are growing rapidly, Alessandra is given oral chemotherapy (Temodar) in an attempt to slow growth while doctors prepare for the alternative treatment. Alessandra has no immediate adverse side effects to the treatment and we continue to monitor the tumors for any growth stoppage or reduction in size. After the 5th dose of chemotherapy and 13 days at the NIH, Alessandra is now back home in Texas.

[Cherrycola]

04.27.09 We are back home. Alessandra has handled chemotherapy very well and is, as always, in great spirits. She is in pain as the tumor under her right arm is getting larger. She also has a tumor on her left flank that is pretty big. I had to buy her larger shirts and pants because of the tumors growth. She was in 18-24 months just a few weeks ago but is now in 3t or 4t shirts and 2t pants because of the tumors. We will be visiting her oncologist here at home for her exams and blood counts twice a week. She has one tumor that has broken through the skin and is bleeding out. A wound care nurse taught us how to properly care for the site and I am currently cleaning and changing the site 3 to 4 times a day. We are waiting for the call from NIH (National Institutes of Health) to fly back up for a treatment similar to this one http://bethesdatrials.cancer.gov/clinic ... -07-C-0176. This will be our 3rd trip up. If the TILs have no significant growth before she is due for the second cycle of chemotherapy than she will receive the Temodar chemo here at home and fly back to Bethesda at a later time. Please pray that they will be ready for us at NIH soon and we can prepare her for the next step. I can't say thank you enough to all of you supporting us.
God Bless,
Carla

[Cherrycola]

04.28.09 Hello all. First I'd like to thank everyone for all their prayers and sweet emails. I'd also like to apologize for not responding to each and every email. Please know I love you all and that your spiritual support and emails mean a lot to us. Now as far as Alessandra goes we had good news today. The TILs at NIH are growing so we will be heading back to Bethesda, MD this weekend to prep her for the treatment. Tomorrow she is going into the operating room again for a minor procedure. They are going to put a tunnel catheter on the left side of her chest because the port-a-cath she has on the right side is being disturbed by the tumor. We had her blood counts checked yesterday and she is doing great so far after the chemo. She is a little nauseous and vomiting but strong as ever. Friday we will have her counts checked again to make sure she doesn't need any kind of transfusions before getting on a plane. Keep the prayers going.
God Bless,
Carla

[Cherrycola]

Alessandra had her tunnel central line put in today. She is home. She is a little uncomfortable with the tumors getting so big and all the medications. I had a hard time giving her any of her medications tonight and when she finally started to take them she vomited. Poor baby. A home care nurse will be out everyday for the next week to flush her central line and teach me so that l can do it everyday. She will also be teaching me how to change her bandages once a week for the central line. We leave Sunday back to NIH in Bethesda, MD. She will have exams done Monday and Tuesday and start chemotherapy on Wednesday. They hope to give her back the TILs a week after her last dose of chemo and then the IL2 treatment.
Carla