I like having a team of doctors care for me, all in one hospital.
Harnessing the Power of Immunity
In March 2015, Meline Dickson, now 58, was excited to go skiing in Vail, Colorado — her first time on western slopes in over five years — with her husband, David, and their friends. It wouldn’t be an ordinary trip: She had won it at a fundraiser, and it included a stay at the Ritz Carlton plus a private ski lesson with Olympic ski racer Tommy Moe.
During her first day on the snow, a Thursday, she felt pain in her chest. Thinking it was just the altitude or maybe the onset of bronchitis, she took two aspirin. When she still felt unwell on Friday, she visited the emergency room of a local hospital. They did a series of tests, and the results stunned her: She had cancerous lesions in her lungs, brain, and liver. “I was shocked. I thought for sure they were someone else’s scans,” she recalls. “I was surprised because I felt pretty well.” It turned out to be metastatic melanoma.
Meline and David had taught tennis and were out in the sun for years. Knowing this, they often saw their dermatologist for skin checks. Meline learned in 2013 that she had a melanoma on her left shoulder blade, but tests did not show that it spread to the lymph nodes. Yet two years later, the cancer had made an unexpected return.
She, David, and their friends packed their bags and returned to their Greenwich, Connecticut home that Friday. Her general practitioner referred her to NewYork-Presbyterian/Columbia University Irving Medical Center, with an appointment scheduled for the following Wednesday. That visit was moved up after another unforeseen event. After dropping off her son, Marshall, at his high school that Saturday evening to see the school musical, Meline had a seizure while driving.
“I remembered feeling a staticky weird sensation,” she notes. She had been slowly pulling away from the school when it happened and hit a parked car. Neither she nor anyone else was hurt, but an ambulance took her to a nearby hospital. A few days later, she was on the operating table at NewYork-Presbyterian/Columbia, where a neurosurgeon removed some of the metastatic brain tumors. Other brain lesions were treated with Gamma Knife radiosurgery, using a pinpoint high-dose beam of radiation directed to tumors to kill cancer cells.
She also began receiving nivolumab and ipilimumab — immunotherapies that boosted the power of her immune system to detect and kill melanoma cells throughout her body. Immunotherapy is revolutionizing the treatment of cancer, especially metastatic melanoma, which once carried with it a life expectancy measured in months after diagnosis rather than years. It’s the same class of drugs that have kept former President Jimmy Carter alive for years after his metastatic melanoma diagnosis.
Richard Carvajal, MD, an expert in melanoma treatment and immunotherapy research, directed her medical care. “He’s amazing — so thoughtful and wicked smart,” says Meline. “The nurses were terrific, too. I didn’t have many side effects — just some itching, but I heard it could be worse.” In summer 2015, she completed the immunotherapy. She also received speech therapy and occupational therapy to restore her function and independence.
Three years later, some metastatic tumors remain, but they aren’t growing. Meline is monitored every three months with brain MRI and every four months with CT scans of her lungs, liver, and other organs to check for cancer spread. In October 2017, her doctors found another type of tumor in her brain — a cancer called a glioma — which she had surgically removed and treated with radiation therapy. She now takes a pill called temozolomide for the glioma and is under the watchful care of NewYork-Presbyterian/Columbia neuro-oncologist Teri Kreisl, MD.
Meline still enjoys racquet sports, especially paddle tennis, and spending time with David and their four children — two of whom are in college, and two who have graduated. She sometimes has problems recalling words and remembering things and often has to write things down. “But otherwise, I’m living life pretty normally,” she concludes. “I like having a team of doctors care for me, all in one hospital. I’m so grateful I was eligible to receive immunotherapy, because it probably saved my life.”