A trip to Alaska, a Baltic cruise, a cross-country drive — nothing keeps octogenarian Patricia Gott from traveling. Not even melanoma.
At age 82, Patricia Gott said that she had never been sick a day in her life. That changed one day when she noticed a series of lumps underneath the skin on her head. Though she had no pain and no impairments, Patricia thought it was best to see a doctor.
“My doctor thought I had a severe sinus infection, so he put me on antibiotics,” Patricia said. “But on a return visit, the lumps had not disappeared, so he ordered a biopsy.”
The test results confirmed stage 4 melanoma. But the news wasn’t all bad: There was no sign that the cancer had spread to her brain. Still, Patricia’s daughter, Anna Marie Gott, insisted her mother seek a third opinion at a different hospital, where the assessment contradicted Patricia’s first diagnosis.
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After undergoing her first round of Gamma Knife surgery, Patricia switched care providers. She began working with a multidisciplinary team of specialists at the USC Norris Comprehensive Cancer Center at Keck Medicine of USC. They included Eric Chang, MD, professor of radiation oncology; Gabriel Zada, MD, associate professor of neurological surgery; James S. Hu, MD, clinical associate professor of medicine; and Naveed Wagle, MD, assistant professor of clinical neurology. The doctors suggested a two-pronged attack: Gamma Knife radiosurgery to destroy as many tumors as possible, followed by Yervoy treatment to shrink any remaining tumors.
“The combination of treatment from Gamma Knife to immunotherapy for melanoma in the brain, a disease that typically has a grave prognosis, has provided tremendous cancer control for Patricia,” said Dr. Wagle.
“Dr. Chang treated my mom for 17 tumors!” exclaimed Anna Marie.
Gamma Knife radiosurgery is a non-invasive treatment that directs focused radiation to specific targets in the brain without damaging surrounding tissue. Yervoy treatment complements Gamma Knife radiosurgery, providing a series of intravenous infusions that prevent melanoma from coming back after it has been surgically removed.
“We’ve known for many years that both radiation and surgery are effective in treating brain metastases,” said Gino Kim In, MD, who is an assistant professor of clinical medicine at the Keck School of Medicine of USC and an oncologist at Keck Medicine of USC. “But now we can also add immunotherapy to that list. It is very exciting to see that combining immunotherapy with radiation or surgery may lead to better outcomes as a result of their synergy, something we call the ‘Abscopal effect.’ Mrs. Gott is a perfect example of this.”
While Patricia did experience side effects from the medicine, specifically colitis and a loss of appetite, she noticed an immediate change in the tumors themselves.
“Within days, my scalp began to itch and tingle,” she said. “The tumors felt different. They were firmed and smaller.” By Patricia’s third infusion, many of the lumps had disappeared.
In the months that followed, Patricia experienced a recurrence of tumors, also addressed with Gamma Knife surgery. Additionally, she was prescribed Keytruda, a drug that works with the immune system in fighting cancer cells, to inhibit several tumors found throughout her body.
“There’s no doubt — the doctors at Keck Medicine of USC are the best in their field,” Anna Marie said. “They communicate with each other and stay on the cutting edge of melanoma treatments. If we had not found them, we would have had a very different outcome.”
Throughout it all, Patricia’s doctors remained amazed at her stamina. She maintained her busy lifestyle, taking a Baltic cruise two weeks after surgery, then traveling to Alaska and even driving cross-country from New Jersey to Los Angeles. Currently, she works as an Uber driver and has driven passengers as far as Los Angeles from her hometown of Los Olivos.
“She has always been ornery and stubborn, but I think she has more energy now than she did before,” Anna Marie said, laughing. “I’ve had to put a tracker on her phone. One minute she claims that she’s tired and on the way home, but two hours later, she’s scrambling around coastal cliffs and walking her dog at a nude beach along Highway 101.”
“I have a great-grandmother who lived to be 105,” Patricia said. “If you start feeling sorry for yourself and think you can’t do something, well, that’s a bunch of hogwash. It really is. You can do anything you put your mind to.”
By Heidi Tyline King
As one of the eight original National Cancer Institute (NCI)-designated comprehensive cancer centers in the United States, USC Norris Comprehensive Cancer Center at Keck Medicine of USC is one of the preeminent academic medical institutions in the country. If you are in the Los Angeles area, make an appointment by calling (800) USC-CARE (800-872-2273) or visiting cancer.keckmedicine.org/request-an-appointment.