- Diagnosed with stage IV melanoma at age 60
- Treated with IL-2 and T-Cells
- Lasting remission achieved by treating with IL-2, T-Cell, and ipilimumab combined
How exactly does a “tough old buzzard” beat stage IV melanoma and become a “prize guinea pig”—with experiences so unique he’s been featured on local TV and written up in prestigious medical journals?
It’s the story in three chapters of Matt Flood, a retired fireman, now in his 60th year, a cancer survivor living in Tacoma, Washington.
Chapter 1: Black humor and basketball
To qualify as a tough buzzard, you have to be strong, both physically and mentally. Matt’s occupation as a city firefighter was physically demanding. However, putting out fires constitutes only about five percent of what the modern-day fireman actually does. The other 95 percent is responding to medical emergencies as a paramedic. As a result, Matt was often the first responder when people were having heart attacks. At car accidents, his job was to help free victims from their vehicles with the Jaws of Life.
“We talk about this all the time in the fire services," says Matt. "You can’t get emotionally involved. Black humor and detachment have to be part of your professional approach. Otherwise it will drive you crazy.” Matt’s self-deprecating humor was an important asset that enabled him to survive the trials he was about to endure. So was his overall fitness. Before his cancer, Matt enjoyed playing five-on-five full court basketball, two to three nights per week. And in his spare time he liked to work on remodeling projects.
Then, in late 2004, Matt noticed a mole on the outside of his thigh. He assumed it just a minor skin irritation from the seam of his heavy work pants. About six months later, it started bleeding. That’s when Matt’s wife, Anne, insisted that he have it checked.
It was melanoma. Matt had the malignancy and quite a bit of surrounding tissue removed by a local plastic surgeon. The procedure also included a sentinel node biopsy, which showed that the disease had already spread to his lymphatic system. Matt opted for a second surgery to remove infected lymph nodes, combined with a year’s worth of treatment with high-dose interferon. These interventions seemed to produce a complete response. Matt returned to work. And basketball. And remodeling. Over the next four years, his annual cancer screening started to feel “like just another routine doctor visit.”
That changed abruptly in November 2009, when Matt received some stunning news: “The doctor walked in and said, ‘we’ve got two nodules here… And by the way, the survival range for someone who’s in stage IVA is four to nine months.’”
Chapter 2: You need all the help you can get
Matt is not someone to accept a prognosis like that passively. He immediately thought, “What treatment is available? How can I beat the odds? I decided I was going to fight as hard as I could because I wanted to see both of my daughters graduate from high school—which was still a couple of years away.”
Matt and Anne didn’t waste any time. They researched their treatment options, deciding that Seattle Cancer Care Alliance (SCCA) offered leading-edge therapies that were the most promising—less than an hour’s drive from home.
At SCCA, Matt worked with John Thompson, MD, a medical oncologist specializing in melanoma. He explained that Matt’s best odds were with high-dose interleukin-2 (IL-2). Interleukins are growth factors that can stimulate white blood cells into stepping up their activity against tumors.
However, the side effects Matt experienced were almost beyond endurance. “I was sick as a dog,” says Matt. “It's like you've got the cold, the flu, the chills, the aches, all at the same time. I could hardly eat, but I was gaining weight from all the fluids they were giving me. I gained 40 pounds in a week.”
Matt also experienced atrial fibrillations and the skin peeled from his entire body—twice.
Worst of all were his immediate reactions during the infusions, which were delivered via what Matt calls “the major leagues of IVs—a PICC line that goes in through your brachial artery,” which is the major blood vessel in the upper arm. He experienced chills that sent him into convulsions, and he was also having hallucinations and memory lapses. “Half the time I didn’t even know what I was doing,” says Matt. “They had to tell me afterwards. One night I actually removed my PICC line. It took a nurse two full hours to install it and I, in my hallucinogenic stupor, actually pulled it out.”
That’s when Matt and Anne decided he needed to have someone watching him 24 hours a day. His support system included his two daughters, Jennifer and Erin; his brother Stu from Layton, Utah; friends such as Jeff Wyrwitzke and other paramedics from the Fire Department; and, of course, Anne.
Matt is unrestrained in his praise for everyone who supported him throughout his treatment. “You have to have a support group. I couldn’t have made it without mine. I highly recommend it to everyone.”
Chapter 3: Prize “guinea pigs” need great experiments
After all that, the interleukin-2 produced a remission that lasted less than three months. Matt gamely moved forward and asked Dr. Thompson to explain the options available in clinical trials. One technique takes T-cells that have responded to the patient’s tumor, grows them in very large numbers, and then infuses them back into the patient to destroy the cancer. Another option was an investigational drug called ipilimumab, which was in trials at the time. (It was subsequently approved by the U.S. Food & Drug Administration.) “Ipi” is a monoclonal antibody which, on the molecular level, “turns on a switch” that allows white blood cells to recognize and destroy the cancer.
Matt first enrolled in studies that applied these techniques individually. But his cancer continued to progress. By the fall of 2011, Matt was in a tough spot. As Dr. Thompson recalls, “He had been through IL-2; he had been through T-cells; he had been through Ipi—and his cancer was still growing. At this point Dr. Aude Chapuis had a protocol that involved giving T-cells plus low-dose IL-2, plus Ipi, in a combination of different agents. Matt went through that and, lo and behold, he started responding!”
After what Matt went through with IL-2, it’s remarkable that the successful trial had so few side effects. This is one of the main reasons why immunotherapy holds so much promise for patients. All of the treatment was delivered on an outpatient basis, including a blood draw to harvest T-cells and a two-hour session to infuse the T-cell-Ipi-and-IL-2 cocktail. Matt’s only adverse reactions were itchy skin, some slight discomfort in the GI tract—and his eyebrows and lashes turned white. “My eyelashes have already been documented in more than one publication,” says Matt with obvious pride. “I told Dr. Chapuis, ‘I am your prize guinea pig. Really and truly, that’s my role.’ And I'm more than tickled about it.”
Rightly so. Dr. Thompson says that Matt’s prognosis is good. “His last treatment was in November 2011 and his melanoma is in complete remission. At this point we'll just continue to monitor him on a less frequent basis and hope for continued good health. The nice thing about immunotherapies of this sort is that if we see a response this dramatic, typically it’s a lasting response. I think it’s more likely than not, that he will stay in this remission.”
Epilogue: Enjoying life
At home in Tacoma, Matt is obviously enjoying life. He’s now retired from work. Although he’s had to give up basketball, he’s enthusiastic about swimming instead. And he continues to work on projects around the house.
He and Anne share a passion for gardening, which is threatening to metastasize into a small-scale farm in his residential neighborhood of Tacoma. The list of the plants and varieties they grow is impressive: blueberries, strawberries, lingonberries, exotic varieties of hydrangeas, and unusual specimen trees including coral bark and lace leaf maples.
Says Matt, “Anne was an actual horticulture major at San Francisco State. She knows all the scientific names and she likes that aspect of it. It’s different for me,” he laughs. “I just know that the blueberries taste really good, the strawberries taste really good.”