Welcome to the “Westover Alliance” page. Debbie’s melanoma has recently progressed to Stage IV, so we’ve created this page to share updates about her health, treatments, and journey ahead. So many kind friends and family have asked how they can help — thank you. To make things easier, we've added a "Care Calendar" to the site where you can see specific ways to support us, including meals, transportation, and childcare. Your love and support mean the world to us. Debbie’s Melanoma Journey: Debbie had a large mole on her back, between the shoulder blades, that we had been concerned about. It had increased some in size and seemed irregular. After waiting a while to try and get an appointment with an in-network dermatologist, Debbie found a community dermatologist who could quickly get her in. They removed the mole on Nov 18th, we got results on Nov 22nd stating it was melanoma, and she was referred to Surgical Oncology at Winship at Emory Healthcare. They quickly got her in for an appointment, and she was seen on Dec 3rd. On Dec 19th, Debbie had a “wide local excision” (WLE) of the area around the mole (primary site) to ensure everything had been removed. The excision was 4 cm (1.5 in) in diameter and went down to the muscle. To pull everything together and close the wound, the entire incision was a little over 12 cm (5 in) long. Additionally, she had a sentinel lymph node biopsy (SLNB) from under each arm. 2 lymph nodes were removed from under each arm. The 1st lymph node under each arm had a 2 mm metastatic tumor, but the 2nd lymph node in line was negative. Having small tumors in her lymph nodes made it Stage III Melanoma. About 1.5 weeks after the surgery, the incision on her back “dehisced,” which means a portion of it opened (about 2-3 inches). Unfortunately, this meant a much longer healing process. Josh became her wound care nurse, doing wound packing and dressing changes twice a day. Thankfully Debbie works for a great healthcare system, with great benefits, so she was able to take 8 weeks off work to fully heal. In February, while still off work, Debbie was seen by Medical Oncology, and the decision was to pursue immunotherapy. Melanoma is a type of cancer that can easily spread, so the goal of immunotherapy is to “unmask” anything remaining or hiding and to strengthen the immune system to recognize and attack the cancer cells. She had a brain MRI and neck/chest/abdomen CT that did not show anything, so she started Keytruda infusions at the beginning of March. The plan was for 1 infusion every 6 weeks for 1 year. In mid-April, I noticed some bruising and what felt like a lump in my breast. The decision was to proceed with my 2nd round of treatment and I referred for a mammogram. On April 22nd, the mammogram and ultrasound showed a small mass, so due to her melanoma history, the decision was made to schedule a biopsy for the next week on April 30th. On May 7th, we received the results – the biopsy was positive for melanoma. Her care team quickly got her in for a CT on May 9th, which confirmed the breast mass, as well as several small subcutaneous (soft tissue) nodules in her abdomen. None of these nodules were present prior to starting treatment. As her care team says, Debbie is “technically” Stage IV Melanoma. However, everyone on her care team is very optimistic. The treatment options for melanoma have come a long way and show great outcomes. And the nodules showing up now mean she’s responding to the immunotherapy because it’s doing its job of “unmasking” the cancer cells. She will start a new treatment of stronger targeted immunotherapy meds on May 27th. She’ll receive dual therapy of nivolumab (Opdivo) & ipilimumab (Yervoy) every 3 weeks for 4 treatments. Then the plan is to transition to nivolumab every 4 weeks for another year.