The dark spot under his big toe had been there for years. So when it started getting worse in November 2011, Richard Dey became concerned. He saw a Philadelphia doctor and learned it was stage 3 melanoma, the deadliest form of skin cancer. Three weeks later, doctors amputated Dey's toe, and four weeks after that, they removed lymph nodes from his left groin to prevent the cancer from spreading further.
Yet his story didn't end there. After living cancer-free for a year-and-a-half, Dey heard news he never expected: the melanoma had spread to his lungs and therefore had become stage 4. "My doctor said none of the therapies was a cure, and that I had four-to-six months to live," he says.
Dey and his family were devastated. Yet hope soon emerged. Here's how:
July 2013 – Dey's Philadelphia-area doctor recommends a clinical trial, a type of research study. The trial combines two promising medications to fight advanced melanoma. One drug called ipilimumab (Yervoy) was already FDA-approved at the time, and the other drug, nivolumab (Opdivo), was still under investigation. These medications, called immunotherapies, harness the power of the body's own immune system to fight cancer. Because each drug affects the immune system's cancer-fighting forces differently, researchers hoped they might work even better when used together in sequence.
August 2013 – Dey, who lives in Washington Crossing, Bucks County, learns two nearby hospitals offer the trial. He chooses Lehigh Valley Health Network (LVHN) and hematologist oncologist Suresh Nair, MD, with LVPG Hematology Oncology-1240 Cedar Crest. "He spent an hour-and-a-half with me and my wife, explaining every little detail," Dey says. "He was very positive and thought I'd be a great candidate if I qualified. It was a great experience."
September 2013 – Dey receives his first treatment in the trial. Because it was not a blind study, every patient received both experimental drugs and none received a placebo (sugar pill). What differed was the order the drugs were given. Dey began with four infusions of ipilimumab every three weeks. Then he switched to nivolumab for 33 more treatments every two weeks.
For Dey and many other participants, the results were remarkable. "Richard became cancer-free about six months into his treatment and has stayed cancer-free," says Nair, who is also director of LVHN's cancer program. "In fact, we currently have 11 patients who are completely cancer-free."
May 2015 – Dey receives his final treatment. Although he experienced some side effects during the trial, including a temporary rash, achiness and fatigue, they were relatively minor. "I was very lucky," he says. "I felt ok, and the side effects didn't hold me down."
Today – Dey's cancer has not returned. Now almost 69, he is back to fully enjoying the activities he loves and only sees Nair for "healthy" checkups every three months. "I was given just months to live, and because of Dr. Nair and LVHN, I'm still here and cancer-free," Dey says. "My wife and I do quite a bit of traveling now, and we also exercise a lot, mostly yoga and walking."
The clinical trial has also led to dramatic improvements in treating advanced melanoma, and could eventually lead to a cure. "When Richard entered the clinical trial, 90 percent of patients with stage 4 melanoma were dying within a year," Nair says. "This trial was a major breakthrough. Thanks to him and other patients who participated, these medications are now FDA-approved for combined use, and the melanoma survival rate has nearly doubled."