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Feature

Donna Kuhlmann

Melanoma survivor Donna Kuhlmann fought her disease with the help of the U's Cancer Center.

Surviving melanoma

University of Minnesota undertakes clinical trials for skin cancer

Oct. 6, 2006

Four years ago, Donna Kuhlmann was diagnosed with melanoma, the most serious form of skin cancer. After two failed treatments, she was referred to the University of Minnesota where she participated in a clinical trial for an experimental vaccine conducted by a Cancer Center researcher. The vaccine did not cure Kuhlmann of melanoma, but she experienced a partial response and the disease remains under control. She's now looking forward to the birth of her first grandchild.

"Your attitude changes a little when you think you only have a year to live," says Donna Kuhlmann, a vibrant woman battling melanoma with the help of the University of Minnesota Cancer Center. "Materialistic things don't matter anymore. Friends and family and time spent with them are what really matter. Every morning now I open the window and think how beautiful the world is."

Diagnosed with melanoma in May of 2001, Kuhlmann had been on a roller coaster ride of results until participating in a clinical trial run by Arek Dudek, a University of Minnesota hematology and oncology specialist who does clinical research at the University's Cancer Center.

According to Kuhlmann, Dudek is her hero.

Kuhlmann lives in the central Minnesota community of Swanville. Her story began when her husband noticed an unusual spot on her back. Kuhlmann mentioned the spot in a follow-up doctor's appointment and later had it removed and tested. Similar to most people, Kuhlmann was not aware of the difference between melanoma and other types of skin cancer. "I thought skin cancer was easy to treat and didn't realize that melanoma was any different," says Kuhlmann.

Kuhlmann's sister, DiAnn Loven, works in an oncology unit and she urged her sister to not waste any time. Kuhlmann had surgery to remove the spot on her back, as well as several lymph nodes where the melanoma had spread. For the next year, Kuhlmann received a common treatment for melanoma called interferon. She experienced side effects, including nausea, chills, and diarrhea, and couldn't remember what it was like to feel good.

At her six-month check up after the interferon treatment, Kuhlmann's doctor found a spot on her liver and lungs and referred her to the University of Minnesota. University surgeons successfully removed Kuhlmann's diseased lung lobe, but found more spots on her liver in the next CT scan. The spread of cancer left Kuhlmann without surgical options. She received two treatments of a very toxic, though standard melanoma treatment, called Interlueken-2. This treatment also proved unsuccessful.

Targeting melanoma

At the Melanoma and Pigment Lesion Clinic at the University of Minnesota, center director Peter Lee and his colleagues perform a variation of the Mohs micrographic surgery to remove cancer that has not penetrated deeply in cosmetically sensitive areas, such as on the nose and eyelids. Damaged skin is removed in horizontal sections during the procedure. (Routine surgery removes vertical sections.) Only a few medical centers in the country offer Mohs surgery for melanoma.

Dudek, principal investigator of an upcoming experimental vaccine clinical trial for melanoma, took over Kuhlmann's care and enrolled her in the trial. The clinical trial was designed to treat melanoma patients like Kuhlmann with a Large Multivalent Immunogen (LMI) cancer vaccine--a vaccine generated from the patient's tumor cells to boost the immune system's ability to recognize and destroy cancer cells. Kuhlmann was one of 31 patients with advanced stage-4 melanoma to participate in the trial.

"Some of my friends asked me if I was scared to be a part of a clinical trial," Kuhlmann recalls. "But I knew that if I didn't try, I was going to die. I also thought that this wasn't just about me--if it didn't work for me, maybe it could help someone else," she says. "I am 100 percent for research. I don't think melanoma gets enough attention, because people aren't aware of how deadly it is."

In August of 2003, Kuhlmann received one injection of the experimental LMI vaccine. After several CT scans, Dudek found that her tumors had stopped growing, and recent scans showed her tumors had shrunk. Kuhlmann did not suffer any noticeable side effects from the vaccine.

"I am excited about these results," says Kuhlmann. "My first grandchild is due in July, and I get to be here. I feel so lucky."

Dudek is now preparing for another clinical trial; instead of using a cell from a patient's own tumor, this new trial will couple the LMI vaccine with a genetically engineered cancer cell.

To learn more about skin cancer, visit the University of Minnesota Cancer Center or call 1-888-CANCER-MN (1-888-226-2376).