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Interferon is a protein produced in your body to help fight disease. Recent studies have shown that Interferon can
also help stop the growth and spread of cancer cells.
People with melanoma who have one or more positive lymph nodes are at a high risk to have their melanoma recur. It
is believed that 70 to 80% of these individuals will have their melanoma come back within the next three to five
years.
Many drugs have been studied in clinical trials to see if this risk for recurrence could be decreased. Interferon
is the only agent at this time that has shown the ability to decrease the risk of melanoma recurrence. The approval
of Interferon was based on a study that showed a 10 to 15% decrease in melanoma recurrence in patients with one or
more positive lymph nodes at the time of surgery. For example, if you had a 75% chance of your melanoma coming back
in the next three to five years, treatment with Interferon can lower that risk to 60 to 65%.
"Adjuvant" Interferon means Interferon being given to try and prevent the melanoma from returning when
there are no physical signs of disease present. It is like an insurance policy to try to eliminate any melanoma
cells that may be present in your body, that we are unable to detect by physical exam or x-rays. This involves
12 months of treatment using the following schedule:
Weeks 1-4 (1st Month)
You come into the clinic daily Monday through Friday for four weeks (20 total days) to receive high dose Interferon
intravenously (through the vein). We usually place a long term IV catheter in your arm on the first day of treatment.
This IV line can stay in the entire four weeks to prevent having to have a new one put in every day.
Blood work is checked every Monday to be sure that your blood counts are safe for treatment that week. We may need
to wait to give the Interferon or decrease the dose if blood counts are outside of the accepted ranges.
Two plain Tylenol should be taken every four hours while you are awake during this phase of the treatment to prevent
fever and chills that can occur with Interferon.
Months 2 through 12
Interferon is given as an injection under the skin three times a week at bedtime - usually Monday, Wednesday and
Friday nights. The injection is like the type a diabetic uses to give themselves insulin. This continues for 11
months of treatment. You can give the injection to yourself or have someone do it for you. You will be taught
how to administer the Interferon by our clinic staff.
Two plain Tylenol should be taken prior to the Interferon injection.
What side effects should I expect?
- The major side effect most people taking Interferon describe is fatigue. This is worse during the
first four weeks of high dose intravenous treatment. Most patients feel less fatigue during the self-administered
phase of treatment.
- Fever and chills are often seen during Interferon therapy. Tylenol taken as directed usually
prevents the fever or chills that can occur two to four hours after Interferon is given. If fevers exceed
102 degrees, notify your doctor. Other medicines can be used if Tylenol does not control your fever and chills.
- Muscle aches may occur and should be reported. You may find that the Tylenol helps, but you may also
try Motrin or Advil.
- Diarrhea is sometimes experienced during treatment. If you have two or three very watery episodes of
diarrhea in a day, you may take over the counter Imodium following the package directions. Contact your doctor if
this does not take care of the problem. Remember to increase your fluid intake.
- Headaches may occur and are usually relieved by Tylenol, but may require something stronger such as
Motrin or Advil. If headaches persist or increase in frequency, you need to notify your doctor.
- Decreased appetite is also a common problem during Interferon therapy. We recommend that you try
and eat small frequent meals five to six times a day instead of three large meals a day. Keeping a small amount
of food in your stomach helps most patients maintain at least some appetite. You can also add calories between
meals with supplements such as Ensure, Sustacal or Carnation Instant Breakfast.
- Nausea is usually not a problem for most patients, but can occur with Interferon treatment. You will be
given a prescription for an anti-nausea medication and are encouraged to use it, if needed. Let your doctor know
if you have nausea or vomiting that you can't control.
- Depression has been seen in up to a fourth of the patients treated with Interferon. The
depression is not something the patient can control, but is a side effect of treatment. It can be bad
enough at times to require medication to help control the symptoms. Feelings of depression should always be
reported.
Does my insurance pay for the Interferon?
Interferon is an approved drug in the adjuvant treatment of melanoma. It should be covered by your insurance if
you have prescription coverage. Contact your insurance company if you have concerns and let us know if you need
help with financial issues. Help with the cost of Interferon is available through the company that makes it for
individuals who are able to show a financial need.
What can I do to try and help myself?
- Remember that side effects are NOT your fault, they are due to the treatment.
- Drink as much fluid as you can. (We give extra IV fluid during your high dose Interferon treatment to
try to help decrease fatigue.)
- Rest when your body tells you that you need to rest. Don't push
yourself to exhaustion. This is a therapy that causes fatigue and forcing yourself to be active can make
things worse.
- Be sure to call if you are having problems or questions regarding your treatment.
Author: Peg Esper, MSN, RN, OCN, CS 7/98
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