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A Cancer Hail Mary Saved My Life

Mellany Gray, an organized business owner and mother of two, spent most of her time driving her teenagers from one sport to the next. An avid fan of enjoying the “simple pleasures” of life, Mellany’s life suddenly became anything but simple when a lump on her leg was diagnosed as embryonal alveolar pleomorphic rhabdomyosarcoma – a rare form of sarcoma found in less than 1% of adult cancer patients.

After receiving various treatments including chemotherapy, radiation therapy, and a thoracotomy with a lobectomy, Mellany’s cancer continued to spread throughout her body. Running out of options, she met Manny Mangat, M.D., medical oncologist and hematologist at Texas Oncology–Midland Allison Cancer Center, who was determined to find a solution. A few months in, Mellany was admitted to the hospital with a brain tumor and given not much longer to live. Dr. Mangat ensured her they weren’t done fighting. He decided to look into immunotherapy, an advanced form of therapy that helps the body’s immune system fight cancer cells, which was a fairly new treatment option at the time. Throwing a Hail Mary, Dr. Mangat started her on this treatment, with no idea what the outcome would be. Incredibly, Mellany’s scans started to clear up, with no signs of cancer.

Hear Mellany’s story and how immunotherapy, a cancer Hail Mary, saved her life.

Transcript

Ted Canova: With cancer quickly spreading through her body, it took a Hail Mary to save this mother’s life.

Mellany Gray: The nurse tells me that I have no evidence of disease in my body. And I just started crying because I felt like it was over, that this is what I was going for, and I made it to the finish line.

Ted Canova: Hi, and welcome back to Right Here, a podcast from Texas Oncology who knows that family and friends are a huge part of cancer treatment, so being right here makes a difference. For community-based cancer care, go to Texas Oncology.com. I’m Ted Canova.

Ted Canova: Sometimes, detecting cancer starts with a simple itch.

Mellany Gray: Hi, I'm Mellany Gray. I live in Midland, Texas and I beat cancer.

Ted Canova: Before any of her many diagnoses, Mellany says that life was just life. She was living in Florida, raising two teenagers. Matthew played football and Samantha was into competitive cheer. Mellany ran her own company, so she had flexibility to enjoy the simple pleasures.

Mellany Gray: I had a pool. So, I did a lot of swimming and went to the beach, hang out with friends, shuttle kids. There was really no fast paced anything because everything was pretty well organized.

Ted Canova: Until one day, when Mellany was sitting in the car, waiting for Samantha to finish a tumbling lesson.

Mellany Gray: I was just messing around on my phone and had my leg up on the seat while I was waiting for her to get done with her lesson. And I had an itch and whenever I reached around to the back of my leg to scratch it, I felt a lump.

Ted Canova: A fairly large lump. Mellany knew something was wrong.

Mellany Gray: I went home, I called my sister who's a nurse. And she told me to lay down flat and see if it would move, and it wouldn't move. And so, I instantly knew that I just had to get into the doctor.

Ted Canova: But there were no appointments for three weeks.

Mellany Gray: I could feel that it was getting bigger. It was right under my butt, the right post interior thigh.

Ted Canova: What seemed pinpointed would grow to the point of exasperation. She went in for a MRI and was sent to an orthopedic.

Mellany Gray: He felt it and he instantly said, I'm not going to touch it, it's encapsulated so I knew that it was something serious.

Ted Canova: So serious that Mellany set up an appointment with an orthopedic oncologist three hours away.

Mellany Gray: They initially thought it was like a less aggressive type of sarcoma. And then they diagnosed me with a pediatric form of rhabdomyosarcoma.

Ted Canova: Things snowballed from there. Mellany met with specialists, had a treatment plan of chemotherapy, and was going to take part in a kid’s clinical trial. But while getting more blood work done, she got a call.

Mellany Gray: The orthopedic surgeon and says, we’re canceling everything, go to the pediatric oncologist, and she'll explain everything. So, I go over there. And this lady comes in and she takes a piece of paper towel, and she writes E for embryonal. A for alveolar, and P for pleomorphic, which is the only adult form of rhabdomyosarcoma. Sarcoma is 1% of all cancer and I have less than 1% of that 1%. Nobody has what I have. So, she's drawn all this and she's saying what they do and like making me a little diagram and then she gets to the P which is what I have. And she draws a line, and she draws a question mark, and she just keeps circling it and she looks at me and she goes, we don't know what to do with you.

Mellany Gray: So, I went and met with the adult oncologist, and he said, we're going to do the radiation, and try to shrink it because it was so aggressive. And then once you're healed from the radiation burns, we're going to put you into surgery. And then once you're healed from surgery, we're going to put you into a chemo regimen.

Mellany Gray: I was ready for it. I said, Let's do it. I didn't want to waste any more time. The bulge in the back of my thigh just kept getting bigger and bigger. You can visibly see that something was growing.

Ted Canova: So on her daughter’s 16th birthday, Mellany started radiation, and it was working.

Mellany Gray: They were able to kill like 72% of the tumor. And then my burns weren't even healed yet, and they were like, we need to go in and take it out.

Ted Canova: Mellany completed eight weeks of chemotherapy. She started feeling better and had another scan.

Mellany Gray: I was feeling fine. And I went up to the orthopedic oncologist’s office, and they told me that it had metastasized to my lungs. And I had a very aggressive tumor in my right middle lobe. And I had two more tumors in the lower right lobe, and then I had one tumor in the left lobe that was smaller. I was taken aback, but I said okay, what do we do now?

Ted Canova: Mellany’s chemotherapy wasn’t working.

Mellany Gray: The one thing with sarcoma is if you have it in your appendages, it loves to go to your lungs, because what I have is a soft tissue sarcoma. It loved my lungs for years because it kept coming back in my lungs. So, from that day, I met with my lung surgeon. His regimen is, I will try to save the middle lobe, but if it's too aggressive, I'm going to have to take it.

Ted Canova: The surgeon felt confident that he would be able to remove the two tumors that were in her lower lobe.

Mellany Gray: It was like a week after I had that surgery, I had a full thoracotomy with a lobectomy, which is taking out the lobe. I was pretty painful, but I was just like, okay, maybe it'll just be gone.

Ted Canova: Two weeks after lung surgery, Mellany was back on a different chemo. But once again, this regimen wasn’t working.

Mellany Gray: I go back for more scans. And there's more tumors in the right side of my lungs. They said, we're not going to keep cutting on you, we're going to try to use different kinds of chemo to see if we can get it and stop it. And then I got a scan two months after that, and there were more tumors on the right side.

Ted Canova: Doctors kept switching Mellany’s treatment plan until a new chemo drug seemed to stop the tumors from growing.

Mellany Gray: But then almost a year to the day after my first surgery, they said we need to go in and take tumors out of right side of your lung.

Ted Canova: Enough to make you and me cry, right? But not Mellany.

Mellany Gray: I laugh a lot. I had the attitude that every day that I'm living, I'm not going to live being like, oh my gosh, I have cancer. I'm going to live my life. I didn't want to stop living. So, I didn't.

Ted Canova: With her kids out of high school, Mellany decided to start over. She relocated to Amarillo, met her future husband Randy, and moved to Midland where she started working again. Life was just life, as she says, but the change of scenery didn’t clear up her medical issues.

Mellany Gray: now I'm living in Midland, and I decided to start going to Texas Oncology for care and treatment. And that is where I met Dr. Manny, who you will learn is my angel, my savior.

Dr. Manny Mangat: Hi, I'm Dr. Manny Margot, Oncologist and Medical Director of the Texas Oncology Clinic in Midland, Texas.

Ted Canova: First, Dr. Manny caught up on Mellany’s medical history.

Dr. Manny Mangat: Obviously, her case was very challenging, she had gone through extensive diagnostic workup, not to mention surgeries and treatments, before she ended up here in West Texas.

Mellany Gray: I walked into Dr Manny's office, and I liked him instantly.

Dr. Manny Mangat: I tell her that we as doctors can only do so much and I tried to tell her that many times there's some unknown supernatural power, many things outside our control sometimes that help sway the direction that her disease is taking, or the disease took.

Mellany Gray: I have pleomorphic rhabdomyosarcoma?

Ted Canova: Say that five times fast.

Mellany Gray: Pleomorphic Rhabdomyosarcoma, Pleomorphic Rhabdomyosarcoma, Pleomorphic Rhabdomyosarcoma, Pleomorphic Rhabdomyosarcoma, Pleomorphic Rhabdomyosarcoma.

Ted Canova: Ok, but how ‘bout spelling it?

Mellany Gray: P-l-e-o-m-o-r-p-h-i-c R-h-a-b-d-o-m-y-o-s-a-r-c-o-m-a.

Dr. Manny: I told her that look, it's already spread. I don't think removing one particular area of spread is going to really help her. Because of the extensive spread of the disease, probably we'll have to go with a different kind of chemotherapy.

Mellany Gray: And I told him that the tumor in my left lung,  I wanted it removed. And he said that we can do that. I automatically felt at ease with him. I felt like he was a straight shooter, I felt like I could trust my health and my life with him.

Ted Canova: Even in the best hands, Mellany’s case was still complicated.

Mellany Gray: I go to a surgeon here in Midland. He did a scope procedure and took out the tumor. And I thought it was okay. And went back and started going back to chemo. And I started feeling really intense pain in my ribcage. And before I knew it, a lump appeared towards the middle of my ribcage. And it was a tumor that was growing from the inside of my chest wall through my rib muscle and protruding out of my back. And I'm thinking okay, we're going to cut it out. That's it, it'll be done. But it turned out that the outside of the tumor was just as big as it was on the inside of my chest wall. And the hole inside of the left side of my chest wall was dotted with tumors. And then I had two on my diaphragm and one on my heart lining. It was full throttle coming at me.

Mellany Gray: They put me in touch with one of their radiation oncologists. And he said, we have a different plan. They were going to do a new type of radiation, which high volume, low dose, so I was radiated basically from my neck, all the way down to my lower abdomen.

Dr. Manny Mangat: So, she got the radiation. A few months after that, we did some scans and it had again spread- there were other spots in the lungs. The spots on her chest wall had gotten better, but the spots in the lungs had progressed. And so, that meant that we needed to get back on treatment. So, we gave her some more chemotherapy.

Ted Canova: All of this was enough to give you a headache, which Mellany had for a week.

Mellany Gray: I kept saying, I think I have a brain tumor. I think I have a brain tumor. And Randy's like, you don't have a brain tumor.

Ted Canova: Mellany went to the ER for a brain scan, which revealed… a brain tumor.

Mellany Gray: Dr. Manny walks into the emergency room. And he just looks at me and kind of shakes his head.

Dr. Manny Mangat: I remember that very well and I said, “Oh my gosh, as if we needed that.”

Mellany Gray: And I look at him and I asked him, “is this it? Like, am I done?”

Dr. Manny Mangat: Given the extent of the disease, given the numerous organs involved, and now it's gone to the brain. I think any oncologist would have thought the same.

Mellany Gray: And he explained to me that I wasn't done.

Dr. Manny Mangat: I told her that look, there's one spot in the brain, but it is not that big. And so, the hero was actually the neurosurgeon who removed it.

Mellany Gray: And that was the easiest surgery ever. You wouldn't think so. But it was. I was like, this is a cakewalk!

Ted Canova: After a successful brain surgery, Mellany returned to Texas Oncology for radiation treatment to make sure the tumors didn’t return. However, they did return throughout Mellany’s body.

Mellany Gray: And then I was like, Okay, I want to start chemo again. And so, we went back to do a scan, a chest, pelvic and abdomen scan. And to see where my baseline is.

Mellany Gray: So, I get a call from the nurse, and she told me that my liver was ravaged with tumors, that I had so many that they didn't even count them all. And that's when I got really scared. And I went in, and I met with Dr. Manny, and he suggested that I try to go on immunotherapy OPDIVO.

Dr. Manny Mangat: And it was growing rather rapidly. And then she was panicking because it looked as if we'd exhausted most of our options.

Mellany Gray: I’m just running out of chemo options like crazy. The list just keeps dwindling.

Dr. Manny Mangat: She was just clutching at straws. And she was like a fish out of water. She was just looking for anything at all.

Ted Canova: Immunotherapy is advanced form of therapy that helps the body's immune system fight cancer cells. It was proven effective to treat lung tumors, but not ones in the liver. Thankfully, the drug company approved the immunotherapy. But still the reality: at 41 years old, Mellany was given three months to live if this treatment didn’t work.

Mellany Gray: Dr. Manny calls it our Hail Mary. That's what immunotherapy was for us.

Dr. Manny Mangat: Yes, it was literally a Hail Mary because there was really nothing else working and this thing was taking off.

Mellany Gray: I went into Texas Oncology, and all of the oncology nurses are angels as well. One of them, her name is Paula. She was telling me that there's no side effects from this. And so, I decided that day that I would go on immunotherapy.

Dr. Manny Mangat: It was an IV, she would come once every four weeks, get the treatment. And then every three-four months we would repeat a scan and see how we're doing.

Mellany Gray: I went to get a scan and the radiologist who was reading my report thought that all the tumors in my lungs had been cut out because they were just gone. They disappeared. Yeah, I was like, am I reading this right? No way. I hear from Dr. Manny's nurse, Roberta. And she tells me that I have no evidence of disease in my body. And I didn't believe her. And she said, I'll put the report up at the front if you want to come pick it up. And I ran out of that office faster than you can imagine. I was just freaking out. And I walked in and Yvonne, she’s the receptionist that handed me the report, because I know all these people by name. I pulled it out and I just started reading it and when I read that sentence, my knees just buckled, and I had to sit down. And I just started crying. Because I felt like it was over.

Dr. Manny Mangat: Gradually all the spots in her lungs began to disappear. She had some spots in the liver and those also dissipated away. Stories like these don't happen all the time. But every now and then you see such a thing play out and it is very humbling because we realize that there are some forces beyond our control that are playing a role in how each patient responds.

Mellany Gray: There were so many times when the chemo wouldn't work, and Dr. Manny would look at me and asked me if I wanted to keep going. And my answer was always yes. Because if I hadn't said yes, I might not have made it to the point where I was able to do this treatment. And that's what ended up giving me years of not having to even think about cancer anymore.

Dr. Manny Mangat: In her case, it was her strength, her desire to keep going with treatment that kept the battle continuing, many people would have kind of given up. And the fact that we just kept trying new options, and thankfully that treatment worked.

Ted Canova:  Mellany was now cancer free, in her lungs, her liver, her brain and, how shall we say, her butt cheek.

Mellany Gray: It’s been a ride, bumpy ride but hey, there was a lot of blessings in the middle.

Ted Canova: Through it all, Mellany and Dr. Manny learned something from one another.

Mellany Gray: He taught me how to trust. As long as I kept fighting, he’d keep fighting along with me. And he always did. And then that Hail Mary was a hell of a pass.

Dr. Manny Mangat: I learned from Mellany that one should always fight, keep looking for new treatment options, have the strength of character to face challenges as and when they appear. She showed immense strength, courage, and endurance in her battle.

Mellany Gray: Dr. Manny, you know how much I love you, and how much I appreciate everything that you've done for me. And I know that I wouldn't be here today if it weren't for you taking a chance on me and caring about me to the point where you went out of your way to be able to get me the drug that ended up saving my life. And holding my hand through all of it since you've been my doctor. And I thank God for you every day.

Dr. Manny Mangat: Mellany, who would have thought with all that was going on that you would, after all the surgeries, all these treatments, this immunotherapy… be leading a full and productive life for somebody who had pretty much been given the death sentence with the advanced and metastatic nature of the disease.

Ted Canova: That Hail Mary pass seemed to work. What also worked was Mellany being treated so close to home.

Mellany Gray: Texas Oncology being so close, they're right there. It’s easy to navigate your life because you're not having to go so far to get what you need for your cancer to be able to have a doctor that's literally five minutes from my job, 10 minutes from my house versus three hours. They're a blessing, they saved me.

Dr. Manny Mangat: I think it is very important that patients get treated close to home. They have they have the comfort of knowing their family are close by to provide them physical and emotional support.

Ted Canova: Since her last chemo in May of 2021, Mellany’s scans have all been clear. She has her blood work done every few months, and she hasn’t needed any drugs.

Ted Canova: We hope you enjoyed Right Here, a podcast from Texas Oncology who knows that family and friends are a huge part of cancer treatment, so being right here makes a difference. For community-based cancer care, contact Texas Oncology.com. I’m Ted Canova. See you next time.

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