Â鶹ӳ»­

Joy McDevitt was diagnosed with a rare cancer called mucosal melanoma of the nasal cavity on Aug. 6, 2024. She had seen an ENT because she couldn¡¯t breathe out of the right side of her nose. A biopsy revealed the diagnosis. She was 63.

Joy lives in Michigan but spent years living in Houston. So, she was familiar with MD Anderson. Because mucosal melanoma is so rare, she wanted to get treated at a place that had seen this kind of cancer before.

She¡¯d already started filling out the online forms to request an appointment at MD Anderson when her doctor shared the biopsy results.

¡°He said he¡¯d only seen this type of cancer one other time and even spoke to a local head and neck surgeon about it,¡± Joy recalls. ¡°When we discussed where I should go for treatment, he said, ¡®If it were me, I¡¯d go to MD Anderson.¡¯¡±

Enrolling in a clinical trial at MD Anderson

Joy¡¯s first appointment was on Aug. 20, 2024. That week, she had a PET scan and MRI and met with head and neck surgeon , melanoma medical oncologist , and radiation oncologist

Her doctors told her about the PRISM clinical trial (now named PRISAM), which switched up the order of treatment for sinonasal mucosal melanoma. Whereas the conventional treatment protocol starts with surgery followed by radiation therapy and consideration of systemic treatments such as immunotherapy, the PRISAM trial starts with immunotherapy, then radiation therapy, followed by surgery. To be eligible, patients must have no distant metastasis, which means the cancer cannot have spread far from the original tumor.  

¡°With the type of melanoma I had, they thought this treatment might have a greater chance for success,¡± says Joy. ¡°I was glad the cancer was caught early enough that it hadn¡¯t spread. I feel fortunate I was able to enroll in the clinical trial.¡±

Joy underwent two cycles of immunotherapy, and then she started radiation therapy a few weeks later. Mitra targeted the area with a tumor in Joy¡¯s nose. Joy took a month of disability from work, so she could come to Houston for treatment. She had radiation every Monday through Friday for four weeks.

By late November, an MRI showed significant shrinkage of the nasal tumor. So, on Nov. 25, Su performed a nasal sinus endoscopy and polypectomy, a minimally invasive procedure to evaluate the extent of residual disease.

Su performed an endoscopic nasal resection on Jan. 6, 2025, to remove the part of Joy¡¯s nose containing tumors. Due to positive margins, Su performed a final surgery a week later, which was confirmed to have removed all the remaining cancer.

Joy hopes to have surgery to reconstruct her right nasal cavity in late 2026.    

Managing mucosal melanoma treatment side effects

Joy describes the first three weeks of radiation therapy as ¡°the honeymoon period¡± of her cancer treatment because she had no side effects. She and her husband spent time walking in a local park and visiting different places in Houston.

During the last week of radiation, Joy¡¯s oxygen levels and heart rate were low, and bloodwork showed that her troponin levels were high, which can be an indicator of heart damage. Her care team asked her to come to MD Anderson¡¯s Acute Cancer Care Center.

¡°I stayed at the hospital, so they could figure out what was causing the changes in my body,¡± recalls Joy. ¡°I still didn¡¯t have any physical symptoms.¡±

It turns out the immunotherapy had affected Joy¡¯s endocrine system. She developed hypothyroidism, which means her thyroid was not producing enough hormone. She also had central adrenal insufficiency. This caused her slow heart rate.   

She was placed on hormone replacement therapy: Synthroid to manage the hypothyroidism and hydrocortisone to replace the cortisol her body no longer makes.

At her care team¡¯s recommendation, Joy chose to do immunotherapy after surgery instead of surveillance to try to prevent the cancer from coming back.

She was able to do the immunotherapy in January, February and March, but her liver and kidney were overreacting to the treatment. So, she¡¯s currently taking a break from immunotherapy and is taking medication to help with the inflammation in her liver and kidney.

At times, Joy has trouble sleeping while taking the medication. But she¡¯s learned to find a quiet place during the day where she can close her eyes and rest for 10 to 15 minutes.

¡°I¡¯ll then finish my workday, go home and rest,¡± she says. ¡°It¡¯s a hard thing to do because there¡¯s always something to be done, whether it¡¯s at work or at home. But it¡¯s one of the biggest lessons I¡¯ve learned during cancer treatment: giving myself the grace to rest.¡± 

Thankful for the present and planning for the future

Joy continues to get bloodwork monthly back home, and she and her husband come to Houston every month for her checkups. She¡¯s working with her care team to see if she can continue immunotherapy.

¡°I still feel like there¡¯s benefit in the immunotherapy for preventing the melanoma from coming back,¡± she says. ¡°It¡¯s just about weighing that benefit against the issues with my kidney and liver.¡±

Joy is planning to retire by May 2026. Her husband is already retired, and they look forward to spending more time with their grandkids and traveling. She is focused on staying healthy.

¡°I¡¯m doing everything I can to help prevent cancer recurrence. I don¡¯t drink alcohol anymore, I¡¯m exercising more and I¡¯m researching healthy eating,¡± she says. ¡°I¡¯ve had family members die from cancer, and I was diagnosed with melanoma in situ before. So, I already get regular skin checks, and I wear sunscreen and UPF clothing.¡±&²Ô²ú²õ±è;&²Ô²ú²õ±è;&²Ô²ú²õ±è;

Throughout it all, Joy has been blessed with support from church members, friends back home and in Houston and her family. One of her brothers and sister-in-law live in Houston, and she and her husband stay with them when they¡¯re in Houston for Joy¡¯s treatment.

¡°Where you go first for treatment really does matter, especially when you meet so many patients at MD Anderson who were misdiagnosed elsewhere,¡± she says. ¡°I was treated for a very rare cancer, and my care team has been wonderful. I¡¯m so thankful I chose to come to MD Anderson ´Ú¾±°ù²õ³Ù.¡±&²Ô²ú²õ±è;

or call 1-877-632-6789.