Beating the Odds

Vivian Bucay: A Savvy Survivor

In the 2008 issue of the Journal, Dr. Vivian Bucay told the riveting story of her successful battle with advanced melanoma. Six years later, we considered this the perfect time to see how she's doing. Dr. Bucay, whose parents are from Mexico City, is a perfect example of how someone Hispanic can use knowledge and awareness to save herself from skin cancer and prevent future cancers. "I remind patients that being Hispanic doesn't exempt them from skin cancer. We trace our ancestry to Europe, so we assume some of the skin cancer risks that many Europeans have," says Dr. Bucay. "My advice to Hispanic patients is the same as for other patients — avoid peak sun exposure, apply sunscreen daily, cover up, do monthly self-checks, and see a dermatologist once a year for a complete skin exam."

It has been seven years since Vivian Bucay, MD, a San Antonio, TX, dermatologist, beat stage IV melanoma. The cancer that began in her navel spread to her lungs in 2007 after several failed treatments, when she decided to try the immune therapy interleukin-2 (IL-2, Proleukin). She remained optimistic despite the odds: only 14 percent of patients respond to IL-2 and a mere six percent have a lasting complete remission; on average, these lucky six percent survive 10 years or longer.1 After two cycles of treatment, a CT scan revealed the lung lesions had completely disappeared. Dr. Bucay had made the "six percent club."

Dr. Bucay is living testimony that there is hope with a stage IV melanoma diagnosis, especially given the recent breakthroughs in targeted and immune therapies.

The mother of three daughters, wife, and physician turned patient, Dr. Bucay is living testimony that there is hope with a stage IV melanoma diagnosis, especially given the recent breakthroughs in targeted and immune therapies.

Dr. Bucay is grateful today to see her daughters growing into young women. The eldest (a freshman in high school when Bucay was first diagnosed in 2006) recently graduated from Yale. The two younger daughters are in college.

Sunscreen and Beyond: Post-melanoma,
a Multi-pronged Routine

Today, Bucay is vigilant about her skin and overall health. In addition to applying high-SPF sunscreen daily, she stays out of the sun during peak midday hours, and uses antioxidants, which she believes help counteract both ultraviolet A (UVA) and ultraviolet B (UVB) damage. "I'm trying to be proactive to avoid further treatment," she said.

On a recent family trip to Acapulco, Mexico, the family slathered on sunscreen from head to toe before heading outside, and sought out shade, proudly returning from vacation as "pale-skinned as when we left," she said. She prefers physical sunscreens, such as zinc oxide and titanium dioxide, which deflect the broadest spectrum of UVA and UVB rays, over chemical sunscreens, which absorb UV rays.

Based on her reading of the latest research, Dr. Bucay also takes several antioxidant supplements, including: Heliocare, derived from a South American fern, which she believes lessens the damage from UVA and UVB rays; N-acetylcysteine (NAC), a building block for glutathione, one of the body's most important antioxidants; and Coenzyme Q10 (CoQ10) for immune health and skin anti-aging benefits. She also applies a DNA repair enzyme cream, which studies have shown may reverse DNA damage.

It may seem like an exhaustive daily regimen, but Dr. Bucay is a strong believer in using multiple approaches. "The Food and Drug Administration is loathe to approve combinations, but no single mechanism produces skin cancer...so why should there be only one thing to prevent recurrence?"

Meanwhile, she's using her personal experience to make a difference. In September 2013, her home state of Texas passed a ban on tanning beds for all minors under age 18. "Texas got smart," she said. "I sent as many letters as I could."

Her survival story has inspired many. A friend's mom, who had melanoma that spread to her brain, was ready to give up. Dr. Bucay met her for coffee for four hours, explaining treatment options and insisting there was hope. Two years later, the friend's mom is cancer-free. "It's not just staying alive or being around, but being out there flourishing and contributing," she said.


References

1. National Cancer Institute at the National Institutes of Health, Melanoma Treatment (PDQ), http://www.cancer.gov/cancertopics/pdq/treatment/melanoma/HealthProfessional/Page9#Section_610. Accessed March 13, 2014.