Melanoma survivor: Protect your skin

I usually don’t consider myself fair-skinned, because I used to tan pretty easily. But I’ve seen pictures of myself badly sunburned as a kid, so that’s probably a more accurate description than I’d like to think.

I grew up mostly near the Texas coast, and my family was always outside. I only remember using suntan lotion occasionally. It didn’t offer any UV protection, since SPF wasn’t even a thing yet back then. I wasn’t aware that I needed it.

My first melanoma diagnosis

I was first diagnosed with melanoma in February 2016 at age 56. My wife had noticed an unusual spot on my back about six months earlier and asked me to have it looked at. I didn’t see a dermatologist until it changed dramatically in size and appearance, and began draining a clear fluid. Then I had a punch biopsy. The results showed it was melanoma.

My first reaction was disbelief. Then I felt angry because I hadn’t seen a doctor about it sooner. Eventually, I felt sadness, because I knew it was something that could eventually kill me.

Fortunately, the cancer wasn’t very advanced then, and I was able to have it removed surgically. My dermatologist sent my biopsy results to MD Anderson, and I had my first appointment there on Feb. 4, 2016. My surgeon, Dr. Jeffrey Gershenwald, removed the cancerous lesion and two of my lymph nodes that same day. The melanoma hadn’t spread yet, so I didn’t need chemotherapy or radiation.

My second melanoma diagnosis

I was considered cancer-free until two years later, when I had a CT scan for an unrelated condition. It showed a small nodule on my left lung. I sent the report to Dr. Gershenwald, and he ordered full-body scans during my next check-up. Those revealed that the melanoma had spread to a spot under my skin behind my right shoulder, as well as a few more places in my lungs.

My oncologist, Dr. Sapna Patel, recommended that I try an immunotherapy drug called nivolumab. But after three months on it, the spots on my lungs showed no change, and my shoulder tumor had gotten bigger. So, Dr. Patel switched me to two targeted therapy drugs known as BRAF inhibitors: binimetinib and encorafenib. I started taking them in October, and since then, all of my tumors have shrunk.

Unfortunately, my tumors haven’t disappeared completely. But at this point, I'm very happy with my progress. BRAF inhibitors work by inhibiting cancer cells’ growth. They tend to become less effective over time, though, so I don’t really expect to be cured.

At some point, I may join a clinical trial. Dr. Patel said I qualify for one now, but I’m saving that option for later. She feels that BRAF inhibitors are the best way to go right now, and I trust her completely.

How a melanoma diagnosis has changed my lifestyle

I know now that my melanoma was likely a result of sun damage I sustained as a boy. I regret not knowing then what I do now about cancer prevention.

My family still likes going to the beach, but I am very careful now to minimize my sun exposure. I wear hats, long-sleeved shirts with UVB protection, and sunscreen with SPF 30 or higher. And when I’m not in the water, I sit in the shade under a big beach umbrella.

Doing those things may not seem very important — especially to children or teenagers — but melanoma is not just “skin cancer.” It has the highest death rate of all skin cancers and is the most likely to spread. So I tell everyone to wear hats and sun-protective clothing, use sunscreen and don’t tan. It’s the easiest way to protect yourself. And melanoma is one of the most preventable forms of cancer.

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