Young Melanoma Survivor: Get Skin Checks, Use SunscreenMay 1, 2008
When doctors told Ron Schwartz he had stage IV melanoma at age 30, he blamed the diagnosis on a mix-up in the laboratory. After all, they had simply removed what he thought was a cyst from his shoulder. He convinced himself that he was too young to get cancer and that the diagnosis was a mistake. He soon learned that he was very wrong.
"My initial reaction to the cancer diagnosis was two fold," recalls Schwartz, now 38 and a principal with Deloitte and Touche's Forensic and Dispute Services in Atlanta. "'This has got to be a mistake' was my first reaction. My second reaction was 'Okay, I've got melanoma, but the doctors removed it so I'll go on my way now. I'll get on with life as usual.'"
He adds, "I didn't realize what the ramifications of stage IV cancer were. I quickly educated myself, and it was very scary."
Through his research, Schwartz learned that his chances of survival were much lower because his melanoma was detected late. He learned that stage IV meant that the melanoma had spread from where it started on the skin to another part of the body (in his case to the area under the skin in his shoulder).
Skin cancer is the most common of all cancers. Melanoma, which often looks like a dark brown or black mole on the skin, accounts for less than 5% of skin cancer cases but causes about 79% of skin cancer deaths. The number of new melanoma cases in the United States is increasing. The American Cancer Society estimates that there will be more than 62,000 new cases of melanoma diagnosed in the US in 2008 and more than 8,400 deaths from the disease. Melanoma detected early is often curable, but the survival rate decreases significantly when it is found in later stages.
A 'Stunning' Diagnosis
Ron Schwartz's battle with melanoma began on a beach outing in late summer 1999 when his sister, a physician visiting Schwartz and his family in Tampa, noticed a few "angry-looking" moles on her brother's back. She convinced Schwartz to go to a dermatologist to have the moles checked, which he did a couple of months later. The doctor removed 5 or 6 moles from his shoulders and back. He also removed what appeared to be a cyst from Schwartz's shoulder. He told Schwartz he would send the cyst to a laboratory for routine testing and asked him to see a nurse the next week to have the stitches removed.
"When I went back to get the stitches out, I asked for a nurse and was told the doctor wanted to see me," Schwartz says. "I remember thinking that couldn't be good."
He was right. The doctor told him test results indicated the "cyst" was actually melanoma. And because the growth was beneath the skin, it was classified as metastatic melanoma. The dermatologist immediately sent Schwartz to an oncologist, who classified the melanoma at stage IV.
"It was all a foreign language to me, just gibberish," says Schwartz. "I knew nothing about melanoma or the stages of cancer, was just stunned at what I was hearing and couldn't believe that the test results were correct. I told myself it was all a misunderstanding, that my test results had gotten mixed up with someone else's results. I wanted a second opinion."
The second opinion was the same as the first: stage IV melanoma. He told his family the bad news. His sister, who practices medicine in Toronto, provided him with information on melanoma and treatment options. His parents, also living in Toronto, flew to Tampa to help with research and provide emotional support. His wife, Fredell, helped with research and tried to be optimistic.
"Your life as you know it just comes to a screeching halt with a diagnosis of cancer," Schwartz explains. "My wife and I were at the stage in our lives that were planning to start a family. She tried to put on a poker face and convince both of us that we were going to beat this thing. But it was a really tough time for her. She needed a shoulder to cry on, and she knew it couldn't be my shoulder."
Fighting To Survive
Schwartz underwent a battery of scans and tests to determine if the cancer had spread to other parts of his body. The scans came back negative. He began talking with physicians about treatment options. He had read about vaccines being tested to treat melanoma and decided to try a combination of vaccines and interleukin-2, an immune-boosting drug.
"It was a very traumatic experience for a young, seemingly healthy person to be going through," he remembers. "It was a very anxious time, just unbelievably frightening." But despite the seriousness of the disease and the treatment schedule, he was still in denial – refusing to slow down and take any time off work.
His attitude changed dramatically in fall 2000 when his doctor discovered a swollen lymph node in Schwartz's neck. When the node continued to grow, the doctor decided to take it out and test it for cancer.
"The denial was gone at that point," Schwartz exclaims. "Now I was scheduled for massive surgery, where 14 or 15 lymph nodes were going to be taken out of my neck. The surgery showed that only the one node was affected, but doctors put me on an aggressive one-year regimen of interferon [another immune-boosting drug] that they warned would knock me off my feet.
"Now I finally got it. My job was to fight cancer and survive. I took a year off work, moved back to Toronto be near our families for support, and got on with the battle."
Nearly 9 years later, Schwartz is still cancer free. He now has twice-yearly appointments with both his oncologist and dermatologist. He and his wife are back on track with their plans for a family – they welcomed daughter Alex in 2004. Schwartz rejoined Deloitte and Touche in the company's Atlanta offices. And he and his wife are active volunteers with the American Cancer Society, spreading the word about the importance of regular screening for skin cancer. Schwartz was recently named to the Society’s South Atlantic Division Board of Directors.
His advice to others for the prevention and early detection of melanoma and other skin cancers is simple: Get checked by a dermatologist at least once a year. Always use a good sunscreen. Don't think melanoma is an old person's disease. And don't believe that only fair-skinned people get melanoma.
"The key lesson to be learned here is that we can't be too busy to see the doctor on a regular basis," he says. "If I had spent an hour or two in the doctor's office every year, I could have avoided the hundreds of hours I spent with doctors after I was diagnosed with cancer. I could have prevented the suffering and pain that I and my family went through."
Have you or someone you love been touched by cancer? Help us give hope to people across the country and around the world by sharing your story. It's stories like yours that provide comfort and courage to others whose lives have been touched by cancer.