“Here’s How I Knew I Had Melanoma”: One Cured Patient’s Story Thanks to Medical Advancement

Our skin is often the first line of defense against illness and infection, as well as the first place signs of trouble can appear. Melanoma, a type of skin cancer that begins in the cells that are responsible for skin pigmentation, is one skin issue that stands out for its potential severity.

Despite being less common than other skin cancers like basal cell or squamous cell carcinoma, melanoma poses a significant threat because of its ability to spread to different parts of the body like the lungs, liver, spine, and brain. This is why it’s so important to catch the cancer early and address it quickly.

Dermatologist Klint Peebles, MD, emphasized a recent increase in melanoma diagnoses in a 2022 American Medical Association publication: “Rates of all skin cancers are rising,” Dr. Peebles said, “and melanoma rates have been rising rapidly in the United States in the last 30 years.” It’s a startling trend, with projections suggesting a 50% increase in melanoma diagnoses globally between 2020 and 2040.  According to the American Cancer Society, in 2024 about 100,640 new melanomas will be diagnosed, and about 8,290 people are expected to die of melanoma.

Ahead, you’ll read about Bill, a 68-year-old husband, dad, and business owner who triumphed over stage 4 melanoma—which until recent years had typically come with a terminal prognosis. Bill shared that while his father had been the son of Italian immigrants with skin that had always tanned to a deep olive color in their Pennsylvania summers, less was known about his mother’s heritage until her grandson’s at-home ancestry kit confirmed that the extremely fair skin and freckles she’d passed down to most of her offspring had come from Irish and English roots.

While this patient story highlights some themes that may resonate personally for melanoma patients, it’s a common misconception that only those with lighter skin are at risk. The truth is melanoma can affect anyone.

Melanoma risk factors

Research has shown melanoma risk factors include, but may not be limited to:

• excessive sun exposure
• lighter skin
• a history of sunburns
• a family history of melanoma
• numerous moles
• older age
• or a compromised immune system.

How to do a melanoma self-exam:

When you’re performing a self-exam to look out for signs of melanoma, think ABCDE. The ABCDE rule will help you spot worrisome changes in moles and so you can bring them to the attention of your healthcare provider:

• Asymmetry: One half doesn’t match the other.

• Border irregularity: The edges are uneven or blurred.

• Color: A palette of colors may be present, including brown, black, pink, red, white, or blue.

• Diameter: The width of the spot may be larger than a pencil eraser, though melanomas can be smaller.

• Evolution: Any change in size, shape, or color warrants attention.

How to prevent skin cancer

Skin health experts agree that the number-one way to prevent skin cancer is to reduce your UV exposure:

• Seek shade during the sun’s most intense hours

• Use sunscreen that protects against a wide range of UV light. Dr. Peebles also reminds us to apply sunscreen to areas we might not think about, like our ears, neck, hands, feet, lips, and scalp, especially those with thinning hair.

• Wear clothes that cover your skin

• Avoid tanning beds

Routine dermatology examinations and monthly self-assessments are essential measures to prevent melanoma. It’s also important to be aware that “skin cancer [can] be on any part of the body,” said Dr. Peebles, “including the palms, soles, buttocks, and genitalia. But we can also see these cancers beyond the skin, including in the eye and inside the mouth, among other sites.”

Continue reading to learn more about Bill’s story and what made his experience so enlightening and so cautionary.

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“Here’s how I knew I had melanoma”: One cured patient’s story celebrating medical advancement

By Bill Gasbarre, as told to Dr. Patricia Varacallo, DO

One night at dinner in January 2011, my wife brought it up again. “I don’t like the looks of that,” she said, referencing a brown spot on my left temple that she’d started mentioning on occasion with concern. “It just seems to keep getting bigger.”

After more than 30 years of marriage, I knew when it was time to listen and schedule a consultation with our dermatologist in town. When he examined me, he said the spot looked relatively harmless, but he recommended a skin biopsy for certainty. I’d never realized what a tender area the temple is until he cut away a small sample of it for analysis.

Less than a week later, we got the call: It was melanoma. The dermatologist explained that melanoma is the most serious, and often fatal, type of skin cancer. I didn’t need to know more than that, except to trust in experts’ guidance. Throughout my melanoma journey, I was intent not to search the Internet for details about my condition and find information that would scare me or deflate any hope.

My dermatologist’s first step was to refer me to a surgeon in Pittsburgh, two hours away from where we lived, so I could undergo Mohs surgery. Mohs surgery is a precise surgical technique for skin cancer that involves removing the cancerous tissue layer by layer, with a pathologist examining each layer and all the borders until no cancer cells remain. One of the goals of Mohs surgery is to ensure healthy tissue is preserved as much as possible.

My Mohs surgery was scheduled for February 6 (a day I distinctly remember because it was the Monday after the Steelers played in the Super Bowl, meaning I had to abstain from having drinks with our friends). The surgery required multiple rounds of tissue removal, totaling nine attempts over two days, to make sure all the cancer cells were gone.

This would become one of the most traumatic experiences in my melanoma fight. Not having expected the procedure would take more than a day, I asked to be admitted to the hospital overnight so my wife wouldn’t have to drive home on winter roads in the dark. The doctor wasn’t able to accommodate that, so we drove home in a snowstorm as fluid from a golf ball-sized incision soaked through the gauze, bleeding down my face and onto my clothing and seatbelt. The next morning, we returned to the clinic, and a short while later that wound was covered up with a skin graft from my neck.

As the skin graft was supposed to be healing, when she went to clean it after a couple days my wife noticed it didn’t seem to be improving. Immediately my dermatologist brought me in. It turned out that I’d developed a blood clot at the site of the graft.

That was just the beginning of my experience with battling melanoma—but fortunately, when I moved into the hands of a highly skilled and caring team, the experience would start to go smoother.

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Being diagnosed with melanoma…again

Following my initial recovery from Mohs surgery, I started to undergo routine CT scans every six months. During this period, Lisa Pfingstler, MD, a dear childhood friend of our son, had recently started her dermatology residency at Geisinger Health in Danville, PA. After hearing what I’d gone through with my Mohs treatment, Lisa suggested I see an exceptional Mohs surgeon she’d gotten to train with. That was when I transitioned my medical oversight to Geisinger, where a new oncologist continued my bi-annual scans.

For a few years, my scans returned clear, but there was a recurrence of melanoma on my left temple. This time around, the Mohs surgeon enlisted the expertise of a plastic surgeon, and together, they planned how to reconstruct the affected area of my face. I was awake through the three-hour procedure, which was a little jarring as I overheard the surgeons work, but the family connection through Lisa put me at ease, and I knew that I was in excellent hands.

In February 2016, I was due for another scan. This time, the doctor shared some unexpected news: The scan showed a tiny speck on my lungs. He guessed that it was probably just a fleck of dust on the lab lens, which he explained can happen sometimes. Even so, he proposed scheduling another scan in three months to monitor changes. Eager for immediate answers, I suggested we do the scan the next week, but he advised against it, explaining that waiting would allow us to see if there was any growth. He cautioned that conducting the scan too soon could mean missing any crucial changes. I’d learn he was absolutely right.

Following his recommended follow-up scan on May 3, 2016, the news wasn’t good: “Your lungs are full of cancer,” he said. His earlier dismissal as a mere speck of dust had left me ill-prepared for this blow. Overwhelmed, I remember breaking down in tears and confiding in my brother over the phone from the parking lot. I had moved through every step aiming to keep a level head and make the most educated decisions my doctors advised. But this was one of the really emotional times that I remember during my experience with melanoma.

My second call was to none other than Lisa. Her response was prompt and caring: Through her connections, we could navigate the decisions to find the best course of care. Thanks to the efforts of her and her close colleague who was also in residency, Dr. Ryan Andrulonis, I was able to secure an appointment with the highly recommended Dr. John Kirkwood, the Director of the Melanoma Center at UPMC Hillman Cancer Center in Pittsburgh. This marked the beginning of a new stage in my fight against stage 4 melanoma.

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My experience with immunotherapy for melanoma

I remember a lot of the details from my cancer journey, but my first encounter with Dr. Kirkwood in May 2016 would be especially unforgettable. He entered the exam room accompanied by a few of his physician assistants and some medical students. I shared my entire story with them. In a moment that caught everyone’s attention, Dr. Kirkwood asked the students: “How long do you think he’s had cancer in his lungs?”

Confused, they referenced my chart and appeared to make some mental calculations. Dr. Kirkwood corrected them. “No,” he said. “It hasn’t been since May. It’s been in his lung for as long as it’s been on his face.” I was taken aback when he expressed some skepticism toward the Mohs surgery. He explained that cancer remains within the body and the surgery doesn’t guarantee its removal, suggesting it’s bound to recur.

For the first time, I couldn’t be sure how this was going to turn out. That’s exactly when Dr. Kirkwood looked in my eyes. “I’m going to cure you,” he said.

On the trip home, my wife and I kept asking each other, hoping we’d heard him right: “Did he say ‘cure’?” We’d heard of remission, but we hadn’t known that the idea of a total cure was possible.

Dr. Kirkwood and his team proposed that I participate in a clinical trial. I understood that until just a couple years prior, melanoma on the skin that had metastasized to another organ probably would have meant a life expectancy of a few months at best. I agreed to participate in the trial, knowing that a good outcome wasn’t guaranteed, but hoping that in the future it would help other families avoid what mine was going through.

While Dr. Kirkwood and his team were developing my treatment plan, another scan revealed that the cancer had already spread past my lungs to my spine. Within a month, one of Dr. Kirkwood’s PAs, Melissa, had helped me bypass the trial paperwork to expedite my treatment. Based on how swiftly she and the team were moving, I could tell there was no time to waste.

I would receive a form of immunotherapy, specifically a medication named Keytruda. Unlike conventional chemotherapy, which targets all rapidly dividing cells—even healthy ones—immunotherapy is a more focused approach that empowers the body’s immune system to recognize and combat cancer cells more effectively.

This treatment began on June 29th, 2016, and was administered every three weeks. It consisted of regular blood tests and precise weight monitoring to tailor the drug dosage to my exact weight at the time. Then the care team, led by my PA Melissa who had become an unwavering source of support, would prepare the drug. For the following hour or so, my wife and I would sit in a private room while I received the IV treatment.

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Cured of stage 4 melanoma

December 2016 brought some unexpected news: Dr. Kirkwood entered the room, announcing that I wouldn’t be getting my treatment that day. Confused, I asked, “Why not?”

He replied: “Because you’re cured.”

Overwhelmed with emotion, I broke down in tears.

Even better, Dr. Kirkwood explained that his original plan had been for me to receive targeted radiation therapy. Now, there was no need for that because the cancer in my spine had also disappeared. In my case, Keytruda had effectively combated cancer within bone tissue. Dr. Kirkwood said in his experience, this outcome was a first.

A small bell was mounted on the wall of the Hillman Cancer Center. During my treatments, every time my wife and I heard it chime, we always shared a smile—in celebration for that patient, and in hope for us. “It’s your turn to ring the bell,” Dr. Kirkwood said.

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A setback: Pneumonitis

In April 2017, four months after I’d been cured of melanoma, I encountered an unexpected challenge: Pneumonitis. Pneumonitis is an inflammation of the lung tissue that can cause the lungs to become stiff and fill with fluid, making it difficult to breathe.

This raised significant concern among my healthcare team, who said this would most likely prove to be the biggest challenge I’d face to date. Melissa described it as my lungs “locking up,” essentially becoming rigid. I was admitted to the hospital.

Within a week I’d recovered, leaving my doctors shocked again. This said this was the first time they had cured a case of pneumonitis like this.

Life after being cured from melanoma

Today, my life has been profoundly enriched by the bonds formed at the cancer center during my treatments. I continue to visit Hillman every six months for routine blood work and CT scans. We continue to keep in contact with Melissa regularly—she became like family to me.

I believe my survival is probably thanks to the relatively early detection, even though the melanoma spread. Now I’m vigilant about my skin health. Although I’m not particularly mole-prone, my skin has always been prone to rashes and irritation. Reflecting on my childhood, from ages eight to twelve, I spent every summer day at the swimming pool or heading down to , resulting in blisters on my shoulders and nose. Our family has always loved boating in the summer, and for decades I was a runner and ran several marathons.

Dr. Kirkwood speculated that such repeated sun exposure might have been a contributing factor—as well as my career, which consisted of a ton of travel, mainly by car across states like Pennsylvania, Ohio, and Indiana. He deduced the placement of my melanoma was likely due to exposure to the morning sun through my driver’s side car window.

So, a word of advice from personal experience: Never underestimate the importance of sunscreen, regardless of whether you’re spending your day indoors or behind the wheel. I don’t enjoy lotion sunscreen, but my daughter has introduced me to powder sunscreens that dust on easily, some with no scent. The sun’s rays can reach you, making protection essential at all times.

For more inspiring stories of diagnoses and recovery, subscribe to The Healthy by Reader’s Digest newsletter and follow The Healthy on Facebook and Instagram. Keep reading:

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