A History of Sunburns and an Early Stage Melanoma Diagnosis: Jill Roth

Jill Roth has lived her entire life in Dennison, Ohio. There, she grew up in a close-knit family, eventually started her own, and later became a caretaker to her elderly parents. Now retired, she looks back on her upbringing fondly – especially the countless summers spent by the pool.

However, with these fond summer memories come recollections of blistering sunburns. “I always had trouble with the sun,” said Jill. “But years ago, we didn’t worry about protecting our skin like we do now.”

Research shows that one blistering sunburn during childhood or adolescence nearly doubles a person’s lifetime risk of developing melanoma later in life. Jill recalls how in her teenage years she lathered on suntan oil and even used tanning beds.

A Family History of Skin Cancer

Decades later, Jill was diagnosed with a basal cell carcinoma. This – along with several other non-melanoma skin cancer diagnoses in her family – was a turning point for Jill as she began to truly understand – and reckon with – her previous UV exposure.

“Non-melanoma skin cancers have been very common in my family,” she said. “We all spent significant time in the sun together, completely unprotected.” Roughly nine out of ten skin cancers – including melanoma – are caused by unprotected exposure to UV rays.

Consequences of the years spent together under the summer sun became more serious when Jill’s father was diagnosed with an early-stage melanoma in 2015 after his doctor biopsied a scabbing lesion on his ear. In his mid-80s at the time, Bill – a Korean War Veteran – already had many non-melanoma skin cancers removed over the years. In fact, the active-duty military and veteran community are at an increased risk for skin cancer, including melanoma. Among this community, melanoma is the fourth-most common form of cancer.

Luckily, Bill’s melanoma was caught early during a routine appointment at the VA. He was successfully treated with surgery, which resulted in a portion of his ear being removed. Today, Bill is 93 years old and remains cancer-free.

Prioritizing Sun Safety and Early Detection

Seeing more skin cancer arise in her family, Jill began to take further preventive and early detection measures. Sunscreen became a regular part of her sun safety routine, and she made sure her family followed suit. Jill also started checking her own skin regularly, as well as seeing a dermatologist yearly for full-body skin exams.

It was at one of her yearly skin exams, a few years after her father’s diagnosis, that Jill’s dermatologist flagged a suspicious lesion on her abdomen. The small red mark was biopsied and confirmed as melanoma. “I’m usually very good at keeping track of my moles and noticing when something is changing,” stated Jill. “But this seemed to come out of nowhere.”

For treatment, Jill visited the Cleveland Clinic for a wide local excision where the entire melanoma and some surrounding tissue was removed, resulting in a 5-inch scar. To determine if her melanoma spread beyond the origin site, her doctor performed a sentinel lymph node biopsy (SLNB) under her arm closest to the melanoma. Luckily, the SLNB came back negative for metastasis, confirming her melanoma as Stage 1A. For many patients with an early-stage melanoma like Jill’s, a wide local excision is curative.

Prognostic Testing for Melanoma

While at the Cleveland Clinic, Jill’s doctor brought up prognostic testing. Prognostic tests can be used to estimate the severity of a melanoma or the risk of recurrence after surgery and can help inform further treatment decisions. Jill’s melanoma was tested using Gene Expression Profiling (GEP) and it was determined that her melanoma had a low risk of recurrence. “Those results gave me great peace of mind,” said Jill.

Prognostic testing is relatively new and has not been universally adopted; some doctors believe more research is needed in this area. Other doctors routinely order prognostic tests and consider them an important part of their overall arsenal of tools in providing personalized patient care. If you are interested in learning more about prognostic testing, talk to your doctor.

Following her diagnosis, Jill visited her dermatologist every six months for skin checks and has since remained melanoma-free. “I’m very lucky that my melanoma was caught early and cured with only surgery,” remarked Jill.

“Everyone should be paying close attention to their skin. Especially those at risk of skin cancer,” said Jill. “Early detection could save your life.”