Having Melanoma Made Me a Better Dermatologist: Dr. Beth Strow’s Story

Dr. Beth Strow’s path to dermatology was neither short nor simple, but it was exactly where she was meant to end up. In fact, her first step into the medical field was as a nurse, when she worked for some time at Children's Hospital of Chicago at Northwestern University. While there, she found herself assisting in some bench research on the side, which sparked her interest in attending medical school.

Starting out at Southern Illinois University School of Medicine, Dr. Strow pursued her medical degree and went on to spend eight years in residency while deciding on a specialty. Initially in pathology, but wanting more patient contact, she landed on internal medicine where she was briefly introduced to dermatology. It was at this point that Dr. Strow knew she found her calling and shifted her specialty for a final time to dermatology.

Dr. Strow attended Emory University for her dermatology residency. Upon completion of her studies, she returned to Illinois where she opened her own practice in 1992. Coming from a family of physicians – her father was a local ophthalmologist – Dr. Strow had patients in the door from day one.

An Early Stage Melanoma Progresses

Dr. Strow was roughly a decade into running her dermatology practice when she noticed a new mole on her flank. She decided it would be best to have it removed and biopsied. Pathology results revealed an atypical dysplastic nevus – an unusual-looking mole that has irregular features and can increase one’s risk for melanoma. Dr. Strow’s lesion was re-excised to achieve clear margins. “At that time in dermatology, most of us were re-excising moderately atypical nevi,” explained Dr. Strow.

However, about a year later in 2003, Dr. Strow noticed a small bump at the site of the excision scar. This time, pathology results were clear: it was a Stage 1 melanoma. She underwent surgery again to remove the lesion, however no additional treatment was recommended due to the superficial depth of the lesion. “It was not the standard of care at the time to do any lymph node dissection or biopsy,” remembered Dr. Strow. “I just needed to keep up with my follow-up dermatology appointments.”

Nearly five years later, during a routine breast exam, a swollen lymph node was detected under Dr. Strow's arm. A biopsy confirmed it was Stage 3 melanoma. As a result, 58 lymph nodes in total were removed, but only one was positive for melanoma. After surgery, she began interferon – an early immunotherapy used in the adjuvant setting to reduce the risk of relapse – and stayed on the therapy for an entire year. But just six months after her year of therapy, scans showed new metastases in her liver. Her melanoma was now Stage 4. “I was told I had no more options,” said Dr. Strow.

Despite her oncologist’s words, Dr. Strow was determined to keep fighting. As a doctor herself, she never gave up on her patients and always wanted them to have hope. Jumping into action, Dr. Strow was joined by a close friend and fellow dermatologist. Together, they spent hours researching available clinical trials.

Unfortunately, the research landscape for advanced melanoma wasn’t encouraging. But, Dr. Strow wouldn’t be deterred: “I always told my patients to be their own advocates,” explained Dr. Strow. “Now it was time to do the same for myself.”

Seeking a Clinical Trial

Dr. Strow’s clinical trial journey officially started at Vanderbilt University in 2010, where she met Dr. Jeffrey Sosman, an MRA-funded investigator and trial leader at the time. “Everything started to click once I connected with Dr. Sosman,” said Dr. Strow. “It’s important to be surrounded by specialists who refuse to give up.”

The trial, studying a new at the time BRAF inhibitor – first required participants to receive interleukin-2. Dr. Strow was able to complete four rounds of interleukin-2 before she needed to stop due to side effects. Fortunately, this was enough to qualify, and she was able to enroll into the clinical trial.

Within six months of joining the study, Dr. Strow’s liver metastases had resolved. She remained in the trial until 2016 – but within a year of discontinuing the experimental therapy, melanoma was detected in one of her lymph nodes. To treat this new metastasis, Dr. Strow started on a combination BRAF/MEK-inhibitor treatment. However, due to adverse side effects, Dr. Strow was unable to continue it. She went back on the BRAF-only inhibitor to stabilize her disease.

Dr. Strow’s melanoma remained stable until 2019 – when her annual brain scan detected fifteen tumors. She began systemic treatment for her melanoma in 2020 with combination immunotherapy nivolumab + ipilimumab. She also underwent gamma knife radiation to target specific tumors in her brain. However, her melanoma persisted and within just three months, nine more tumors appeared in her brain.

At this point, Dr. Strow and her oncologist agreed that immunotherapy was not yielding the results they were hoping for. Not only was her melanoma progressing, but she began to experience severe side effects, including colitis and severe dry eye and dry mouth (called Sjogren's syndrome). She and her care team decided to end her immunotherapy regimen and restart BRAF/MEK targeted therapy.

Once back on the BRAF/MEK targeted therapy, Dr. Strow finally began to see results. The melanoma in her liver cleared, and her brain mets stabilized. This remained the case for two years, until the fall of 2022, when scans once again revealed new tumors in her brain. She underwent additional gamma knife sessions, and continues to take her BRAF/MEK inhibitors today.

Providing Care and Leading with Compassion 

“If I hadn’t been a dermatologist, I would be dead,” said Dr. Strow.

Early detection still remains one of the most important weapons in the fight against melanoma. The sooner a melanoma is detected, the better the outcome. And since Dr. Strow’s first melanoma diagnosis in the early 2000s, the melanoma treatment landscape and standard of care have evolved tremendously. Giant leaps and bounds in treatment options, and hundreds of currently recruiting clinical trials, have resulted in new options and longer lives for patients with advanced melanoma. 

Living with melanoma while also practicing dermatology undeniably affected the way Dr. Strow interacted with her patients. She always emphasized hope when delivering a melanoma diagnosis and leading with compassion was always her priority. “I knew what it was like to sit in their chair and to hear that devastating news,” said Dr. Strow.

“Having melanoma made me a better dermatologist.”

She also knew firsthand how overwhelming it can be for patients to navigate our health care system, including the multiple specialists. It’s easy to get lost in the system,” said Dr. Strow. “You have to help your patients throughout every step of their journey.”

Unfortunately, due to the Sjogren's syndrome she developed from immunotherapy, Dr. Strow had to close her practice in 2020. Today, she enjoys spending time with her two daughters and young grandson, and remains an advocate for the melanoma community.