By Renee Orcione, the Digital Engagement & Communications Manager at Melanoma Research Alliance (MRA)
Andrew Smith was 37 years old when his wife Anna noticed an odd-looking spot on his nose and encouraged him to get it checked out. While this father of three wasn’t particularly concerned, he did bring it up with his primary care physician to assure his wife that everything was okay.
Like Andrew, his doctor initially wasn’t concerned about the spot either. However, with Anna’s urging, Andrew asked for a referral to a dermatologist. With his referral in hand, he scheduled his first-ever appointment with a dermatologist.
The dermatologist took a more proactive approach to the odd spot on Andrew’s nose and biopsied it. Several weeks later, he received the news that the seemingly innocuous spot was melanoma, the deadliest form of skin cancer.
“I was a bit overwhelmed at first,” remembered Andrew. Ahead of his surgery, he started learning more about melanoma and the risk of it spreading. He also had to mentally prepare himself for potentially serious surgery on a very difficult — and highly visible — location of his face. “The unknown was the scariest part,” he said.
During deployment in Iraq, Andrew Smith experienced severe sun exposure.Courtesy of Melanoma Research Alliance
While awaiting surgery, Andrew took a deep dive into old photos of himself to pinpoint when the spot first appeared. He noticed that the spot on his nose appeared out of nowhere about two years prior but had grown larger in the month leading up to his diagnosis. Often the first sign of melanoma is a change in the shape, color, size, or feel of an existing mole. However, melanoma may also appear as a new mole or a rapidly enlarging bump.
When it came time for the surgery to remove his melanoma, Andrew underwent a wide local excision where the entire left side of his nose was removed to achieve clear margins. A section of skin on his neck was also removed to reconstruct his nose using a skin graft. His surgeon then removed several lymph nodes from his neck, in what is called a Sentinel Lymph Node Biopsy (SLNB) to ensure the melanoma had not spread — which fortunately all came back negative.
Skin on Andrew Smith’s neck was removed to reconstruct his nose.Courtesy of Melanoma Research Alliance
For several weeks of his recovery, Andrew had a large bandage on his face covering the wound. “If I went through this in my early 20s, I would have been more concerned about my physical appearance after the surgery,” said Andrew. “Now, my only concern was beating this cancer, being there for my family, and fulfilling the life I was called to live.”
Luckily Andrew’s surgery was a success, and his Stage 1 melanoma was completely removed. Afterward, he began seeing his dermatologist every three months to monitor his skin for any new or suspicious lesions. Since then, these follow-up visits have resulted in a few biopsies — but each has come back negative for melanoma. Nearly three years later, Andrew remains cancer-free.
A History of Unprotected Sun Exposure
Going through a melanoma diagnosis as a young father caused Andrew to reflect on his past relationship with the sun — something that never crossed his mind before his ordeal. Andrew recalled growing up and spending his summers outside in the ’80s – an era where sun protection wasn’t on anyone’s radar. “I had a great childhood, but we didn’t know anything about sun safety,” he said.
Not only did Andrew experience his fair share of sun exposure as a child, but it continued into adulthood when he joined the Army. He recalled the worst sunburn of his life happened during his 13-month deployment to Iraq.
“The sunburn was so bad that I wasn’t able to move for a couple of days,” remembered Andrew. “But I was in my early 20s, and it wasn’t a big deal to me at the time.” A personal history of sunburn is just one risk factor for developing melanoma later in life.
“A lot of guys who deployed at that time are now dealing with their own cancer diagnoses,” said Andrew. In fact, a recent study found that U.S. veterans are at increased risk for melanoma and other types of skin cancers, and that they are also more likely to have advanced-stage disease when it’s detected. Associate chief of dermatology with the VA Boston Healthcare System and study author Dr. Rebecca Hartman explained that veterans are less likely to use sunscreen, but more likely to be exposed to harmful UV rays. “Primary care providers and dermatologists who care for veterans, as well as veterans themselves, should be aware of the elevated advanced melanoma risk in this population,” explained Dr. Hartman.
Another recent study conducted by the Pentagon found that military pilots and ground crews were at greater risk of developing cancer of any kind compared to the general U.S. population.
Sun Safety for the Entire Family
While Andrew acknowledges that unprotected sun exposure occurred often in his past, he now knows that it will not interfere with his future. “After my diagnosis, my doctor was very blunt with me and told me that I can’t be in the sun anymore,” said Andrew. “I had to figure out for myself what that looked like.”
For Andrew, his priorities were two-fold. Being able to safely travel and spend time outdoors with his family, while keeping everyone protected, was his top priority. “Sun safety extends to the whole family,” explained Andrew. His children — Addi, Colt, and Kinsley — all understand the significance of their dad’s melanoma, how having a family history puts them at higher risk, and the importance of staying vigilant when outdoors. With this in mind, the family of five continues to travel, spend time outdoors, and make memories together.
Andrew Smith and his family practice sun safety while enjoying the outdoors.Courtesy of Melanoma Research Alliance
Andrew’s next priority was ensuring that he could continue to be a champion for his non-profit organization, Orphans in Asia, which requires him to take frequent trips overseas. Andrew founded the organization just months before his melanoma diagnosis, after he and his wife spent time in India volunteering at local orphanages. Since then, the group has now helped over 200 children and families.
Like many people who experience a melanoma diagnosis, finding a healthy balance with the outdoors is one of the first steps in reclaiming their life. Andrew believes he has found that balance.
“When I was first going through my diagnosis, I found comfort in other people’s stories,” said Andrew. “It meant a lot to me to be able to connect with other melanoma patients and see that this disease didn’t stop them from living productive lives.”
Andrew’s most important message is to get your skin checked — something he would not have done without the encouragement of his wife Anna. Early diagnosis of melanoma often leads to better outcomes and more lives saved. “Know your skin, know your risk, and protect yourself.”
This post was originally published by the Melanoma Research Alliance. It is republished with permission.
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