When David Castor was diagnosed with stage III melanoma skin cancer in March of 2015, he turned to the head and neck cancer expertise of Henry N. Ho, M.D., a board certified otolaryngology specialist, president of The Ear, Nose, Throat and Plastic Surgery Associates and co-director of the Head and Neck Program at the Florida Hospital Cancer Institute.
“I would say the biggest benefit of coming here was Dr. Ho’s skill as a surgeon,” says David. “His staff was so passionate, compassionate and professional.”
What is Melanoma?
In the vast majority of cases, melanoma represents a cancer of the skin. It accounts for roughly one percent of all incidences of skin cancer, but is responsible for most skin cancer deaths. It affects men and women of all ages, color and ethnicity, but white males over the age of fifty represent the majority of patients diagnosed with the disease. Under the age of fifty, women have the greatest risk of developing melanoma.
Melanoma starts in melanocytes, the cells responsible for producing the pigment melanin, which colors the skin, eyes and hair. It can often manifest in moles on the skin, but normally most moles do not become cancerous.
Melanoma typically falls into three categories:
- Cutaneous Melanoma – the most prevailing form of melanoma and affects the skin
- Mucosal Melanoma – more rare and can manifest in the mucous membranes of the body such as the throat, the nose, the mouth and the anus
- Ocular Melanoma – another rare form of melanoma that develops in the eye
“Since it appears on the skin, melanoma is easier to identify in its early stages,” says Dr. Ho. “However, if it isn’t discovered early on, it can grow and spread along the skin, and penetrate to ever deeper layers of the body, eventually affecting the organs, the lymphatic system and the blood vessels – known as metastatic melanoma, or stage IV.”
When melanoma reaches stage IV, it becomes exceedingly hard to treat, often resulting in death.
Causes of Melanoma
There are a number of key risk factors associated with developing melanoma skin cancer, the most prevalent being exposure to ultraviolet (UV) rays and radiation, either from direct sunlight or in a tanning salon.
The DNA genes of skin cells can be impaired by exposure to UV rays, and skin cancer can manifest when the reproduction and growth of skin cells becomes altered as a result of this damage.
Other factors that can play crucial roles in the development of melanoma include:
- Family history
- Strength of one’s immune system
It’s important to get to know one’s body and skin, in order to detect early signals of melanoma, including:
- Changes in scope, diameter or color of moles or other lesions
- Development on the skin of any new growths
- Sores on the skin that don’t heal
“Individuals with more than fifty moles on their body have a higher risk of developing melanoma,” says Dr. Ho. “You should pay particular attention if you notice any asymmetrical moles on your body.”
David was put at ease by the comfort he felt in Dr. Ho’s presence. “I have a host of medical doctors that I am personal friends with,” David says, “and when they heard that my surgeon was Dr. Ho, they just said: ‘David, you’re in good hands.’ I found him very easy to understand, he spoke at my level. I always felt at ease with him.”
Melanoma treatment for each patient will be unique and depend on a number of factors including:
- The stage of the disease
- Medical history
In its early stages, melanoma treatment surgery alone can often efficiently treat the disease. Whereas in its more progressive stages, supplementary therapies like immunotherapy or targeted therapy may be indicated.
Depending on a patient’s particular circumstances, and the stage of melanoma, patients may consider:
- Clinical trials – research studies testing new or experimental drugs
- Radiation therapy
- Targeted therapy – using medications to target the tumor cells while not affecting other normal cell tissue
Treatment for stage III melanoma often includes surgery coupled with lymph node dissection, targeted therapy, immunotherapy and clinical trials.
David’s healing journey was a prime example of a patient coming through after a series of successful surgeries.
“When we were through with the surgeries a couple of months later,” David says, “Dr. Ho looked into my eyes and said: ‘I think we got it. I think we got everything.’ And I got up from the examination chair, he allowed me to hug him and cry in his arms.”
David was also grateful for the flexibility of the staff in scheduling his surgeries around his busy professional life. “I went on six mission trips in 2015,” David says. “And the nurse scheduled all those surgeries, I didn’t miss one of my mission trips.”
Completing a successful melanoma treatment program is often just the first step in living with melanoma. A patient’s head and neck specialist will want to continually monitor health status in case the disease returns. Once someone has been diagnosed with melanoma, they possess a greater risk of it coming back; so it’s crucial to schedule and be present at all follow up appointments.
Most patients diagnosed with melanoma are healed after the first surgery. The five-year survival rate for all patients with skin melanoma is 92%, while the ten-year survival rate is 89%.
With a successful melanoma treatment and surgery, David is eternally grateful to Dr. Ho and his staff.
“He’s just very passionate,” David says. “ A very compassionate doctor. I would recommend him to anybody.”