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Know the signs
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Most people have moles, and the majority of them are harmless. But, it’s important to watch for moles that may have signs of melanoma. The “ABCD” rule can help you recognize any that may be abnormal:
Asymmetry: One half of the mole doesn’t look like the other half.
Border: The edges of the mole are ragged, notched, blurred or irregular.
Color — The color of the mole is uneven. Shades of black, brown and tan may be present. Areas of white, grey, red, pink or blue also may be seen.
Diameter: Melanomas tend to be larger than ¼ inch — about the size of a pencil eraser.
Evolving: The mole changes in any way, especially shape or color.
Be sure to check with your doctor if you have any of these signs.
Protect yourself
Here are some ways you can reduce your risk of developing melanoma and other skin cancers:
- Limit sun exposure. Avoid being out in the sun for too long, especially in the middle of the day when UV light is most intense.
- Use sunscreen with an SPF of 15 or higher. Apply it every two hours and after swimming or sweating, even on hazy or overcast days.
- Wear sunglasses. Your eyes need protection, too. Look for sunglasses that block UVA and UVB light.
- Protect your skin with clothing. Wear a wide-brimmed hat, long sleeves and pants, and sunglasses that block UV rays.
- Talk with your doctor if you notice any irregular moles or changes to your skin. Early detection is key to successfully treating skin cancer.
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 A bright new outlook: Healing from skin cancer
Brian Patenaude grew up in Central Florida. It was a great place for him to be. No one loved the great outdoors more. “I was running up and down the beach from 8 in the morning until 6 at night,” he said. Back then, sunscreens weren’t used as widely as they are now. So, he spent his days soaking up the sun — and, unfortunately, unprotected from its harmful rays.
Brian was more cautious as he got older. He started using sunscreen and carefully monitored his skin for any signs of damage. In April 2006, at age 48, he noticed a bump on his forehead near his hairline. It was about half the size of a pencil eraser head and developed a black spot in the middle. He suspected this wasn’t good, so he immediately called his dermatologist.
The dermatologist was concerned about the bump and did a biopsy to determine if it was cancerous. The results revealed that Brian had melanoma, the most serious type of skin cancer. Brian was driving in his car when he received the news. “I had to pull off to the side of the road,” he said. “I was just trying to take in the whole thing. I didn’t know the gravity of it until the dermatologist was explaining it to me and I asked what my chances were. She didn’t know at that point. That was sort of like a rug being pulled out from under me — realizing how serious the situation was.”
Brian was scheduled for surgery. Because the melanoma was on his face, he would be seeing a plastic surgeon. His doctors told him it was caught early and didn’t appear to have spread to the rest of his body. The cancer was removed, and Brian was given a clean bill of health. He was relieved to have his life return to normal.
The cancer spreads
Nine months later, his life was turned upside-down again. Brian discovered a lump in his neck and was worried that the cancer had returned. Unfortunately, he was right. His doctors performed several tests and found that the cancer had spread to his lymph nodes. He needed surgery on his neck to remove the affected nodes.
But, his troubles didn’t end there. About five weeks after the surgery, Brian found another lump in the same place on his neck, which led to an additional operation.
“That was a pretty dark time,” Brian said. “I realized that the horrible cancer was spreading. Where was it going next? Would it be stopped here? That’s when I was assessing my entire life.”
After the second surgery on his neck, scans showed that Brian was cancer-free. But, he was placed on interferon therapy, a drug treatment that helps boost the immune system to fight off any cancer cells that may have remained after the surgeries. He wanted to do everything he could to make sure the cancer never returned again, so he enrolled in a clinical trial that was testing a promising new form of the drug.
The treatment was a difficult period — both physically and mentally — for Brian and his family. “I had the standard side effects from interferon — weakness, flu-like symptoms and loss of weight,” he said. “It’s like having the flu every day of your life.” He said he lost nearly 30 pounds because he had no appetite.
After six months taking the trial drug, Brian had a severe reaction. He developed blisters and a rash all over his body. He also contracted an antibiotic-resistant Staphylococcus aureus (MRSA), a serious infection. Brian dropped out of the clinical trial and was treated with medication for the MRSA. Once he recovered from the infection, he continued with his interferon treatment for several more months, this time taking the standard form of the drug.
Family matters
Brian’s family helped him get through the most difficult times. “My wife Jackie was my Rock of Gibraltar,” he said. “She was always there encouraging me, giving me hope and just doing everything she could to make the situation as easy for me as possible.”
His son, Nathan, was 4 years old when Brian was undergoing his interferon treatment. Brian and his wife didn’t tell their son about the cancer, but Nathan recognized that there was something wrong. “He knew I was sick, but he didn’t know the gravity of it,” Brian said. “We were trying to protect him.”
One night, Brian’s son surprised him with just how much he understood about what was happening to his father. “I was getting him ready for bed and saying our nightly prayers when he started singing, ‘You are my sunshine…please don’t take my sunshine away.’ It just tore me up. I sat there paralyzed with the realization that my son at 4 years old had a deeper understanding.” Brian wanted to fight even harder.
“I lost my dad to cancer when I was in the seventh grade,” Brian said. “My hope and my desire to see my son grow up, graduate and get married was a tremendous motivator to do everything that I could do to get through this and survive. I have an awful lot to live for and an awful lot to fight for.”
Recovery and support
Brian completed his treatment in July 2008. About six months later, scans showed that his body was still cancer-free. “Once you go a year and a half in the clear, that’s kind of a milestone,” Brian said. He’ll continue to have scans every six months and also has regular checkups with his dermatologist, oncologist, and ear, nose and throat doctor.
Brian credits his family, friends and church for helping him fight cancer. “The support and prayers that I received were amazing,” Brian said. “I never went to a cancer support group because the support around me was so tremendous that I never felt the need to. But, I would have to say that anybody who is going through any type of cancer or life-threatening situation and doesn’t have a support group — they need to find one. The strength that you get from that is tremendous.”
In addition to family support, Brian found he also had the support of his health insurance. During this time, he was racking up a lot of miles in his car, driving back and forth from South Daytona to Tampa for his treatments. He traveled across the state several times a week and often had overnight stays. A UnitedHealthcare nurse, Dorthea Koch, was assigned to support Brian with his treatment. She called to let him know that, among many of his other benefits, UnitedHealthcare could help him pay for his travel expenses.
“She called me out of the blue. At the time, I was still going through the trauma of everything and really did not want to talk about it.” Dorthea offered to send him a packet of information about his benefits. When Brian received it, he realized that she could really help him and called her back.
“Dorthea told me about my options and getting second opinions,” he said. “She was instrumental. When you’re going through something like that, it goes a long way to have someone there that’s caring. It impressed me so much. They wanted me to get the best possible treatment. I felt like I always had someone standing behind me.”
A life-changing experience
Now, Brian is very careful to shield himself and his family from the sun. “We’re a five-minute drive from Daytona Beach and we are on the beach in the summer,” he said. “But for us, it’s the highest level of sunblock and under an umbrella with a hat and shirt on. We are very cognizant of protecting ourselves and our son.”
As a landscape designer, Brian spends much of his time outdoors. He makes sure he and his co-workers are protected. “I’ve got sunscreen at my desk,” he said. “People at work know if they need sunscreen, I’ve got it. I’m 51 years old and a lot of the workers are in their 20s, so I kind of feel like the nagging dad. But, I do not want to see any of them go through what I went through. “
He said his experience has given him a much deeper appreciation for his life and his loved ones. “I feel like I have a new lease on life,” he said. “[Surviving cancer] has given me a tremendous respect for life and what life has to offer. I don’t take even one day for granted — because you don’t know how long you have on this earth.”
Although it’s an experience Brian wishes he didn’t have to go through, he said he can look back now and smile. “I thank God every day that I’m alive. I have a wonderful wife and son and life is well worth fighting for. Our family has a strong faith that we cherish. Having a solid belief system gave me the strength and desire to make it through this trying time in my life.”
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Get the facts
Learn more about skin cancer by going to myuhc.com. Once you log on, click on “Look up health topics” and type “skin cancer” into the search bar.
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