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Our son Dan was 24 years old and living on the West Coast when he surprised us by a visit home for the Memorial Day weekend of 1996. He had moved to California a year earlier to take an engineering position at a company in the semiconductor industry. He had graduated from the University of Miami in 1994 with a degree in environmental science and a minor in chemistry and was Academic Captain of the UMiami Varsity Crew team, excelling in rowing as well as in academics, and in top-notch physical condition. Dan was soft-spoken, considerate, sincere, conscientious, and bright. His work supervisor called him a "superstar." He had a good sense of humor and was greatly admired by his younger brother and sister and by his friends, many of whom were former crewmates from UMiami.
During that fateful visit, Steve noticed an ominously large mole on Dan's lower back after he had showered. It was dark brown, nearly half an inch wide, and almost as thick. He promised to see a dermatologist as soon as he returned to California and, true to his word, had the mole removed three days later. A week later he called from California, crying. His dermatologist had just called with the news that the mole was a late-stage melanoma and he would require further treatment. Not knowing about melanoma, he had searched the internet. The statistics that emerged were frightening; when it spreads internally, melanoma is one of the most malignant and incurable of all cancers.
The statistics that emerged
were frightening; when it
spreads internally, melanoma
is one of the most malignant
and incurable of all cancers. |
No one at Peabody High School or at the University of Miami had ever educated him about melanoma or given him any literature. Unfortunately, that situation is typical at most high schools and colleges.
Dan had a dark complexion and tanned easily but always wore a T-shirt when rowing. A melanoma specialist who examined him thought sun exposure was not a factor but his dermatologist thought it was. At any rate, Dan had the mole as a child, though not at birth. He first noticed a change in the mole (slight bleeding) about four or five months prior to his visit home, but attributed it to irritation from the rough fabric of a new computer chair he had bought. That tragic assumption and the location of the mole resulted in his subsequent inattention. Most likely, it had undergone other changes before it began to bleed, but he didn't notice because it was difficult to see the mole in a wall mirror. In most cases, melanomas are completely curable when they are less than 0.75 mm thick but the cancerous part of Dan's mole was more than 6 mm thick.
His treatment began by removal of a large area of skin surrounding the original mole (with early melanomas, just the mole and a small margin of surrounding skin is removed). There was no evidence of internal spread, but because the prognosis was unfavorable, Dan returned home in August and telecommuted on a part-time basis while receiving medical follow-up at a Boston hospital. In September, he felt a small lump in his right armpit; needle biopsy showed the melanoma had spread to his lymph nodes. The next step was removal of all 29 lymph nodes in the affected area. Two of the nodes tested positive for melanoma. In December 1996, he began a yearlong treatment with Interferon, an immune system stimulant with flu-like side effects, which, in Dan's case, included exhaustion, aches, and depression. When the treatment ended in late 1997, we were hopeful because there had been no evidence of further spread. Dan began to resume normal activities, even vigorous workouts, but in April 1998, after he felt abdominal pain, CT scans showed that the melanoma had spread to his liver and lungs and was inoperable.
CT scans showed that the melanoma had spread to
his liver and lungs and
was inoperable. |
At that point he transferred to another hospital in Boston and was treated by an advanced melanoma specialist. First he received a mix of chemotherapy agents (dacarbazine and cisplatin) and immune system stimulants (Interferon and Interleukin-2), then Taxol, BCNU, and finally, experimental treatment with Thalidomide that required exhausting trips to Atlanta every two weeks. Still, none of the treatments slowed the progression of his disease; the cancer continued to increase in his abdomen, and spread to his bones and brain. He required increasingly strong pain medication and unsuccessful treatments to try to relieve severe fluid accumulation in his abdomen and legs. In his final days he was unable to walk and was barely able to sit up, but late in the night of October 9, 1998, he called us into his room. Somehow he had mustered the strength to sit up on the side of his bed. As we sat at his side, he put an arm around each of us and said "I love you both." He died early the next morning.
Dan faced his illness with extraordinary courage and dignity, never complaining or expressing anger or asking "Why me?"
The Melanoma Education Foundation was founded to honor our wonderful son's memory and to prevent other families from experiencing the tragedy that happened to him and his family.
Stephen & Gail Fine
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