Understanding Melanoma
- Finnian Garbutt, a 28-year-old actor best known for his role on BBC One’s “Hope Street,” has shared that his metastatic melanoma has entered its final stages.
- Despite the diagnosis, he is choosing to focus on gratitude, family, and the life goals he’s achieved while cherishing time with loved ones.
- Melanoma is the most dangerous form of skin cancer. It starts in the same cells that give your skin, hair, and eyes their color. In melanoma, the cells change, allowing them to spread to other organs. Changes to a mole you’ve had for a while or a new growth on your skin could be signs of melanoma, according to SurvivorNet’s experts. You’ll want to watch them and tell your doctor about any changes you notice.
- Clinical trials can be an option for people with cancer at many points during the treatment process. Your doctor may have spoken with you about possibly enrolling in a trial if you have advanced disease or if there’s a drug that’s currently considered investigational that may work better than the standard for you.
- If you’re looking for a clinical trial, check out our SurvivorNet Clinical Trial Finder.
Garbutt, a cherished Northern Irish actor who plays police constable Ryan Power in “Hope Street” on BBC One, admitting in a recent social media post that he’s now in his “last stages” of life, while choosing to embrace time with his loved ones.
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Opening up about the emotional weight of sharing his diagnosis, he admitted that speaking to loved ones individually has been one of the hardest parts.
He continued, “I hope now it’s in the open then I can enjoy the time with my amazing family and friends.”
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Offering inspiration to others living with a metastatic cancer, Garbutt said, “Since being diagnosed 4 years ago I have achieved so many of my life goals – 30 episodes in a TV show, being the lead in a movie (that should be out soon), buying my own house, marrying my best friend and becoming a father to the most incredible baby girl who never fails to make me smile.
“Thank you to all that have reached out over the years and supported me and my family. If anyone wants to meet up for a pint, coffee or general bit of craic please reach out and we can try and make it work.”
Back on August 30, 2024, Garbutt announced his stage 4 melanoma diagnosis, leading up to the birth of us daughter.
He captioned the Instagram post, featuring him in the hospital, “A routine scan picked up a few hotspots in my body and a more detailed MRI confirmed that the melanoma has come back. I have every trust in my oncology team and the groundbreaking treatment options available with the NHS.
“Check your skin, if something seems wrong then get it checked. Don’t take no for an answer.”
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More recently, however, Garbutt described his cancer journey, which began in 2021, as a wild ride.
He wrote in his December 2025 Instagram post, “4 years today I was diagnosed with cancer. It’s been a mad journey so far. Major surgery, countless scans and biopsies, 10 different treatments and now in search for a clinical trial.
“Wouldn’t be able to have managed without my family, my wife @louise.agnew [Louise Agnew] and my best little mate, my daughter, Saoirse. Here’s to many more happy years.”
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In honor of his most recent post, supporters of Garbutt offered words of encouragement, with one writing, “We were stuck for hours, filming in that bloody police car one day. Way out on the peninsula somewhere. We had the craic. We shared personal stuff. In between stories we had comfortable silences, during which I had repeated thoughts like … ‘How the f**k does this kid keep going?’ How does he process the sheer unfairness of this, the insanity of it?’
“If I had half his courage I’d be a much stronger man than I am now.’ … That is how I will remember you kid. In that car, in that rain storm, the day they just left us there for hours. If my daughter grows up half as proud of me, as your daughter is going to be of you, I will have done something very right.”
Another commented, “Finn, you are some man for one man, my God. A breath of fresh air, an effervescent burst of energy, the most powerful craic, kindest human and altogether amazing soul.
“What a legacy & imprint you have left on this World. We will speak your name Legend often & into the world so that your girls & all who come after you, know what an impact you had on us all. Sending you strength, love, pints & hugs brother.”
A third wrote, “What an achievement what an impressive impactive indent in the world. Would love to see you for a pint. God bless.”
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Understanding Melanoma
Melanoma starts in the same cells that give your skin, hair, and eyes their color. In melanoma, the cells change in a way that allows them to spread to other organs.
Changes to a mole you’ve had for a while or a new growth on your skin could be signs of melanoma.
You’re most likely to find melanoma on sun-exposed skin areas like your face, neck, arms, and legs. Surprisingly, you might also find them in other places as well, like:
- The palms of your hands or soles of your feet
- On your eyes or mouth
- Under your nails
The top way to protect yourself is by staying out of the sun, especially during peak hours, and avoiding unprotected sun exposure because ultraviolet (UV) radiation can lead to melanoma.
According to experts like Dr. Anna Pavlick, an oncologist at NYU’s Perlmutter Cancer Center, tanning beds pose ultraviolet radiation risks for skin cancer and should be avoided completely.
RELATED: How Do I Know My Skin Cancer is Gone?
Dr. Pavlick notes that people who are covered with moles stand a higher risk of developing skin cancer, especially people with dysplastic nevis syndrome, or “atypical” moles.
Atypical moles are those that are unusual-looking and, when seen under a microscope, they have irregular features. Although usually benign, a high number of atypical moles do signal an increased risk for melanoma, according to the Skin Cancer Foundation which says people with 10 or more atypical moles have 12 times higher risk of developing melanoma.
Warning Signs of Skin Cancer – Remember ABDCE
The most important thing to look out for when it comes to finding melanoma is a sudden, new spot on your skin or a spot that is quickly changing in size, shape, or color.
Dr. Cecelia Larocca, a dermatologist at Dana-Farber Cancer Institute, recommends implementing the ABCDE rule to determine if a mole requires further examination.
The ABCDE rule:
- A: Asymmetry of the mole, or when one half of the mole doesn’t match the other
- B: Border irregularity or Bleeding
- C: Color change either lightening or darkening of a mole
- D: Diameter greater than 6mm or enlarging moles
- E: Evolving size, shape or color.
WATCH: Dr. Cecila Larocca on the ABCDEs of checking moles for signs of skin cancer
Melanoma that moves into the body, away from the skin, becomes an entirely different treatment journey for patients.
Treatment options for melanoma that has spread include targeted therapy and immunotherapy, which give people a better chance of living a long and healthy life than ever before. If you’re diagnosed with melanoma, there’s a good chance surgery will be the treatment your doctor recommends.
Cancer removal usually leads to a cure in the early stages of the disease. After surgery, the removed tissue and lymph nodes are examined to measure the melanoma and determine if it has clear margins. Clear margins mean the cells around the area of tissue that was removed don’t contain any melanoma.
When no cancer cells are left around the removed area, your cancer is less likely to return.
Melanoma Treatment Options
Melanoma treatment has come a long way. Survival rates have risen dramatically, thanks to a “treatment revolution,” say SurvivorNet’s experts. With breakthrough treatments like targeted therapy and immunotherapy now available, people who are diagnosed today have a much better chance of living a long and healthy life than ever before.
If you’re diagnosed with melanoma, there’s a good chance surgery is going to be the treatment your doctor recommends. In the early stages of the disease, removing the cancer should lead to a cure. The question is typically not whether you’ll get surgery, but which kind you’ll have.
WATCH: Dermatologic Surgeon Dr. Nima Gharavi, On The “Gold Standard Treatment” For Melanoma
For an early-stage melanoma that is close to the skin surface, Mohs surgery might be an option. This technique removes skin cancer, layer by layer, until all the cancer is gone.
In general, stage I melanoma surgery consists of the simple, in-office removal of the cancerous cells by a dermatologist. If the cancer is thicker, your surgeon will remove it through a technique called wide excision surgery.
The removal of stage II and III melanomas are performed by surgeons or surgical oncologists, not dermatologists. You may also have a sentinel lymph node biopsy to see if the melanoma has spread to the first lymph node where it’s most likely to travel. If your cancer has reached this first lymph node, it may have spread to other neighboring lymph nodes, and possibly to other organs. Where the cancer is will dictate your treatment.
After surgery, the removed tissue and lymph nodes will go to a specialist called a pathologist, who will measure the melanoma and find out if it has clear margins. Having clear margins means the cells around the area of tissue that was removed don’t contain any melanoma. When there aren’t any cancer cells left around the removed area, your cancer is less likely to come back.
Once your cancer spreads, treatment gets a little more complicated, but there are still ways to stop it. New treatments have vastly improved the outlook for people with metastatic, or stage IV, melanoma.
Targeted drugs and immunotherapy have been shown to be more effective than chemotherapy. So, with many more choices, there is no standard treatment. Treatment will vary based on your condition and whether there is recurrent disease.
Research has found that immunotherapy drugs such as Keytruda (pembrolizumab) and Opdivo (nivolumab) helped some people live longer. Combining immunotherapy drugs Yervoy (ipilimumab) and Opdivo (nivolumab) has also extended survival. Opdivo (nivolumab) + relatlimab is a new therapy option added to the National Comprehensive Cancer Network guidelines in 2022. The combination of two immunotherapies is called Opdualag.
For those with the BRAF mutation, targeted drugs which shrink or slow the tumor can be a good option. This could include a combination of drugs, such as:
- Zelboraf (vemurafenib) and Cotellic (cobimetinib)
- Braftovi (encorafenib) and Mektovi (binimetinib)
- Tafinlar (dabrafenib) and Mekinist (trametinib)
- Zelboraf (vemurafenib) and Cotellic (cobimetinib) can also be combined with atezolizumab.
“Every patient is different and every situation is different,” says Dr. Anna Pavlick, medical oncologist at Weill Cornell Medicine. She emphasized that “there is no cookie-cutter recipe,” for treating stage IV melanoma.
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Dr. Pavlick also notes the importance of personalized care and treatment. “It really is a matter of looking at the tools we have so that we can pick the right tools to give the patient the best outcome.”
So, while there is no one-size-fits-all approach to treating metastatic melanoma, your doctor will work with you to develop a treatment plan that is tailored to your individual situation. Advances in research and technology are making the fight against metastatic melanoma more hopeful than ever.
RELATED: SurvivorNet’s Guide To Clinical Trials: What Are They And Are They Right for You?
Understanding Clinical Trials
Clinical trials are available for eligible cancer patients if other treatment options don’t seem to work. A clinical trial can be defined as a research study that compares the most effective known treatment for a specific type or stage of a disease with a new approach.
Participating in one does not guarantee you will get the most effective treatment and they are certainly not for everyone, but it does give you the chance to potentially access new, cutting-edge treatments while advancing science.
Before getting involved in a clinical trial, talk with your doctor(s) and consider the following general risks of enrolling:
- The risk of harm and/or side effects due to experimental treatments
- Researchers may be unaware of some potential side effects for experimental treatments
- The treatment may not work for you, even if it has worked for others
“Clinical trials are critical to the development of new therapies, and as we live through this extraordinary revolution in genomics, immunotherapy and targeted therapy, it’s clear that one of the most pressing needs for patients, clinical trials sponsors, and researchers is simply a better way to find patients,” SurvivorNet CEO Steve Alperin said.
“Even one percent more people successfully enrolled in clinical trials can change the world.”
Why I’d Choose a Clinical Trial For Myself
Your doctor may have spoken with you about possibly enrolling in a trial if you have advanced disease or if there’s a drug that’s currently considered investigational that may work better than the standard for you.
A lot of patients may feel uncomfortable about the thought of participating in a trial, but the trials can provide amazing opportunities for patients. For one thing, they give patients access to a bevy of new drugs that are currently being developed by pharmaceutical companies.
If participating in a clinical trial is something you think you may be interested in, the government has a list of trials that are currently ongoing. SurvivorNet also has a tool to help you find trials for your particular disease.
Clinical Trials Can be Life-Saving for Some
Leading Experts Urge Us to Be Proactive
“If I had any advice for you following a cancer diagnosis, it would be, first, to seek out multiple opinions as to the best care,” National Cancer Institute Chief of Surgery Steven Rosenberg told us in a previous interview, “because finding a doctor who is up to the latest of information is important.”
As we highlight in several areas of SurvivorNet, highly respected doctors sometimes disagree on the right course of treatment, and advances in genetics and immunotherapy are creating new options. Also, in some instances the specific course of treatment is not clear cut. That’s even more reason why understanding the potential approaches to your disease is crucial.
At the National Cancer Institute, there is a patient referral service that will “guide patients to the right group depending on their disease state so that they can gain access to these new experimental treatments,” Rosenberg says.
Cancer Research Legend Urges Patients to Get Multiple Opinions
Furthermore, getting another opinion may also help you avoid doctor biases. For example, some surgeons own radiation treatment centers. “So there may be a conflict of interest if you present to a surgeon that is recommending radiation because there is some ownership of that type of facility,” Dr. Jim Hu, director of robotic surgery at Weill Cornell Medical Center, tells SurvivorNet.
Other reasons to get a second opinion include:
- To see a doctor who has more experience treating your type of cancer
- You have a rare type of cancer
- There are several ways to treat your cancer
- You feel like your doctor isn’t listening to you, or isn’t giving you good advice
- You have trouble understanding your doctor
- You don’t like the treatment your doctor is recommending, or you’re worried about its possible side effects
- Your insurance company wants you to get another medical opinion
- Your cancer isn’t improving on your current treatment
RELATED: Be Pushy, Be Your Own Advocate, Says Leading Expert
Bottom line, being proactive about your health could be a matter of life or death. Learn as much as you can from as many experts as you can, so that you know that you did your best to take control of your health.
Resilience: Navigating Life’s Curveballs
Accepting that cancer is something that just happens, and it’s not your fault, is a big part of coming to terms with the disease.
Breast cancer survivor Heather Maloney said simply trying to enjoy her life, even on chemo days, made a big difference when she was facing the disease.
Sometimes Bad Things Happen — Enjoying Life, Even With Cancer
“Find moments of gratitude, and you will get through it,” Heather says. “Not everybody does, but we all do eventually see an ending to it.”
She concluded, “Life is hard for everybody, but I’m able to more readily and easily access a level of gratitude about being alive. I’m lucky to be alive today.”
Contributing: SurvivorNet Staff
Learn more about SurvivorNet's rigorous medical review process.
