Dad of Two’s ‘Unusual Spot’ On His Left Bicep Was Biopsied & Declared Noncancerous. But 7 Years Later, a New Mole Appeared & It Was Stage 4 Melanoma— The Power of Clinical Trials

He told the news outlet how a suspicious mark on his left bicep, which he noticed back in 2007, prompted him to get his skin checked. Following a biopsy, his dermatologist informed him the spot was a noncancerous mole called a dysplastic nevus, which increased his risk of being diagnosed with melanoma.

Donaher didn’t need additional treatment, however, in 2014 another “pencil eraser”-sized spot showed up in place of the removed dysplastic nevus.

He admitted the new mark “didn’t look like a big deal,” explaining it was the color pink and “looked healthy, like a freckle.”

“It wasn’t big and scary-looking,” he recalled

Clinical Trials Can be Life-Saving for Some

Due to his previous skin cancer scare, Donaher decided to get checked and have another biopsy yet again, revealing he had stage 4 melanoma which spread to his lymph nodes.

Thanks to a medical oncologist at Atrium Health Levine Cancer, Donaher ultimately joined a clinical trial. Although he needed to drop out of the trial due to the side-effects he had to deal with, he went into remission for six years.

RELATED: Clinical Trials and What Statistics Really Mean

But, in 2020, a “tiny” blackhead on his chin, which was hard to notice due to his facial hair, led him to get checked again, revealing he had melanoma recurrence and the disease had spread to his liver, lungs, and muscles in his shoulder.

By November of that year he entered another clinical trial to try a new drug-combination, followed by the original drugs he took in the first clinical trial, which prompted his tumors to “disappear.”

About two-and-a-half years later, some of the masses came back in his abdomen and lungs, leading him to try targeted therapy because it was discovered he had an NTRK3 mutation.

He was later declared “cancer-free” in September 2023, and feels “very fortunate” that the medication he continues to take is working.

Donaher, who is set to turn 60 this year, said, “I would almost definitively say that if these options and clinical trials didn’t exist, I wouldn’t be sitting here today.

“I have great admiration and respect for the people running and willing to participate in clinical trials. That’s where progress comes from.”

He also praises his wife for being his “primary caregiver, motivator and advocate” throughout his skin cancer journey.

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.

RELATED: Speaking Out After Skin Cancer Surgery: ‘Summer House’ Star Ashley Wirkus ‘Always Wore Sunscreen’ Says it Still Wasn’t Enough

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.

There Is No “Cookie Cutter Recipe” for Treating Stage Four Melanoma

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

Who Can Sign Up for Clinical Trials?

If you’re interested in taking part in a clinical trial, the first thing to do is to speak to your doctor about the possibility of a trial. Blindly searching trials on the internet might not be the best advice available; using either the government’s clinical trials database or SurvivorNet’s resources specifically for cancer patients is your best option.

RELATED: Dr. Nina Shah says if you’re interested in a new treatment, don’t be afraid to ask questions.

However, just because you’re willing to take part in a clinical trial doesn’t necessarily mean you will be able to join. These trials have specific criteria that patients need to meet in order to take part. At the end of the day, even though these trials can have incredible results and provide you with access to cutting-edge therapies, these are controlled experiments.

For each trial, there will be certain inclusion and exclusion criteria.

Why Do People Get Excluded From Clinical Trials?

Sometimes, patients may be excluded from certain trials if their cancer has spread to their brain. If the metastases aren’t under control, the patient may be unable to participate because researchers are concerned that they won’t be able to complete the whole study.

There are options for people who may not be eligible for the clinical trials they wish to participate in, but still want to try the therapies. A few years ago, the U.S. passed something called “Right to Try” legislation. This gives terminally ill people access to highly experimental drugs that are in “phase one” of the clinical trial process.

Your doctor may also request access to a single patient IND (investigational new drug) on your behalf, which can also give access to treatments that the FDA has not yet approved.

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.

Contributing: SurvivorNet Staff

Learn more about SurvivorNet's rigorous medical review process.

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