41-Year-Old Woman Thought Her Melanoma Was Behind Her—Then Excruciating Hip & Leg Pain Revealed Cancer Recurrence: How Immunotherapy Helped

“It’s something I waited too long to get checked out. I’m aware of that. I don’t dwell on it, but that’s what it was. It was a mole on my back that I needed to get checked out,” said Megan.

Megan, who was found to carry a CHEK2 gene mutation, a known risk factor for breast and colon cancers, ultimately underwent surgery to remove the cancerous mole along with a margin of surrounding tissue. Doctors also surgically removed 10 lymph nodes from her right armpit.

According to the American Cancer Society (ACS), stage 3 melanoma treatment often begins with surgery to remove the tumor and nearby lymph nodes, then often, doctors will add immunotherapy, targeted pills (for BRAF gene changes), radiation, or clinical trial drugs to lower the chance it returns.

However, the National Comprehensive Cancer Network (NCCN) 2026 guidelines, explained that stage 3A melanoma “includes tumors that may be 1 mm thick or less with or without ulceration (broken skin) or 2 mm thick or less without ulceration. This stage also means that between 1 to 3 lymph nodes have cancer detected microscopically after a sentinel lymph node biopsy (SLNB) [a procedure that checks whether the cancer had spread to the nearest lymph nodes.”

The NCCN adds, “For most stage3A tumors, no further treatment is needed. Instead, observation is preferred. Observation means periodic doctor visits or follow-up care that includes skin and lymph node exams; attention to any concerning signs and symptoms; and/or imaging scans, when needed.”

In Megan’s case, she underwent surgery and had her lymph nodes removed after her initial diagnosis. Only one lymph node tested positive for melanoma. Follow-up testing showed no evidence that the cancer had spread, so her doctors continued to monitor her through regular follow-up appointments.

Megan experienced no further issues for five years and continued routine screenings for thyroid, breast, and colon cancers, due to her heightened risk.

In early 2022, Megan began experiencing worsening pain in her hip.

In the following months, her symptoms intensified, and additional testing revealed that her melanoma had returned and spread to her femurs, pelvis, spine, and stomach—meaning the disease had progressed to stage 4.

Melanoma: Symptoms & Diagnosis

Additionally, due to the cancer having weakened her femur, she needed orthopedic hardware [such as metal screws, plates, and rods, surgically placed to stabilize fractured bones and repair or support damaged joints] before starting immunotherapy and radiation.

RELATED: The Genetic Mutation That Drives Many Metastatic Melanomas

She explained to The Patient Story, “In January of 2022, I was stretching. I was on Instagram, and I was just scrolling around, and it said to release the tension from your hips—you know, one of those posts. And I said, ‘Oh, okay.’ So I just do stretches. Just stretching, nothing out of the ordinary, nothing that would harm me or be unsafe. So I do stretches, and then the next two days I felt like you do after you overdo it working out, but it didn’t feel like a regular strain.

“This is strange, but I didn’t think a lot of it. I just took some Advil, and I didn’t think too much of it. And I even got my regular CT scan and everything. My regular CT scan, of course, wasn’t on my legs or my hips or my back or anything like that. But I was getting this pain, and I wasn’t even thinking that it could be cancer. 100%. I just thought, ‘People get leg pain.’ But I ended up having excruciating pain in my lower back, on my left side, and down my leg, in my hip.”

As her pain worsened over several months, she sought medical attention and was referred to an orthopedic specialist.

After undergoing physical therapy and an MRI that raised further concerns, doctors ordered a PET scan, which ultimately revealed that her cancer had returned and spread.

Megan continued, “And then we just started going to appointments, because we had to get everything found out. We needed to get everything solidified. You don’t just jump on a bench and get radiation. There’s the consult, there’s the mapping. There’s a lot to it. There are the biopsies; there’s a lot that you have to get done before they start everything.

“So … I started immunotherapy right away. And I started radiation right away. And I had fantastic results. It took time, and it wasn’t immediate, but I started to see results — like the spots in my stomach, the tumors in my stomach, things were getting better, thankfully.”

She then admitted to being “very positive” that she’s doing everything can to better her health.

“I am never going to be in the clear, because it’s in my bones, or it was in my bones. They can’t really give you a clear ‘you’re fine’ when it’s been in the bone. I don’t have symptoms. They’re not concerned about it. But due to the nature of what cancer does to the bone, the scans just don’t read it the same way that they read other tumors and other cancers. So I just live positively, knowing that it’s fine,” Megan said.

Offering advice for others going through a health journey, she added, “It’s important to be proud of yourself. I have said that out loud, for myself and for others, because it’s very important.

“You have to advocate for yourself. You have to take care of yourself. You can do it, but you’ve got to work at it. And if you are just taking it in, day by day, actually able to work through it — I do think you have to find your happiness. And that’s hard, but you’ve got to find what makes you happy yourself. And that really, really helps.”

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.

Immunotherapy Advances Offer New Hope in Melanoma Treatment

Melanoma treatment, like all cancer care, is highly individualized—shaped by tumor stage, location, and patient-specific factors. Yet across the spectrum, a multi-pronged approach is common, often combining surgery, immunotherapy, targeted therapies, and radiation.

Among these, immunotherapy has emerged as a transformative force in oncology. Rather than attacking cancer cells directly, it empowers the body’s own immune system to do the work. One standout example is pembrolizumab—commercially known as Keytruda—a checkpoint inhibitor that’s reshaping outcomes for patients with advanced melanoma.

Checkpoint inhibitors, like pembrolizumab, help the immune system do its job by removing the “invisibility cloak” that cancer cells use to hide. Normally, a protein called PD-1 acts like a brake on T cells, keeping them from attacking healthy cells. But cancer takes advantage of that brake to avoid being targeted. Pembrolizumab blocks PD-1, releasing the brake and letting T cells go after cancer cells more aggressively—just like they’re meant to.

“We have known for a while now that immunotherapy is a very important weapon in the fight against melanoma,” Dr. Janice Mehnert, associate director of clinical research at NYU Langone’s Perlmutter Cancer Center, previously explained to SurvivorNet.

“This study sought to investigate whether giving the anti-PD-1 antibody pembrolizumab to melanoma patients with bulky stage IIIB through stage IV disease may be superior to the standard of care approach, which is surgery followed by immunotherapy.”

The implications are significant. Instead of waiting until after surgery to deploy immunotherapy, researchers are exploring whether earlier intervention with pembrolizumab could improve outcomes for patients with more aggressive disease.

Used across multiple cancer types, immunotherapy has already revolutionized treatment paradigms. In melanoma, it’s not just a promising option—it’s a game-changer.

RELATED: Melanoma Relapse Treatment: Advances on the Horizon

FDA-Approved Immunotherapy for Melanoma

There are several FDA-approved immunotherapies for melanoma. Each is approved for certain instances of melanoma.

• Ipilimumab (Yervoy)
• Nivolumab (Opdivo)
• Pembrolizumab (Keytruda)
• Atezolizumab (Tecentriq)
• Nivolumab + relatlimab (Opdualag)
• Pembrolizumab + berahyaluronidase (Keytruda Qlex)
• Aldesleukin (Proleukin)
• Interferon alfa-2b (Intron A)
• Peginterferon alfa-2b (Sylatron/PEG-Intron)
• Talimogene laherparepvec (Imlygic)
• Vusolimogene oderparepvec (Tudriqev)
• Lifileucel (Amtagvi)
• Tebentafusp-tebn (Kimmtrak)
• Hepzato (melphalan, liver-directed)

The goal is to steadily reduce the risk of recurrence in all patients. It’s not a one-size-fits-all approach. Some people may not be candidates for this therapy, and side effects vary from person to person.

Research has found that immunotherapy drugs such as Keytruda (pembrolizumab) and Opdivo (nivolumab) helped some people live longer.

The following immunotherapy drug combinations also exist for melanoma:

• Yervoy + Opdivo (ipilimumab + nivolumab) – extends survival further than single drugs, but with higher risk of side effects
• Opdivo + relatlimab (Opdualag) – newer combo, included in NCCN guidelines

Other immunotherapy approaches consist of:

• T-VEC (Imlygic) – a virus-based therapy injected directly into melanoma tumors
• Lifileucel (Amtagvi) – a newer cell-based therapy using a patient’s own immune cells (taken from the tumor, grown in a lab, then infused back in); used for advanced melanoma when other treatments haven’t worked

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,” said Dr. Pavlick. She emphasized that “there is no cookie-cutter recipe,” for treating stage IV melanoma.

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

Immunotherapy Side Effects During Treatment for Melanoma

A study recently published in JAMA Oncology is shedding light on the long-term side effects of immunotherapy in melanoma patients—revealing that chronic complications may be more widespread than previously thought.

“Chronic and long-lasting side effects were more common than we expected and involved a variety of often overlooked organs like the thyroid, salivary glands, and joints,” Dr. Douglas Johnson, senior author of the study and associate professor of medicine at Vanderbilt University Medical Center, previously told SurvivorNet.

WATCH: Tell Your Doctor About Immunotherapy Side Effects

Despite the findings, Dr. Johnson emphasized the groundbreaking nature of immunotherapy, especially anti-PD-1 drugs. “It has been an absolute game-changer for patients with melanoma,” he noted. “I think the first thing to recognize is how really transformative the Anti-PD-1 drugs have been… patients can have very long-term responses to treatment.”

Still, for patients with advanced melanoma—especially those who’ve undergone surgical removal and have a low risk of recurrence—Dr. Johnson advised more nuanced conversations around treatment. “So determining whether the risks of the side effects, weighing the benefits of treatment with the risks of the side effects, can be an important consideration,” he said. “What our study did was we basically saw that some of these side effects were more common, really, than had been previously reported.”

Reported side effects can range from mild to severe, including dry throat, inflammation of the eye blood vessels, numbness, or tingling. And for many, the decision comes down to weighing symptom severity with potential longevity benefits.

Dr. Anna Pavlick, another expert in melanoma care, added context around immunotherapy management. “Depending upon the severity, it depends upon how we manage it,” she said.

“The percentage of patients who have very serious side effects from immunotherapy is contingent upon whether patients will get one medicine or a combination of two medicines.”

She explained that patients receiving a single immunotherapy drug face a 10–15% chance of experiencing severe reactions like rash or diarrhea. But for patients with metastatic melanoma, a dual-drug regimen—though more effective at controlling the cancer—comes with about a 50% chance of developing side effects.

Understanding Melanoma & The Warning Signs

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, according to SurvivorNet’s experts. You’ll want to watch them and tell your doctor about any changes you notice.

WATCH: How do you perform a skin check using the ABCDEs?

SurvivorNet experts recommend avoiding unprotected sun exposure because ultraviolet (UV) radiation can lead to melanoma. Tanning beds pose ultraviolet radiation risks for skin cancer and should be avoided. Many dermatologists recommend using spray tans to reduce the risk of melanoma skin cancer.

The most important thing to look out for when it comes to finding melanoma is a new spot on your skin or a spot that is changing in size, shape, or color, SurvivorNet’s medical experts say.

WATCH: Beating Aggressive Melanoma: An Immunotherapy Success Story

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.

Questions to Ask Your Doctor

If you are diagnosed with skin cancer, you may have some questions for your doctor. SurvivorNet suggests the following to help you on your cancer journey.

• What type of skin cancer do I have?
• What treatment options exist for my type of melanoma?
• Will insurance cover this treatment?
• Would treatment through a clinical trial make sense for me?
• What resources exist to help manage my anxiety because of this diagnosis?

Check out SurvivorNet’s proprietary AI tool “My Health Questions,” designed specifically for patients and caregivers.

WATCH: How One Cancer Survivor and Her Sister Used “My Health Questions” to Navigate Care

Contributing: SurvivorNet Staff

Learn more about SurvivorNet's rigorous medical review process.

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