Early Detection Leads to Successful Outcomes in Unexpected Skin Cancer Diagnosis

In October 2023, Phil Russom woke up in the hospital and was told he had been found unconscious in his home—and that he had just undergone neurosurgery to remove a brain tumor he didn’t know he had. The experience left him feeling incredibly fortunate to be alive. As he began the difficult process of recovery, one of the nurses attending to him noticed a lump on his neck. Concerned, she urged Phil to get it checked out once he had returned home and fully recovered from his near-death ordeal. Recognizing the seriousness of her concern, Phil promised that he would follow her advice.

Not long after his surgery, Phil scheduled an appointment with a dermatologist to examine the lump on his neck. During the visit, the dermatologist decided to perform a full skin check to ensure there were no other areas of concern. The examination revealed two additional issues: a lump on his upper right arm and a large mole on his upper left back, both of which raised alarms.

The dermatologist conducted tests on all three areas, and the results were shocking. Phil was diagnosed with Stage I melanoma on his upper right arm and Stage II melanoma on his back, and the lump was determined to be basal cell carcinoma.

Melanoma is a type of skin cancer that develops in the melanocytes, which are the cells responsible for producing melanin, the pigment that gives skin its color. Melanoma is one of the most dangerous forms of skin cancer because it can spread to other parts of the body if not caught early. The stages of melanoma are defined based on the thickness and other features of the tumor, and whether it has spread to nearby lymph nodes or other organs. Stage I melanoma is typically confined to the skin and is usually treatable with surgery. Stage II indicates a thicker tumor that may have started to penetrate deeper layers but has not yet spread to lymph nodes.

Basal cell carcinoma is another type of skin cancer, arising from the basal cells in the epidermis, which is the outermost layer of skin. Basal cell carcinoma is the most common form of skin cancer and is generally less aggressive than melanoma. It grows slowly and rarely spreads to other parts of the body, but if left untreated, it can cause significant damage to the surrounding tissues.

Given the seriousness of his skin cancer diagnoses, Phil was promptly referred to Dr. Casey Duncan, a surgical oncologist affiliated with Memorial Hermann, for surgery.

“Surgery for removing skin cancer involves excising the tumor along with a margin of surrounding healthy tissue to ensure that all cancerous cells are removed, and sometimes a lymph node biopsy,” explained Dr. Duncan. “In cases like Phil’s, where multiple sites are affected, we carefully plan each procedure to minimize scarring and preserve function, while also prioritizing complete removal of the cancer. The goal is not only to treat the current cancer but also to prevent recurrence.”

Having grown up in Australia, a country where melanoma is common due to intense sun exposure, Phil had always been vigilant about sun protection and was fully aware of the risk of skin cancer. Because of his precautions, his own diagnosis of three cancers came as a complete shock.

“I was fair-skinned, and I used to get sunburned often, so I would always cover up and use sunscreen,” Phil said. “Then, in my late twenties, I moved to Iceland, which has the lowest UV rate in the world. So, when the dermatologist told me I had not one but two melanomas, I was very surprised. I guess the message is—if it can happen to me, it can happen to anyone.”

Phil was fortunate. The cancer had not spread to his lymph nodes, allowing Dr. Duncan to successfully remove all the cancerous tissue during surgery.

“The surgery was tough—I ended up with a seven-inch scar on my arm and an even larger one on my back because they had to go deep to ensure all the cancer was removed,” Phil said. “But Dr. Duncan did an incredible job, and she made sure to get everything.”

Phil joked that his only complaint is how one of the scars messed up a tattoo he’d previously had done on his arm. Despite that, he says he’s “good as gold” today. By sharing his story, he hopes to emphasize the importance of protecting oneself from sun exposure and getting annual skin checks through a dermatologist. 

“I’ve got scars, but I’m alive,” Phil said. “I beat this one, but melanoma is sneaky, and you can’t be too careful with it. If you have even an inkling that something doesn’t look right, or if someone tells you to check something out, you should go and do it immediately.

Dr. Duncan reiterated the importance of early detection.

“Melanoma can affect anyone and any body part, regardless of age or background,” Dr. Duncan said. “It’s a stark reminder that no one is immune, even those who take precautions. Protecting yourself from sun exposure by using sunscreen, wearing protective clothing and seeking shade is crucial. Regular skin checks are equally important because early detection can make all the difference in successful treatment.”

As for Phil, he plans to continue to protect himself from sun exposure and maintain yearly dermatology appointments, and he is grateful for the nurse who first urged him to get checked. “Had I not had my brain tumor, and had I not had that one nurse notice the lump on my neck, there is no telling where I would be today,” Phil said. “I feel extremely lucky.