Sun Lover’s Wake Up Call

Posted on: November 17th, 2008 by California Skin Institute

El Camino Hospital, Your Guide to Women’s Services

Katharine Smith always loved the sun. A 38-year old mother of two, aged 3 and 6, she is a tournament water skier at Santa Clara Water Ski Club and an accomplished athlete who enjoys surfing, mountain biking, and swimming.

Growing up, she spent many family vacations in San Diego enjoying water sports and the beach. She faithfully used sunscreen and wore a hat; however, as part of water skiing she was a rotating “spotter,” doing what all water skiers do — sitting on the boat with her feet and legs exposed.

Katharine knew to check her skin, and as she puts it, she is “very freckly.” None of her freckles seemed discolored or abnormally shaped. But one day while shaving her legs, she felt a hard bump underneath one of her freckles on her shin. Thinking that if it were anything serious it would change in shape or color, she waited 7 to 8 months before finally being seen by her primary care physician.

Upon examining her, Katharine says her doctor “became kind of quiet.” Then she referred Katharine to dermatological surgeon Dr. Greg Morganroth, saying “he is the best doctor to get rid of skin cancer.”* Dr. Morganroth performed a biopsy, which resulted in her diagnosis of stage 1 melanoma — the worst type of skin cancer.*

To get rid of the melanoma, Dr Morganroth performed Mohs micrographic surgery, an advanced procedure to remove the cancer and as little normal tissue as possible.* Using only a local anesthetic, he removed a thin layer of skin containing the tumor in the shape of a pie.* This pie-like specimen was divided into slices for freezing and then examination in his on-site Mohs lab.* The advantage of this approach over other surgical techniques is that in examining the edges or “the crust” of this pie, Dr. Morganroth can be completely certain that the entire surgical margin is free of cancer.*

This examination was done in the office, while Katharine waited.*

Within a couple of hours, she knew that her melanoma, which showed as only a small spot on the surface, was the size of a quarter underneath and quite deep, but that the margins were clear — all cancer had been removed.* “Dr. Morganroth then performed skin grafts like no one else does — taking my own skin from the site which promotes faster healing.”*

During Katharine’s follow-up visit, she and Dr. Morganroth decided to take three more biopsies on her upper thigh and, “sure enough, one of them came back as in situ melanoma, a stage just before developing into a melanoma.” Two months later, Dr. Morganroth performed three more biopsies on her arm and found yet another in situ melanoma, which is highly uncommon.*

“I am now terrified of the sun. This has changed my life dramatically. Throughout this process, Dr. Morganroth counseled me and helped me. His advice — don’t stop doing what you love. So now my husband and I do all our sports from 6 am to 10 am. And we are all out of the sun completely from 10 to 3 every day. Plus, I wear specially designed and treated protective clothing — pants, long-sleeved shirts, etc. Dr. Morganroth is very confidant that we have caught it all. I have checkups every three months and I feel so lucky to have caught it early enough that it didn’t spread.”*

*Individual results may vary and are not guaranteed.