By Meredith Whittemore

On average, the Houston area has 204 sunny days.  For each of those days, Sabrina Farber has to tackle an inner battle against fear that her melanoma may return.

“Once you’ve had a diagnosis of melanoma, it almost makes you afraid of the sun. One day I told myself, ‘Forget this. I am going to put on my protective clothing and I am going to enjoy the outdoors,’ but it’s a battle to keep that fear out,” said Farber.

Farber, a fair-skinned, red-headed mother of five, says she’d always taken the extra precautions to try and protect her skin from the sun and has been vigilant about undergoing a yearly skin cancer screening.  She’d had biopsies over the years and even some basal cell carcinomas removed, so she didn’t think twice about a biopsy on a spot on her forearm.

“The results came back that it wasn’t cancerous, but the spot never quite healed well. When I asked my dermatologist, he suggested a second biopsy, but I was afraid that would only exacerbate the problem,” said Farber.

With the condition of her arm unchanged, Farber eventually went in for the second biopsy that would change everything.

“I don’t know how to communicate what it feels like when someone tells you that you have cancer, that you have a tumor. It’s frightening, no matter what type of cancer it is,” said Farber.

Diagnosed with Stage 2B Melanoma

“Melanoma is the most serious form of skin cancer because it often spreads. The surgery surrounding the removal of the cancer is much more involved and patients require surveillance for the rest of their lives,” said Casey Duncan, MD, a surgical oncologist affiliated with Memorial Hermann-Texas Medical Center and assistant professor at McGovern Medical School at The University of Texas Health Science Center at Houston (UTHealth).

Farber says it was also difficult that she received the diagnosis near the holidays, but was thankful Dr. Duncan treated her in a timely manner.

“She told me she had availability to perform the surgery on New Year’s Eve, and I told her if she was willing to come in, I would be there! I was so impressed by her responsiveness and her supportive nature throughout the entire process,” said Farber. 

Dr. Duncan also biopsied the lymph nodes in Farber’s armpit to ensure the cancer hadn’t spread.

“When Dr. Duncan called and told me there was no sign of cancer in my lymph nodes, it was like getting a ‘not guilty’ verdict when you faced the potential of the death penalty. I can’t even explain the weight it lifted off my shoulders,” said Farber.

Melanoma Can Reoccur or Spread

Dr. Duncan says Farber, like all patients she treats for melanoma, will need to undergo skin checks every three months for the rest of her lives.

“Once you have melanoma once, you are at a higher risk of it developing again. Combine that with the danger of melanoma spreading, and we want to catch any spots as early as possible,” said Dr. Duncan.

The American Melanoma Foundation encourages people to know the “ABCDEs” of skin cancer.

• Asymmetry – When the lesion is divided into halves, if the right half does NOT look like the left half, it is asymmetrical in shape.
• Border – Moles that have irregular or poorly defined borders should be reported. The borders appear notched or seem to fade or “stream out” onto the surrounding skin.
• Color – Is the color of the mole varied? Does the mole have tan, brown, black, blue, red or white areas?
• Diameter – Is the mole larger than 6 millimeters in diameter (the size of a pencil eraser)? Although 6 millimeters is used as a general guideline for evaluating growth of a mole, any mole that is asymmetrical, has an irregular border, has color variations and is changing should be evaluated by your healthcare provider — even if it is less than 6 millimeters in diameter.
• Evolving – Watch for any moles that start to evolve or change over time. Any change in size, shape or color can point to a dangerous change.

Dr. Duncan also recommends putting on sunscreen, or wearing protective clothing, when you will be in the sun for an extended period of time. The American Academy of Dermatology recommends using broad-spectrum sunscreen of at least SPF 30 that is also water-resistant.

Farber says the whole experience, while tough, helped give her clarity.

“You really start to realize what’s important and what isn’t. You see how strong your family is. Now, I do everything I can to encourage my kids, my friends and family to wear sunscreen, put on hats and take the extra steps to protect their skin. You just can’t take it for granted,” said Farber. 

Learn more about skin cancer treatment options offered through Memorial Hermann Cancer Centers, or find a dermatologist near you to schedule an appointment for a skin cancer screening.