Derm-it Trotter! Don't Swear About Skincare.
Feeling frustrated or overwhelmed with everything skin? Does the skinformation overload make you want to swear about skincare? Join Dr. Shannon C. Trotter, board certified dermatologist, as she talks with fellow dermatologists and colleagues in skincare to help separate fact from fiction and simplify the world of skin. After listening, you won’t swear about skincare anymore!
Derm-it Trotter! Don't Swear About Skincare.
Beyond the Diagnosis: A Melanoma Warrior's Voice
A routine Saturday turned life-changing when Leah’s dad had a seizure behind the wheel—ER scans revealed brain lesions, and a full-body scan showed his lungs “lit up like a Christmas tree.” A biopsy confirmed stage four metastatic melanoma, forcing Leah and her mom into an accelerated crash course on brain radiation, immunotherapy, and caregiving. What began as a stage zero melanoma in 2019 suddenly escalated, rewriting everything they thought they knew about “being done” with cancer.
Leah shares the real story behind survival: seven rounds of gamma knife, twenty-one infusions, and the moment treatment had to stop to save his lungs. Stability came not by chance but through vigilance, monthly scans, and grace as the intervals lengthened to six months. Beyond medicine, Leah gets candid about the emotional and practical toll—losing independence, routines, and normalcy—and what caregivers and clinicians can do better: slow down, explain, listen, and humanize every stage. This conversation blends practical guidance with grounded hope for anyone navigating melanoma or supporting someone who is.
And then I had my stage one A melanoma a month after his, so very close together. And then he and I thought that we kind of left melanoma in the history books uh back in 2019. And so they did another scan, full body, and then they saw his lungs lit up like a Christmas tree. There were lesions all over his lungs. He did seven rounds of gamma knife radiation to the brain to treat the lesions because the lesions in his brain were all inoperable. So they were all very tiny and scattered. So there was no way surgery would be able to treat that.
SPEAKER_00:Welcome to Dermit Trotter, Don't Swear About Skin Care, where host Dr. Shannon C. Trotter, a board-certified dermatologist, sits down with fellow dermatologists and skincare experts to separate fact from fiction and simplify skincare. Let's get started.
SPEAKER_01:Welcome to the Dermitrotter Don't Swear About Skin Care podcast. Today we have another episode in what I've called sort of our patient perspectives. You know, my goal is to really bring to not only expert skin information, but I really want to help you understand the patient perspective because listeners out there, I know you've gone through something similar and you're probably looking for, okay, I know the dermatologist knows what they're talking about, but what is the patient perspective? What about somebody else that's actually experienced what I'm going through? And for our healthcare providers, I want you to remind yourself of the human side of why we do what we do, that patients are people and they go through real things. So back on the show today, I'm so excited to have Leah Adams. She's an avid runner, a melanoma survivor, and the daughter of a stage four melanoma warrior. Welcome back to the podcast, Leah.
SPEAKER_02:Thanks, Dr. Trotter, for having me. I'm excited to be back here today.
SPEAKER_01:Well, you shared a lot of words of wisdom with us on our previous podcast where you just talked about your own personal experience with melanoma, but your story is a bit more unique than others, and that you've also had a family member, your dad diagnosed with melanoma. And I think he has a very interesting story for us to be aware of too, because nobody wants to take melanoma for granted, even those early stages, because sometimes it's much more than we anticipate. So I'm really excited to have you here today to really share kind of your perspective on what he went through, and then also talk a bit about what it is like to help care for somebody, watching somebody go through more advanced melanoma as well. So I'm gonna kind of start there. And I know for those of you that heard the other podcast with Leah, you might have heard her mom is a rock star. She needs to be a dermatologist and come to the office because she was not only able to recognize Alicia on her husband, Leah's dad, but also on Leah and helped identify her melanoma. So I want you to take me back to where your mom noticed something on your dad, or maybe something occurred before that that made you suspicious.
SPEAKER_02:Yeah. So my mom back in August of 2019 noticed a suspicious small on my dad's upper back. And it was not looking good. It was oozing, it was pussing, it was pretty large. And at the time, I believe my dad was in his early 60s. Um, so and up until that point, he never went for a skin check. So it was probably time for him to get one. So um my mom made him an appointment, and he went in and he had that mole biopsied, and it came back stage zero in site two melanoma, and um they treated it like an outpatient procedure, wide local excision, and was told to return every six months for skin checks. And not entirely sure if he did that, uh, but that was his first bout of melanoma. And then I had my stage one A melanoma a month after his, so very close together. And then he and I thought that we kind of left melanoma in the history books uh back in 2019. Uh but unfortunately that was not the case because in January of 2021, so we were still kind of in the height of the pandemic and for COVID. Um, my dad was with my mom, thankfully, but they were out on a Saturday morning running errands. And my dad was driving and he had a seizure behind the wheel. And um, luckily, my mom was able to grab the wheel, pull them over, call 911, and he was taken to the closest hospital. They scanned his brain to see what was going on, and his brain scan lit up like a Christmas tree. There were lesions all over his brain. Um, and the hospital he was rushed to, after seeing that, knew that he needed to go to a bigger hospital that was going to be able to accommodate a situation like that. So he was lifelited to another hospital to do more testing and a full body scan. And because they realized, well, if there's things in his brain, there may be other things, other places in his body. And so they did another scan, full body, and then they saw his lungs lit up like a Christmas tree. There were lesions all over his lungs. And before they did any biopsy, they saw those lesions in his lungs. And his doctors at the time were saying these resemble metastatic melanoma in the brain. And once we heard that, we were very shocked and very confused. And as I mentioned, this was in still kind of the height of COVID. I was not able to see my dad because at that time, only one person was allowed to go into the hospital. And that person was my mom. And so hearing all this news, having, you know, her basically being the messenger and reporting it to me, and I was kind of outside of the hospital, and it was just a really crazy time. And so they basically never want to go into the brain unless they absolutely have to. So they did an immediate lung biopsy to take one of the lesions in his lungs, test it, and see what it was. And the results came back stage four metastatic melanoma. And so, kind of putting their speculation of what they saw in the brain and then it matching the results from the lungs. That's when he was deemed stage four metastatic in the brain and lungs with melanoma. And we were all very shocked because, again, like I mentioned, we thought we put this in the history books back in 2019. Um, you know, his situation is um, whenever I tell his story, it's scary for people because a lot of people that have had early stage melanoma, like zero or one, they wonder, oh my goodness, could that, you know, be me over time? And after having a lot of conversations with his doctors, they're pretty confident that since it's very rare for a stage zero in SIT2 to recur and metastasize, they believe that this was two different primary sources of the melanoma that caused this. And so they immediately wanted to get him onto treatment. And so he did seven rounds of gamma knife radiation to the brain to treat the lesions, because the lesions in his brain were all inoperable. So they were all very tiny and scattered. So there was no way surgery would be able to treat that. Um, and then to treat the lesions in his lungs, he was scheduled to do 24 rounds of immunotherapy, four rounds of a combo drug, and then the remainder would be a single-agent drug. And um that was really hard to see his body and him go through that. Um, those drugs and that radiation is very powerful on the human body. And um, you know, I don't think we were totally prepared for that because those drugs are powerful and a lot of people can withstand them, but a lot of people cannot. Some people don't, they can't, their body just can't tolerate it, so they have to stop. Um so my dad got through all seven rounds of gamma knife radiation, and he got through 21 rounds out of the 24 rounds of immunotherapy. And the only reason why they stopped him at the 21 of immunotherapy round is because when you have stage four metastatic melanoma, kind of the routine is every month you go in, you get blood work done, you get a scan, and then they clear you for treatment. Well, they noticed that something was going on in his lungs that wasn't cancer related. It was lung inflammation and fluid building up in his lungs. And they had to try to figure out was this cancer progression or was it a reaction from the immunotherapy drugs? And they were able to do some tests that identified that that was actually coming from the drugs. Um, so his oncologist told us, you know, if we don't stop this treatment now, he's not gonna die from melanoma. He's gonna die from his lungs basically becoming inflamed and filling up with fluid. So his, you know, it was kind of a bittersweet moment because um up until that point he was really responding well to treatment, kind of got bad through all the negative side effects. Um, his body adapted to the treatment. Um, but at the same time, he was so close to finishing, you know, just a couple uh rounds away. Uh but his oncologist felt confident because knowing how many rounds of radiation and how many rounds of immuno he had, and knowing how well he responded, they felt confident saying, you know, we're gonna just pause this year, we'll do every three-month scans and go from there. And that stopped in November of 2022. And to this day, in May of 2025, his cancer is still stable. Um, he now got graduated to every six-month scans. We're hoping to move to once a year soon. But looking at his scans from now to back then, it's incredible what that treatment has done. And no, it hasn't been an easy journey on myself as a daughter or my mom as a wife and a primary caregiver. But we're also just super grateful, you know, that he's still here because I love telling my story and my dad's story because it's a really good learning opportunity for people to understand what melanoma is. My dad and I have had the same cancer. The only difference is that one was caught early and one was not caught early. And that is the seriousness and really speaks to the point of how melanoma is the fastest spreading, deadliest type of skin cancer. So that is my dad's story and everything we've been through with him.
SPEAKER_01:How do you feel like your your dad did? I mean, obviously, I don't know if you had conversations with him, but when you're watching somebody go through it in it, and it's your dad, right? You know, your parents are kind of your heroes, they're a bit invincible, you know, especially when we're younger. And now you see sort of this human vulnerable side to him. How did he deal with a diagnosis? And did he let you kind of help and help him sort of process what was going on and getting better?
SPEAKER_02:It was hard for him because one of the biggest things that was a challenge is when he had the seizure, um, knowing we live in the state of Ohio, and I think it's pretty common in other states as well, uh, you get your license taken away from you because you're not medically deemed to operate a vehicle after having a seizure. And I think the minimum wait time is six months. And so that really impacted him because before his seizure, he was actually an Amazon driver for work. And so melanoma not only impacted his ability to drive, but it also took away his job. And um, you know, my dad, he's like one of those guys where even though I could drive or my mom can drive, whenever we were in the car all together, he wanted to be the one to drive. Like that was like his thing. And um, I think taking that, you know, small act away from him really hit him hard, um, knowing it impacted, you know, his daily routine, it impacted his job, it impacted his financial situation. Um and, you know, not to be sexist, but I think men and women sometimes deal with certain things like that differently. There's something about, you know, you know, when something like that happens to a man versus a woman, like sometimes men can, I think, take it a little harder, you know, because you know, they're the man, they're the man of the house, they're the man to do this. And, you know, my dad couldn't even drive to go get his hair cut. He couldn't drive to the grocery store to pick up, you know, a gallon of milk. Like I drove my dad around and my mom drove him around. And obviously we did it very graciously, but he felt like he was a burden. He felt like, you know, he couldn't do anything. And that played a toll on him, I think, mentally and emotionally, his ego, who he was as a person. Um, and it impacted him a long time. Um and unfortunately, you know, given that he had additional seizure activity past that six-month timeframe, um, he didn't drive for two years. And imagine like us right now, if our license was just taken away from us, like not being able to drive, how much that would impact us? Um, it makes things challenging. And so, again, putting it back to the perspective of melanoma, imagine if a skin cancer could do that to you. That's what melanoma can do to you, you know, if that is how it presents in somebody's brain that causes seizures.
SPEAKER_01:And you're right. I think that's what people just don't think about is what's the impact. You know, you know, okay, cancer, I'm gonna have to go through treatment, you know, I'm gonna have to do surgery, the side effects. But then really, how does it change, you know, your life? I mean, this is a life-altering, you know, diagnosis. And I I think many diagnoses are, but in particular, like you said, this stigma we've talked about, skin cancer, that, you know, it's oh, cut it out and forget about it. And sometimes too, he may have had a little bit of comfort, you know, with that early stage, thinking like, oh yeah, stage your I'm I'm good to go. And nobody thinks lightning strikes twice, right? I mean, although we know if you've had one melanoma your risk for another is significantly higher, and who knows, you know, where they think maybe that was a different primary, how long that could have even been there, you know, and and obviously, you know, him having it spread and become more dangerous. You know, if people are out there caring for somebody, do you have any tips or tricks, you know, to sort of share with them? And you can empathize in a different way, obviously, because you had melanoma, but how to sort of help them process things or be there for support? Did anything, you know, from working with your, you know, or I should say working, taking care of your dad, did it really kind of give you an ability to kind of help people through a more difficult situation?
SPEAKER_02:It really allowed me to practice the skill of empathy because yes, I've had melanoma, but I haven't had that kind of melanoma. And boy, did that open my eyes to what melanoma can do to a person and their body. Um, you know, from a caregiver's perspective, I mean, my mom was really the primary caregiver, and I was kind of the secondary caregiver. I'm an only child, so it's either me or my mom, uh the ones caring for my dad. But I would say that it was really important, I think, for me to meet my dad where he was at. So there would be days where I'd go over there, and I may have had expectations of, oh, maybe he'd want to go, like, I'll take him to go play nine. He's a golfer, he loves to golf, or maybe go to the driving range. And those that first year of him in treatment, I mean, he was kind of like not well. Um, like he wasn't himself, he wouldn't um really feel up to doing much. Even walking around the house would be a lot for him. Um, and so that would be sad, you know, to see a parent like that. But at the end of the day, I always had to remind myself that, you know, that's okay. Like we can watch a television show together, or we can just hang out in the living room. And, you know, it really made me value the little things because I started to learn while being a caregiver to my dad that these little things in life that happen to us, they're really the big things. And, you know, there's some people that may not have a relationship with their dad or may not even have their dad around. But, you know, I would again doing that reframing that I was speaking about in our first episode together, there's really power to that and how you interpret your situation and what happens to you into something that's beneficial that will allow you to kind of move forward with whatever you're going through. Um, something else that I learned as a caregiver is that you can't pour from an empty cup. It is super important to take care of yourself. Um, so you know, as much as there were times where I remember I was training for a marathon the year my dad was going through training. And I remember there were a couple calls on my long runs. I had to log, I think, a 14, 15 mile run. But in mile eight, I got a call that my dad went to the emergency room because of, you know, side effects from his treatment and um trying to not let that interfere with what I was doing or get to me or get me down. And, you know, and again, knowing that um, no, I may have not have finished that mileage or, you know, that I was supposed to run, but I still got out and ran a little bit. And I still, you know, took a little bit of time to myself and did what I loved and know that I'm still working towards a goal. Um, and again, that didn't always come easy. Um, and learning that didn't always come easy, and also reminding my mom to do that too and take care of herself, uh, which I know a lot of moms need that reminder. Um, but that is something I had to learn as a, you know, a daughter taking care of a dad. Um, but yeah, I think it's it's really important to kind of meet the patient where they're at, um, take care of yourself. And also, like, not always talk about cancer. Like, there's other things that we can talk about. Like, I learned that too. Like, I remember when I would see my dad, I'd ask him how he was doing, and then I wouldn't talk about it again. Like, we talk about sports, we talk about the weather, we talk about other things. Because I try to put myself in their shoes. I wouldn't want to talk about cancer the only time I was seeing, you know, my child or parent or what have you. Um, so you know, it again, there's a lot of tips and tricks I can provide, but those are like the really big ones that I learned throughout being a caregiver.
SPEAKER_01:That's a big lesson I think for people to, you know, try to grasp. And it's hard because, you know, you've been this person up to a certain point, right? And then you get a diagnosis. And I think too many people let it define them, you know, and and some people embrace that, thinking that it's a healthy approach. And I think I would agree with you on kind of what you're saying that, you know, it's a part of who you are, but it doesn't necessarily define you. You don't necessarily let the cancer or melanoma define you. You know, what's a part of it's a part of you and what's happened, but what defines you is how you handle it, how you process it, how maybe you mold it or help it evolve into something more positive for yourself or for others, just like you and it sounds like your dad have been able to do. But not that that's um an easy task, I think, for most people, because it obviously is going to be dominating for your thoughts and your mind. And so I think that can be a challenge for anyone, but great advice to try to use it in a way that, like you said, you know, I doesn't necessarily, you know, become a def definite part of who they are from the standpoint that that's all you talk about. You know, you're so much more than that. And people need to be reminded of that. I think that's healthy and a part of the healing process. As both you and your dad have gone through that healing process, one of the things I wanted to ask you, especially for healthcare providers that listen, we have dermatologists, family medicine docs, pediatricians, MPs, PAs in Durham, other specialties that have helped deliver the news of a melanoma diagnosis or maybe something more advanced, you know, that's going on with the patient if it's, you know, a more serious melanoma. What's your feedback or experience been like? I think the good, the bad, and the ugly, because we need to know, I think, as providers out there that we're delivering this in a useful way for patients with compassion, with accurate information. So I wanted to get a little bit of kind of your side of how, both for you and dad, if you can recall, how did that go? And what would you tell somebody out there that's getting ready to call a patient, maybe tonight or later today with a diagnosis of melanoma? How do you help them through that?
SPEAKER_02:I think from an early stage perspective, um, for me, I would like to be treated like any other stage cancer patient and um, you know, have my dermatologist or provider ask me if I have questions, you know, do I understand any, you know, thoughts, concerns, you know, feelings come to mind, um, and maybe provide resources, you know, to work through what just happened to me, uh, you know, getting a cancer diagnosis and especially one that's melanoma, that at the time, you know, that person may not know where to go, you know, to provide or to receive resources. Um, so that's something that I wish I had, even though I was, you know, stage one, I would have loved to know if there was like maybe like a younger adults group, support group I could have maybe got involved with, because at the time of my melanoma, the only person I knew was my dad who had stage zero a month before me. And it would have been nice to kind of find community with people that were maybe around my age with a similar stage. Um, and then as far as my dad's experience, um, you know, again, during the height of COVID, I actually wasn't there when my dad received the results. But what I did see were those appointments that went really well with my dad's doctors and his team. And I will say the most memorable appointments were the ones where the oncologist answered every single question. Like I remember some of them, if my dad didn't understand things, they'd get out a piece of paper and draw a diagram and say, like, does this make sense? Like, do you understand this? And just we just felt really secure and felt really reassured. And the fact that we didn't feel like we were being rushed out of that room. Like there were times where they really took the time to talk to patients. And I know that's not always the case because I get it, there's a ton of cancer patients, and you all have a very limited time frame to get through all those patients. But I will say the most memorable were the ones that took the time to meet my dad where he was at, as far as like comprehending treatment or comprehending scans. And um, that really meant a lot to us because, you know, yes, you're dealing with a cancer diagnosis, but a lot of this stuff, it's a lot to process and take in. And especially if you add like medical terminology on top of that, where like I get test results sometimes and I don't even know what I'm reading. It's hard to interpret, you know? And then looking at my dad's scans, I mean, that's like reading a different language, you know. So I remember just those experiences with my dad's doctors who are still like that, you know, every six months. We just see them less now. They're still lovely. And um, you know, we really appreciate that because you talked about this before, Dr. Trotter. We want to be treated like we're human. And it was the doctors that really kind of put themselves in our shoes that really made us feel um okay when maybe things weren't okay, but we had their support and we had their reassurance, and that meant the world to us.
SPEAKER_01:Well, and I think we forget that sometimes, you know, when we're we are rushed, you're right. There's, you know, we're worried about, oh gosh, we're running so many minutes behind, or there's a patient next door, and you forget sometimes to just really focus and listen, you know, to that patient and give them the time. I will say, particularly in dermatology, we can be guilty of it. We are a faster-paced specialty. And sometimes, you know, you need to stop and take that breath and ground yourself and realize this is a little bit different patient that I'm about ready to walk into or talk to or maybe do their skin exam and not to discredit, you know, somebody who might have a wart next door and it's driving them crazy, right? But at the same point, when you have somebody with melanoma, you know, to really give them an understanding that you're really here for them and to remind them that, you know, even though you may not have all the answers, you're gonna help them through the process and you know, do the best skin check you can, especially on the derm side, but just to deliver, I think you said that time and attention. Even when we don't know the answers or something's not right, boy, does that just go the extra mile? You know, I think that's what people want. They want that time. And sometimes we can forget to do that. So in the derm climate, it can be a little difficult, I know. And you've probably seen this at dermatology offices. Um, and so it's a challenge, but I think we can rise to it to really help our patients and really make a difference for them, especially when they carry a melanoma diagnosis. Now, I apologize. We are running out of time already again. So I I want to thank you so much for sharing, though, the story of your dad and being a caregiver, how you can help us out there as you know, it's on the forefront of trying to diagnose melanoma and help with early management and get people to the right place. For our listeners out there, Leah, if they want to try to track you down, where can they find you online?
SPEAKER_02:Yeah, the best place to find me online is Instagram, and I can be found at the Leah Alexis. And you can follow my journey with melanoma, my running journey, as well as my dad's journey on there.
SPEAKER_01:Thank you so much for sharing. And thanks again for coming on. Um, it's really brave of you to share, you know, you know, this experience. You know, I'm a private person, so it's hard for me to come on. I really appreciate people that are willing to put themselves out there and to help others. So thank you again for coming on the podcast.
SPEAKER_02:Well, thanks for having me, Dr. Trotter. It's been a pleasure.
SPEAKER_01:Of course. And stay tuned for the next episode of Dermot Trotter. Don't swear about skincare.
SPEAKER_00:Thanks for listening to Dermot Trotter. For more about skincare, visit dermittrotter.com. Don't forget to subscribe, leave a review, and share this podcast with anyone who needs a little skincare sanity. Until next time, stay skin smart.
