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Stephanie's Story

Stephanie Schaefer discovers melanoma spot after interview at Ellis Fischel Cancer Center

In the summer of 2007, KMIZ-TV health reporter Stephanie Schaefer was doing a report on how viewers could spot skin cancer and ways they could prevent it.

For her story, she interviewed Paul Dale, MD, a surgical oncologist at Ellis Fischel Cancer Center.

Stephanie Schaefer listens to story pitches during a news meeting at KMIZ-TV.
On camera, Dale described the signs of melanoma, a deadly form of skin cancer that becomes more common as you age but can strike at nearly any age.

Melanoma, he explained, usually presents itself as a mole with an irregular border and color, which can change shape and itch.

That night, Schaefer told her husband about the story and a spot that concerned her on her left thigh. It was a slightly raised, reddish brown spot about the size of a pencil eraser.

She had first spotted it while on her honeymoon a couple of years earlier. And recently, it had begun to itch a little.

"It looked almost like a blister," she said. "It had never concerned me too much because it was perfectly round, and you always hear about how you should look for an irregular shape. But, it worried me that it itched."

Schaefer was pregnant at the time and waited to have the spot checked out shortly after her son, Spencer, was born in July.

The spot was biopsied and tested positive for melanoma. At age 32, Schaefer became a mother and a cancer patient.

Schaefer meets with Paul Dale, MD, for a regular checkup. She will have to keep a close watch on her skin for the rest of her life.

Even though she had an inkling it might be cancer, the diagnosis was shocking.

Simply, Schaefer did not believe she was at risk to develop skin cancer.

The journalist grew up in St. Louis and doesn't remember getting bad sunburns.

Although she and her sister went to the pool regularly during the summer, they usually put on sunscreen. She had used tanning beds on a handful of occasions for special events, but doing so was rare.

And, unlike her fair sister, Schaefer has olive skin.

"If anyone in our family was to get this, you would have thought it would have been my sister. She's the one who would burn, not me."

Curable if caught early

Melanoma is an increasingly common cancer, said Dale, who is the Margaret Proctor Mulligan Distinguished Professor in Medical Research, chief of surgical oncology and director of the Margaret Proctor Mulligan Breast Health and Research Program. In 1935, about one in 1,500 people would develop the cancer in their lifetime, he said. Now the  number is roughly one in 60.

Dale said the rapid increase is likely due to increased sun exposure, the No. 1 risk factor for developing melanoma.

Having fair skin and light eyes, a family history of melanoma and living in a Sun Belt state also puts one at increased risk.

Michael Nicholl, MD, also a surgical oncologist at Ellis Fischel, said melanoma is relatively easy to treat if it's caught early.

"In the early stage of the disease, most patients are cured after they undergo surgery," Nicholl said.

Unlike other types of cancer, melanoma often doesn't respond to chemotherapy and radiation. And, unlike other types of skin cancer, melanoma often spreads quickly. At Ellis Fischel, research is under way to find better ways to diagnose and treat melanoma. For example, Dale has partnered with scientists at the University of Missouri to develop a way to identify cancer cells that circulate in the bloodstream with the use of photoacoustics.

The technology uses lasers, sound and light to find skin cancer cells in a vial of blood. Additionally, clinical trials are available for patients to receive new drugs to determine if they are more effective than standard treatments for melanoma.

Still, researchers know that finding the cancer early is one's best defense.

"Any spot that itches or bleeds or seems to be growing rapidly should be a warning sign," Nicholl said. "Also, if you have freckles, look for spots that don't look like the others."

After surgery, no more signs of cancer for Schaefer

When she learned she had melanoma, Schaefer, now 34 and an anchor at KMIZTV, made an appointment to see Dale - this time as a patient.

Because the lymph nodes are the first place melanoma spreads, Schaefer had a sentinel node biopsy from her groin. The test was negative, meaning there was no evidence the cancer had spread.

To make sure all the cancer was removed, Dale performed what is called a wide local excision, in which he removed several inches of skin around the area where the mole developed.

Schaefer said her surgery went well, and she has a well of gratitude toward Dale and the rest of the Ellis Fischel staff.

"I feel like I had the best doctor taking care of me," she said.

For the past two years, all of her tests have been good and Schaefer is cautiously optimistic about her health.

"I won't go so far as to say I don't have it," she said. "I say it's been two years since I've shown any sign of it."

Dale said her prognosis is quite good.

Now she meets regularly with Dale and a dermatologist to have her skin monitored, something she will do for the rest of her life.

"Now when I have a new spot that shows up, I call and get in right away," she said. "I don't take a chance."

She also has become diligent about applying sunscreen every day - even on cloudy days. Her son and husband also wear it daily, and when they're out in the sun, everyone dons a hat.

Additionally, she has encouraged her sister and other family members to get their skin checked out, and she doesn't hesitate to nag co-workers to put on sunscreen before going out on assignments.

"There's no excuse not to use it," she said of sunscreen. "I'm a person who likes to be outside, and we still spend time outdoors. But, you have to be responsible about it. It's just not worth the risk to try to get a tan."

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