An Unexpected Diagnosis – the Risks of Underestimating Non-Melanoma Skin Cancer

James Whelan is a performer. As a lifelong musician, he has spent most of his life writing music in his studio or out performing for a crowd. But a life devoted to art came to a screeching halt with a startling and sudden diagnosis: a skin cancer called cutaneous squamous cell carcinoma (CSCC). A skin cancer he’d never even thought to look for, or even heard of.

The second most common form of cancer in the U.S., CSCC is nearly five times more prevalent than melanoma. Yet, according to a survey from The Skin Cancer Foundation, nearly 3 out of 4 Americans are not familiar with it.

An Unexpected Diagnosis

CSCC doesn’t always look scary. It can present in many different forms, including a rough or scaly red patch, an open sore, or even thickened or raised skin.

And James’ diagnosis with advanced CSCC doesn’t sound like your average skin cancer story. He didn’t have a history of having suspicious spots removed from his skin or visiting the dermatologist for skin checks.

“I was actually in the emergency room being treated for a persistent fever,” James remembers. “There was this spot on my shoulder that started out looking like an infected pimple, and by the time I reached the hospital it had split open. Since it had been there for a while, I thought it had something to do with my fever.”

But when doctors examined it, the presumed split open “infected pimple” turned out to be much more. It was skin cancer, they said, and it had spread into his shoulder and through his chest wall. Before he even left the hospital, James was diagnosed with advanced CSCC, and underwent surgery to remove it.

Although often cured when caught at an early stage, CSCC can progress and become dangerous when advanced. In the U.S., approximately 40,000 cases each year will progress to advanced stages, but, according to The Skin Cancer Foundation survey, less than 30% of Americans know that CSCC can be life-threatening when advanced.

A Journey with Advanced CSCC

James’ surgery was extensive and required the removal of part of his abdominal muscle, but doctors still couldn’t get the entire tumor without damaging the nerves that controlled his fingers and arm. He underwent multiple rounds of radiation to eradicate what was left of the cancer in his shoulder, and he had to stop playing guitar until he was able to regain his strength, adjust to the loss of stomach muscle, and teach himself how to play again.

“It was torture,” he recalls.

While the surgery and radiation worked for a period of time, the cancer started to return after several treatments, and at the urging of his doctor, James finally had to seek support from a whole team of different kinds of doctors that could help him with a treatment plan.

The shift felt almost instantaneous.

“Immediately I felt like this was a whole different ball game,” James remembers. “The breadth of treatments, the depth of specialists — it’s what you need.”

The first one of those treatments discussed was a radical surgery. But it wasn’t an option for James.

“I overheard doctors mention removing my arm, and I’m a guitar player. So the idea of losing an arm was crazy,” he says. “All of a sudden your mind runs away, and I’m sitting there thinking, ‘Well, would I just give away or sell off all my guitars? Would I be able to play piano right-handed?’ I couldn’t do it.”

He worked with his team of doctors to find a treatment plan that worked for him.

Today, James has returned to his music, including the guitar, and is grateful for that. He knows how important it is to have a team of doctors by your side, exploring all possible treatment options when CSCC becomes advanced.

This summer, learn about CSCC, including how it can advance and when you should talk to your doctor. Visit The Skin Cancer Foundation’s website to learn more.