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Life on the farm carries its fair share of risks.
Among them is skin cancer from too much exposure to the sun.
Carolyn Schneider, who spends many hours outdoors helping her husband run the family farm, has thought about those risks, especially on really hot, intense days.
“I’ve always worn sunscreen,” she says. “You really have to be careful.”
Despite the precautions, Schneider, 47, was surprised and apprehensive last fall when a suspicious lesion developed at a mole site on her back.
She immediately made an appointment with Mark Cleveland, MD, a dermatologist at the Great River Medical Center in Burlington.
“As soon as he saw it, he said, ‘Yep, that’s melanoma (a malignant skin cancer),’” Schneider says.
Cleveland removed as much of the lesion as he could, then referred Schneider to specialists at the Pappajohn Clinical Cancer Center, located in the Holden Comprehensive Cancer Center at The University of Iowa.
During an initial visit with UI surgical oncologist James Howe, MD, Schneider underwent a thorough evaluation that included a scan by positron emission tomography (P.E.T.).
P.E.T. is a non-invasive imaging technology that uses radioactivity emitted from injected tracer chemicals to measure and image biological activity. Doctors use the technology to see whether the cancer has spread, and where.
In Schneider’s case, the P.E.T. scan showed cancerous activity in a lymph node, under her right arm, in her right breast, and in her thyroid.
“You’re kind of in a daze at that point,” she says. “I was shocked.”
Biopsies revealed a right breast cancer that had spread to the lymph node under her arm, and possible cancer of the thyroid.
After long discussions among the surgeons and other members of the health care team, Schneider underwent a four-hour procedure performed by Howe and fellow UI surgical oncologist Carol Scott-Conner, MD, PhD. Howe successfully removed the melanoma while Scott-Conner removed the right breast and armpit lymph nodes.
Treatment for the thyroid was deferred because the other cancers were deemed more urgent. Schneider spent one night in the hospital.
After completing chemotherapy with UI breast medical oncologist Mark Karwal, MD, in January 2008, Schneider underwent a second procedure in March (performed by Dr. Howe) for removal of her thyroid, which revealed cancer.
During recovery, she found that climbing on and off the tractor was an effective form of physical therapy for her arm and back. “It really helps!” she says.
There has been no further evidence of cancer. Schneider has resumed her busy life. She and husband, Dale, farm 400 acres of corn and soybeans, and raise cattle on a farm located near Wapello, Iowa.
“I feel great,” she says. “I do have to take some medication for my thyroid but otherwise I’m fine.”
Melanoma
- Highly malignant
- Treatable when caught early
- Can vary in color (not just black)
- Becoming more common
- Diagnoses has doubled in past 30 years
For questions about cancer, people should cal the University of Iowa Cancer Information Service at 319-356-3000 or 800-237-1225, or e-mail cancer-information@uiowa.edu.
For more information about cancer care at UI Hospitals and Clinics, patients and family members should call UI Health Access at 319-384-8442 or 800-777-8442 and ask for the Holden Comprehensive Cancer Center Clinic, or call the Clinic at 319-356-4422. More information also is available at www.uihealthcare.com/cancercenter.
For consultation or referral, physicians should call UI Consult at 319-384-8008 or 800-322-8442.
—Michael Sondergard
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