Boy, 15, with advanced melanoma recalls early symptom that doctors said was a sign of puberty

Before a wrestling tournament in early 2020, Samuel Gee, then 15, underwent a skin check to make sure he didn’t have ringworm that could spread to others. During the inspection, a referee pointed something out to Gee. 

“They’re like, ‘What’s that?’ I was like, ‘I don’t know. It’s just a spot I had since I was little,’” Gee, now 19, a biomedical engineering student at Texas A&M, tells TODAY.com. “They were like, ‘Well, we’ll let you wrestle this time, but you have to get it checked out.’” 

Gee visited a dermatologist and learned that the mole was cancerous. Soon after he was diagnosed with Stage 3 melanoma. 

“I was definitely surprised,” he says. “I was in shock.” 

A changing spot

While Gee had the mark on his back for as long as he could remember, it started to look different in the months before the wrestling tournament.

“It almost looked like it was drying out,” he says. “I had the mole ever since I was young, but over the years it gradually (became) raised.” 

Still, he thought little of it. At the time, he was grappling with another unusual health change. About a month prior to tournament, Gee noticed a puffy bump in his upper right leg.  

“I had some serious swelling,” he says. “I thought it was an inguinal hernia.”

Inguinal hernias occur when part of the intestine pokes through the abdomen near the groin and can look like a bump, according to the . A visit with a pediatric surgeon revealed what it was. 

“He was like, ‘It’s not a inguinal hernia, but likely a swollen lymph node,’” Gee recalls. “He’s like, ‘It’s just from puberty. … Come back in a few weeks if it hasn’t gone away.’” 

Gee then visited a doctor about the mole and underwent a biopsy, which revealed that he had melanoma. It had spread locally, causing the swollen lymph node in his leg. Doctors considered Mohs surgery, where skin is cut away layer by layer to remove the cancer with clear margins, but Gee needed immunotherapy first. 

At the same time, school moved online as the COVID-19 pandemic shutdowns had begun. That helped Gee manage some of the symptoms he experienced from immunotherapy. 

“I would get fatigued a little bit. It would make me nauseous,” he says. “It was a very day-to-day thing. Some days I would feel fantastic. Some days I would feel like I needed to throw up or I was really tired.” 

In January 2021, Gee underwent surgery and had the melanoma and lymph nodes removed. Following surgery, he completed several more rounds of immunotherapy before he finished treatment. 

“I was disease free,” he says. “That was when they said, ‘OK you’re cured.’” 

Melanoma 

Melanoma occurs most often in “older white males,” and the average age of a patient with metastatic melanoma is in their 60s, says Dr. Hussein Tawbi. But it does occur in younger populations. 

“The No. 1 cause of cancer in women between age 30-40 is melanoma, for instance,” Tawbi, director of personalized cancer therapy in the department of melanoma medical oncology in the division of cancer medicine at the University of Texas MD Anderson Cancer center, tells TODAY.com.

But “pediatric melanoma is relatively rare," he adds.

People often develop skin cancer, including melanoma, because of sun exposure. Tawbi urges people to start using sunscreen regularly in childhood, as sun exposure in adolescence and young adulthood increases the risk of metastatic melanoma later in life.

“It’s a very direct relationship between sun exposure and a higher incidence of melanoma,” he says. "We do recommend people to start using sunscreen as early as possible.” 

He also urges people to undergo regular visits to a dermatologist to undergo skin checks. 

“Early diagnosis is still key,” Tawbi says. “If you find the melanoma early enough, it is still largely curable with surgery alone.” 

Experts talk about the ABCDEs of skin cancer to help assess if a mole or mark on the skin is cause for concern. Any of these qualities should prompt a visit to the doctor:

• A: Asymmetry, when a mole doesn’t appear the same on both sides
• B: Border, when the outside of the mole looks jagged or uneven
• C: Color, when the hue of the mole changes, becoming lighter, darker, white, red or blue 
• D: Diameter, when a mole is larger than the size of a pencil eraser 
• E: Evolution, when a mole changes or appears to be different 

Surgery can cure 95-99% of early melanomas, Tawbi notes. For those who have advanced stage melanomas, either Stage 3 or 4, immunotherapies can often extend lives. Since about 2010, checkpoint inhibitor immunotherapy — a type of treatment that uses the body’s immune system to better fight cancer — have transformed melanoma treatment. 

“(They've) absolutely changed everything and started resulting for long-term survival for patients,” Tawbi says. “The survival for melanoma has actually increased by 10-fold.” 

Before checkpoint inhibitors, the median survival time for metastatic melanomas like Gee's was seven months. Now it is 72 months, he adds.

“That’s pretty pretty impressive,” he says. “The only way we got patients to have better survival rates in the last 10 years has been purely through research.”

"Total sunscreen freak"

Before being diagnosed with cancer, Gee thought he would pursue electrical engineering or computer science. After his experience as a patient and seeing how technology improves medicine, he’s majoring in biomedical engineering. 

“Seeing all those cool machines and wanting to make those threw me into biomed engineering,” he says. 

Today, he’s a “total sunscreen freak."

“I’m all about the sunscreen now,” he says. “I hope people will start wearing their sunscreen. … That’s really what I want to get across is wear sunscreen, don’t tan on purpose.” 

Gee also hopes his story helps other young men with melanoma feel less isolated. 

“You really don’t see that too much. When I was first getting started, they were surprised. They didn’t know what doctor to put me with. You just don’t see it,” he says. “It’s so rare for … adolescent males to get melanoma and it can be stressful.” 

Having cancer at a young age provided Gee with new insight into what’s important. 

“I’ve got a new perspective on life,” he says. “It’s very important that we take care of ourselves, and I think a lot of young people neglect that.”

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