During seventh-grade gym class, Ruth Garcia remembers a friend pointing out a black mole she had on her left knee. Ruth didn’t think much about it until two years ago, when she began to feel pain in her knee and noticed that the mole had grown and changed colors to gray and red.
“That’s when I started to worry more,” said Ruth, now 17.
In spring 2016, Ruth’s mother took her to see her primary care provider near the family’s home in Walla Walla, Washington. They did a biopsy on the mole, and she was diagnosed with spitzoid melanoma. Ruth was referred to Seattle Children’s Cancer and Blood Disorders Center.
A child born in the U.S. has about a one in 40 chance of developing melanoma during their lifetime. Seattle Children’s sees about six children a year who were either misclassified with melanoma or have spitzoid melanoma. The cause of spitzoid melanoma is unknown.
“I was surprised,” said Ruth. “I never thought something like that would happen to me.”
Removing the melanoma
At Seattle Children’s, Ruth learned that the melanoma reached from her knee, the origin of her tumor, to her pelvic area, which was where the cancer cells were most likely to spread.
In June 2016, Dr. Kenneth Gow, an attending surgeon in the Division of Pediatric General and Thoracic Surgery at Seattle Children’s, removed a spitzoid melanoma from both the inside of Ruth’s left knee and her pelvic area.
“In the past, some argued that spitzoid melanoma is the same as a malignant melanoma, which tends to be very aggressive, spreads to lymph nodes and usually requires chemotherapy,” said Gow. “Now, we usually consider spitzoid to be a less aggressive form, and so we remove the lesion as well as some of the skin around it to ensure the melanoma has been removed.”
Soon after the successful surgery, Ruth was back to normal, with no pain in her leg.
Throughout the next few months, Ruth had frequent follow-up appointments with Gow at Seattle Children’s Tri-Cities Clinic, which is located in Richland.
Because Ruth’s parents are Spanish-speaking, the family found Seattle Children’s interpreter services to be vital during appointments.
“Interpreters do a great job and are much needed because we have a large Spanish-speaking population in the Tri-Cities area,” said Gow.
Follow-up care without the long drives
Ruth continues to have annual appointments at the Tri-Cities Clinic to ensure the melanoma doesn’t come back. Gow travels to the clinic to see Ruth for her exams, which means her family does not have to drive four hours to Seattle and back.
“I am glad we can just go to Tri-Cities for my follow-up appointments because it makes it a lot easier for my parents,” said Ruth. “Dr. Gow checks to see if anything has changed. Hearing him say that everything is fine is really great.”
Gow, who travels to the Tri-Cities Clinic once a month, is passionate about seeing patients in their communities to make it easier and less expensive for families.
“In the Tri-Cities, we see a lot of families who are working hard just to make ends meet,” said Gow. “If we can go out to the communities and see kids and families where they are, we’re essentially saving them a day of travel, at the minimum.”
Amy Taylor, nurse manager at the Tri-Cities Clinic, also strives to help patients be able to get the care they need as close to their home as possible.
“We want families in the Tri-Cities area to receive the same service they would receive if they went to our Seattle campus,” said Taylor. “If we can prevent families from driving over the pass and missing school or work, that enhances their quality of life. Our goal is to have the illness of the child be the least impactful to a family’s life as possible.”
With her follow-up visits close to home, Ruth has more time for the activities she loves, like photography, reading and making plans for the future. Currently a high school senior, Ruth hopes to get her associate’s degree after graduation and join a police academy to train to be an officer.
“Ruth is doing great,” said Gow. “She recovered well from her surgery and is essentially back to her regular activities. The best part of my job is making sure kids get to do what they want to do in life.”
“I’m glad that I can take trips and do photography without worrying that the melanoma will come back,” said Ruth. “Now, I’m pretty much back to normal.”