Fitted Genes

Genetics are a risk factor for recurrent melanoma.

Brooklyn, New York native Dennis Piaseczny spent 25 years teaching business classes in high schools and business schools throughout New York City. In 1994, he retired and moved to Florida. In 2016, he was blindsided by a horrifying discovery.

Alina Collins, ARNP, at Blue Ocean Dermatology in Port Orange treated Dennis Piaseczny for recurrent melanoma on his shoulder.

Dennis Piaseczny

“I went to my primary doctor, and she had me take off my shirt to examine me,” shares Dennis. “She spotted something unusual on my left shoulder and told me I should see a dermatologist right away.

“I didn’t have any pain and didn’t know anything was on my shoulder. Nobody looks at their shoulders anyway. I was quite startled when my doctor found that spot.

“I wasn’t going to a dermatologist at the time, so my doctor recommended Blue Ocean Dermatology. I immediately called for an appointment, and there I met Alina Collins.”

Alina Collins, ARNP, is a registered nurse practitioner who specializes in dermatology at Blue Ocean Dermatology in Port Orange. Also on the clinical staff at Blue Ocean are Jason L. Welch, MSN, NP-C, and Nitra H. Welch, MSN, NP-C, who are also certified nurse practitioners specializing in dermatology; and Lawrence G. Blasik, Jr., MD, a physician who is board certified in both dermatology and internal medicine.

“Alina took a biopsy of the spot on my shoulder and said she’d get back to me in a week,” says Dennis. “But she called me the next day and said it looked serious. She told me I should call a surgeon to have it removed right away. It turned out to be invasive melanoma.

“I had the surgery a few days later. The surgeon told me the cancer was headed toward my heart and I could’ve died, so that biopsy and immediate action from Alina saved my life.”

“Dennis’ lesion was an amelanotic melanoma,” describes Alina. “Generally, melanoma arises in a dark mole, but it can be skin colored, like a bump on the skin. Or, it can be red, purple or white. Amelanotic simply means there’s no melanin involved. Melanin is the substance that gives skin its dark color.

“Dennis had a skin-colored lesion. It simply looked unusual and out of place on his shoulder, which is why we biopsied it.”

Genetic Inclination

When melanoma is diagnosed, it is assigned a level of severity, one through four. The level is based on the depth of cancer penetration and whether or not the cancer has spread to the patient’s nearby lymph nodes.

“Initially, Dennis was a level three, which means his cancer was pretty deep, but it hadn’t spread to his lymph nodes,” notes Alina. “About a year later, he had another lesion arise on the same shoulder, then it happened again. After his third melanoma, he saw an oncologist.”

“This melanoma became malignant but hasn’t metastasized, or spread beyond my shoulder,” reports Dennis. “I just started immunotherapy at the hospital. The staff opened a port in my chest where they drip medicine that uses my own immune system to counteract cancer cells.”

“Dennis appears to be genetically inclined to develop melanoma,” asserts Alina. “We’ll use immunotherapy to kill cancerous cells in the area, as well as those that are predisposed to develop this cancer in the future.”

Genetics and a family history are risk factors for melanoma, but there are others, explains Alina. They include extensive sun exposure, particularly if there are many sunburns; multiple moles on the body; fair skin, especially with light eyes, freckles and red hair, and immunosuppression, such as with organ recipients and chronic steroid users.”

Alina Collins, ARNP, at Blue Ocean Dermatology in Port Orange treated Dennis Piaseczny for recurrent melanoma on his shoulder.

“The surgeon told me the cancer was headed toward my heart and I could’ve died, so that biopsy and immediate action from Alina saved my life.” – Dennis

In addition, there’s a genetic mutation, called the BRAF mutation, that’s been found to put people who have it at a much higher risk for developing melanoma. Fortunately, there are very promising treatments for melanoma in those who possess this mutation.

“People who have any of these risk factors should get routine skin exams by a dermatologist to look for precancerous changes on their skin,” stresses Alina. “Anything that looks suspicious can be biopsied and removed before it has a chance to develop into cancer.”

In Good Hands

After his surgery to remove the melanoma, Dennis visits Alina at Blue Ocean Dermatology regularly. She closely examines the multiple moles on his back for precancerous changes. She also helps Dennis coordinate his ongoing treatment.

“Alina’s been the focal point of everything that’s going on with my cancer and my moles,” he states. “She stays on top of the situation and organizes everything. She keeps in touch with my surgeon and oncologist, and sends out reports on what’s going on with me.

“Alina keeps up with what’s going on with my shoulder because mine is a very aggressive melanoma. She’s the fulcrum of the whole treatment process. I feel I’m in good hands.”

Dennis has help at home as well from two friends, Linda and John. Linda cares for the moles on his back, which he can’t reach himself. She washes and puts clean bandages on them. John drives Dennis to his doctor and hospital appointments.

“With Alina at Blue Ocean Dermatology and Linda and John at home, I’ve got a great supporting cast working for my cancer survival,” he relates. “I’m truly blessed!”

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    • Blue Ocean Dermatology

      Blue Ocean Dermatology provides outstanding medical and aesthetic dermatology to people of all ages. All services are performed with integrity and honesty, and with high regard to humane concerns.... Read More

    • Lawrence G. Blasik, Jr., MD

      Lawrence G. Blasik, Jr., MD, earned his undergraduate degree from Valparaiso University in Valparaiso, IN. He was awarded his medical degree from the University of Illinois College of Medicine in Chicago. Dr. Blasik is board certified in dermat... Read More

    • Nitra H. Welch, MSN, NP-C

      Nitra H. Welch, MSN, NP-C, received her Bachelor of Science degree in Nursing from Troy State University in Troy, AL. She was an ICU nurse for eight years. She earned her Master of Science degree in Nursing and her family nurse practi... Read More

    • Jason L. Welch, MSN, NP-C

      Jason L. Welch, MSN, NP-C, received his Bachelor of Science degree in Nursing from Florida State University in Tallahassee.  He was an ICU nurse for seven years. He earned his Master of Science degree in Nursing and family nurse pract... Read More

    • Alina Collins, ARNP

      Alina Collins, ARNP, received her Bachelor’s degree from Walsh University in North Canton, Ohio and her Master’s degree in Nursing from the University of Central Florida in Orlando. Prior to earning her Master’s degree, she worked as a registere... Read More