Together Every Step of the Way

A melanoma diagnosis just months before their wedding would be a challenge for any couple, but the Surgical Oncology team worked with both Joel Boehm and his fiancée throughout the entire treatment process

Reviewed by: Joel Boehm, Alex B. Haynes, MD, MPH, FACS, and Emily McLeod, MSN, APRN, ACNS-BC, ACHPN
Written by: Lauren Schneider

Joel Boehm, Katelyn Marak, and another couple stand on a boulder in hiking gear. Trees can be seen behind them far into the horizon.

While there’s no good time for a melanoma diagnosis, when Joel Boehm received his diagnosis earlier this summer, the timing could not possibly have been worse. The alumnus of The University of Texas at Austin School of Law is set to marry his fiancée, Katelyn Marak, this November.

At first, the couple was worried about the emotional toll of Joel’s illness, particularly at this critical time in their relationship.

“We heard from a lot of folks that it’s often harder on the partner and family members of somebody dealing with diagnoses like these than it is on the patient themself,” says Joel. “It’s a step removed from the physical fallout, but the emotional and psychological impact can be even greater on the folks who are in the inner circle of the patient.”

In addition to treating Joel’s melanoma, UT Health Austin practitioners kept Katelyn involved at every stage of his health journey, allowing the couple to face the challenge together.

Clarity and Reassurance

Joel first noticed that a mole on his body had become inflamed shortly before Memorial Day weekend. When a visit to the dermatologist confirmed the presence of a melanoma, he was referred to Alex B. Haynes, MD, a surgical oncologist at the Surgical Oncology Clinic within the Livestrong Cancer Institutes at UT Health Austin.

At this first appointment, Dr. Haynes initiated a plan to surgically remove Joel’s melanoma. The team then obtained a PET scan of his body and an MRI of his brain to determine whether the cancer had spread.

Joel describes this first experience with Dr. Haynes as “very reassuring, very positive,” praising the clarity with which the team communicated the next steps in his treatment as well as the likely outcomes.

Whole-Person Cancer Treatment

After the initial diagnosis and treatment, Joel and his fiancée shared apprehension about his treatment journey. The couple met with Emily McLeod, MSN, an advanced practice nurse in the Livestrong Cancer Institutes who specializes in palliative care, to address these concerns.

“Palliative care is focused providing relief from symptoms, and from the stress of an illness,” she explains. “The goal is to improve quality of life for the patient and the family. A big part of my role is managing physical symptoms, but I also address emotional, psychosocial, [and] spiritual needs and concerns.”

McLeod welcomes those who wish to be involved in their loved one’s cancer journey.“ Those types of care partners can provide perspective about how things are going outside of clinic visits, which can have a positive impact on overall care and our ability to address needs and issues as they arise.”

A “Straightforward” Surgical Experience

In late June, Dr. Haynes performed what he calls the “definitive treatment” of melanoma. Known as a wide excision, the surgery involved, “removing a safety margin around the area of Joel’s melanoma.”

The excision was carried out at the Ambulatory Surgery Center (ASC), a facility at UT Health Austin devoted to outpatient surgical care.

Joel speaks highly of his experiences at the ASC. “I was given very clear instructions about where to be and when to be there, what the cost would be based on my insurance, and all the rest. It was all very straightforward.”

“I think my fiancée also walked away super-impressed with how they handled everything,” Joel adds.

Moving Forward

Along with the wide excision, Dr. Haynes performed a sentinel lymph node biopsy at the ASC to evaluate the extent to which Joel’s cancer had spread. Lymph nodes are small bean-shaped structures located throughout the body. Part of the immune system, lymph nodes help the body fight infection and disease. Because they are natural filters, testing a piece of a lymph node can detect any cancer cells they capture.

There was no sign of melanoma at the original disease site, or in most of the lymph nodes sampled; but two lymph nodes showed very small amounts of disease spread.

Joel travelled to MD Anderson Cancer Center in early August for consideration of adjuvant treatment to reduce the risk of his melanoma recurring. “The doctors at MD Anderson reconfirmed what the initial prognosis had been from the folks here in Austin,” he says. “We feel like my health is in a good place.”

Meeting Every Patient’s Need

According to Dr. Haynes, Joel’s case is not unusual from a clinical perspective, but it illustrates how the Livestrong Cancer Institutes addresses a current gap in cancer treatment for young adults. He notes that most services are tailored towards either the needs of people over sixty, who are more likely to develop cancer, or the pediatric population.

McLeod notes that a cancer diagnosis can be acutely painful for the young adult population as they must rely on others at a time when they would hope to be making important strides in establishing their own family and career.

“Our clinic is particularly attuned to the critical needs of young people with cancer,” Dr. Haynes says. “People who are starting their families, who are thinking about reproductive health, thinking ‘How do I plan for my future?’”

For these patients, “the kind of support that the CaLM model provides is really important beyond simply giving the right surgery, giving the right treatment, doing the right tests,” says Dr. Haynes.

Joel says that this model is the perfect fit for him and his fiancée. “We think about health holistically instead of strictly in terms of lab results and things like that,” he explains. “Being attuned to that, we wanted to be proactive in working with [practitioners] that are trained in providing counseling and coping mechanisms.”

Whole-person cancer care

The whole-person support available through the Livestrong Cancer Institutes typifies the clinic’s CaLM model of care. Short for Cancer Life reiMagined, the CaLM model encompasses the emotional, physical, and psychological support services that complement the cancer treatment offered at the clinic.

The care team employs a dietitian, a social worker, a genetic counselor, a supportive and survivorship specialist, and more to provide patients a whole-person treatment experience.

For more information about the CaLM care team, click here.

About UT Health Austin

UT Health Austin is the clinical practice of the Dell Medical School at The University of Texas at Austin. We collaborate with our colleagues at the Dell Medical School and The University of Texas at Austin to utilize the latest research, diagnostic, and treatment techniques, allowing us to provide patients with an unparalleled quality of care. Our experienced healthcare professionals deliver personalized, whole-person care of uncompromising quality and treat each patient as an individual with unique circumstances, priorities, and beliefs. Working directly with you, your care team creates an individualized care plan to help you reach the goals that matter most to you — in the care room and beyond. For more information, call us at 1-833-UT-CARES or request an appointment here.