ADVANCES IN SKIN CANCER DETECTION: Applying Data on DecisionDx-SCC and DecisionDx-Melanoma Into Clinical Practice Foreword by Leah Adams, Melanoma Patient and Advocate Beginning when I was a teenager, I took every opportunity I could to lie outside in the sun, seeking the tan that I considered a sign of health and beauty. Feeling more attractive when my skin was tanned and unaware of the risks of sun and ultraviolet light exposure, I also became a frequent customer at tanning parlors between summers. My perspective changed in September 2019 when my father underwent exci-sion of a mole on his upper back and was diagnosed with Stage 0 melanoma. Wanting to educate myself about this disease, I realized from my research that I was at risk because of my personal and family history. Worrisome as well was the fact that I had noticed changes in the appearance of some moles on my body. There was one mole in particular on my chest that my mom thought was abnormal-looking, and she encouraged me to get a skin check. I was able to get an appointment with a dermatologist in a few weeks. The doctor conducted a full-body skin exam, performed an excisional biopsy of the worrisome mole, and sent the tissue to the laboratory for a pathologic diagnosis. Given my age, my father’s diagnosis, and relative lack of knowledge about mela-noma, I was not too worried. However, the pathology report came back show-ing I had Stage 1A melanoma, bordering on 1B. My dermatologist discussed the implications of the diagnosis with me and recommended that I undergo wide local excision and sentinel lymph node biopsy (SLNB). I agreed, and both my dermatologist and surgical oncologist suggested that I also take the DecisionDx-Melanoma test. They explained that the test provides information about risk of metastasis and recurrence based on an analysis of genes that are predictive of the tumor’s aggressiveness, and that the results would be useful for guiding decisions about appropriate future care. I had no reservations about consenting to the test as it did not require me to undergo any additional procedures. The surgery was much more extensive than I anticipated, and afterward I faced the challenges of my physical recovery combined with mental stress from the fear and uncertainty about what the SLNB and DecisionDx-Melanoma test results would show. Fortunately, the news was good on both fronts. The SLNB results were negative, and my DecisionDx-Melanoma test came back Class 1A, meaning I was at low risk for melanoma metastasis or recurrence. My treating physicians advised me to begin having quarterly skin examinations by the dermatologist but said I did not need to have any imaging or treatment. I cannot express what a strong positive impact the DecisionDx-Melanoma test result had on my emotional well-being. Although the negative SLNB result was reassuring, it only showed that my tumor had not yet spread. The Deci-sionDx-Melanoma test, on the other hand, predicts risk of spread or recur-rence into the future, and so the Class 1A result allowed me to have a more positive outlook moving forward. Of course, I recognize that my story could have had a different ending if the DecisionDx-Melanoma test came back showing a higher risk for metastasis and recurrence. Certainly, that would have been more unsettling, but reflecting on that possibility, I think I still would ap-preciate having the information because it would help my doctors develop a per-sonalized plan of care that would allow me to have the best possible outcome. In the six years since my initial mela-noma diagnosis, I have had multiple suspicious lesions biopsied. Fortunately, they all turned out to be benign. But there is more to my story. In January 2021, my father was hospital-ized after experiencing a seizure while driving, and the work-up revealed he had Stage 4 melanoma with lesions in his lungs and brain. The DecisionDx-Mel-anoma test was not discussed with him when he was first diagnosed with melanoma because it was Stage 0, and although they don’t know for sure, his Featuring: SHANNON TROTTER, DO, is a Dermatologist at DOCS Dermatology in Springfield, OH, a Clinical Assistant Professor at Ohio University Heritage College of Osteopathic Medicine in Athens, OH, and host of the podcast, Derm-it Trotter! Don’t Swear About Skincare . ANDREW BAKER, MPAS, MBA, PA-C, is a Physician Assistant at DOCS Dermatology in Columbus, OH, and President-Elect of the Society of Dermatology Physician Assistants. November/December 2025 Supplement | S1
The Dermatology Digest November/December 2025 Castle Supplement: S-1
