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https://doi.org/10.1001/jamadermatol.2014.310
Copy DOIJournal: JAMA dermatology | Publication Date: Nov 1, 2014 |
Citations: 1 |
Asthecollegefootball seasonapproaches, itbehoovesustorecallJoeRoth (1955-1977), theUniversityofCalifornia,Berkeley, starquarterback in the mid-1970s, and perhaps themost famous athlete to die ofmelanoma. Hisstorydemonstratesextremepersonalcourageanddramaticallydocuments changes inmelanoma diagnosis andmanagement. In the spring of his senior year at Granite Hills High School in San Diego, Joe noticed a bleeding and enlargingmole in front of his left ear. A physician burned off the 1⁄4-in (approximately 6-mm) tumor but did not obtain a pathologic diagnosis. When the tumor recurred 6months later, adermatologistperformedabiopsy.Thepathologicaldiagnosiswas melanoma, so the tumor was completely reexcised. Routine 6-month checkups were uneventful. Joe became a star quarterback at hometown Grossmont Junior College and transferred to the University of California in 1975, leading the Golden Bears to an 8-3 record and national ranking. In 1976, he was a Heismancandidate andshowedwhy in the first 2gamesashepassed for almost700yardsagainstpowerhousesUniversityofGeorgiaandUniversity of Oklahoma. His routine chest radiograph revealed a spot that was interpretedasanartifact.Therestof theseasondidnotgowell; Joe’spassingskillsdeteriorated,butmore importantlyhe lostweightbecauseofpersistent nausea and vomiting. At Thanksgiving, he noticed several lumps onhis chest. Soon thereafter, thediagnosis ofmetastaticmelanomawas made, with liver and lung lesions, and Joe started chemotherapy. Aware that his outlook was grim, Joe still interrupted his chemotherapy for2weeks toplay inpostseasonbowls inHawaii andJapan.During this time, the story was leaked that hewas fightingmelanoma. After returning to Berkeley, he was determined to live out his final days a normal student. Shortly after turning inhis final termpaper, hewashospitalized for severe arterial emboli to his legs and died on February 19, 1977. Today, all physicians know that rapidly growing pigmented tumors should be excised, not cauterized, and always submitted for pathologic evaluation.With better options available today, Joe’s diseasewould be stagedmorecarefully,his tumorwouldbemolecularlycharacterized,and hewouldbeconsidered foradditional systemic therapies.Wecannot say that he would have benefited, but manymore patients do. JoeRoth’s story teaches us a lot about personal courage. It is simply impossible for those of us caring for severely ill patients with melanoma to imagine someone playing top-level sports while full of metastases. Toward the end of his life Joe said, “Dying is not so tough. For the last three years I’ve livedwith the realization that the next daymight be my last. I’m lucky to be here as long as I was, so don’t feel any pity... I’m nothing special. I’m Joe Roth, a student and a football player.”
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