Brian Saracino uses the phrase “an interesting twist” often when he talks about himself. He’s had many interesting twists throughout his life including a car accident that led to the discovery of a lung nodule that turned out to be melanoma.

Three years ago, a car made an illegal left turn in front of him, as Saracino moved through a green light, causing an auto accident on Kipling Avenue. His chest and knee were banged up. He was evaluated at the hospital with medical imaging and was fine except for damage to his left knee. Then, five months later during a wellness exam, Saracino’s personal physician mentioned that a lung nodule was visible in one of those scans. Nothing to worry about, the physician said, but they would watch it.

The nodule grew. After a year of continued growth, doctors scheduled Saracino for what was to be a simple surgery to remove the benign growth. However, the nodule wasn’t benign. They removed one-third of his lung along with 16 lymph nodes. The nodule was cancerous – specifically melanoma that had spread to his lung.

Saracino learned that skin cancer spreading to an organ is rare. He began treatment as the cancer metastasized to his neck and shoulder area, back and at one point to his brain.

“The good news,” he joked “is that it proved I actually have a brain.”

His cancer was stage 4, which means it had spread from its original location to distant parts of his body. Stage 4 cancers are advanced and often harder to treat successfully. Saracino said at that point a provider asked him what his plans were, implying that he had the choice whether to continue treatment or stop, effectively ending his life.

“I told her my plan was to keep working through this and take this one step at a time.”

Jeffrey Owsley, DO, a medical oncologist with Intermountain Health Cancer Centers of Colorado, said about 3% of melanomas present in situations where the primary lesion hasn’t been surgically removed and cancer is found as a distant metastasis, or as cancer cells that separated from the primary lesion and travel to a different part of the body to form a tumor.

“These can occur in sites with little to no sun exposure,” Dr. Owsley said. “One challenging aspect of melanoma is that it can metastasize to anywhere in the body.”

“Luckily, Brian has had a great response to immunotherapy, and he currently has no evidence of cancer.” Dr. Owsley said.

Saracino, who is now 68, had seen a dermatologist for full body skin checks annually since he was 25, but looking back there was confusion as to whether anything of concern was ever found. The dermatologist said he’d never found melanoma but later said a spot had been removed. Another “interesting twist,” Saracino said.

Today, he feels good. He has had side effects from immunotherapy but manages those with medication.

Yet another twist to the story: Years before his cancer diagnosis, he stood by his brother, a highly decorated Denver Policeman who was diagnosed with early onset Alzheimer’s. Saracino cared for his brother for six years until his brother passed away from the disease.

He also saw his father die from acute myeloid leukemia, or AML, which he described as “a tough one.” Both of those diseases give him a perspective about his own cancer diagnosis.

“Things could be worse,” he said. “Cancer is certainly challenging, and dementia is also.”

But Saracino shared that he feels so fortunate for the wonderful medical care his doctors have provided, using some of the latest medical technology in cancer care.

He also has a prevention message: “Take the simple steps necessary. Find a good sunscreen and take care of your general health,” he said. “If there is a twist, take that one step at a time.”

Intermountain St. James Hospital is setting the stage for skin cancer prevention at the upcoming 2024 Montana Folk Festival. 

Intermountain St. James is sponsoring the Broadway Stage where they will help festival goers learn to  protect themselves from harmful UV rays. 

“Skin cancer is due to a cumulative effect of skin exposure to UV rays or sunlight over time. Protecting  your skin now is just as important as applying sunscreen when you’re 70 years old,” said Jerri Doyle, director of the Intermountain Health St. James Cancer Center. “We want all concertgoers to be aware what they can do to prevent UV damage.” 

The Intermountain team will share sunscreen, skin cover, and cooling items at the booth. They also have tablets with special UV-detecting cameras to see where people miss when applying sunscreen. 

The Intermountain St. James booth will be open from 5 to 9 pm on Friday, July 12, and from noon to 7 pm on Saturday, July 13. 

“St. James Hospital has been a longtime supporter of the Montana Folk Festival, and we are excited to expand our role this year at this important cultural and community event, said Karen Costello, president of Intermountain St. James Hospital. “We look forward to enjoying some incredible music alongside our friends and neighbors, along with educating them about protecting themselves from skin cancer.”

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