In late 2019, John Baxter noticed a small bump inside his lower lip. At first, it didn鈥檛 seem serious. But after a visit to an ear, nose, and throat specialist in California and a quick biopsy, he learned it was melanoma鈥攁 rare type known as desmoplastic melanoma. Unlike the more common skin-based pigmented melanomas, this form can feel and look like a scar and accounts for less than 4% of all melanoma cases.

John, now 53, underwent surgery at a local hospital to remove the tumor. Not long after, he and his family moved across the country to Rhode Island. It was early 2020, and the COVID-19 pandemic was just beginning. As the world shifted into lockdown, he began seeking out the next phase of care for his rare cancer. After speaking with a close friend in the medical field, he chose Dana-Farber Brigham 天美传媒.

Even during the height of the pandemic, John found the experience manageable and well-organized. He recalled, 鈥淓veryone was really careful and made sure the process was smooth. It wasn鈥檛 easy, but they made it feel as normal as possible under the circumstances.鈥�

Once in Boston, he began working with Brigham and Women's Nicole LeBoeuf, MD, MPH, FAAD, a dermatologist who specializes in treating complex skin cancers, and , Medical Director of the Melanoma Cellular Therapies Program at Dana-Farber Cancer Institute. Together, they monitored John鈥檚 recovery and helped guide his follow-up care. For a time, things were stable.

Though the drive from Rhode Island to Boston took about an hour and a half each way, John considered it well worth the trip. 鈥淭he care at Dana-Farber Brigham was top-notch,鈥� he noted. 鈥淣o question it was worth the trip for that level of expertise.鈥� Dr. LeBoeuf recalls: 鈥渕eeting John in the height of the pandemic was memorable for many reasons 鈥� we were monitoring a large scar on his lip to try and catch any change. He was incredibly motivated and let nothing stand in the way of getting care 鈥� especially those masks!鈥�

In 2022, the cancer returned in the same area鈥攁long the lower lip and chin. This time, John鈥檚 care team expanded to include Brigham and Women's  a surgeon who specializes in skin malignancies and head and neck cancers. After reviewing his case, the team recommended starting with immunotherapy鈥攁 treatment designed to help the immune system find and destroy cancer cells.  Dr. LeBoeuf notes, 鈥渨hen we examined John, it was clear that the surgery required to remove the tumor would be very challenging. His medical oncologist, Dr. Buchbinder, and  Dr. Rettig had a long conversation about whether it was worth waiting to give immunotherapy a chance, knowing that if it didn鈥檛 work, the cancer would be larger and harder to cure with surgery. We discussed with John and decided to take the risk.鈥�

Over the next four months, the tumor thankfully shrank significantly. When it came time for surgery Dr. Rettig and her surgical team were able to remove less tissue and preserve more of John鈥檚 lower lip. When the tissue was examined by pathologists, no remaining active cancer was found, showing a complete response to immunotherapy. A targeted reconstructive procedure of his lower lip and chin followed. 鈥淭he most challenging part of Mr. Baxter鈥檚 case was deciding how much lip to remove. We certainly didn鈥檛 want to leave any tumor behind or compromise his survival, but we also wanted to maximize his function and physical appearance, which can be difficult with large lip resections,鈥� recalled Dr. Rettig.

After surgery, John continued immunotherapy for another eight months. Today, he returns for regular follow-ups, including PET scans, MRIs, and dermatology visits with Dr. LeBoeuf. While he is currently cancer free, there is always a chance it can return.  His care is ongoing, but the most difficult part of his treatment is behind him.

Fair-skinned and red-haired, John recognized he was at higher risk for sun-related skin damage. Since his diagnosis, sun protection has become part of his daily routine. 鈥淢y wife keeps sunscreen everywhere in the house,鈥� he explained. 鈥淚 wear hats, put sunscreen on the scar, and try to stay out of the sun when I can.鈥� While his melanoma grew toward the inside of his lip and was perhaps not initiated by sun exposure, patients who have had one melanoma are at risk for developing more.  He cannot control everything, but he can protect the rest of his skin. 

He鈥檚 also mindful of protecting his three children, especially his oldest daughter, who shares his fair complexion. 鈥淲e remind the kids to use sunscreen, especially when they鈥檙e outside,鈥� John said. 鈥淚t鈥檚 something we all take seriously now.鈥�

What stands out most from the experience, John noted, is the care and coordination among his providers. From his initial visits with Dr. LeBoeuf and Dr. Buchbinder to his later surgery with Dr. Rettig, every step was collaborative. 鈥淭he doctors really took the time to explain everything and work with me. That made a big difference.鈥�

Today, John continues to work full-time at Dell Technologies and enjoys spending time with his family while staying vigilant about his health. He offers this advice to others facing similar concerns: 鈥淒on鈥檛 ignore anything unusual, even if it鈥檚 just a small bump. And if you have fair skin or a history of sun exposure, please take sun protection seriously. Early action can make all the difference.鈥�

John and Dr. LeBoeuf after having completed the 2025 Boston Marathon.