{"id":36857,"date":"2026-04-01T12:00:36","date_gmt":"2026-04-01T18:00:36","guid":{"rendered":"https:\/\/www.uchealth.org\/today\/?p=36857"},"modified":"2026-04-06T08:32:51","modified_gmt":"2026-04-06T14:32:51","slug":"diagnosed-with-mucosal-melanoma-a-rare-and-hidden-form-of-skin-cancer","status":"publish","type":"post","link":"https:\/\/www.uchealth.org\/today\/diagnosed-with-mucosal-melanoma-a-rare-and-hidden-form-of-skin-cancer\/","title":{"rendered":"Diagnosed with mucosal melanoma: A rare and hidden form of skin cancer"},"content":{"rendered":"
<\/div>
\"Garry
Garry Keller cheers after his family made it safely through Skull Rapid (class IV rapid) on the Westwater section of the Colorado River in July 2020. Garry was diagnosed with mucosal melanoma in April 2016 and enrolled in several clinical trials. He’s had no cancer detected since 2018. Photo courtesy of Garry Keller.<\/figcaption><\/figure>\n

For Garry Keller, the strangest thing about facing a life-threatening cancer is how healthy he looked and felt when it all began.<\/p>\n

Back in 2016, Keller was in his early 40s and at his peak. He was a busy special education teacher, but still squeezed in daily CrossFit workouts. In the summer, he worked as a raft guide, and in the winter, he enjoyed snowboarding with his young son.<\/p>\n

Then he found a swollen lymph node in his groin. Doctors soon diagnosed a rare form of skin cancer: mucosal melanoma, which fights within membranes that line cavities of the body. The odds weren\u2019t good. Initially, he had a 20% to 30% chance of survival.<\/p>\n

\u201cBefore I knew it, I was trying to find a way to fight the cancer and not feeling sick at all, but the doctors were saying I\u2019m pretty sick,\u201d he said.<\/p>\n

He would spend the next two years battling a cancer raging inside his otherwise healthy, fit frame. To others, the cancer wasn\u2019t noticeable \u2014 except that his once light-brown hair had turned stark white, resembling a Marvel superhero character. Keller enrolled in clinical trials and tried experimental drugs \u2013 anything to stay alive for his wife and now 16-year-old son.<\/p>\n

Melanoma in the family<\/strong><\/h2>\n
\"Garry
Garry Keller with his wife, Becky, and son, Boden, before his April 2016 mucosal melanoma diagnosis. It\u2019s now been a decade since that day and nearly eight years since he became cancer free. Photo courtesy of Garry Keller.<\/figcaption><\/figure>\n

The news of cancer hit close to home. Just five years before Keller\u2019s diagnosis, his father-in-law was diagnosed with melanoma. His wife’s father tried to fight it with trials and immunotherapy, but it didn\u2019t work. So when Keller had to call his wife, Becky, to tell her he also had melanoma, it was all too familiar. But telling his son was even harder.<\/p>\n

\u201cHe remembers grandpa reading stories to him, so as soon as we told him, he knew what was up,\u201d Keller said. \u201cWe had to be matter-of-fact. But there was a piece of me that didn\u2019t want him to think I was sick. \u2026 Even though there was that piece that wasn\u2019t healthy, I wanted to show my son I can power through. That I\u2019m OK. I\u2019m not going to die today. I\u2019d say that a lot to myself.\u201d<\/p>\n

What is mucosal melanoma?<\/strong><\/h2>\n

Unlike the melanoma that afflicted Keller\u2019s father-in-law, exposure to UV from the sun has nothing to do with mucosal melanoma. This aggressive skin cancer attacks the mucous membranes that line the cavities of the body, such as the oropharyngeal, vaginal or gastrointestinal tract.<\/p>\n

And it is rare, with only one out of 100 melanoma diagnoses being mucosal.<\/p>\n

\u201cWe don\u2019t know much about why it develops or who is predisposed. Genetic drivers are different, and response patterns to immunotherapy are different compared to the more common cutaneous melanomas,\u201d said Dr. Theresa Michelle Medina<\/a>, a medical oncologist who specializes in cutaneous oncology at the University of Colorado Cancer Center<\/a> on the Anschutz Medical Campus.<\/p>\n

Keller\u2019s cancer started in his rectum and spread to nearby lymph nodes, but it hadn\u2019t metastasized beyond that. One of his first symptoms was rectal bleeding, but given his age, it was attributed to having hemorrhoids. In retrospect, it was due to his primary tumor. Traditional treatment would be a lymph node dissection followed by immunotherapy.<\/p>\n

Keller wasn\u2019t a fan of the low odds of traditional therapy, given the high risk for recurrence or distant metastasis despite surgical therapy, and the risk that he could lose the opportunity to continue to be active and make lasting memories with his son was too high for him.<\/p>\n

\u201cI love snowboarding with my son and going on multiday rafting trips. If they started taking organs \u2026 what if I lose that?\u201d Keller said.<\/p>\n

\"Garry
Garry Keller snowboards with his son, Boden, around the time he was diagnosed with mucosal melanoma, a rare skin cancer. The diagnosis threatened the moments he loved most, so he did everything he could to fight it, including joining clinical trials. Boden is now 16. Photo courtesy of Garry Keller.<\/figcaption><\/figure>\n

Keller and his doctors decided to take a different route: roll the dice and hope for better odds in the experimental world than in the known world, wrote his wife, Becky, in her blog, “Life according to a paranoid optimist<\/a>.”<\/p>\n

Having been alongside his wife during her father\u2019s battle with melanoma, Keller knew there was only one place he wanted to go to beat those odds.<\/p>\n

A Comprehensive Center for Rare Melanoma<\/strong><\/h2>\n

Rare melanomas, such as mucosal melanomas, are not well understood, and current melanoma treatments<\/a> are less effective. Medina and her colleagues at the Center for Rare Melanoma<\/a> at UCHealth University of Colorado Hospital<\/a> on the Anschutz Campus are dedicated to understanding and treating these rare melanomas.<\/p>\n

Keller began working with Medina.<\/p>\n

\u201cThere were two drug therapies approved that showed to be effective, but they also carried high rates of side effects,\u201d she said. \u201cThere were clinical trials ongoing at the time with another promising combination that was much better tolerated. People were having good responses and not having the immune toxicity that goes along with it.\u201d<\/p>\n

A month after his 2016 diagnosis, Keller started his first clinical trial, which aimed to determine the efficacy of a combined treatment of Epocadastat and Nivolumab.<\/p>\n

\"Garry
Garry Keller enjoys time with his son in their backyard while he was going through clinical trials. Boden, now 16, calls his dad a \u201csuperhero\u201d not only because he fought off a rare form of melanoma but also because that battle left him with bright white hair. Photo courtesy of Garry Keller.<\/figcaption><\/figure>\n

The emotional side effects of being diagnosed with mucosal melanoma<\/strong><\/h2>\n

As Keller continued to fight for his life, most people were oblivious to the cancer raging inside his body.<\/p>\n

\u201cIt was the hardest part to overcome,\u201d Keller said. \u201cI didn\u2019t feel sick. It was hard to believe what these doctors were telling me. It\u2019s overcoming those physiological pieces.\u201d<\/p>\n

Patients with melanoma often struggle with this, Medina said.<\/p>\n

\u201cThey don\u2019t typically do chemo, so they don\u2019t have the same outcomes as others, such as losing their hair. So that means when they are out in the community, they don\u2019t look like they have cancer,\u201d she said. \u201cThey feel lucky that they don\u2019t have to deal with those side effects, but then they discount the experience they have to go through.\u201d<\/p>\n

Through most of it, Keller continued to work as the co-director of a special education program. He continued to work out at his CrossFit gym daily. And he took his son snowboarding and rafting.<\/p>\n

\u201cGetting to work and doing something; not sitting home and feeling sorry for myself, that helped,\u201d he said.<\/p>\n

\"Garry
Garry Keller with his son, Boden, left, and wife, Becky, at Casa Bonita recently. Photo courtesy of Garry Keller.<\/figcaption><\/figure>\n

Being involved in clinical trials for melanoma<\/strong><\/h2>\n

For 22 months, Keller felt hopeful.<\/p>\n

\u201cI was doing well,\u201d he said. \u201cThen all of a sudden, I wasn\u2019t. It grew again and was aggressive.\u201d<\/p>\n

Keller and his UCHealth team switched gears and tried another study, but after a few months, the results were disappointing, and the side effects left Keller feeling horrible.<\/p>\n

Then Keller enrolled in a new trial<\/a>.<\/p>\n

The TIL trial for melanoma<\/strong><\/h2>\n

\u201cI was patient number one,\u201d Keller said of the Tumor Infiltrating Lymphocytes (TIL) trial. \u201cThey didn\u2019t know what was going to happen, but it was either do or die for me, so I wasn\u2019t thinking of that.\u201d<\/p>\n

The National Cancer Institute study involved collecting white blood cells from a patient\u2019s tumors, growing them in the laboratory in large numbers, and then returning them to the patient. These cells are called tumor-infiltrating lymphocytes.

Tumor-infiltrating lymphocyte, or TIL therapy, is approved for advanced melanoma. It’s also showing promise in helping the immune system fight other solid-tumor cancers. Here is Jennifer Melahn\u2019s story<\/a>.<\/div>\n

Surgery is required to get the patient\u2019s cells. Then they are given a round of chemotherapy to prepare their immune system to accept the white blood cells.<\/p>\n

\u201cThey only wanted to get the cells fighting cancer because what they\u2019ve found before, with similar treatment, is that if other immune cells are active, the body can\u2019t support that,\u201d Keller explained.<\/p>\n

The patient\u2019s white blood cells grown from the tumor are then infused back into the patient’s body. Concurrently, the patient receives a chemotherapy drug to boost their immune system\u2019s response against white blood cells. Keller had eight total immune-boosting treatments.<\/p>\n

Eight months into the trial, scans showed a lesion that appeared to be enlarging. But it turned out to be an inflammatory reaction and not melanoma, Medina said.<\/p>\n

\"Boden
Boden Keller reading “Calvin and Hobbes” to his father, Garry Keller, while he was being treated for mucosal melanoma in 2017. Photo courtesy of Garry Keller.<\/figcaption><\/figure>\n

Returning to a cancer-free life<\/strong><\/h2>\n

Keller was supposed to remain in the TIL trial for three years with scans every three months, but about a year in, every scan showed he was cancer free.<\/p>\n

\"Garry
Garry Keller helps his son, Boden, tie a tie for his homecoming dance. In moments like these, Keller is reminded how grateful he is to be cancer-free. Photo courtesy of Garry Keller.<\/figcaption><\/figure>\n

“I was free and clear, so at that point I left the study,” he said.<\/p>\n

He now gets scans every six months, along with an office visit with Madina.<\/p>\n

Keller still rafts, snowboards and does CrossFit. When he turned 50 in August 2025, he decided to add mountain biking to the mix. He’s now an assistant principal and spends most of his spare time cheering on Boden at swim meets.<\/p>\n

The sense of doom that once shadowed Keller has faded, and the urgency to make the most of every second is no longer top of mind. The only reminder of his cancer is his bright white hair.<\/p>\n

\u201cMy son thinks I\u2019m a superhero, a Marvel character,\u201d he said.<\/p>\n

And considering Keller\u2019s fight against something he couldn\u2019t see or feel, it\u2019s a title he has earned.<\/p>\n","protected":false},"excerpt":{"rendered":"

For Garry Keller, the strangest thing about facing a life-threatening cancer is how healthy he looked and felt when it all began. Back in 2016, Keller was in his early 40s and at his peak. He was a busy special education teacher, but still squeezed in daily CrossFit workouts. In the summer, he worked as […]<\/p>\n","protected":false},"author":2164,"featured_media":36860,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"_relevanssi_hide_post":"","_relevanssi_hide_content":"","_relevanssi_pin_for_all":"","_relevanssi_pin_keywords":"","_relevanssi_unpin_keywords":"","_relevanssi_related_keywords":"","_relevanssi_related_include_ids":"","_relevanssi_related_exclude_ids":"","_relevanssi_related_no_append":"","_relevanssi_related_not_related":"","_relevanssi_related_posts":"","_relevanssi_noindex_reason":"","footnotes":""},"categories":[5,7],"tags":[28,3508,49,168,167,189,9070,6762,6838],"class_list":["post-36857","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-innovative-care","category-stories","tag-cancer-care-oncology","tag-cancer-care-patient-stories","tag-cancer-treatment","tag-chemotherapy","tag-clinical-trials","tag-immunotherapy","tag-melanoma","tag-melanoma-treatment","tag-skin-cancer-treatment"],"acf":[],"yoast_head":"\nDiagnosed with mucosal melanoma, a rare skin cancer - UCHealth Today<\/title>\n<meta name=\"description\" content=\"Garry didn\u2019t feel or look sick, but he was diagnosed with mucosal melanoma. 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