Advancing the Science

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June 14, 2022

Dawn’s journey: Overcoming a near-zero survival rate

By Advancing the Science contributor
Dawn Botsford sits in a chair. Her husband sites on the arm next to her with his arm around her.
Dawn Botsford (left) and John Botsford (right)

Dawn Botsford was sitting in a chair at the hair salon in the fall of 2011 when her hairdresser commented on a spot on the top of her head.

It was bug season in North Dakota, so Dawn didn’t think much of it. “When I told my hairdresser that, she said, ‘I really think you need to get it checked out.’ She saved my life,” Dawn recalls.

Dawn met with a local dermatologist to have the spot examined. A few hours after her biopsy, Dawn’s dermatologist told her she had melanoma, a form of skin cancer.

Dawn’s dermatologist wanted her to see a local oncologist as soon as possible, but there were no appointments available.

“With that kind of news, I got worried,” Dawn says.

Dawn visited her local physician for another trusted opinion. His comment was even more unsettling: “This looks pretty serious.”

He then picked up the phone and called Mayo Clinic to make a referral.

After receiving news of availability and discussing with her husband, John, and their son, Tom, Dawn made an appointment at Mayo Clinic in Rochester. Dawn and John made the trip to Mayo Clinic and met with Eric J. Moore, M.D., the next day. Dr. Moore scheduled surgery for Dawn two days later.

“We're fortunate to have the No. 1 medical system in the world a six-hour drive away,” Tom says. “We never really questioned that we were going to go to Mayo.”

In October 2011, after several appointments and the initial surgery to remove the spot, doctors confirmed that Dawn’s melanoma was late stage.

“The physicians at Mayo Clinic were all so kind and caring,” Dawn says. “They really wanted to give me hope that this diagnosis was not fatal.”

A month after surgery, Dawn developed an infection in the incision on the top of her head. Dawn happened to be in Minneapolis with family, and they decided to head to Mayo Clinic in Rochester's emergency department about 75 miles away. When they arrived, she was amazed to see a doctor waiting for her who had read her chart and was up to speed on what was going on.

“That is remarkable patient care,” Dawn says.

Finding hope in a clinical trial

In early 2013, doctors performed a precautionary lung X-ray and found that melanoma had spread to her lungs. Dawn's oncologist, Robert R. McWilliams, M.D., suggested she enroll in a clinical trial with an immunotherapy drug, conducted by Svetomir N. Markovic, M.D., Ph.D., a medical oncologist and hematologist who specializes in the care of patients with advanced melanoma.

“Dr. Markovic said a clinical trial was her only option, and that the survival rate at the time was 2%,” Tom says. “I still remember sitting in our home office, my dad and I Googling this stuff, looking for papers on outcomes and survival rates. That's what we found — 2%.”

Dawn decided to take part in the study.

“It was always equally as important to her that she was participating in a clinical trial, not knowing if it would help her, but knowing that the results would eventually help others,” John says.

Best bet: surgery

By the end of 2013, Dr. McWilliams and thoracic surgeon Stephen D. Cassivi, M.D., M.S., decided that surgery on both lungs was now Dawn’s best bet.

“I got back to the hospital, and in my room on the whiteboard there was a sign that said, ‘Welcome back, Dawn!’ I just felt like everybody took such good care of me," Dawn says. "They didn't know it, but they were challenging me too. I had to get my lungs working again." In July 2015, another spot was found on her right lung. Dawn then had three stereotactic radiation treatments, a noninvasive radiosurgery technique. After her treatments, Dawn came back to Mayo Clinic every six months for routine testing.

10 years later

After numerous PET scans and appointments and with the strong support of family and friends, Dawn officially completed her time with the oncology program at Mayo Clinic in July 2020 — 10 years after the first spotting of melanoma and five years since the last recurrence.

"I can't say enough about the people and the facilities at Mayo Clinic," Dawn says. "The entire team of researchers, providers and staff who saved my life and always gave me hope is something the clinic can be very proud of.”

For John and Tom, Mayo Clinic means even more.

“Not only did Dr. Markovic and the team at Mayo Clinic save my mom, but they allowed her to get to know her grandkids," Tom says. "That’s something you can never put a price on.”

Eds Note: The individual featured in images was following social distancing guidelines, and in compliance with Mayo Clinic’s COVID-19 safety guidelines while unmasked.


This article was originally published in Mayo Clinic Magazine.


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Tags: cancer, clinical trials, dermatology, Eric Moore, immunotherapy, Mayo Clinic Cancer Center, melanoma, oncology, People, republished, Robert McWilliams, skin cancer, Stephen Cassivi, Svetomir Markovic

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