One Saturday morning, Banks was brushing his teeth when his wife, Johanna, noticed a new spot – a freckle? — on the back.

“It grew a little bit and it just didn’t look right,” he recalled. It wasn’t a mole, but as Banks pointed out, “You have to look at the freckles, too.”

On Monday morning, Banks bumped into a surgeon – Dr. Eric Mallico — and told him of his concern. They went into an office and Banks took off his shirt. Mallico took a look and suggested they move quickly.

The spot first noticed on a Saturday was removed – and a sample sent for biopsy – on Tuesday. Then the results came back on MyChart a few days later.

“I’m telling you: I was not prepared to read what I saw on the screen: malignant melanoma, stage 2B.”

Mallico told him that he would have to do a second, more involved procedure. This required a wide excision, or removal.

“With melanoma, you have to check the lymphatic system to see if the cancer has infiltrated,” Banks explained.

Mallico cut off four lymph nodes and sent them to pathology.

“It was 3 millimeters deep,” Banks said. “At 4 millimeters, it hits the lymph nodes. So I was only 1 millimeter short of having stage 3 (more serious) melanoma.

Suddenly the healer needed healing.

“It was crazy to think I needed the operating room now,” he said. “But I know the capabilities of this facility and the staff, and I wouldn’t have gone anywhere else.”

He and Johanna had to miss out on a trip he had won to Turks and Caicos because of his surgery. But their consolation prize takes off for the Banks’ happy place – a trailer they keep on the beach.

About nine days after having four lymph nodes removed from her armpit — an agonizing wait — Banks learned her lymph nodes they weren’t affected. “I thought: Thank God. Now I can relax.”

Immunotherapy as insurance

Even though Banks’ lymph nodes were clear, he did not finish treatment.

Mallico told her he would reduce the risk of recurrence through immunotherapy, which Banks described as “overriding the immune system to recognize cancer cells so the immune system chases them down and chases them away.” It’s an insurance policy of sorts.

Mallico sent him to an oncologist/hematologist Dr. William Brinkley of Novant Health Cancer Institute – Rowansaying, “He is to whom I would go.”

“For stage 2B melanoma, the risk of recurrence is 15 percent at 5 years and 20 percent at 10 years,” Brinkley said. “Based on Cale’s stage and level of risk, we recommended immunotherapy — every three weeks for a year — over the other option, which is simply surveillance.”

He also discussed the possible side effects of Keytruda infusions. Inflammation anywhere in the body is a concern, as is colitis, hepatitis, arthritis, dermatitis “and anything else that ends in -itis,” he joked. “It can affect thyroid function, pituitary gland, electrolytes. In general, however, the risks are small.”

Immunotherapy does not come with the severe side effects that chemotherapy can have. Banks with experience not side effects.

And his oncologist made things even easier. “Dr. Brinkley is fantastic,” he said. “He wants to know everything about you. I felt very good about his treatment plan.”

However, people encouraged Banks to talk to another doctor – for his own peace of mind. He sought a second opinion in Charlotte, half wondering if cancer care in a “big city” would be any different than Salisbury. The referrals were identical and he was excited to receive care close to home.

How close? “I just crossed the street” from the hospital, he said.

Big city grooming in a small town

“The entire staff at Rowan Cancer Institute is phenomenal,” he added. “I became friends with the people there. And the facility itself is gorgeous. It is flawless. Salisbury may not be Charlotte and we are not Atlanta or New York City, but we have the same capabilities.”

Brinkley said that with some exceptions — such as bone marrow transplants, which are not offered at Rowan Cancer Institute — patients can expect the same care in Salisbury as they would in Charlotte.

And what’s more, he added, “Being part of the Novant Health network means cancer patients get the best of our collective knowledge. Our Tumor Board meets regularly to discuss patients in all our markets. So patients can be physically located anywhere in our region and benefit from oncologists and other specialists across the network.”

And downtown Rowan County even has some extras you won’t find anywhere else. Individual infusion chambers, for example.

“When this center was designed,” Brinkley said, “the staff talked about how important it is to give cancer patients privacy and a sense of security while they’re being treated.”

Banks has never been afraid of his infusions.

“You can sit in a chair and watch TV,” he said. “I actually found it relaxing. I would put some music on my headphones and take a nap for 30 minutes. And the next thing you know, I wake up and I’m done.”

Most nights, he went to his bowling league right after the infusion.

The aftermath of cancer

Banks and his wife love the beach – especially the Caribbean. She used to apply sunscreen at the start of the day and not think about it. “Our last vacation was different,” he said. “I don’t want to be Mr. Tan anymore. I’m the guy with the big floppy hat reapplying sunscreen every hour.”

Brinkley applauds the new mindset. Melanoma is associated with sun exposure, he said.

Another thing that’s different: Banks will now have a skin exam every year. He had never needed a dermatologist before. Now he has a doctor who knows his history and will be on the lookout for anything unusual.

He will also see Brinkley again. The oncologist follows his patients closely after the treatment is over. He will see Banks every three months for two years. After that, she will see him every six months until year five. At that point, Banks will move to annual checkups.

Does Banks view surgery patients differently now that he’s been one?

Not really. “We always strive to give everyone the best possible care,” he said. “Everyone is a VIP here.”