The summer before her fourth-grade year, Cate Sauer noticed what looked like a skin tag under her chin. After a couple of weeks of trying to cover it up with makeup, Cate’s mom realized it wasn’t going away. She took Cate to see a dermatologist, Dr. Robin Gehris, who removed the skin tag and biopsied it out of an abundance of caution.

The results came as a shock: Stage III melanoma. Cate’s mom delivered the news in the car as she drove her home from a day of swimming at the pool. Cate remembers her mother was crying and told her that she could have whatever she wanted. Cate answered immediately and asked if she could get another dog.

“I was so young and my mom was more scared than I was,” said Cate, who lives in Pittsburgh. “I don’t think I really understood the severity of what was happening until later.”

Even now, when Cate – now a high school senior who will attend Princeton next year – shares her melanoma journey with others, she said she feels like she’s describing it as an outsider.

“It was like an out-of-body experience,” she said. “I feel like I disassociated a bit because it was so much on my body at once.”

After two surgeries to remove the cancer and lymph nodes in her chin, Cate began treatment under the guidance of Dr. John Kirkwood. For six weeks during her fourth-grade year, Cate left school early so she could receive four to five hours of interferon infusions each evening at Children’s Hospital in Pittsburgh. After that time, she received interferon injections at home three times a week.

Her doctors, Dr. John Kirkwood and Dr. Peter Shaw, hadn’t administered the drug to a child before and weren’t sure about the side effects Cate would experience. The first few rounds were tough, she remembers. She had chills and a fever and had trouble sleeping. But her mom helped her treat the symptoms, and though the injections exhausted her, she continued attending school full-time.

Her peers took turns staying inside with her for recess – a precaution to protect the port in her arm – and she, along with a child life therapist, Mike Shulock, from the hospital spoke to her class about melanoma and what treatments she would be going through.

“We tried to keep everything as normal as possible while we were going through it so as to not add any additional stress or fear,” she said. “But I know that people around me were scared for me. Even though I was weak and my hair thinned out, I really did feel like I knew I was going to get through it.”

The heavier, emotional conversations with her family came years later when Cate was old enough to understand the severity of her diagnosis.

“I didn’t really realize it when I was that age, but when I look back, I realize I could have died.”

Those conversations made Cate much more aware of her body and motivated her to check her skin frequently and take precautions when she’s in the sun.

But the biggest lesson, she said, came from recognizing her own resilience and inner strength.

Cate, who stands at 6 feet 1 inch tall, has always been athletic. She played basketball, field hockey and lacrosse and is a standout rower who was chosen for Princeton’s team, one of the top Division 1 women’s rowing teams in the country. She said she loves the feeling of being on the water, working in unison with her teammates, and she has her sights set on rowing for the U.S. Olympic team.

“Knowing how far I’ve come and everything I’ve done to get here – both athletically and physically – really makes me proud because I did have to work for it,” Cate said.

It took Cate almost two years to rebuild the physical stamina and strength she lost during her melanoma treatment.

In her first lacrosse practice after her treatment, Cate remembers heaving after trying to run alongside her teammates.

“Just walking left me out of breath and I had to reset my whole body,” she said. “The whole experience has made me grateful for everything in my life.”

As she wraps up her senior year of high school, Cate is focused on giving back and continuing to share her story. She’s chosen to partner with AIM at Melanoma for her senior project and wants to help fundraise and spread awareness about melanoma and its prevention.

She’ll also be an honoree at this year’s AIM walk in Pittsburgh in May.

“Being able to still share my story is really important to me because it was such a big event in my life,” Cate said. “The fact that people still want to hear about it and still want to learn from it makes me feel really inspired. I really want to learn from others’ stories and experiences and have them learn from mine.”