'I noticed a mark on my toe - then life changed in a second'
A woman was startled to find out the peculiar mark on her nail, which she discovered while removing nail varnish and presumed to be a bruise, turned out to be the early warning sign of aggressive skin cancer. Laura Jennings, an active 40-year-old from Leeds initially thought little of it.
She said: "I'm fairly active and can be clumsy at times, so I figured I'd kicked something and got a bruise under the toenail that would naturally fade.
"It certainly didn't look like anything I should be worried about, and it wasn't painful so I kept it covered up with nail varnish and carried on as normal."
But the situation took a worrying turn when her nail began to disintegrate upon removing the varnish: "Then one day, I took the nail varnish off and part of the nail disintegrated. I thought, 'Well, that's not good.' But people lose their toenails all the time, right?".
What Laura didn't realise was that this was the start of her battle with cancer that kicked off in April 2022, during a time when COVID's lingering effects were still causing havoc with healthcare access. Struggling for a face-to-face appointment, Laura's GP consultation happened over the phone, where she sent in photos of her toenail, eventually leading to a misdiagnosis of a fungal nail infection and a futile anti-fungal treatment, while her nail sample went off for analysis.
Despite her test results showing no signs of infection, Laura's GP reassured her and advised her to continue with the treatment plan. She was told it could take up to a year for a new nail to grow back, so she didn't worry when her toe didn't improve after several months.
However, by Easter 2023, she became worried as her condition seemed to worsen.
"I like to think I'm fairly intelligent and pay attention to health-related campaigns. I know if there is blood in my poo or a lump in my boobs or if a mole starts to itch, bleed or change colour, I know to get those things checked out. But no one ever tells you to look out for this," Laura said.
"I went back and I pushed for a face-to-face appointment. I thought my toenail just needed to be taken off to be free to grow a new one. But the GP I saw knew straight away that this could be something much more serious."
Laura's doctor had recently attended a conference on melanoma where she learned about acral lentiginous melanoma, a rare type of skin cancer that appears under the nail or on the palms of the hands or soles of the feet.
She immediately referred Laura to a dermatologist and within a month, Laura found herself in an operating room. A specialist removed her nail and extracted as much of the tumour as they could.
When tests confirmed that she had cancer, the mum-of-one felt her world crumble.
"I just went into a state of shock," she remembered. "My legs were shaking. My whole body was shaking. I'm a solo parent. I've got a little boy and a lot of living still to do. You know, anyone that receives a cancer diagnosis, your life changes in a second."
Further operations were needed, resulting in part of Laura's toe being amputated to get rid of the cancerous cells. She also had a lymph node in her groin taken out to check if the disease had spread up her body.
As she waited for the results, Laura faced the most challenging emotional toll of her journey.
"My mind was the challenge," she said. "I was taking my son to swimming lessons, wondering if that was going to be the last one I would take him to. I couldn't help thinking, 'What if I don't see him through school? What if I'm not here for him if he gets married? What if I never get to be a grandma?'".
"Out of nowhere, my whole life started flashing before me because of this thing called melanoma. It was like my body had turned against me. I'd never been so scared that my life could be taken away without me wanting it."
Around 17,500 new melanoma cases are diagnosed each year in Britain, an average of 48 every day, according to Cancer Research UK. Acral lentiginous melanoma (ALM) is far more rare - with 1% to 3% of melanoma patients diagnosed with the condition.
It is considered a more aggressive form of melanoma cancer and is most common in people with dark skin and those who are middle aged or older.
While the exact cause is still a mystery, experts believe it's not caused by sun exposure. Initially, treatment kicks off with surgery to remove any bad cells or the tumour itself, and depending on how far the cancer has gone, might involve immunotherapy, drugs targeting the cancer, chemo, or radiation therapy.
Laura felt a weight lift when she was told they'd got all the cancer out and that it hadn't spread according to her lymph node biopsy. Still, she's looking at regular appointments for three more years – five checks in total – before she can really be considered clear. But there's always that chance it'll come back.
With May being Melanoma Awareness Month, Laura's determined to let people know about Acral Lentiginous Melanoma (ALM) and what signs to watch for.
"Friends will ask what I think if they have a mark on a nail, and I say, 'I'm not a doctor, but what I think is you should go and get it checked if you're worried,'" she advised.
"Because if something is not normal about your nails, you must get it checked. It might be a fungal nail infection, it might be because you banged it with something. But it could be something more. Early detection really is key."
Having decided not to dwell on her tough times or the missed opportunity for an earlier diagnosis, Laura said she was actually quite impressed with how well her toe had healed.
"My fantastic consultant is also a plastic surgeon, so it doesn't look bad at all," she explained. "In fact, lots of people don't really notice. It's like I've just got a shorter toe and no toenail.
"Every single day is very important to me, and actually, I think having a visible reminder of what I've been through is important. It's a daily reminder of how precious life is, that encourages me to make the most of every day, every opportunity to celebrate and most of all, life's simplest pleasures. Because after all, life isn't a dress rehearsal."
For further details on melanoma skin cancer, check out Melanoma Charity for Professionals, Patients and Public or ring the complimentary Melanoma Focus Helpline on 0808 801 0777.
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