LAURA Jennings would never have guessed the ugly mark on her nail was a sign of deadly cancer.
“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,” the 40-year-old from Leeds says.
4
4
“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 when she took the nail varnish off part of the nail disintegrated.
“I thought, ‘Well, that’s not good.’ But people lose their toe nails all the time, right?” she added.
She didn’t know it at the time, but Laura was at the beginning of a cancer journey.
It started in April 2022 – a period when the impact of the Covid pandemic was still disrupting healthcare services and limiting face-to-face appointments.
Unable to get an in-person appointment, the business development director had a telephone consultation with her GP and submitted photos of her bruised toenail.
She was diagnosed with a fungal nail infection, prescribed an anti-fungal ointment and part of her nail was sent off for tests.
And despite results showing no sign of infection, her GP reassured her and told her to carry on with the treatment plan.
Warned it could take as long as a year for a fresh nail to grow out, Laura didn’t think twice when her toe failed to improve after several months.
But by Easter 2023, she grew concerned by the lack of improvement – in fact it looked much worse.
The mum-of-one said: “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 says, recalling her concern.
“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 attended a conference on melanoma where she learned of acral lentiginous melanoma (ALM), a rare type of skin cancer.
Signs appear under the nail or on the palms of the hands or soles of the feet.
She immediately referred Laura to a dermatologist.
Within a month she found herself in an operating room where a specialist removed her nail and extracted as much of the tumour as they could.
When testing confirmed that she had cancer, the mum felt her world shatter.
“I just went into a state of shock,” she recalled.
She added: “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 surgery followed, and part of Laura’s toe was amputated to remove the cancerous cells.
She also had a lymph node in her groin removed to test if the disease had spread up her body.
As she awaited the results, Laura encountered the hardest emotional toll of her journey.
“My mind was the challenge,” she explained.
“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.”
4
4
Around 17,500 new melanoma cases are diagnosed each year in Britain, an average of 48 every day according to Cancer Research UK.
ALM is far more rare – with one per cent to three per cent 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 cause is not yet fully understood, it is not believed to be linked to sun exposure.
Treatment begins with the removal of the affected cells or tumour and can later include immunotherapy, targeted therapy, chemotherapy, or radiation therapy – depending on the stage and spread of the cancer.
Laura was relieved when she was told the cancer had been successfully removed and the test on her lymph node showed that it had not spread.
However, she will require regular check-ups for the next three years, five in total, before she can officially be considered free of the disease – but even then, there is no guarantee it won’t return one day.
May is Melanoma Awareness Month and Laura hopes sharing her story can help raise awareness of ALM and what to look out 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 explained.
“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.”
What is melanoma, what are the symptoms and how can you prevent it?
Melanoma is the most serious type of skin cancer that has a tendency to spread around the body.
It is diagnosed 16,000 times per year, and tragically takes the lives of 2,340 people per year.
The number of people being diagnosed with melanoma is increasing, and it is the 5th most common cancer in the UK.
But it is also one of the most preventable cancers, with 86 per cent of cases in the UK avoidable.
The best way to protect yourself from melanoma is to be sun safe – wear SPF every day, wear a hat and sunglasses and keep out of the sun in the hottest hours. It is also advised to avoid sunbeds.
People who are fair-skinned, have blue or green eyes, blonde or red hair and a large number of freckles or moles are more likely to get skin cancer.
Surgery is the main treatment for melanoma, particularly if it is found early. This will involve removing the affected tissue in the skin.
Radiotherapy, medicines and chemotherapy are also sometimes used to try and stop the cancer from growing. Treatment depends on the severity of the disease.
What are the symptoms?
The key thing to look out for are changes to an existing mole, or a new mole on your skin.
Most experts recommend using the simple “ABCDE” rule to look for symptoms of melanoma skin cancer, which can appear anywhere on the body.
There are five letters/words to remember:
- Asymmetrical – melanomas usually have two very different halves and are an irregular shape
- Border – melanomas usually have a notched or ragged border
- Colours – melanomas will usually be a mix of two or more colours
- Diameter – most melanomas are usually larger than 6mm in diameter
- Enlargement or elevation – a mole that changes size over time is more likely to be a melanoma
A mole that changes size, shape or colour may be a melanoma.
But other signs to look out for include moles that are:
- Swollen and sore
- Bleeding
- Itchy
- Crusty
How deadly is it?
Melanoma is a deadly form of skin cancer.
The outlook of a person’s disease depends on the stage of the cancer when it was diagnosed.
Survival is better for women than it is for men.
“We don’t know exactly why this is. It may be because women are more likely to see a doctor about their melanoma at an earlier stage,” says Cancer Research UK.
The charity says that generally, statistics show that in England, more than 85 out of every 100 people (more than 85 per cent) will survive their melanoma for 10 years or more after they are diagnosed.
- Around 100 per cent in England diagnosed with melanoma at stage 1 – when the cancer cells are only in the top layer of skin – will survive for five years or more after diagnosis.This drops to 80 per cent for stage 2.
- Some 70 per cent live for a further five years when they are diagnosed in stage 3, which is when the cancer has started to spread to nearby lymph nodes.
- At stage 4, when the melanoma has spread elsewhere in the body, almost 30 per cent survive their cancer for 5 years or more.
Cancer Research says the stage 4 data does not account for age differences. Age can affect outlook and younger people have a better prognosis than older people.
Age can affect outlook and younger people have a better prognosis than older people.
What is melanoma?
Melanocytes are cells in the skin that give us the colour of our skin because they produce a pigment, known as melanin.
When you sit in the sun, melanocytes produce more pigment (a sun tan), which spreads to other skin cells to protect them from the sun’s rays.
But melanocytes are also where cancer starts.
Too much UV causes sunburn, and this is a sign of damage to the skin’s DNA.
The UV triggers changes in the melanocytes, which makes the genetic material become faulty and cause abnormal cell growth.
People who burn easily are more at risk of skin cancer because their cells do not produce as much pigment to protect their skin.
Those with albinism are at the most risk because their skin produces no pigment at all.
Admitting life is too short to be angry over her ordeal and the fact she missed a chance to be diagnosed sooner, Laura adds that she is proud of the way her toe has healed.
“My fantastic consultant is also a plastic surgeon, so it doesn’t look bad at all,” she says.
“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.”