A WOMAN has shared how she found a worryingly small early symptom of cancer on her husband’s toenail – which was dismissed by doctors as a fungal infection.
David Edges wasn’t concerned when a faint line appeared on one of his toenails, but it rang alarm bells for his wife Kelly.
Kelly Edges spotted a subtle sign of skin cancer on her husband David’s toenail[/caption]
She grew concerned when she saw a line across his toenail – but doctors dismissed as a fungal issue[/caption]
The line gradually grew thicker and it turned out to be a sign of melanoma[/caption]
The 47-year-old skin specialist had taken a course about nail conditions during her training and remembered that changes like the line could hint at something serious.
She insisted David, 52, get checked by a doctor, who said to just keep an eye on the nail.
A second opinion from another GP, prompted by Kelly, had a similar result – with this doctor allegedly dismissing the line as a fungal issue.
But Kelly monitored the change in the nail and noticed the line thickening over time.
The couple insisted that doctors get a biopsy from David.
This revealed that the 52-year-old in fact had a type of skin cancer called melanoma, confined to just that area of the skin.
“It’s awful to hear the words melanoma,” Kelly, from Solihull, said.
“I first noticed the line in May 2022 and it rang alarm bells because I remember learning about nail conditions and changes during my training back in the late 90s.
“I also understood that you cannot tell the difference between a malignant subungual melanoma (skin cancer that develops under the nail) and a benign one.
“Doctors are great at quick referrals for changes in moles on the body but because subungual melanomas are so rare, there didn’t seem to be a lot of concern for his toe.
“David visited the GP that same month and was told to keep an eye on it.
“He was happy to go with the professional’s advice, but I wasn’t happy.
“I kept an eye on it and the following October I noticed the line was wider and had darkened in colour.”
This time, a second GP said it was “likely to be fungal”.
Kelly kept insisting that the line on David’s toenail was something sinister[/caption]
David’s toe after a skin graft[/caption]
Kelly said: “I felt very frustrated at this point so we booked a private appointment.
“The doctor thoroughly checked David’s toe nails and she asked for comparison photos of the toe.
“I’d taken two spaced 17 months apart, and she acknowledged that there was in fact a change.
“The line was over 3 mm in width.”
Following a biopsy, he was finally given the diagnosis.
Kelly said: “I was so happy to hear the word ‘in situ’ as this means it’s confined to the epidermis and hasn’t spread.”
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.
David underwent a procedure to remove all the cancerous cells, with a skin graft taken from his thigh added to the area to give a healthy margin of skin.
Luckily, there was no residual cancer left following the treatment.
Kelly added: “We didn’t tell our children until David got the all-clear as he didn’t want to worry them.
“Our son was doing his GCSE so it wasn’t right to worry about him.
“He’s been very private during appointments and biopsies, but now he has the all-clear he feels it’s important to let people know the warning signs.
“We don’t want to scare people with this but just want to emphasise the importance of finding cancer early.
“Now, his toe is healing nicely and we’re going on a family ski holiday in April.”
Kelly has gone on to train with Skcin, a UK-based charity dedicated to the prevention and early detection of skin cancer.
The signs of subungual melanoma
Subungual melanoma, or nail melanoma, is skin cancer under your nail.
It usually appears as a dark, vertical streak on your nail.
Subungual melanoma is rare but serious.
Unlike other skin cancers, subungual melanoma isn’t linked to sun exposure.
It’s most likely to develop in your big toe, thumb or index finger.
It usually has a distinct shape, which some may describe it as looking like you drew a line on your nail with a black or brown marker.
It appears as a dark line on your nail and runs from bottom to top.
This streak or stripe may start small but grow to cover the entire nail and extend to the cuticle.
The line will typically get wider over time, and they can also multiply.
Source: Cleveland Clinic
