Melanoma: “I didn’t think anything so small could be sinister”

Posted on: 20 July 2010 by Mark O'haire

Eleven years ago an article in YOU magazine prompted Jill Fordham to get the unusual mark on her arm checked out – which subsequently saved her life. Here she tells her story.

MoleIn early 1998, I was feeling unwell – exhausted, I thought, by my role as a single parent to three children (then aged 19, 17 and 14) coupled with a career as an education social worker. My resources felt so depleted that I decided to visit my doctor. Then, the night before my appointment, I read an article in YOU entitled ‘My new mole looked harmless…’

A couple of months earlier I had noticed a pinprick of a mark along the edge of a birthmark on my inner right arm, but it hadn’t changed since, so I hadn’t thought about it – until I read that article.

At my GP’s surgery, I focused on my exhaustion, for which I was prescribed antidepressants and a sedative to help me sleep. Then, as I was about to leave, I asked him to look at the mark. He did, and said something reassuring about it probably being nothing – but also that he would refer me for a specialist opinion, just to make sure.

On Monday 9 February, at my local hospital in Harrogate, I attended an outpatients’ clinic where, under local anaesthetic, a large area of my skin was removed. The doctor said it was a ‘precautionary measure’ and I would receive the results of the biopsy in a couple of weeks.

When I returned for the results I wasn’t too concerned. I didn’t think that anything so small could be really sinister, and it wasn’t as though my inner arm had seen much sun – if it had been somewhere more exposed I would have been more worried, for as the daughter of an RAF officer, I had spent many of my formative years living in hot climates.

The new mark, although slightly raised, had been barely visible; the other had been there for 45 years with no problems.

The doctor told me that someone must have been watching over me, because I had an early-stage malignant melanoma, a skin cancer that, untreated, could have killed me. I needed another operation the following day, in order to remove a larger area of skin and eliminate any remaining risk that the cancer might still spread.

The words were delivered kindly, but the diagnosis left me numb. A nurse gave me a cup of tea, which I spilt in shock. Instead of relief that the cancer had been caught early, I had a feeling that there was worse to come.

article-1198378-047742C6000My memory of that evening is vague. I only know that I was determined there would be no disruption to the children’s lives, and in particular to my daughter Gemma, who was about to sit her A-levels. Having raised them alone for most of their lives, I wasn’t going to allow anything to distract them from finding success and happiness in whatever field they chose.

There is no easy way of telling your family that you have cancer: all I could do was try to reassure them that, as it had been caught early, I was sure to be all right. Gemma responded with questions that I attempted to answer as positively as I could. Ben, the eldest, took the news passively – stunned, I think, into silence – while Abbie, the youngest, sought comfort in the company of friends.

My brother Mike took me to hospital the next day. I saw the same doctor, who dug deeper this time, across a larger area, leaving me with a ragged wound. My diary entry reads ‘extensive surgery to arm’ – I didn’t know that there was worse to come. My next appointment, on 10 March, reinforced my fears.

The consultant dermatologist told me that sufficient clearance hadn’t been achieved, and while it was unlikely that the cancer had spread, the biopsy indicated that to ensure that it didn’t, further surgery was required. There was a high probability of my needing plastic surgery, so I was to be referred to St James’s Hospital in Leeds.

My first appointment at St James’s was three days later. My consultant surgeon left me in no doubt about the seriousness of my condition, yet made me feel confident. He inquired about my life history and asked if I had ever been overexposed to the sun.

The years I had spent living abroad as a teenager had come back to haunt me, for this, he believed, was when the damage had been done. It can take 20 or more years for a melanoma to become visible, after which, within a much shorter space of time, the often tiny tumour can spread cancerous cells, and if left untreated cause death.

I returned to Leeds at the end of the month and underwent the next procedure under heavy sedation. St James’s is a teaching hospital, and I was vaguely aware, through a drugged haze, of my surgeon informing watching students that ‘if she makes the next five years, then her life expectancy will increase to 70 per cent of the norm; after ten years it will return to that of someone who has never had cancer’. 'The years I had spent living abroad as a teenager had come back to haunt me'

This time I was left with numerous stitches as nerves were removed from deep within my arm to prevent any spread of cancer through the lymph system. This was done with such skill that I didn’t need plastic surgery. There followed another agonising two weeks before I was told whether this third attempt had caught all the cancer.

I was relieved to see the children apparently pursuing their lives as normal. It was only later that I found out how worried they’d been – in particular Ben, who had hidden the fact that he couldn’t sleep for fear of losing me. I became self-absorbed – experiencing dreadful pain in my arm from the surgery and aware that if the cancer had not been completely cleared, I might have to lose my limb. For at present there is no treatment for melanoma other than surgery.

I was finally given the all-clear at St James’s on 9 April. The children’s response was rapturous, but I felt relieved rather than elated. The months of worry had taken their toll and, with my energy reserves depleted from the start, it was only gradually that I began to regain control over my life.

There have been periodic reminders since of my need for vigilance. Two years later, two moles were removed from my back and proved benign. More recently, a small raised mark on my nose was removed by cryotherapy, a process of freezing with liquid nitrogen.

The face is particularly at risk owing to its constant exposure to the sun – a fact brutally reinforced when, during a period of retraining, I worked in a hospice, thinking that my experience of cancer would be of help. One of the terminally ill patients had lost her entire nose; another young woman died shortly after admission, both as a result of melanoma.

Most dispiriting of all, two of my dearest friends lost their lives to cancer in recent years – one to a melanoma diagnosed at the same time as mine, but tragically at a later stage.

Yet I have endeavoured throughout these years to grasp every opportunity and enjoy every experience I can – the most precious of which are spent with my children. In 2004 I was forced, as a result of ill-health unrelated to the melanoma, to take early retirement, but through that my writing has evolved – inspired by a visit to India.

Life is too short to waste, and as I reflect on the past 11 years, which I could easily have lost had it not been for YOU magazine, I hope that, in telling my story, I can help others in the way that the piece I read all those years ago helped me.

Melanoma: the facts

  • Malignant melanoma is the most serious type of skin cancer, causing the majority of skin-cancer-related deaths. According to Cancer Research UK, cases have more than quadrupled in 30 years. The total number of cases in 2006 (the most recent figure available) was 10,410. This is expected to rise to more than 15,500 by 2024, making melanoma the fourth most common cancer.
  • Early diagnosis is essential to prevent cancerous cells from spreading. Causes are almost always linked to overexposure to UV light, especially during the first 20 years of life (the use of sunbeds raises the risk), but rarer forms can appear in areas that have had no sun exposure (such as inside the mouth).
  • Most at risk are fair-skinned people who burn easily (particularly anyone with past episodes of severe sunburn), those with a large number of moles (more than 50) and with moles of irregular shape and colour. The risk is raised if another family member has had a melanoma, or if you have had one previously yourself.
  • Check your skin regularly and report any changes to your doctor promptly. key changes to look out for include…

Size and shape Some melanomas can begin as a dark area that looks like a new mole. Also be aware of any existing moles that have become larger and changed shape. Be particularly aware of asymmetry (where the two halves of the area differ in shape) and the border around the mole — the edges may be irregular or blurred, and sometimes show notches.

Colour Look out for uneven shades of black, brown and pink.

Diameter Most melanomas are at least 6mm across.

Tingling and itching at an early stage; later it may feel hard and lumpy, and may bleed, ooze or crust up.

Superdrug operates a mole-checking service in 19 of its stores, with prices starting from £30 for a single mole check-up. Call 0845 678 9111 for more information.

Further information can be obtained from Macmillan (tel: 020 7696 9003, Macmillan) and Cancer Research UK (tel: 020 7242 0200, cancerhelp.org.uk).

(This feature has been reproduced with the kind permission of YOU magazine and The Mail on Sunday.)

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