We have a well-documented passion for sunscreens and saving our skin from the brutality that can come of the sun’s harmful rays, but sometimes news of a life taken from skin cancer far too soon reminds us of the importance of prevention—and, in this case, getting a second opinion.
UK teen Freja Nicholson passed away at the young age of 18 from melanoma and her mother Jennifer has been working to spread awareness of the far-too-common disease ever since. But, the story doesn’t stop there. Nicholson, as told to the Mirror, says she spotted a mole on her daughter’s back four years before she died, noting that it grew from small and brown to larger, lumpy and black. Concerned, doctors cut out the mole and ran a biopsy on it, telling the family it tested negative for cancer. Fast forward to constant pounding headaches a couple of years later, doctors discovered a new lump on her arm—it measured five centimeters, extending under the skin—and tested positive for melanoma.
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Tests showed that the cancer had spread to her brain, revealed a stage 3 tumor and a poor prognosis. After the doctors removed the tumor, the cancer returned in the breast, brain, arm and lung, leading to her death in late 2015, which Nicholson says is when she remembered the mole on her daughter’s back. According to Nicholson, she asked the doctors if the mole and cancer were related, and their response was that she should, in no way, have let her guard down. “If I’d known, I would have had her covered from head to toe,” Nicholson tells the Mirror, adding that until this day she still suffers from massive amounts of guilt, thinking that she could have saved her daughter’s young life.
After asking the experts about the chances of a false positive in a severe case like this one, New York dermatologist Whitney Bowe, MD, says that it’s almost unheard of for a mole to be biopsied and come back benign (or normal) and actually be melanoma. “Dermatopathologists (pathologists who are trained in examining the skin) are incredibly well trained at differentiating concerning lesions from benign ones,” Dr. Bowe explains, adding that if they are at all concerned, they usually report that there is “atypia,” in which case the dermatologist is alerted to remove a margin of normal tissue during a second procedure just to be certain that the entire lesion is removed.
“For a lesion to come back as 100 percent benign and then ultimately turn out to be a melanoma is a very rare occurrence and I would be more inclined to believe that this poor girl had a different lesion that was the source of her metastases,” advises Dr. Bowe. “The arm lesion might have been the primary melanoma that then spread, or it might have been a “met” or a metastasis of another undiagnosed melanoma.” Dr. Bowe says that, for example, she might have had a primary melanoma in her eye (something she might not have known unless she had been to an eye doctor), or under her fingernail or between her toes that was missed and then spread to other parts of her body.
According to Dr. Bowe, a changing mole can be a normal part of the lifecycle of a mole, or it can be a sign of cancer. “That’s why it’s so critical to show any changing lesion to your dermatologist, even if you notice it in between your annual skin check.” She says that by the sound of the story, this young girl wasn’t seeing a dermatologist regularly, nor was she doing monthly self exams, shedding further light on the importance of protection and sun-safe behaviors no matter what climate you live in or what your family history may be.
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