John Wilson, a nurse in London for nearly eight years, thought he had seen his fair share of strange lumps and moles. But it wasn't until 2014, when his GP pointed out an oddly shaped mark on his back, that the then 30 year old realized he had missed a key warning sign of skin cancer on his own body.
Wilson's doctor took a small shaving of the mole, which was large, black and jagged edged, hidden just under his right armpit, and tested it on the spot. By the next day he had a diagnosis of melanoma, the deadliest form of skin cancer. The disease was in its earliest stages and doctors removed it that same day.
Wilson said it was a massive shock to get a diagnosis like that, and he was grateful the GP had noticed it. After the cancer was removed, he decided to get out and live his life. Over the next decade he worked as a nurse across the world, treating disadvantaged communities in Australia and Asia and sailing the Atlantic.
Then in January this year, just weeks after moving back to London, Wilson ended up in hospital again, this time with a suspected kidney stone.
Cancer had spread
When doctors looked at the CT scan to confirm the kidney stone diagnosis, they also found what looked like a tumor in his liver. After more scans, Wilson and his partner, Felicia, were given devastating news: his cancer had returned, this time spreading to his lungs, liver, kidney and abdominal wall.
Wilson was stunned. He had no new skin changes and felt completely fine, other than being more tired than usual, which he had put down to the stress of moving.
Wilson said it was like a sledgehammer to the face, but added that he was insanely lucky to have had the kidney stone, or he could have gone on for months or even years without knowing. He said that as a nurse, he hadn't recognized the symptoms or signs of skin cancer either time, and that members of the public without medical training have even less of a chance. He said better awareness is needed around the signs of melanoma.
Rising cases
Diagnoses of skin cancer have climbed significantly in Britain over the past decade, with melanoma cases rising by almost a third. There are now around 21,000 new cases of melanoma every year and nearly 2,300 deaths, making it one of the most common cancers in the country.
The main symptom is any new or changing growth, including moles that change in size, shape or color, or that develop jagged, irregular borders. Skin cancers can also look like persistent sores that bleed, itch and crust, or unusual waxy, scaly bumps. Nine out of ten cases are considered avoidable, with exposure to ultraviolet rays from the sun or sunbeds the leading cause. The condition is more common in men than women, with cancers tending to appear on the torso or neck in men and the lower limbs in women. Experts say rising cases are likely due to an ageing population, improved diagnostics, and the increasing popularity and affordability of foreign holidays and outdoor sunbathing.
A survey published earlier this year by the charity Melanoma Focus found that one in nine British adults have deliberately burnt their skin, putting them at heightened risk of melanoma. The survey of more than 3,000 UK adults also found that one in three admitted to never using sunscreen. Health Service advice is to always use suncream with an SPF of at least 30, applying six to eight teaspoons to the entire body every two hours, and always after swimming, sweating or towelling dry.
Dr Christopher Rowland Payne, a consultant dermatologist at The London Clinic, said most melanomas are spotted because they appear as a new mole or a change in an existing one, usually in areas exposed to the sun. Caught early, melanoma is almost always curable, but it becomes far harder to treat over time. He said signs that the cancer has spread can vary depending on the organs affected, but common symptoms include hard lumps under the skin, swollen lymph nodes, persistent fatigue and unexplained weight loss.
Low chance of recurrence
The chance of a removed stage 1 melanoma recurring is generally low, and Wilson believes he was simply unlucky. Dr Rowland Payne advised anyone who has had cancer and notices a change in energy levels, weight or any new lumps to see their GP, and said the best way to avoid skin cancer is to limit sun exposure in the first place.
Wilson is now having immune-boosting treatment. He said his diagnosis has again given him a new sense of what he wants to do next. He is studying for a qualification in dermatology and hopes to one day train others to spot signs of skin cancer and give free mole checks through his charity, Spot It Early.
Wilson said he wants to use what he has learned, and what he is going through, to make a difference for others. He said the difference between catching cancer early and late can be everything, and that he knows that better than anyone.
Wilson is raising money for his charity on GoFundMe.
