A young woman’s battle with skin cancer
By Caroline Coveyduc
My melanoma story began in June 2019. I noticed a raised dark brown mole on the back of my right arm that sometimes got itchy and would shed its skin like a reptile. Strange, I thought. So I wanted to get it removed, just to be safe. I got an appointment later that month to have it removed by a doctor at a walk in clinic, I had no family doctor at the time because my soon-to-be husband and I had just moved to British Columbia for work.
I went on with life as usual, doing some final planning for our wedding back in Nova Scotia in August. I received a call to come into the clinic where I had had the mole removed so that a doctor could review the results with me. I figured this was just a money grab from the government. More appointments equals more money, right? Not the goal in this case. As I sat across from a doctor I’d never met before, he started to explain that the results came back as positive for malignant melanoma. My heart sunk at the sound of his words. I looked at my fiancée and laughed because I didn’t know what else to do. The doctor then said he would be in touch with my family doctor and make sure I was referred to all the necessary specialists to get this managed as soon as possible. I left the clinic and waited until I got to the car to burst out in tears. My fiancée hugged me and said, don’t worry things will work out. So I sniffed up my tears and told myself, lots of people get skin cancer spots removed and that’s the end of it so don’t panic until we know more.
August comes and we fly home to Nova Scotia to get married. The day was perfect and we enjoyed all our time with friends and family. A much-needed escape from reality. After a week we returned to BC and worked on getting our new home all set up the way we wanted it. Soon after I would hear from a surgeon about getting more testing done before more tissue are removed around where the melanoma had been. After several scans and biopsies, I got a stage 3c diagnosis. The cancer had spread to at least one lymph node in my right armpit. There were also spots in my liver but they were too small to test further. Not just the simple skin cancer case I had hoped for.
“No skin cancer case is simple, as I quickly learned.”
The first phase included surgery to excise more tissue from the original site of the melanoma, plus removal of 21 lymph nodes from my right armpit. After a few weeks of pain, nausea, and emptying the drain attached under my armpit, I starting feeling better. There is still some pain and numbness in the areas of the surgeries and some mild lymphedema but otherwise, things have healed nicely. Phew.
The second phase involved adjuvant treatment with immunotherapy. The hope is that post-op treatment will mop up any cancer cells that remain to prevent spread and reduce the risk of disease recurrence. Unfortunately, I only got two treatments in with Keytruda before getting a cardiac side effect that hospitalized me just before Christmas of 2019. Because of this, treatment was stopped and I was put on a host of drugs to help my heart recover. All while praying there was no cancer growing inside me anywhere.
The third phase (and current phase) involved initiation of targeted therapy (Dabrafenib & Trametinib) which target a specific mutation in the cancerous cells. Not everyone has this mutation but luckily I did so I was able to qualify for treatment. FYI: If you don’t possess the BRAF mutation the medication is unlikely to have benefit as this is the basis of the mechanism of action. So, I started on the highest dose available and studied and kept chugging along. Unfortunately, I’ve come to experience many of the listed side effects from this medication combination which has made the road a bit rough. One to mention is called iritis, an inflammation inside the eye that doesn’t go away unless treatment is stopped but can be managed with eye drops, provided it isn’t too severe a case. My symptoms include decreased distance vision, white flashing spots in my peripheral vision, sun sensitivity; red blood shot eyes, and general eye irritation. I used prednisone eye drops daily to help manage the symptoms and see an ophthalmologist at least monthly. The other non-eye symptoms included fatigue, body pain, leg swelling, various types of skin rashes and diarrhea! So I felt like I have the flu most days but I focused on the fact it would help me live a longer disease-free life. I managed to find a lower dosage that was more tolerable but still had to take some time off work to cope.
Fast forward to today and I now have two enlarged lymph nodes, one near my breast on the right side and one in my left armpit. The next phase will involve getting a PET scan. This will rule out disease anywhere in my body so I can stop worrying about disease recurrence, at least for a little while. Recurrence rates are high and scary but the new treatments available to us have come a long way from basic chemotherapy and for that I am thankful!
I want to thank Melanoma Network of Canada for being part of my support system throughout my journey with cancer.
