When a mole went ‘rogue,’ she knew something was wrong. What followed was years of cancer ‘being very sneaky

By Christl Dabu

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    TORONTO (CTV Network) — Mary Lynn LeBlanc first noticed a mole on her left shoulder about seven years ago.

At first, doctors didn’t find anything worrying about it. She said the mole didn’t have any distinguishing features. Initially about the size of a penny, around 2019, she noticed it looked different and grew. It was round with bumpy edges. The top part was reddish-brown.

“I call it going rogue,” the 70-year-old retired teacher from London, Ont., said in a video interview with CTVNews.ca. “It didn’t hurt, but it was irritating because there was a little bit of a piece, like a skin tag, that was there. It had changed a little bit and I needed it to be looked at.”

Since she was new to the city and didn’t have a family doctor, she went to a nearby walk-in clinic.

The dermatologist did a biopsy and she was diagnosed with nodular melanoma, a less common type of skin cancer but one of the most dangerous, in January 2020.

She got surgery to remove the tumour as the melanoma had spread to her back but it returned, though smaller. After removing it, the cancer spread to her left lung and she had to get surgery again.

“The melanoma hides and it’s talked about as being very sneaky, and so it can come back and it metastasizes,” she said. “It’s a disease that definitely is difficult to identify at first and that’s why you have to be extra careful.”

LeBlanc didn’t feel any pain or other side effects, which makes melanoma hard to detect if people don’t get tested, she said. It could even turn fatal if it spreads too much in the body.

She said she received monthly immunotherapy treatments, which is different from chemotherapy and radiation, for a year.

However, she discovered she was allergic to the drug used during immunotherapy and experienced side effects, but taking other medication allowed her to get the infusions, she said.

During her latest CT scan, surgeons were concerned about a lymph node, meaning she will be examined again for possible skin cancer, she said. She has a needle biopsy scheduled in July.

Dangers of sun exposure

LeBlanc shared her story of surviving skin cancer with CTVNews.ca as cases of melanoma increase in Canada.

While doctors weren’t able to pinpoint exactly what caused her skin cancer, LeBlanc believes it was due to years of sun exposure.

As a child, she didn’t know the dangers of being exposed to the sun. She only started wearing sunscreen regularly in her early 20s. LeBlanc later developed an allergy to sunlight during that time, with a rash showing up on her neck. She would wear a shirt when swimming outside and use sunscreen but not on all parts of her body.

As a pet owner, she would regularly get direct sunlight. She recalls years of taking her Bernese mountain dogs outside for daily walks at least half an hour twice a day.

During treatment, she says she didn’t go outside as much. As she recovers, LeBlanc avoids going out between 10 a.m. and 4 p.m. when the sun’s rays are strongest, she added.

“I definitely do more sunscreen but mostly I cover up,” LeBlanc said, noting she wears a light, long-sleeve shirt and long pants. She also wears hats with large rims. “I’m very, very careful about being in the sun.”

Advice for patients

Those who are diagnosed with melanoma or other types of cancer can find support groups and resources such as Melanoma Canada and Wellspring, LeBlanc said.

Although melanoma is one of the rarest skin cancers, it’s one of the most serious types. It can be caused not only by sun exposure but also genetics, said Dr. Maxwell Sauder, an onco-dermatologist at Princess Margaret Cancer Centre in Toronto and assistant professor at the University of Toronto.

“It’s a more significant one because it’s the type that can spread to other parts of the body and can ultimately kill someone,” Sauder said in a video interview with CTVNews.ca. “In the last 30 years, the number of new cases of melanoma has tripled.”

In 2023, about 9,700 melanoma cases were diagnosed in Canada, Sauder said.

Basal cell carcinoma and squamous cell carcinoma are more common types of skin cancer, which usually don’t require advanced treatment and can be treated at a regular doctor’s office, Sauder said.

There’s good news if melanoma is caught early, he added.

“Melanoma that is caught early is very easy to deal with,” he said. “We essentially just cut it out with adequate normal skin around and that’s it. And generally, if it’s caught early, it’s got a very low risk of spreading. It’s when we leave it and it continues to grow. That’s when there is an increased risk of melanoma spreading.”

Those diagnosed with melanoma can get either targeted therapies or immunotherapies, Sauder said.

Targeted therapies, typically pills, target the genetic mutation, while immunotherapy activates the body’s immune system to find, detect and destroy the melanoma.

Prevention

Not much can be done to prevent melanoma arising from genetics, but sunscreen can help protect people since two-thirds of melanomas are driven by UV radiation, Sauder said.

Sauder recommends people do monthly self-examinations and see a doctor to check for possible skin cancer once every year, especially those at high risk of developing skin cancer.

High-risk individuals include those who have a family history of melanoma and those who sunburn easily, according to the Mayo Clinic.

“I generally recommend people check yourself on the day of your birthday so that you remember to do it,” he said.

According to Sauder and other experts, safe sun practices include wearing a hat, wearing UV protective clothing, applying sunscreen liberally and frequently, avoiding peak hours of sunlight and staying in the shade.

“Certainly avoiding artificial tanning,” Sauder added. “The UV tanning booths are basically high-intensity UV radiation that are significantly associated with melanoma and non-melanoma skin cancer.” Check for abnormal changes

Check for any moles or changes on your skin, including asymmetry, irregular borders, different colours, or anything larger than a pencil eraser. Lesions that change drastically in size or shape, itching, burning or bleeding could be bad signs and individuals in those cases should get their moles checked, Sauder said.

“Normal moles have nice smooth borders, whereas ones that should be reviewed have possibly jagged edges or finger-like projections coming out of them,” Sauder said. “A melanoma is essentially a mole that’s gone wild.”

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