Shannon Gaudette and her husband, Brad, were overjoyed when they learned she was pregnant with their first child at the end of 2010. Before that, she had been treated for melanoma, an aggressive form of skin cancer, twice: first in 2005, after it appeared in a mole on her arm, and then when it came back five years later in a lymph node in her armpit on the same side. Although doctors and a clear PET scan reassured her she was fine, five months into her pregnancy she started noticing strange symptoms.
“My foot went numb,” Gaudette says in a phone interview. “I started to feel like I had the flu. I had insomnia and these weird muscle twitches.”
Her doctor assumed her problems were linked to the exhausting effects of pregnancy. But within three weeks, after she got to the point where she could barely walk, an emergency-room physician gave her devastating news.
“An MRI showed two tumours in my brain,” Gaudette says. “One was the size of an orange; the other was the size of a lemon.”
Melanoma is the most dangerous of all skin cancers. The most common sites for it to spread are the lymph nodes, lungs, brain, spinal cord, and liver, according to the B.C. Cancer Agency (BCCA). And its incidence and mortality rate are increasing.
“I had heard about melanoma for the first time in 2005 after [MP] Chuck Cadman passed away from the disease,” Gaudette says. “When I heard that news, I just thought: ‘What? How is that possible?’ I didn’t know that skin cancer could kill you. Then two weeks later, I heard the word again, this time directed at me.”
Doctors at the first hospital she visited told Gaudette and her husband there was nothing they could do for her and that he would probably lose his wife and their baby. However, Richard Chan, a neurosurgeon at Royal Columbian Hospital, agreed to have her transferred and take on her case. Besides an experienced neurosurgery team, RCH also has a neonatal intensive-care unit that could provide the baby with the best chances of survival if something happened to her mom during the risky operation.
Not only did Mom and baby survive the procedure, but within a week, Gaudette was walking.
Now she’s savouring every moment with her one-year-old daughter. She’s also a board member for the Save Your Skin Foundation, a North Vancouver–based organization that seeks to educate people about melanoma and the deadly effects of the disease. It also pushes for new and effective treatments and helps people from around the globe access them, including drugs being tested in clinical trials.
Malignant melanoma originates in melanocytes, the cells that produce the pigment responsible for skin colour (melanin), according to the BCCA. Too much exposure to ultraviolet light—which is a form of radiation—particularly repeated, intermittent, or irregular episodes of intense sun exposure during childhood, damages the skin. UV light from tanning beds also causes skin damage.
Melanoma is most common in light-skinned people with freckles and many moles. In women, melanomas usually occur most on the back and legs, while in men they occur most often on the back and trunk. People who have had one melanoma have a greater risk of developing more.
Kathleen Barnard started Save Your Skin after her own harrowing experience with melanoma. In 2002, one of her nieces urged her to see a doctor about a mole on her back and a lump on her left arm.
Barnard went to her family physician, who said everything was fine and that the lump was merely fatty tissue. Three months later, because of her niece’s insistence that she get the mole and what were now two lumps on her arm checked again, she went back, only to be told once more that she had nothing to worry about.
“My doctor said, ‘If you’re worried about how you look, I’ll send you to a plastic surgeon,” Barnard explains in a phone interview. “The plastic surgeon took one look and said, ‘Oh, my God. We have a problem.’ ”
She quickly discovered that melanoma had spread into her lymph system, and she had surgery to remove the mole and lumps, as well as radiation treatment and a course of interferon. Barnard went back to work, only to attend a routine checkup in 2005 to get more bad news: there was a 14-centimetre mass in one of her lungs.
One doctor suggested removing a lung; others told her she had six to nine months to live.
Barnard and her family frantically started researching other treatment options around the world and found a clinical trial she qualified for that was taking place at the Cross Cancer Institute in Alberta. It cost her $40,000, but Barnard went to Edmonton for treatment.
She responded quickly to the drug and the mass began to shrink. Then, in 2007, she had a tumour in her small bowel removed. She’s been advocating for melanoma patients ever since. Barnard, who travels the globe to speak at cancer conferences, says Canadians should have faster access to new, lifesaving drugs for melanoma.
“In 2005, five young kids I’d met under the age of 30 died of melanoma,” she says. “I will never forget them. I mention them in every presentation I do. They should never have died.”
According to Save Your Skin, it’s crucial to see a doctor who specializes in skin diseases and who can spot melanoma at its earliest stage. The BCCA recommends annual screening for high-risk individuals, ideally by a dermatologist, but not for everyone. “General population screening for cutaneous malignant melanoma either by regular clinical assessment or by self-screening is not recommended, as no trials have demonstrated that such screening decreases mortality,” the agency’s website states.
Barnard, however, urges people to check themselves and their loved ones for moles. She shares the “ABCDE” slogan to remember how to spot a suspicious mole. Warning signs include asymmetry; borders (a mole with uneven, scalloped, or notched edges); colours (a variety of shades, such as brown, red, white, black, or blue); diameter greater than six millimetres (about the size of a pencil eraser or larger); and evolution (watch for changes in size, shape, colour, or height of a mole). Plus, be wary of new symptoms such as bleeding, itching, or crustiness.
“I really want more awareness around this disease,” she says. “It’s absolutely preventable. If caught early, it’s curable. We need to keep our kids safe, and we need to be checking our skin so that people don’t get to where I got.”