Jacinta O’Brien had been taught as a child to always check her body for signs of skin cancer. When she was in her 20s, her family lost her uncle to melanoma. “I’m aware of the danger of it,” she says now.
n 2018, she was living in London, working as procurement manager, a job she still holds, now with Tesco. Then aged 38, when a mole on her forehead began to itch, she visited her doctor three times. “It discoloured a little bit and got darker. He kept sending me away, telling me it all looked normal.”
It was when a colleague who sat opposite Jacinta in work asked, “is that mole on your forehead ok?” that she decided to expedite matters. “She had noticed it because it had changed. That was really the push that made me become more aggressive.”
She returned to the doctor, describing her anxiety, and he agreed to take it off because of her concerns. “It’s very non-invasive,” Jacinta explains of the removal procedure which followed.
Afterwards, she and her husband, Chris, essentially forgot about the matter; the small scar was easily covered up with make-up. Sometime later, she received a letter from the dermatology department of a hospital.
“I thought they were bringing me in to check my moles. It never even entered my mind that it was cancer because the doctor had been so adamant with me.” Jacinta was told she had melanoma. “It was stage two, but it was 3.8mm, which is quite a deep.”
“Melanoma is a type of skin cancer that occurs when cells in the skin that are responsible for pigment production (melanocytes) mutate and begin to divide uncontrollably,” explains Bernie Carter, assistant director of nursing services at the Marie Keating Foundation.
“Each year in Ireland around 1,197 people are diagnosed with melanoma skin cancer,” Bernie adds. “Melanoma can develop anywhere on your skin but is more common in areas where the skin is exposed to sunlight.
“In men, it is most likely to affect the chest and back. In women, the legs are the most common site. Other common sites of melanoma include the face, but you can develop melanoma anywhere on your body including melanoma of the eye. That’s why it is so important to be aware of your skin and seek advice if you notice a change.”
Regarded as one of the least common forms of skin cancer, it is also one of the most serious, as melanoma can spread to other parts of your body and affect other organs (metastasise). Caught in time, it is very curable and has a high five-year survival rate of 91pc. Untreated, it can spread to areas of your body such as the lungs, liver, bone, brain and stomach. When melanoma advances in staging and spreads, it is more difficult to treat.
“I was all over the place,” Jacinta recalls. She was told surgery would be the next step. From the start, Jacinta was very open about her diagnosis, documenting her treatment and progress on Facebook. “Everyone has their own way of dealing with things, for me it was being open. I just thought I have no choice here because it’s so in your face.” She smiles ironically.
“I didn’t know yet what I was going to look like afterwards. I think I was trying to cushion that. If I looked really dodgy, I had kind of forewarned everyone anyway,” she laughs.
The impact on her face post-surgery was more dramatic than she had expected. “I remember going in and them taking off the bandages. I had thought it was keyhole surgery, and it wasn’t. There was a cut down my whole forehead, they had taken a little bit of my eyebrow and then there was a cut going from here all the way down my jawline,” she says, indicating her ear.
Jacinta recalls how happy she was to be told she was cancer free. “We actually left the hospital that day and went straight to the airport and got on a flight to Lanzarote. We were just getting on with our life.”
Sometime after, she and her husband moved back to Ireland, where her family live. They live in Bray, where Jacinta grew up. “I was just getting on with my check-ups every six months and everything was fine. Then in March last year, I had a spot under my skin, a little boil or something. It started growing and getting bigger.”
Even though she was in the system, lockdown was now underway, and Jacinta struggled to get an appointment with any urgency. She adds: “I rang a couple of hospitals to try and get my appointment pulled forward. I was saying, ‘look I’m willing to pay to get someone to look at me’, and they wouldn’t see me for another three months, even with private health care.”
Understandably, it became extremely stressful. “I’m quite angry about what happened with Covid and the cancer services,” she says. “I understand it was a bad situation, but cancer kills a lot of people. I’d really hate to think what’s coming down the road, because if I was in the system, and I was crying out saying I need an appointment pulled forward, what else has gone on in that time? Melanoma doesn’t wait for you to get your appointments back up and running.”
In the end, Jacinta went to her family doctor in late March, he had the appointment moved forward, and booked a scan.
“At this stage the lump was pretty big,” Jacinta recalls of the appointment. “I think those few weeks between them saying something is wrong, but they don’t know what it is, and the diagnosis, are the hardest time. When they tell you you have cancer, it’s a relief. During those couple of weeks, I thought, ‘I’m dying, this is it’.”
Jacinta was told she had stage three cancer. “I thought, ‘at least it’s stage three and I’m going to get a chance, it’s not that bad’. When we left the hospital, I was feeling a bit better about the situation. At least I knew what was wrong; there were options.”
Because of the potential for damage to Jacinta’s facial muscles during surgery to remove the tumour, which could have led to paralysis, she was put on a new drug before her operation, rather than afterwards. In a number of weeks, the size of her tumour dramatically reduced.
Having started the drugs in July 2020, her surgery took place in November of the same year. Her doctors removed two tumours and 55 lymph nodes. She will stay on medication until November 2022. “It’s like I’ve been given this chance,” Jacinta smiles.
“I don’t think anybody ever prepares you,” she says of the anxiety you experience after you get an all clear. “The first time I got cancer, I was so resilient. I was like, ‘that’s it, it’s never coming back’.”
This time has been different, she explains. “I thought that once I got told I didn’t have cancer anymore, I’d feel the same way. But there’s a lot of anxiety. I try to be quite positive, not always be thinking, ‘is it going to come back?’ Because it’s just going to get on top of you. But the thing is, at the same time, it did come back.”
She finds chatrooms with fellow cancer patients helpful. “There are so many people in that group. If you put up something saying you’re worried about whatever, they’ll all support it. I talk to people on groups all the time.
“I’d post about my new treatment and I’m constantly showing pictures of my face, to just say to others, ‘I had that surgery, it’s going to be ok, I’m fine’.”
The Marie Keating Foundation Talks Cancer podcast, supported by Novartis, provides information and advice to anyone on a cancer journey and their loved ones. This series, they are ‘Talking Melanoma’. Visit mariekeating.ie/podcast. For more on Jacinta’s story, see withlovefromjay.blogspot.com