The woman’s breast tumor was melanoma, but there was no mole

We’ve all been taught that melanoma – the deadliest form of skin cancer – sends out warning signals before it invades any deeper and spreads. The key is to watch for moles that are growing, changing color, or otherwise evolving.

But what if there is no mole to signal the threat?

This is what happened to Amanda Hunt, a lawyer who was stunned to discover that the lump in her chest turned out to be a melanoma tumor that had also spread to her lungs and many other parts of her. his body.

Still, she never had a spot on her skin that was diagnosed as melanoma – a rare but possible scenario, doctors said.

“I had no idea it was even possible until it happened to me,” said Hunt, 39, who lives in Titusville, Fla., TODAY.

“(I thought) you’ve got a mole or something on your skin that’s changing, you go to the dermatologist, hope they catch it early enough and all take it off, and then you’re safe.” … So it took a bit for me to wrap my head around what it really meant, and once it sank I was terrified. “

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About 3% of melanomas are considered “unknown primary melanomas” – where doctors don’t know where they started on the body, said Dr. Zeynep Eroglu, Hunt’s oncologist at the Moffitt Cancer Center in Tampa, Fla.

Melanoma is only detected after it has already spread to lymph nodes, subcutaneous tissue or organs such as the lungs or liver, Eroglu added.

UV exposure takes its toll

As a fair-skinned kid growing up in Florida spending summers by the pool and at the beach, Hunt remembered getting multiple sunburns as a girl. She remembered using sunscreen but not reapplying it.

Then, around the age of 18, Hunt started using tanning beds and continued this practice until her early 30s, sometimes four times a week for years, she said.

Her first contact with skin cancer was in 2011 when she noticed a spot that looked like a mosquito bite on her upper arm. When it didn’t go away, got scaly and started to bleed, she saw her dermatologist. The diagnosis: basal cell carcinoma, a very common skin cancer that is generally not life threatening.

It was taken out and Hunt began performing annual skin checks from that point on.

In May 2020, she was in bed and preparing to fall asleep, when she grabbed the blankets and her hand brushed her right breast. She felt a lump.

Hunt has a history of breast cysts, so she has mammograms and ultrasounds every year. She wasn’t too concerned about the new lump, but showed it to her doctor, who removed it.

The diagnosis: melanoma.

“Of course everyone panicked at that point because it was already in my body,” Hunt said. “Honestly, I had no idea that there was anything going on in my body, which is insane to think about it.”

CT scans revealed tumors in both lungs, the left kidney, the left adrenal gland, and the orbit of each eye. Within weeks, she also began to notice several palpable tumors growing below the surface of her skin, some on her back and neck.

Respond to immunotherapy

The origin of these spotless melanomas on the skin is still in question, noted Eroglu, Hunt’s oncologist. One hypothesis is that they sometimes occur because the original melanoma spreads to other parts of the body, but regresses under the skin before the sites of metastases are diagnosed – so the primary melanoma is not more visible and can not be found, Eroglu mentioned.

Hunt began immunotherapy in July 2020 and responded to it, with many tumors shrinking and disappearing. But the treatment, which stimulates the immune system to fight cancer, can also work against healthy cells and create toxicities. Hunt developed type 1 diabetes as a complication of his immunotherapy.

“I am permanently insulin dependent because my immune system attacked my pancreas as it tried to find and kill the cancer,” she said.

Hunt is also recovering from meningitis after treatment recently created a dangerously high level of immune cells in his cerebrospinal fluid. She is far from returning to a normal life and has not asked her doctors for a prognosis, but is focusing on recognition and awareness through her blog, Love & Sunblock.

“The most important thing for me, if I could go back, would be to kiss my pale skin and protect my skin,” Hunt said. As a mom to a 14-year-old girl, she is alarmed by the social media posts she has seen where young people glorify tanning beds and show others how to tan faster.

“I also want people to know that time is so precious,” she noted. “We never really know when our time will end here, so I encourage everyone not to wait until they are faced with a fatal disease to get it right.”