A STUDENT had to have her thumb amputated after developing a rare form of cancer she believes is linked to biting her nails.
Courtney Whithorn started biting her nails after being bullied at school – and her habit became so bad she bit her thumb nail completely off in 2014.
The now 21-year-old soon noticed her thumb started to turn black, but managed to keep it hidden from her friends and family for four years.
The psychology student was eventually diagnosed with a rare cancer, acral lentiginous subungual melanoma, which may be linked to the severe trauma biting off her thumb nail caused.
Since her shock diagnosis in July last year, Courtney has undergone four surgeries.
Despite attempts to save her thumb, she had to have it amputated last week.
Courtney, originally from Newton Aycliffe, Co Durham, but moved to The Gold Coast, Australia, nine years ago said: “When I found out that biting my nail off was the cause of the cancer it shattered me.
“My hand was just constantly in a fist because I didn’t want anyone to see it – not even my parents.
“I got a bit freaked out when my skin started to go black so I showed them for the first time this year.
“I can’t even explain how self-conscious I was. I always had fake nails to hide it because it was so black. It was like paper whenever it grew back.
“I went to the doctors because my skin started turning black but I went for cosmetic reasons and my GP referred me to a plastic surgeon.
“I saw two plastic surgeons, and they were thinking to remove my nail bed to get rid of the black and then put a skin graft over it so at least it would be skin colour – I was happy with that.
“But before my first surgery to remove the nail bed, the doctors could tell something was wrong and decided to do a biopsy.”
Acral lentiginous subungual melanoma is a type of melanoma that appears on the palms of the hands, underneath the nails, or soles of the feet.
The cause of the rare cancer is not known as it's not always linked to sun exposure, but some studies have suggest prior trauma to the care – like a cut or injury – could be linked to the disease.
Six weeks later Courtney was sent to a specialist in Sydney because doctors couldn’t tell whether the biopsy was cancer or not.
“They did more tests and when those results came back, I was told that it was a malignant melanoma which was very rare to have there, especially for someone my age and at that size,” she recalled.
“I was obviously very shocked I couldn't believe it at all. My mum just burst into tears.”
After Courtney’s second surgery to remove her nail bed, she had a PET scan to produce a detailed 3D image of the inside of her thumb and no more cancerous cells were found.
But panic arose when just a week after thinking she was in the all clear, specialists in Sydney told Courtney’s surgeon that the protocol for her form of melanoma is amputation.
The surgeon decided to first perform a third surgery, creating a wider incision in Courtney’s thumb to remove any more malignant cells – but that operation only confirmed the need to amputate.
Part-time receptionist Courtney, who is still recovering from her amputation, said: “I went in for a third surgery and the doctor told me that if he saw anything cancerous then he would have to take the whole thumb.
“So I went to sleep not knowing whether or not I was going to wake up with my thumb. When I woke up and it was still there and I was so happy.
“I also had two lymph nodes taken out for them to test whether or not the cancer had spread. The pigmentation from my thumb had travelled so it was dark but none of the malignant cells had travelled yet.
“Literally everything we’ve caught, we’ve caught it on the cusp of it going to the rest of my body – the timing has just been everything.
“Because it had started to travel, the only option left was amputation but this time I was much more prepared for that news.
“I wasn’t scared going in for the amputation surgery – I was more nervous as I’m not a big fan of needles and stuff.”
Courtney’s passion for writing will going to be affected as she had her thumb amputated from above the knuckle.
The student has also had to defer her studies at Griffiths University to recover.
“I love to write, I journal a lot. I write everything down that I’m feeling as a relief sort of thing,” she said
“The thought of not really being able to write for a while is definitely a big change for me.
“I’ve had to defer university as well because I can’t write. I’m in my second year and I’m supposed to graduate next year but now it won’t be until the year after.
“I’m still waiting for that set of results from the surgery last week and if it’s clear then the surgeon watches me for the next five years and I get regular scans and bloods.
A TYPE OF CANCER THAT COULD BE LINKED TO TRAUMA
Acral lentiginous melanoma is type of melanoma that starts on the palms of the hands, nail beds or soles of the feet.
It is more common on feet than on hands and arise in normal-appearing skin, or it can develop within an existing mole.
It starts as a slowly-enlarging flat patch of discoloured skin.
At first, the malignant cells remain within the tissue of origin, the epidermis.
Acral lentiginous melanoma becomes invasive when the melanoma cells spread to other areas.
It is relatively rare compared to other types of melanoma, and is not linked to sun exposure.
The cause or causes of acral lentiginous melanoma are unknown, but some studies have linked it to trauma in the area – like a cut or injury.
- large patch of discoloured skin
- may be different colours including brown, blue-grey, black and red colours
- smooth surface at first that later becomes thicker with an irregular shape
- ulceration or bleeding
The cancer needs to be cut out during surgery.
Biopsies will need to be carried out to determine how far the cancer has spread, and how much flesh needs to be cut away.
“There’s not enough research to say what the survival rate is or what the likelihood of it coming back is because – we just don’t know much about it. I’ve just cried every time it’s been brought up.”
When Courtney was 16 she was bullied at school, and the stress and anxiety triggered her intense nail biting.
“Rumours were started about me and if I sat with people at lunch they would completely ignore me like I didn’t exist. Nail biting became a coping mechanism for me,” Courtney said.
“I didn’t even know I was biting my nails sometimes – it just happened. I sort of lost the feeling because I was doing it that often.
“I didn’t even realise I’d bitten my whole thumb nail off until I saw how much blood was on my hand.
“It never really grew back the same. It only grew on one side of my thumb and I kept biting it off then eventually the bottom of my nail turned black."
After her classmate Tyson Donnelly, now 20, stuck up for her they became more than just friends – and have been dating for four years.
Tyson has helped his girlfriend through the trauma of her cancer diagnosis and Courtney believes it has brought them closer together.
Courtney said: “Without my boyfriend or family I honestly don’t know how I would have got through all this.
“I want to share my story for people who are being bullied and people who are doing the bullying.
“I hope it would make them stop doing what they’re doing or give someone the courage to speak up and get help or tell their parents what’s been happening at school.
“I just wish I was as confident and as outspoken as I am now back then.”
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