A woman had to have her thumb amputated after she developed a rare type of skin cancer, which she says was caused by her biting her nails.
Twenty-year-old Courtney Whithorn says she had caused such major trauma to her nail after biting it completely off four years ago that it developed into acral lentiginous subungual melanoma.
Courtney, who is originally from Newton Aycliffe, Co Durham, but moved to the Gold Coast, Australia nine years ago, said that she began biting her nail after being bullied while at school, but that one day she managed to bite her nail clean off.
The nail went black, but Courtney says she was too embarrassed to show it to friends and family.
She eventually saw a doctor, who gave her the shocking news that she had cancer and would have to undergo surgery. However, despite several attempts to save the thumb, it was completely removed last week.
Courtney said: "When I found out that biting my nail off was the cause of the cancer it shattered me.
"In my head I thought, 'I've done this to myself,' but obviously I knew I shouldn't have that mentality. I couldn't believe it.
"When you think about it how many kids bite their nails it's crazy it came to that.
"I bit the nail off four years ago and I was obviously very self-conscious of how black it was.
"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.
"I had to wait six week for the results. They were sent down to Sydney because they couldn't tell if the biopsy was malignant or benign.
"The result came back uncertain, so the surgeons wanted to be safe and remove the whole nail bed and any blackness.
"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.
"I was obviously very shocked I couldn't believe it at all. My mum just burst into tears."
Once the nail bed was removed, she underwent tests and it was found that she had no more cancerous cells - but that still wasn't the end for Courtney, who was then told that the protocol for that type of cancer is amputation.
She added: "The plastic surgeon texted me saying that protocol for this melanoma, because it's so rare, is amputation.
"I had a panic attack at work, I read the word 'amputation' and ran outside - I couldn't breathe.
"My mum had to come to my work, my boss was tying my hair up and wafting my shirt. I freaked out - we'd never even spoken about amputation.
"We went and saw a melanoma specialist who also agreed that amputation was protocol because this was such a rare cancer.
"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."
Now she must wait for the results from her most recent surgery, and if given the all-clear she will be monitored for the next five years, including having regular blood tests and scans.
"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," Courtney said. "I've just cried every time it's been brought up.
"The location of the cancer in my thumb is unknown so if it still shows up then they're just going to have to keep cutting away until we get a clear result."
According to the NHS, acral lentiginous melanoma is a rare type of melanoma that usually occurs on the palms of the hands and soles of the feet. They can also sometimes develop around a nail, most commonly the thumbnail or big toenail.
Acral lentiginous melanomas are the most common type of melanoma in people with dark skin, but they can occur in people with any skin type.
Melanoma is caused by skin cells that begin to develop abnormally, certain things can increase your risk such as having pale skin, red hair, having lots of moles or freckles or having a family member who has had it.
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