With warm weather often a novelty in the UK, it can be easy to forget to slap on the sunscreen in the same way that we do when we're somewhere hot abroad. And that was true for Michelle Richardson.
She said she'd always apply it when abroad, but often neglected to do so when at home. Michelle didn't think too much of it, until five years ago when she found a mole underneath her bra strap.
The mole was removed and, with it, a thin layer of skin cancer. However, a year later small tumours came out all over her body within the space of a week. It even covered her lungs and brain as stage four incurable melanoma spread everywhere, reports the Mirror.
In 2017, Michelle, a mum-of-one, first thought it was just the fabric of her bra irritating her back. But then it started to bleed after she scratched a small mole there, leading her to suspect something more sinister was going on.
Michelle called her GP to get it checked out and within two weeks she was referred to a dermatologist. They reassuringly said it was nothing to worry about and asked the mum, who worked as a neurophysio, to return in three months just in case, telling her to keep an eye on it. But the itchiness persisted and it grew darker.
"He [the dermatologist] said 'it is probably just your bra strap rubbing, I don't think it's melanoma, see you in three months'," Michelle told the Mirror.
"When I went back to see him, I asked for a biopsy which he did that day. He was very reassuring and said 'don't worry, I'll give you a call as the results come back. If anything is concerning we will bring you in, but I'm absolutely sure it's not'."
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When she returned in February 2018, they were joined by the oncology nurse. They had found a thin layer of skin cancer, at stage 1B, which was removed.
"I knew at the time something was wrong and I just went numb," Michelle said. "I just wanted facts. I knew nothing about melanoma.
"But he was really reassuring, saying it was really thin, we've taken it out and the wider tissue removed around it. It was caught early and he's not worried about it."
Scans showed that the cancer hadn't spread. However, as she received private healthcare through her husband's medical insurance, Michelle insisted she had a lymph node surgery too just in case.
It was here that they came across a tiny microscopic deposit of cancer - a micrometastasis - that wasn't picked up on a scan due to its size, which set her at stage three Melanoma. The micrometastasis was also removed, but with no treatment available at the time, such as chemotherapy or radiotherapy to mop up any other rogue cells, there was nothing else they could do.
"From a mental health perspective, it really hit me," Michelle said. "It happened very quickly. There was no treatment at the time, that was the weirdest bit.
"Living with the knowledge there could be cancer, but nothing to do about it. That was the hardest part, as there was no plan. So I threw myself back into work and focused on my daughter, who was just nine at the time."
Michelle had to have CT scans every six months and an ultrasound of her armpits every six months too, which meant she was having a scan every three months, as they alternated.
The results were clear each time. But the two-week wait to find out after each scan was unbearable. Ten months later, Michelle experienced her first-ever panic attack.
"I've never been someone anxious - I usually just get on with things," she said. "I was driving home after a presentation for work and I just started screaming in the car and couldn't stop myself.
"I was sobbing with so much pent-up fear and anxiety. I kept thinking 'what are they going to find on the scan?' I was thinking about it every single day and it was getting me down."
Michelle turned to counselling to help with her fears, which revolved around dying and leaving her young daughter without a mother. She also received help and support from charities including Melanoma Me and Melanoma Focus, along with the Facebook group Melanoma Mates.
And as a team leader in a hospital treating those who had suffered catastrophic brain injuries, she felt it only right for her patients, their families, and her own family, that she stepped down to a less stressful position. The clear scans continued but after the summer of 2019, Michelle's health took a turn for the worse.
Bloated and exhausted, she put it down to a post-summer holiday crash. On the first Monday of September she felt rough after returning to work all day.
The next day she treated herself to a bath, thinking it would make her feel better. During this whole time, she'd been checking the area near her lymph nodes every day, and nothing ever showed.
But laying in the bath, she suddenly felt a small chickpea-size lump on her pelvis. The following morning, she checked to see if it was still there, and worryingly three more had appeared - one on her back, her ribs, and her pelvis. She managed to book an appointment with the dermatologist that afternoon, by which time she had gained seven lumps.
"It was utterly terrifying," Michelle said. "He [the dermatologist] went white when he looked at me. I knew then it was stage four. I knew the outlook was going to be very, very bad. That was when utter devastation and complete guilt for my daughter hit me."
Doctors said she had high-grade melanoma, with tumours doubling every two hours. Her worst fear came true - that the killer cancer had been dormant in her lymphatic system before multiplying and getting into her bloodstream, spreading all over her body.
By the Friday, she was hospitalised as a chest x-ray showed tumours had filled both of her lungs, resulting in her not being able to breathe properly. Five tumours had also been found on her brain.
"I went from working to not being able to walk, sit up and breathe the following Monday," Michelle said. "Tumours were wrapped around my kidney, my spleen, in my stomach, my pelvis, my shoulder blades.
"I had lumps everywhere under my skin, so all of my chest and stomach and back and face and neck were covered in really painful lumps. It happened in the space of a week."
Luckily, a new life-saving treatment had become licensed in the UK a year earlier - immunotherapy - which suppresses the immune system to attack cancer cells. However, with only a 50%, Michelle had to prepare for the worst. With potentially less than a few months to live, she wrote heartbreaking letters to her husband, parents, and her daughter, and got her will ready.
"I was prepared to die," she said. "We all thought it would happen quite quickly. My daughter had just started year six and went from having an active mum to me not being able to get out of bed.
"She kept asking if I was going to be alive for her birthday in December. I told her the doctors were working very hard and I’ll try my best. It was horrific, but we had to explain to her what was happening."
It was a waiting game to see if the doses of treatment were working and, after four weeks, she showed signs of turning the tide. Michelle was able to sit up again, breathe more easily, and the lumps had shrunk.
In December 2019, on the day of her daughter's birthday party, the oncologist phoned to say the treatment had been working. Sat sobbing on the stairs as she received the call, Michelle felt utter relief.
And in September 2020 she was told she is in remission, but the fear of her cancer returning any day still hangs over her. She's been receiving the brutal treatment every month for two years, and while she is eternally grateful, it has knock-on effects.
It has seen the once fit and healthy mum unable to work, which has had devastating financial implications for the family, while she is left exhausted after simple tasks. As it targets her immune system, she has had problems with her adrenal gland - which produce hormones that help regulate your blood pressure and response to stress - and her skin has been stripped of any colour.
As a repercussion, she now suffers from vitiligo - which sees her with white eyebrows and white patches on her skin. Michelle, who still has the odd lump of dead tissue mass on her shoulder blade and abdomen, copes by focusing on the now and keeping busy with her family.
This Melanoma Awareness Month, and as we approach the summer in Britain, Michelle is begging the nation to wear SPF. New research from the charity Melanoma Focus shows that 32% of Brits reported rarely or never using sunscreen when in the UK and only 11% said that they always use it.
"The skin is the largest organ, it goes everywhere. It’s the fastest growing cancer in young people and because it is in the skin, it will go everywhere," Michelle, who doesn't think she applied enough suncream up to her bra line in the past, added.
"It kills and it's utterly devastating. With any other cancer, if they said you could put a cream on your skin to prevent it, you’d do it without question but people aren't with melanoma. It's just not worth it for a tan."
Melanoma skin cancer is becoming more common in the UK, with around 16,700 new cases every year. Recent research has shown that there has been a huge increase in the number of people in the UK being diagnosed with melanoma, despite efforts to educate the public on the risks.
Susanna Daniels, CEO of Melanoma Focus, said: "About seven people die from melanoma every day in the UK and more people die from melanoma in the UK than in Australia. The fact that people are continuing to ignore the warnings and not take the necessary precautions to protect themselves from skin cancer is concerning. About nine in 10 melanoma skin cancer cases are preventable and it is vital that people take the warnings about the dangers of excessive sun exposure and the dangers of sunbed use seriously.
"Sunbeds can be incredibly dangerous and it's concerning that their use is so popular in the UK. The best way to protect yourself from the dangers of sunbeds is to avoid them altogether and use high-factor sun protection, along with seeking shade and wearing a hat when in the sun."
