43-Year-Old Woman Felt Like She ‘Pulled a Muscle,’ But It Turned Out To Be Late-State Melanoma— Avoiding Misdiagnosis & Symptoms Patients Should Know

Her diagnosis followed pain that arose in her right shoulder when she was handing over a croissant to her daughter in her car while her husband was driving, and it was a discomfort that worsened weeks later told Kennedy News and Media in a recent interview, according to the Daily Mail.

She ultimately sought additional medical advice when the upper part of her shoulder began to swell and wearing a bra or holding a bag on her shoulder became impossible.

Turner’s shoulder pain started up in October 2023 and she wasn’t diagnosed until about three months later—after multiple visits to her doctors and the hospital

When she received her diagnosis, after having scans and a biopsy, she was informed she had cutaneous malignant melanoma and the disease had spread to her shoulder, lymph nodes, liver, and buttocks/thighs.

Turner told Kennedy News, “It was a blessing that injury happened. I don’t know what I did that day but obviously some movement made that tumor swell and move.

“We were off to the beach heading down for the weekend with friends to the coast. We had a packed breakfast for the children. As we were heading down they all said they were hungry. I passed breakfast, including a croissant, banana and bottle of water, back to one of them and I felt like I pulled a muscle.”

After the first hospital visit, an X-ray revealed nothing serious, with doctors telling Turner she seemingly had a torn ligament. After taking pain medication, the pain subsided, but when her shoulder started swelling she was referred to orthopedic consultant and had an MRI scan.

Recounting how “shocked” she was about her diagnosis, Turner admitted, “Melanoma is a dodgy mole and it goes from there, that’s what I thought. It starts with a skin lesion, you look at it and ignore it, that’s what I thought skin cancer was.

“The doctor said I had a 50/50 chance of coming out of the other side of this.”

She continued, “There was no primary on my skin. The nurse told me, ‘It could be that there was something on the skin and your body healed it. But the cancer cells got so deep that they travelled round for months or even years and created other tumors.'”

After undergoing immunotherapy as part of her treatment, the tumors across her body have either decreased in size or completely disappeared.

WATCH: How Immunotherapy Helps Fight Melanoma

Immunotherapy involves reengineering your immune cells to target the cancer cells from within to kill them.

It’s unclear what type of drugs Turner took, but immunotherapy drugs like (generic name: pembrolizumab) (brand name: Keytruda) and (generic name: nivolumab) (brand name: Opdivo) can help some people with melanoma cancer live longer.

Combining immunotherapy drugs might also extend survival. However, your doctor can best determine which treatment is right for you.

As for sun bed dangers, according to the FDA, indoor tanning beds emit a type of UV ray, and UV exposure can increase the risk of skin cancer. (The sun also emits UV rays.)

RELATED: One Tanning Bed Session Can Increase Your Risk of Melanoma by 20%: What You Haven’t Heard About the Dangers of Tanning

The National Center for Biotechnology Information published a 2011 study by Yale Cancer Center researchers examining indoor tanning and the risk of early-onset basal cell carcinoma. The study concluded that tanning beds were a “strong risk factor.”

Additionally, a study published recently in Cancer, a peer-reviewed journal of the American Cancer Society, suggests that banning tanning beds among minors would prevent thousands of cases of melanoma in adolescents, along with millions of dollars in healthcare costs.

“Studies have shown that exposure to tanning beds increases the risk of skin cancer and ocular cancer,” says Dr. Lynn A. Cornelius, chief of the Division of Dermatology at Washington University School of Medicine in St. Louis. “It also induces changes that lead to premature aging of the skin. There is no ‘safe’ tanning bed.”

Dr. Cornelius recommends spray tans and sunless lotions for safer alternatives to tanning beds. While “one should take precautions not to inhale the product when getting a spray tan,” she said, “skin allergic reactions are rare.”

Which Sunscreen Should I Choose To Prevent Cancer?

Understanding Melanoma

Melanoma starts in the same cells that give your skin, hair, and eyes their color. In melanoma, the cells change in a way that allows them to spread to other organs.

Changes to a mole you’ve had for a while or a new growth on your skin could be signs of melanoma. However, in Claire Turner’s case, she didn’t have any signs of melanoma on her skin.

RELATED: Speaking Out After Skin Cancer Surgery: ‘Summer House’ Star Ashley Wirkus ‘Always Wore Sunscreen’ Says it Still Wasn’t Enough

You’re most likely to find melanoma on sun-exposed skin areas like your face, neck, arms, and legs. Surprisingly, you might also find them in other places as well, like:

• The palms of your hands or soles of your feet
• On your eyes or mouth
• Under your nails

The top way to protect yourself is by staying out of the sun, especially during peak hours, and avoiding unprotected sun exposure because ultraviolet (UV) radiation can lead to melanoma.

According to experts like Dr. Anna Pavlick, an oncologist at NYU’s Perlmutter Cancer Center, tanning beds pose ultraviolet radiation risks for skin cancer and should be avoided completely.

RELATED: How Do I Know My Skin Cancer is Gone?

Dr. Pavlick notes that people who are covered with moles stand a higher risk of developing skin cancer, especially people with dysplastic nevis syndrome, or “atypical” moles.

Atypical moles are those that are unusual-looking and, when seen under a microscope, they have irregular features. Although usually benign, a high number of atypical moles do signal an increased risk for melanoma, according to the Skin Cancer Foundation which says people with 10 or more atypical moles have 12 times higher risk of developing melanoma.

Warning Signs of Skin Cancer – Remember ABDCE

The most important thing to look out for when it comes to finding melanoma is a sudden, new spot on your skin or a spot that is quickly changing in size, shape, or color.

Dr. Cecelia Larocca, a dermatologist at Dana-Farber Cancer Institute, recommends implementing the ABCDE rule to determine if a mole requires further examination.

The ABCDE rule:

• A: Asymmetry of the mole, or when one half of the mole doesn’t match the other
• B: Border irregularity or Bleeding
• C: Color change either lightening or darkening of a mole
• D: Diameter greater than 6mm or enlarging moles
• E: Evolving size, shape or color.

WATCH: Dr. Cecila Larocca on the ABCDEs of checking moles for signs of skin cancer

Melanoma that moves into the body, away from the skin, becomes an entirely different treatment journey for patients.

Treatment options for melanoma that has spread include targeted therapy and immunotherapy, which give people a better chance of living a long and healthy life than ever before. If you’re diagnosed with melanoma, there’s a good chance surgery will be the treatment your doctor recommends.

Cancer removal usually leads to a cure in the early stages of the disease. After surgery, the removed tissue and lymph nodes are examined to measure the melanoma and determine if it has clear margins. Clear margins mean the cells around the area of tissue that was removed don’t contain any melanoma.

When no cancer cells are left around the removed area, your cancer is less likely to return.

The Melanoma Workup

Unlike other diseases, the workup for melanoma is pretty straightforward. For any skin lesions, your dermatologist will give you a head-to-toe visual examination to look for any other atypical moles or suspicious lesions.

If a growth warrants further evaluation, you might get a biopsy. And if advanced melanoma is found, you may need additional imaging and blood tests to help determine the best treatment plan.

Blood tests may include:

Complete blood count (CBC): looks at the number and types of cells in your blood, including red blood cells, white blood cells, and platelets
Comprehensive Metabolic Panel (CMP): measures the blood levels of certain enzymes, proteins, electrolytes, and minerals
Lactate dehydrogenase (LDH): an enzyme that’s increased in many cancers

Imaging tests may include:

CT scan: uses x-rays and a computer to create detailed images of your body
PET scan: uses radioactive materials (called tracers) and a special camera to create pictures of areas inside the body where cancer may be growing
MRI: Uses radio waves and magnets to create images of organs and tissues

A pathologist may also examine your tissue sample under a microscope to look for certain mutations. This is called biomarker testing, which helps determine the best treatment options for you. The BRAF mutation is the most common mutation found in melanoma tumors.

It’s important to remember that many atypical skin lesions are not cancer. So don’t worry if your doctor finds something that looks a bit strange it may just be a benign growth. If you have any concerns about the findings, be sure to talk with your doctor.

Melanoma Treatment Options

Melanoma treatment has come a long way. Survival rates have risen dramatically, thanks to a “treatment revolution,” say SurvivorNet’s experts. With breakthrough treatments like targeted therapy and immunotherapy now available, people who are diagnosed today have a much better chance of living a long and healthy life than ever before.

If you’re diagnosed with melanoma, there’s a good chance surgery is going to be the treatment your doctor recommends. In the early stages of the disease, removing the cancer should lead to a cure. The question is typically not whether you’ll get surgery, but which kind you’ll have.

WATCH: Dermatologic Surgeon Dr. Nima Gharavi, On The “Gold Standard Treatment” For Melanoma

For an early-stage melanoma that is close to the skin surface, Mohs surgery might be an option. This technique removes skin cancer, layer by layer, until all the cancer is gone.

In general, stage I melanoma surgery consists of the simple, in-office removal of the cancerous cells by a dermatologist. If the cancer is thicker, your surgeon will remove it through a technique called wide excision surgery.

The removal of stage II and III melanomas are performed by surgeons or surgical oncologists, not dermatologists. You may also have a sentinel lymph node biopsy to see if the melanoma has spread to the first lymph node where it’s most likely to travel. If your cancer has reached this first lymph node, it may have spread to other neighboring lymph nodes, and possibly to other organs. Where the cancer is will dictate your treatment.

After surgery, the removed tissue and lymph nodes will go to a specialist called a pathologist, who will measure the melanoma and find out if it has clear margins. Having clear margins means the cells around the area of tissue that was removed don’t contain any melanoma. When there aren’t any cancer cells left around the removed area, your cancer is less likely to come back.

Once your cancer spreads, treatment gets a little more complicated, but there are still ways to stop it. New treatments have vastly improved the outlook for people with metastatic, or stage IV, melanoma.

Targeted drugs and immunotherapy have been shown to be more effective than chemotherapy. So, with many more choices, there is no standard treatment. Treatment will vary based on your condition and whether there is recurrent disease.

Research has found that immunotherapy drugs such as Keytruda (pembrolizumab) and Opdivo (nivolumab) helped some people live longer. Combining immunotherapy drugs Yervoy (ipilimumab) and Opdivo (nivolumab) has also extended survival. Opdivo (nivolumab) + relatlimab is a new therapy option added to the National Comprehensive Cancer Network guidelines in 2022.  The combination of two immunotherapies is called Opdualag.

For those with the BRAF mutation, targeted drugs which shrink or slow the tumor can be a good option. This could include a combination of drugs, such as:

• Zelboraf (vemurafenib) and Cotellic (cobimetinib)
• Braftovi (encorafenib) and Mektovi (binimetinib)
• Tafinlar (dabrafenib) and Mekinist (trametinib)
• Zelboraf (vemurafenib) and Cotellic (cobimetinib) can also be combined with atezolizumab.

“Every patient is different and every situation is different,” says Dr. Anna Pavlick, medical oncologist at Weill Cornell Medicine. She emphasized that “there is no cookie-cutter recipe,” for treating stage IV melanoma.

There Is No “Cookie Cutter Recipe” for Treating Stage Four Melanoma

Dr. Pavlick also notes the importance of personalized care and treatment. “It really is a matter of looking at the tools we have so that we can pick the right tools to give the patient the best outcome.”

So, while there is no one-size-fits-all approach to treating metastatic melanoma, your doctor will work with you to develop a treatment plan that is tailored to your individual situation. Advances in research and technology are making the fight against metastatic melanoma more hopeful than ever.

Questions to Ask Your Doctor

If you are diagnosed with skin cancer, SurvivorNet suggests some of the following questions to address with your care team:

• What type of skin cancer do I have?
• What treatment options exist for my type of melanoma?
• Will insurance cover this treatment?
• Would treatment through a clinical trial make sense for me?
• What resources exist to help manage my anxiety because of this diagnosis?

Leading Experts Urge Us to Be Proactive

“If I had any advice for you following a cancer diagnosis, it would be, first, to seek out multiple opinions as to the best care,” National Cancer Institute Chief of Surgery Steven Rosenberg told us in a previous interview, “because finding a doctor who is up to the latest of information is important.”

As we highlight in several areas of SurvivorNet, highly respected doctors sometimes disagree on the right course of treatment, and advances in genetics and immunotherapy are creating new options. Also, in some instances the specific course of treatment is not clear cut. That’s even more reason why understanding the potential approaches to your disease is crucial.

At the National Cancer Institute, there is a patient referral service that will “guide patients to the right group depending on their disease state so that they can gain access to these new experimental treatments,” Rosenberg says.

Cancer Research Legend Urges Patients to Get Multiple Opinions

Furthermore, getting another opinion may also help you avoid doctor biases. For example, some surgeons own radiation treatment centers. “So there may be a conflict of interest if you present to a surgeon that is recommending radiation because there is some ownership of that type of facility,” Dr. Jim Hu, director of robotic surgery at Weill Cornell Medical Center, tells SurvivorNet.

Other reasons to get a second opinion include:

• To see a doctor who has more experience treating your type of cancer
• You have a rare type of cancer
• There are several ways to treat your cancer
• You feel like your doctor isn’t listening to you, or isn’t giving you good advice
• You have trouble understanding your doctor
• You don’t like the treatment your doctor is recommending, or you’re worried about its possible side effects
• Your insurance company wants you to get another medical opinion
• Your cancer isn’t improving on your current treatment

RELATED: Be Pushy, Be Your Own Advocate, Says Leading Expert 

Bottom line, being proactive about your health could be a matter of life or death. Learn as much as you can from as many experts as you can, so that you know that you did your best to take control of your health.

Contributing: SurvivorNet Staff

Learn more about SurvivorNet's rigorous medical review process.

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