Mom, 46, Has Infected Toenail Turn Out To Be Melanoma: ‘It Has Changed My Life, But I Can Cope’

Understanding Acral Melanoma

• Donna Bointon, 46, suffered. from an infected toenail which turned out to be a rare form of skin cancer called acral melanoma. Now she’s sharing her story to help others be aware of the warning signs of melanoma.
• Bointon was diagnosed with acral melanoma, which is sometimes called acral lentiginous melanoma (AM). According to research published in the medical journal Neoplasia, acral melanoma “arises on the non-hair bearing skin of the nail bed, palms of the hand and soles of the feet” and is not linked to sun ultraviolet (UV) light like other skin cancers.
• This rare type of skin cancer is more commonly found in people of color and older adults. It’s the type of cancer which led to Bob Marley’s death. However, the type of cancer can happen to anyone. So it’s important to be aware of the signs.
• 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.
• The most important thing to look out for when it comes to finding melanoma early is a new spot on your skin or a spot changing in size, shape, or color.

Health care worker Donna Bointon, 46, started experiencing symptoms of an infected toe nail five years before being diagnosed with a rare type of skin cancer called acral melanoma. Now, the mom of two from Middlesbrough, United Kingdom, is sharing her story to help others understand skin cancer warning signs as the melanoma she was diagnosed with "changed her life." Melanoma: Prevention & Screening Speaking to BBC Radio Tees in a recent interview, she admitted, "It has changed my life, but I can cope. Anyone who gets told they have cancer, your first thought is 'I'm going to die.' But then you start thinking, 'God, I need to sort all these things out,'"—and after three weeks of worrying, she decided to take charge, remain positive, and undergo necessary treatment.

Bointon's first noticed "poison was forming underneath" her right big toe nail back in 2019. She recounted knowing it wasn't normal and decided to visit a nearby emergency room. Although she ended up having her nail taken off, her symptoms persisted, which led her back to her doctor. She explained to BBC Radio Tees , "It never actually healed but I managed with it, putting a plaster over it and just leaving it, because I was just getting these antibiotics." Bointon ultimately noticed a scab on the side of her nail, which she later learned was infected. However, the antibiotics she took didn't help and she was told to see a dermatologist. It was the dermatologist who removed part of her nail and discovered cancer in February 2024. She learned it was acral melanom and "quite deep." The nurses told her it was unknown how long she's had the skin cancer and that it could possibly spread. After undergoing surgery to amputate her toe, she learned the cancer metastasized (spread) to her lymph nodes. However, she kept a "positive" attitude throughout her diagnosis as "it's only a toe."

She also recounted her cancer journey to TeessideLive, saying, ""I had a poorly toe for five years and was backwards and forwards to the GP. Finally they sent me to the hospital to get the side of it taken off and they discovered an acral melanoma, it grows underneath your nail beds. "I didn't expect it to be cancer at all I'd had this infected toe nail for a long time. I was on antibiotics, using different creams and it wasn't clearing up. Over the five years it had been growing so it was quite a deep melanoma." To combat the cancer, she's now undergoing immunotherapy. Bointon, who is employed by the National Health Service (NHS) a publicly funded healthcare system in the UK, added, "I can't go in the sun, I haven't been to work since February. I've worked there [James Cook University Hospital] for 24 years and have never been on the sick and worked constantly. "I've gone from full-time working, going to the gym and being active to now walking with a limp. I have to have physio and my shoes are different, everything has changed. I just hope and pray that the cancer doesn't attach itself to any of my organs because now I'm high risk."

Helping You Cope With Skin Cancer

• Signs of Skin Cancer Can Show Up On Your Nails, But Don’t Jump to Conclusions Just Yet
• Am I at High Risk for Melanoma?
• 3 Skin Cancer Myths, Busted: Can One Bad Sun Burn Cause Cancer?
• Beating Aggressive Melanoma: An Immunotherapy Success Story
• A 17% Decreased Risk of Skin Cancer Just By Eating More Cantaloupes, Carrots, and Sweet Potatoes

Understanding Acral Melanoma

According to the Melanoma Research Alliance, acral melanoma, which is sometimes called acral lentiginous melanoma, is "a rare subtype of melanoma that forms on the palms, soles of feet, or under finger or toe nails. This form of cancer, which led to iconic reggae singer Bob Marley's passing , differs from skin melanoma, as it's not believe to be cause by sun exposure and is often found in areas not normally exposed to UV rays. Am I at High Risk for Melanoma? According to research published in the medical journal Neoplasia, acral melanoma “arises on the non-hair bearing skin of the nail bed, palms of the hand and soles of the feet” and is not linked to sun ultraviolet (UV) light like other skin cancers. This rare subtype of melanoma is more common among people of Black, Hispanic/Latin, and Asian descent, and older adults. "Acral melanoma is a rare form of melanoma, accounting for only about 1-3% of all cases diagnosed. About 2,000 - 3000 cases of acral melanoma are diagnosed each year in the United States," the Melanoma Research Alliance explains. RELATED: Myth Busting: My Fingernails Have Streaks … Do I Have Cancer? The alliance points out that symptoms can vary, but can include:

• A gray, tan, black or brown spot; or discoloration on the palms of the hands or soles of the feet.
• Any changing spot growing on hands or feet.
• A new or changing mole on the hands or feet.
• Discolorations or dark streaks found vertically across toenail or fingernail beds.
• A spot or patch on the hands or feet that itches, bleeds, or is painful

WATCH: How do you perform a skin check using the ABCDEs?

The Melanoma Workup

It's important to understand there are regular skin checks for cancer at the dermatologist and also thorough melanoma checks—which are very different. 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 strangeit may just be a benign growth. If you have any concerns about the findings, be sure to talk with your doctor.

Turning to Immunotherapy to Treat Melanoma

Immunotherapy helps patients, like Donna Boiton, fight melanoma by enabling their own antibodies to attack cancer cells. While we don’t know the exact type of immunotherapy Mellencamp uses for treatment, several medications are available to patients. Some people may not be candidates for this therapy, and side effects vary from person to person. “When immunotherapy came on the market, it was such an exciting time for everyone involved in the care of melanoma, the main reason being is it went from this scary unmanageable cancer with no treatments to one that could potentially have a long-lasting result with patients absolutely never having to worry about their melanoma,” explains Dr. Cecilia Larocca, a dermatologist at Dana Farber Cancer Institute.

FDA-Approved Immunotherapy for Melanoma

There are several FDA-approved immunotherapies for melanoma. Each is approved for certain instances of melanoma.

• Tebentafusp-tebn (Kimmtrak)
• Aldesleukin (Proleukin)
• Atezolizumab (Tecentriq)
• Dostarlimab (Jemperli)
• Interferon alfa-2b (Intron A)
• Ipilimumab (Yervoy)
• Nivolumab (Opdivo)
• Peginterferon alfa-2b (Sylatron/PEG-Intron)
• Pembrolizumab (Keytruda)
• Talimogene laherparepvec (Imlygic)
• Imiquimod (Aldara)

WATCH: Turning to Immunotherapy.

Questions to Ask Your Doctor

If you are diagnosed with skin cancer, you may have some questions for your doctor. SurvivorNet suggests some of the following to help you on your cancer journey.

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

Contributing: SurvivorNet Staff