For Bethany Greenway, melanoma didn't appear in the form of an ominous dark spot doctors always warn about. Instead, the Texas mom noticed a subtle change when she was pregnant with her second child.
“I had what I thought was a liver spot start growing on my forehead,” Greenway, now 41, told TODAY in 2017. “It looked no different than a giant freckle.”
Already generously freckled, she just blamed pregnancy hormones. It was the start of a battle with the deadliest form of skin cancer that forced doctors to take out flesh and muscle from her face.
When contacted on Wednesday for an update, she was still feeling the impact of the treatment for the disease, noting she had recently developed "some pretty nasty side effects" from her immunotherapy infusions that forced her to be hospitalized a couple of times.
Greenway, who lives in suburban Austin, has been chronicling the experience in a Facebook “melanoma photo diary” full of searing pictures from her surgeries and treatment. It helps her process the shock of going from a healthy adult to a cancer survivor, and warn others about the frightening illness.
“It makes me ill [to watch other people tan],” she said. “Please stop frying your skin.”
The ordeal started in the fall of 2014. Greenway noticed the liver spot above her left eye had also grown a mole in its center and started to ache. She watched her mom battle melanoma in her 30s, so she went in for a skin check, but her dermatologist also thought the spot was benign.
It wasn’t. A biopsy eventually revealed the spot itself was melanoma and the mole in the middle was desmoplastic melanoma, a rare form of the disease that looks like a flesh colored or white lesion, said Dr. Julie Karen, a board certified dermatologist in New York, who didn't treat Greenway.
“This raises an extremely important point. Dark is by no means requisite to a diagnosis of melanoma,” Karen said.
“Any spot that is changing — enlarging, not healing, changing colors, whether darkening or otherwise, becoming crusty, scabby, with altered borders — is suspicious and warrants immediate attention.”
Greenway underwent two surgeries in August 2016 to remove the skin and underlying muscle around the spot. The desmoplastic melanoma was nearing the bone, which explained why she felt an aching sensation. Doctors also removed the lymph node near her left ear, which contained melanoma cells.
The surgeries left a big gash on Greenway’s forehead — a scar she named “Bacon” — which had to be covered with a skin graft taken from her thigh. A yellow compression sponge she dubbed “Sponge Bob’s a--hole” was sewn onto her forehead to hold everything in place while her body accepted the new patch of skin.
To stop any rogue melanoma cells from spreading, she underwent immunotherapy infusions and radiation on her head and neck, which burned the inside of her mouth and made food taste like poison.
Through it all, she kept fighting for her daughters, now 4 and 7 years old.
“For me, it’s worth it to go through this year of suffering for another 50 or 60 years of watching my children grow up and being present for my kids and my husband,” she said.
The skin graft has healed well and Greenway uses make-up and a false eyebrow to camouflage the scars. Never a sun worshipper, she uses hats and sunscreen to make extra sure “the giant a--hole in the sky won't be touching my face again.”
"Bacon is a far cry from her former self thanks to my amazing plastic surgeon. It's nice looking closer to my former self," she recently wrote on Facebook.
Her urgent message for others: “Please stop sun bathing and going to tanning salons,” Greenway said. “A tan isn’t a healthy glow — it’s damaged skin.”
Any spot on your body that stands out as distinct from all other spots warrants prompt inspection, Karen said.
Desmoplastic melanoma, which often appears on the head and neck and accounts for fewer than 4 percent of melanomas, is often misdiagnosed because it’s so indistinct, so be on the lookout for any spot that’s changing, she added.