A Farmer Removed His Own Skin Cancer With A Pocket Knife. This Is What Happened To His Brain.

Summary

KC, a 45-year-old farmer, ignored a rapidly growing, asymmetrical pigmented lesion on his arm, opting to remove it himself. Despite this, he developed a lump in his armpit and exhibited neurological symptoms like weakness and seizures. A PET scan revealed hypermetabolic lymph nodes, and an MRI showed multiple brain lesions, indicating metastatic melanoma. Genetic testing confirmed the presence of the BRAF V600E mutation. Despite declining surgery for radiation therapy, KC's condition worsened, and he died from advanced melanoma with brain metastases, underscoring the importance of early detection and professional medical intervention.

Takeaways

• 🌞 KC, a 45-year-old farmer, experienced prolonged sun exposure leading to severe sunburns annually.
• 🏥 KC self-removed a suspicious skin lesion on his arm, which was later identified as melanoma.
• 🔍 Despite the removal of the skin lesion, a PET scan revealed hypermetabolic lymph nodes indicating cancer spread.
• 🚑 KC's wife noticed changes in his walk and personality, culminating in a seizure that led to an emergency room visit.
• 🧬 An MRI revealed multiple brain lesions, confirming that KC had metastatic melanoma, not primary brain cancer.
• 🔬 A genetic test identified the BRAF V600E mutation in KC's cancer cells, a key driver of uncontrolled cell growth.
• 🧠 The blood-brain barrier's proteins allowed melanoma cells to adhere and form brain metastases.
• 🌐 Sunscreen and early detection are crucial in preventing skin cancer and its metastasis.
• 💉 At the time of KC's diagnosis, treatment options were limited, with a grave prognosis for metastatic melanoma to the brain.
• 🌿 The historical context of cancer is highlighted, showing that while treatments have improved, cancer remains a significant health burden.

Q & A

What was the initial symptom that prompted KC to visit the emergency room?

KC presented to the emergency room with a 15-minute seizure.

What was the nature of the lump that KC found on his arm?

The lump was an asymmetrical, pigmented lesion with irregular borders that was growing rapidly on the skin of his right arm.

Why did KC initially avoid seeking medical attention for the lump?

KC avoided medical attention because he believed he could fix the issue himself, as he had always been self-sufficient and capable of fixing things on his own.

What did KC do when he discovered the lump on his arm?

KC attempted to remove the skin tumor himself, believing it was something he could handle without medical intervention.

What was the significance of the PET scan results for KC?

The PET scan revealed hypermetabolic lymph nodes in KC's right armpit, indicating that something was growing inside, which was later identified as widespread cancer.

How did KC's condition progress after he removed the lump himself?

After removing the lump, KC felt great for a while but later noticed a lump growing in his right armpit and developed a weakness on the left side of his body.

What type of cancer was KC diagnosed with?

KC was diagnosed with metastatic melanoma, a type of skin cancer that has spread to his lymph nodes and brain.

What genetic mutation was found in KC's cancer cells?

A single point mutation was found on chromosome 7, on the BRAF gene at nucleotide 1799, changing an A to a T, creating the V600E mutation.

How does melanoma typically spread to the brain?

Melanoma cells can break off from the primary tumor, circulate in the blood, and adhere to proteins at the blood-brain barrier, where they can grow and multiply, forming brain metastases.

What is the prognosis for patients with metastatic melanoma that has spread to the brain?

The prognosis is grave, with a median survival of less than 5 months and only about 10% of patients still alive after 18 months.

What preventive measures are suggested to reduce the risk of skin cancer?

Preventive measures include using sunscreen, sitting in the shade, and limiting sun exposure, especially during peak hours.