The Story So Far

David and I had several conversations in the Summer of 2023 about the mole on the back of his leg. ‘It’s changed’ I told him on each occasion, but I couldn’t be sure and he insisted that it looked just the same as it always had. He wouldn’t go to the doctor because he was so certain (and because he’s a man some might say!), and so I stopped nagging; I wish I hadn’t!

The mole bled in February 2024 and a dermatology appointment was made. Grade 1B Melanoma was diagnosed in March 2024 after the mole had been removed and samples taken. These are the first lessons we learnt:

• Women sometimes nag for a reason!
• See your GP if you (or someone close to you) have any concerns.
• Photograph your moles and get them mapped.
• Check your moles regularly.
• Use high factor sun protection.
• Cover up when you are out in the Sun.

No cancer was detected in the surrounding skin, but a wider excision was carried out at the Royal Free Hospital in June 2024 as a precaution; the lymph nodes in his groin were also checked for cancer. He got the all clear in July 2024 and we went on holiday, where he wore long trousers, not shorts, and used Factor 50.

During the second week of March 2025 David found a hard lump in an area adjoining the location in which the mole had once lived. A dermatology appointment was scheduled for the end of the following month, but the kind dermatologist agreed to bring it forward by four weeks and see him after her surgery had finished. In April 2025 a punch biopsy was carried out. David had been assured that it was highly unlikely to be cancer, but we soon discovered that the melanoma had returned and was spreading quickly; this was due to the fact that he possessed a faulty gene called BRAF. Here is the second lesson we learnt:

• Some cancer cells are too small to be detected; these are called microsatellites. 

Following CT, MRI and PET scans, we endured a long wait before an oncologist at Mount Vernon phoned with the results in June 2025. Grade 3C Melanoma was diagnosed, and some lymph nodes now contained cancer cells. It wasn’t until July 2025, three months after the lump had been discovered, that David was admitted to the Lister Hospital in Stevenage, where plastic surgeons removed the lump together with all thirteen lymph nodes in the groin area of his left leg; they also carried out a sartorius switch, where the sartorius muscle is detached at one end and rotated to cover and protect underlying structures. Cancer was only found in two lymph nodes, but we now knew about microsatellites and did not question the decisions.

The oncology team at Mount Vernon and the plastic surgery team at the Lister had been working together to devise a treatment plan for David; we were advised that he would need cancer treatment, but first he would need some recovery time. In the weeks that followed the operation we learnt that:

• Your body doesn’t stop producing lymphatic fluid following lymph node dissection.
• The lymphatic fluid has to go somewhere!

Initially, a drain was stitched into David’s leg to collect the fluid in a bag. This had to be emptied by him on a daily basis, with the volume and weight of fluid recorded; there was a lot! His first infection of the area occurred at the end of July 2025 when he developed a fever, which necessitated a visit to Urgent Care in Hemel Hempstead. With the help of antibiotics he recovered within a week, continuing the process until the first week of August 2025 when the stitches decided to detach themselves. Fortunately, we had just arrived at the Lister; unfortunately, we were in the car park, and David was forced to endure a wet walk down the long corridor so that we could take the lift to the eleventh floor. So, what happens to the fluid when the drain is removed and the entry point heals? The answer is that it has to be extracted (twice-weekly initially) with the use of a syringe. We learnt that:

• A seroma refers to the accumulation of clear fluid under the skin.
• This process is known as seroma aspiration.

In the middle of August 2025 he reached his peak! The doctors, nurses, David and I placed imaginary bets as to how much fluid would be aspirated, but none of us came close to the 760ml. No wonder his leg had been even more swollen and uncomfortable than usual. Thankfully (or maybe not), he has no feeling in the area. Meanwhile, in Mount Vernon, a decision to put David on targeted therapy had been made. Dabrafenib (Tafinlar®) and trametinib (Mekinst®) are two drugs that have been approved for all cancers that have the BRAF mutation, and David was to take them for a year. The list of side effects was frightening, but we were thankful for the medication, and he was ready to begin the next chapter. We learnt that:

• Dabrafenib and trametinib work by targeting certain proteins that help cancer cells grow.
• By blocking these proteins this combination of drugs stops or slows down growth. 
• You can only have these drugs if your cancer has a BRAF mutation.

David was coping well and growing in confidence, despite the obvious swelling in his thighs as the production of lymphatic fluid continued, but that was to change: in the middle of September 2025, three weeks after he started his cancer treatment, he woke me up in the early hours of a Sunday morning. ‘We need to go to A&E now, and get my blood tested’ he told me, with urgency in his voice. This instruction had come from the person at the other end of the Mount Vernon 24 hour helpline. He had phoned, having gone to sleep shivering and shaking, too tired to alert me, and woken in the night with a fever.

At Watford General Hospital (WGH) he was seen within minutes; the staff were kind and thorough, treating him for the early signs of sepsis. I spent the night sitting on a chair in a stark square room; he spent the night sleeping in fits and starts until a doctor arrived with the results of his tests. It was clear that he had an infection, but what was the cause? I feared that the cancer drugs, which he had been instructed to halt, might have played their part, but thankfully that was not the case: his thigh was the colour of a ripe tomato, swollen and burning hot to the touch, but he hadn’t realised in the night because of the numbness.

As soon as we arrived home early the next morning, he went straight to bed where he slept and slept for several days. By the third week of September 2025 on day six of his course of antibiotics, his leg was so swollen that we knew that further aspiration was needed. This took place, with stronger antibiotics being prescribed for the second week. We don’t know why his leg became infected again, but I have my suspicions: we were confident that every precaution had been taken to avoid infection during aspiration, but inserting a needle into skin can still provide an entry point for bacteria even when a sterile environment is created. The following day we were back at WGH as David had become very unwell again; this time he was admitted. On the last day of the month, he was transferred by ambulance to The Lister, having spent five days on intravenous antibiotics. His leg was still very inflamed, and as the antibiotics did not appear to be clearing the acute infection we were advised that further surgery would need to take place.

The surgery took place the following day. Afterwards, we discovered that there was still a 15cm x 10cm cavity where the lymph nodes had been removed; this was full of serum and other fluids and had become badly infected. After ten difficult days, David finally left hospital with a vacuum pump attached to his leg. We learnt that Vacuum Assisted Closure (VAC) Therapy would:

• drain excess fluid from the wound.
• reduce bacteria.
• keep the wound moist and warm.
• help draw together wound edges.
• increase blood flow to the wound.
• decrease redness and swelling.

A mole caused this!

This is just the beginning of the account of David’s story, which will be continued. Appointments at the lymphoedema clinic and further scans have been scheduled; he will also be having a colonoscopy as blood was detected following a routine bowel cancer test. Regular visits to the Lister will also still be required in the short term, to change the gauze dressing that has been inserted into the cavity to enable VAC.

Last updated 05 October 2025