Are you hiding cancer under your socks?

By Jane Elliott
Health reporter, BBC News

Keith Benham did not know his feet were at risk

Feet are one of the most neglected areas of the body.

Most of us ignore them unless they cause us problems, or we are showcasing them in open toed sandals or shoes.

So cancers of the foot and ankle are often missed or diagnosed too late.

Specialists warn that because of this survival rates from these particular cancers are poor.

One study found the overall five-year survival rates for patients with melanomas of the foot and ankle was 52%, compared with an 84% survival rate for those with melanomas elsewhere on their lower limbs.

'Neglected'

Antony Kontos, a podiatrist at The London Foot and Ankle Centre, said a simple foot check could guard against an aggressive and often undetected skin cancer.

People are quite happy to conceal all sorts of things in their socks and shoes Antony Kontos

"People do not check their feet well enough," he said.

"The feet are a generally neglected area.

"If feet were on display people would make much more of an effort, but they are not and are often hidden away.

"People are quite happy to conceal all sorts of things in their socks and shoes.

Keith had to have a toe amputated

"These lesions are as far away from you as they can possibly be, underneath the toes or underneath the nails and have just been ignored or misdiagnosed as other things.

"But if they are late in presenting the prognosis is worse," he said.

"People aren't aware that melanomas can develop on their feet.

"Melanomas of the foot can resemble a bruised toenail or a blood blister and are often misdiagnosed."

When to go for advice If the moles, marks or freckles are irregular or damaged Have changed recently - in size, elevation, colour or diameter If you have a black toenail but have no recent injury If there is a blackness on the toenail which does not extend along the nail as you would expect with a bruise If there is a mark or mole which is itching or bleeding or asymmetrical

As health professionals at the forefront of foot care, podiatrists play a key role in screening for foot cancer.

During the past three months Mr Kontos has identified two patients with foot melanomas.

Sun danger

He said one reason for the cancers was over exposure to the sun and warned people to cover their feet or protect them.

"Our feet are enclosed in shoes most of the year and then we pack our sandals for a holiday in very hot temperatures.

"This means feet are particularly susceptible to sunburn. However, although people are generally aware of checking other parts of their body for suspicious moles, they are unlikely to examine their feet."

Feet should always be protected

When Keith Benham's toe nail turned black two years ago he assumed it was because someone had trodden on his foot.

Two years later though the discolouration was still there and he went for advice.

This January, Keith, aged 65, from London, was told he had a melanoma, lurking under his nail.

Mr Benham was told he had to lose the toe and now he must wait to see what the future holds.

But he said he had been unaware that the feet were at risk from cancers.

"I had noticed no problems with my feet. I had had a black toe nail for something over two years, but I had never suffered any pain. It just appeared to have gone rotten and the toe underneath was black.

"In January this year I spoke to a doctor, who said there was almost certainly nothing to worry about, but that there was one problem I could have and that I should get it checked.

"I saw the doctor and he referred me to Mr Kontos, he looked it for a fraction of a second and told me that I needed to go that day to see a specialist.

"The specialist saw me the next day and said he knew what it was. He said 'I will do a biopsy, but even if the results are negative, I will do another one and if the results of that are negative I will do another one until I get a result'.

"He was right and at the beginning of March, he removed the offending toe - the fourth on the right foot.

"I didn't even know this sort of cancer existed," he said.