SARAH Ferguson faces an anxious wait to see if the aggressive skin cancer she's been diagnosed with has spread.
Medics have now removed a mole on her body which tested as a malignant melanoma - the most serious form of skin cancer.
Fergie, 64, was hit with this shock health scare just six months after she was treated for breast cancer.
The Duchess of York was on Sunday described as "in good spirits" but finding a second cancer diagnosis within six months as "distressing".
However, she must now await results to see if the aggressive illness has spread anywhere else in her body.
Dermatologists raised the alarm after removing several moles from her body while having reconstructive breast surgery last year.
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Tests which came through just days after Christmas revealed one mole was malignant.
The Duchess of York has been recuperating in Austria in the past few weeks.
Insiders said: "It has not been an easy time".
She is set to undergo further tests but it is hoped that the mole has been found early enough to avoid any further health problems.
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Signs of skin cancer to look out for
MEDICAL expert Dr Philippa Kaye has revealed what to look out for following Fergie's shock skin cancer diagnosis.
The TV doctor added that it is common to have moles and it is important to check your skin for any changes.
And she urged Brits to avoid the sun in the middle of the day, sunbeds and tanning booths, warning: "There is no such thing as a safe sun tan.
"Whatever your skin colour, protect yourself from the sun. Use a high factor SPF, broad spectrum sun cream."
Dr Kaye added: "Malignant melanoma is a type of skin cancer which can spread to other parts of the body.
"Although it is more common in older adults, it can occur at a younger age. The majority of cases are due to sun damage from sun exposure or sun beds. Other risk factors include having a family history of melanoma, having pale skin and getting older."
She encouraged people to use an ABCE checklist to identify any changes. This includes Asymmetry of a mole, the Border of the mole becoming irregular, having two or more Colours, a Diameter of over 6mm or a mole that is constantly Evolving.
She urged anyone noticing these changes to see a specialist, adding: "A dermatologist is likely to examine the lesion and may take an excision biopsy where the mole, or part of the mole and surrounding tissue, is removed and examined."
If the melanoma has not spread, surgically removing the mole generally is curative. If it has spread, then treatment can include radiotherapy and chemotherapy.
Almost all patients diagnosed with stage one malignant melanoma survive at least five years after diagnosis, she said.
Patients may alternatively be diagnosed with a non melanoma skin cancer, which are often related to sun damage and are more likely for older people and those with pale skin.
A malignant melanoma is a type of skin cancer that can spread to other areas of the body.
Sarah is now urging people to regularly check their body for moles which could be cancerous.
It is a fresh health drama for the Royal Family coming as the Princess of Wales remains in hospital after having abdominal surgery.
Kate, 42, will not be able to return to work until April while William has cleared his diary to be by her side at The London Clinic, Marylebone.
King Charles, 75, is resting at Sandringham after being diagnosed with an enlarged prostate and will have a 'corrective procedure' in hospital this week.
A spokesman for Fergie said: "Following her diagnosis with an early form of breast cancer this summer, Sarah, Duchess of York has now been diagnosed with malignant melanoma.
“Her dermatologist asked that several moles were removed and analysed at the same time as the duchess was undergoing reconstructive surgery following her mastectomy, and one of these has been identified as cancerous.
“She is undergoing further investigations to ensure that this has been caught in the early stages.
"Clearly, another diagnosis so soon after treatment for breast cancer has been distressing but the duchess remains in good spirits.
"The duchess wants to thank the entire medical team which has supported her, particularly her dermatologist whose vigilance ensured the illness was detected when it was.
"She believes her experience underlines the importance of checking the size, shape, colour and texture and emergence of new moles that can be a sign of melanoma."
It has not been an easy time
The duchess is being treated by Dr Andrew Furness, consultant medical oncologist at the Royal Marsden Hospital in London, Catherine Borysiewicz, consultant dermatologist at the King Edward VII Hospital in London, it is understood
And for the past few weeks she has been recuperating at the MAYRLIFE clinic in Austria.
The clinic attracts A-list stars and millionaires such as Rebel Wilson and supermodel Karlie Kloss.
The duchess's elder daughter HRH Princess Beatrice is patron of the British Skin Foundation and has worked with skin cancer patients.
It is believed the moles were removed last year but the diagnosis came after she appeared with the Royal Family at Sandringham on Christmas Day.
It comes as ex-hubby Prince Andrew faced shock accusations in US court papers claiming he took part in an "underage orgy" on Jeffrey Epstein's "paedophile island" and appears in "sex tapes" filmed at the billionaire's New York townhouse.
The Sun revealed last summer that Sarah had undergone a mastectomy after being diagnosed with breast cancer.
She was delivered the cancer news after a recent routine mammogram, in June
But the operation at a private hospital in London was "successful" and was told that the "prognosis is good" thanks to the "early detection".
The breast cancer was spotted early due to routine screening.
She later underwent reconstructive surgery in London.
Taking to her podcast 'Tea Talks', the mother-of-two made light of her major operation and revealed she had nicknamed her reconstruction 'Derek'.
Sarah added: "My balance in life is to literally focus on joy."
Speaking at a gala event in November, she described feeling "blessed to be well" and to have "looked cancer in the eye and not blinked".
She vowed to "celebrate life" and later that month began a stint as an agony aunt on ITV's This Morning.
She had effectively been banned from public aspects of the Royal Family Christmas since the early 90s after being photographed having her toe sucked by her financial advisor.
But grew close to the late Queen Elizabeth II in her final years and was welcomed back to Christmas dinner at Sandringham in 2023
Last month, she wowed crowds who lined up to see the Royal Family on Christmas Day walk to church.
Her father Roland Ferguson was diagnosed with prostate cancer and skin cancer during the final decade of his life.
Andy and Fergie, who divorced in 1996 but lived together since 2008, have been threatened with eviction from their 31-room mansion on the Windsor estate.
The Princess of Wales was admitted to The London Clinic last Tuesday for a major abdominal operation.
Prince William, 41, has cancelled engagements until his wife is discharged, and regularly visited to be at her bedside as she recovers.
She is expected to remain in hospital for two weeks before being sent home to recuperate and will not return to front line duties until after Easter, on doctor's orders.
Last Wednesday, the King was diagnosed with an enlarged prostate and has been ordered to put his feet up.
He will have an operation this week and be on light duties for up to a month.
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It means three major royals are not covering royal engagements.
But Queen Camilla, 76, will be in Swindon on Monday.