Craig Brewer

PATIENT STORIES - CRAIG BREWER

Stage 4 melanoma. It's hard to imagine that "stage 4" something can be the most dangerous level of something, but when it comes to Cancer, there's no stage 5, 6 or 7 through to stage 10. Stage 4 is the worst. Not long ago, if you were told that you were stage 4 melanoma your average life expectancy was less than 12 months. As of today, you are a little better than 50/50 to see 5 years. Much better but still, I would never wish this upon anyone.

I was born in the early 70's in Australia when people were only just starting to understand how deadly melanoma was. In Pop culture the term "Bronzed Aussies" came along as many of us flirted with the social achievement of having a "nice tan". This was happening while melanoma was literally killing more young people in Australia than any other Cancer.

I grew up in QLD and Northern NSW almost always living near the water. By the time I was 15, i was spending my weekends and holidays in the surf. for hours on end, sometimes getting myself badly sunburned in the process. I had never met anyone at that time who had died from melanoma. I had read about it and like many of us, I thought it sounded like something that happened to other people. Definitely not me. I had brown skin, well at least if you looked at my face, arms and legs.

That's what I thought. (If you want to know what colour your skin really is, take a look at your bum in the mirror after a shower!) By the time I was in my early 20's I had grown up and stopped flirting with sun anywhere near as much. I still loved to surf however I was being much more careful. The 80's campaign in Australia of "slip, slop, slap" and the terrifying stories of young people my age dying from skin Cancer scared me. I was now being much more careful. The truth was, the damage was probably already done.

In May of 2018, I noticed a small lump on the inside of my bottom lip. I wasn't worried, I just wondered what it was. My GP told me it was a cyst and referred me to a Dermostologist who told me the same thing. He cut it out and I thought that was that. His office called me back a little over a week later. He asked me if anyone had discussed my results with me. I said no. He told me that he had removed a malignant melanoma from my lip and that he was referring me to the melanoma unit at the Alfred Hospital in Melbourne. I'll never forget what he said before I walked out of his office. "melanoma isn't a death sentence anymore". What the hell was he talking about?

I spent the next 3 months finding out. I met with amazing surgeons, skin specialists and oncologists that dealt with melanoma and very quickly came to realise that I had a bit of a journey ahead of me. I quickly had surgery to remove part of my lip and lymph nodes in my neck. The goal here was get any of the melanoma that was left in my lip or face, out of my face and quickly. Then check to see if it has spread.

The biopsy results came back clear from my surgery with an encouraging results. The Cancer wasn't detected in my lymph nodes. Cancer spreads through your body via your lymph nodes, or via your blood so this was encouraging. I then had a consult with an Oncologist who said I should meet with the Radiation team, as a cycle of radiation could help to reduce the chance of the melanoma returning in my lip. My radiation treatment cycle lasted 4 weeks and without pulling any punches here, it was fucking horrendous. Over the course of 20 treatments my lip, the inside of my mouth and left hand side of my face was burnt everyday for 10 minutes. 2 weeks in and my mouth was a volcano of ulcers and raw flesh. I was put on all kinds of pain killers, I couldn't eat. I was a mess. However the end was in sight. I was told that I would have a PET scan and MRI a month after completing the radiation and with all likelihood, the scans would show that the Cancer had not spread.

October 22, 2018: I had my appointment with an Oncologist to get my PET scan and MRI results from the week prior. I was absolutely scared shitless going into that little room once my name was called. Mark, my Oncologist and I, had never met before but within a few short minutes he had to tell me that I had a large tumor in my pelvis. II was stage 4 Cancer. I broke down. Everything about my life changed right then and there.

A month later, I met with Mark again. A biopsy of my Pelvis confirmed that it was melanoma. Mark talked me through my options, start with one Immunotherapy drug or as he put it, go "all guns blazing" and move forward with a dual combination of 2 "check point inhibitor" immunotherapy drugs. It wasn't really a decision for me. I wanted to go after it all guns blazing. Mark did say, I don't expect it to disappear completely. That was ok with me as I knew that all we had to do was stop the Cancer from growing. I had read about people who had responses to the treatment that had allowed them to lead their lives quite normally, living with stage 4 Cancer. That was all I wanted. I wanted to live.

Immunotherapy has been called a Miracle Drug. I remember reading as much about it as I could, as I wanted to know how it worked and what I could expect. I found an amazing group of people just like me, people who had advanced melanoma who were all part of an amazing supportive community and they took me in. I shared my story with them and straight away, they were there for me and we were all there for each other. There were stories of success, people who had achieved a "complete response" from immunotherapy. This means that the Cancer had been completely wiped out and was no longer active in the person. There was also tremendous loss and grief. The amazing thing was that everyone in my group supported everyone else, no matter how tough they were doing it at the time. The strength of these people is something to behold. It's truly inspiring.

3 months into my treatment I had my scans. I did my best to be ready for the results no matter what they were. It was Friday the 8th of February 2019, the day after my PET scan and MRI and I was on the train headed home from the city. I was due to get my results on the following Tuesday and was keeping myself busy trying not to think about it.

My phone rang and it was Mark. He said "I'm calling about a really great scan result"... "I'm looking at the PET and MRI and I can't see any sign of the tumor". It was surreal. I asked Mark to tell me again. He said "You've had a complete response". The cancer was gone.

I'll never, ever forget that moment. I went home and hugged my 2 boys and cried. I called my family and close friends and shared the news. I still get goosebumps even now writing this down. Only around 20% of people are fortunate enough to have a complete response to Immunotherapy when they are stage 4 melanoma. I had lucked out for some reason and felt like I was getting a 2nd shot at my life.

That was almost 4 years ago now. I completed my 2 years of treatment and had scans every 3 months, all of them being clear. I moved to 4 monthly scans this year and was recently told by Mark, that I would have one more scan in 12 months and then we would stop. No more scans, ever. Without going into the medical data to much, I am no longer considered a risk of relapsing so we are stopping the scans.

I hope that sharing my story with you might make a difference to your life or someone else's. I feel obligated to share my story and hopefully provide hope to anyone who is unlucky enough to be diagnosed with melanoma. I also hope that someone might read my story and have their skin checked or take a friend or member of their family to get their skin checked. These checks save lives.

If you got this far, thanks for reading.