How Dr Ed’s watch­ful eye saved Andy’s hide — twice

Port Douglas & Mossman Gazette - - NEWS - Shane Ni­chols

JU­LAT­TEN man Andy Brook­ing walks around to­day be­cause of a re­mark­able set of cir­cum­stances: the care of ex­tra­or­di­nary lo­cal med­i­cal pro­fes­sion­als; the ad­vances of medicine that made a new drug avail­able just in the nick of time; and his own com­bi­na­tion of stub­born­ness and op­ti­mism to keep up the fight against a melanoma can­cer that threat­ened to knock him over in a flash.

As with much of this story, it be­gins with a com­bi­na­tion of serendip­ity and dili­gence.

Jo Forbes, a nurse at the Port Dou­glas Med­i­cal Cen­tre, has known Andy since they grew up to­gether in the UK. “We were in the same class in south Devon, and hung around in the same group,” says Andy. “Then we didn’t see each other again un­til in Port Dou­glas when we were adults.

“I was talk­ing to her one day and she said ‘you know Andy, with your freckly skin you should be checked’ – this was many years ago. She said, ‘we are lucky be­cause one our doc­tors in Port Dou­glas is very in­ter­ested in skin can­cers’.”

So Andy ex­ploited his sec­ond lucky break when he went to see Dr Ed­ward Guir­guis in 2013.

“I be­lieve Ed­ward saved my life twice,” Andy says.

The first time was when he was do­ing a rou­tine ex­am­i­na­tion of Andy’s skin and some­thing about one par­tic­u­lar non­de­script brown patch kept both­er­ing the doc­tor. Dr Guir­guis kept re­turn­ing to the spot to ex­am­ine it. It looked pretty in­no­cent but ex­pe­ri­ence and gut in­stinct sug­gested more in­ves­ti­ga­tion.

It turned out that un­der­neath this small patch was a cat­e­gory 4 melanoma. These can­cers can “hide” – out­wardly there was very lit­tle in­di­ca­tion it was lurk­ing – ex­cept to the scrupulous gaze of some­one like Dr Guir­guis.

That melanoma was re­moved about 5½ years ago. At that time there was no known treat­ment and Andy con­sid­ers he would have died if it had not been de­tected when it was.

“The on­col­o­gist said to me, ‘you do have an ex­cep­tional GP – that would prob­a­bly have not been picked up oth­er­wise’.”

At Ed’s “strong ad­vice” Andy started hav­ing three monthly check ups.

“Just be­fore Christ­mas 2014 I went for a reg­u­lar check up – noth­ing – and just as I was go­ing out the door of the surgery he said ‘wait a minute, let me just check your charts and de­tails’, and he said ‘oh, you’re due for a set of blood tests. It’s been 14 months, in­stead of 12’.

“I thought, two months over­due, big around to it.”

“But he said ‘no, you need blood tests’. So be­cause of his in­sis­tence I got the blood tests.” What fol­lowed was dra­matic and des­per­ate. As soon deal, I’ll get as the re­sults were avail­able, Andy got a phone call telling him to come to Dr Guir­guis’s surgery. He was im­me­di­ately sent to Moss­man Hospi­tal for an ul­tra­sound. With that, he was sent im­me­di­ately back to Dr Guir­guis who packed him off to Cairns. Dr Guir­guis had made the com­plete se­quence of ar­range­ments for Andy.

In Cairns, Andy had a CT scan.

In short or­der, still wear­ing his work clothes, he found him­self in the sur­gi­cal ward booked for a nee­dle biopsy.

Doc­tors did this the next day and the re­sults two weeks later in­di­cated a very large tu­mour just be­low Andy’s ribs – ma­lig­nant metastatic melanoma. Lethal, no cure.

“The sur­geon gave me six months at that stage.”

The tu­mour grew rapidly, eat­ing his red blood cells, and be­com­ing so large it pressed on his stom­ach and left lung. He couldn’t eat much and dropped to 49.7 kg and had water on the lung.

He looked ter­ri­ble but his var­i­ous em­ployes – Andy is a car­pen­ter – in Port Dou­glas re­sorts kept work avail­able for him.

Mean­while, Andy started to tidy up his af­fairs

At that time nurse Jo Forbes reached out to Andy’s wife Wendy to lend sup­port, while Dr Guir­guis was con­stantly re­search­ing for treat­ments that could help Andy.

He told Andy about some new treat­ments and told him he would have to “push” to ob­tain them.

Dr Me­gan Lyall, the head of on­col­ogy at the Liz Plum­mer Cen­tre, started him on a treat­ment but both she and Andy knew it wasn’t go­ing to work fast enough.

She had been in touch with Bris­tol-My­ers Squibb about a new drug, a trial im­munother­apy drug which had pre­dicted side ef­fects that were un­known.

Within days of start­ing on it Andy was markedly im­proved. The tu­mour was shrink­ing and he was putting on weight.

It had come along just in time. Eigh­teen months ear­lier he would have died of the same ill­ness. Now, the most re­cent scan showed no ac­tiv­ity at all with what’s left of that tu­mour.

Andy has had “no side ef­fects what­so­ever, not one”. He still has the drug treat­ment ev­ery other Thurs­day.

Dr Guir­guis has been highly in­volved with Andy’s care all along, mon­i­tor­ing his blood tests and get­ting feed­back about his treat­ment in Cairns.

“He al­ways had a wait­ing room full of peo­ple but he had time for me,” Andy says. “He al­ways wanted to know all the de­tails and fol­low it through.

“We want to get the mes­sage out there – have your­selves checked reg­u­larly.”

The mor­tal­ity of melanomas in this coun­try per year is stag­ger­ing; in fact four peo­ple die from it ev­ery day.

As for Andy, he’s grate­ful to be around, and es­pe­cially grate­ful to a re­mark­able lo­cal GP and his staff.


Andy Brook­ing and wife Wendy. Belwo: Nurse Jo Forbes and Dr Ed­ward Guir­guis

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