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