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I’m a Cancer Survivor, but not a Cancer Victim

The news that Dr Oliver Sacks has been diagnosed with terminal liver cancer as a consequence of the melanoma removed from his eye nine years ago is a little disconcerting. He’s one of the unlucky. The very unlucky. But it’s easy to forget that percentages hide a real number. The real number of unlucky in metastasised melanoma cancers is big enough to be scary.

Self Portrait

I had a malignant “in situ” melanoma removed five years ago last month. The doctor cut it out the moment I presented at the clinic. No big drama. The melanoma was shallow at .7mm, so there is every chance that I’ll be fine. Due to the public health system it was months, rather than days or weeks, before surgeons at the Royal Hobart Hospital removed the surrounding 5cm radius circle of flesh from my inner thigh; but, otherwise, all went well. Some arterial spray on the surgery roof and the possibly dangerous tissue was removed.

My original regime seeing a specialist was full body mole checks every three months for two years. The guy was brilliant. He cared. He’d lost patients and seen incompetence and he looked in my eyes for melanoma, he looked inside my underwear, at my finger and toe nails and through my hair. He would check the lymph nodes under my arms and in my groin, a sign of possible trouble. He even looked inside my mouth. I liked this guy, he asked a lot of questions, but sadly he stopped travelling three hours to the clinic and I had to find another specialist.

The surgeon who removed the 5cm radius from my inner thigh would also see me every three months for the next four years. He took that melanoma very seriously, although he never had time for the full body checks that I received at the private clinic. The surgeon always checked my lymph nodes. Always.

My biggest problem is really with the private clinics. I’d argue that the private clinics I’ve attended see product move through their rooms, rather than people with illness. It’s easy to say “don’t be paranoid” when you’re not the person who might be in that unlucky 2-5%. The mortality rate for this disease is 2% in the first five years and 5% by year ten. OK that’s a small percentage. And a LOT of human beings. Seriously, a LOT of human beings die from cancers as a result of “in situ” shallow melanoma that has metastasised.

The simple fact is that more people die from thin melanomas than thick melanomas. Why? Because while they’re less fatal, they’re far more common. In a Queensland study it was found that while only 14 per cent of deaths in the period were from thick melanoma, a quarter of deaths were from thin melanoma.

The treatment we get in cancer clinics seems to be very fast lane. It’s all about recouping service fees for that expensive fancy machine. Nobody wants to look inside your underwear. Nobody puts a light to your eyes, or checks your fingernails. I haven’t run into anyone since that very first specialist five years ago (or the surgeon) who bothers to check my lymph nodes. I can’t remember anybody for years bothering to tell me that I need to get a check-up if I lose weight, or get super tired for no apparent reason. It’s more pump and dump. We’re customers. The odds (as a percentage) are that 95-98 per cent of patients will fall safely through the inspection net. The cancer clinic business model dictates the odds are that we’ll survive “in the majority” and those odds are greatly in favour of the house. Why spend effort, time and resources digging madly inside our underwear or looking inside our eyes to save those few? The clinic expects casualties and nobody is going to penalise them for the inevitable dead minority.

That’s why I liked that very first specialist who really cared about the melanoma. He treated the individual. He’d never have said “Don’t be paranoid” – exactly the opposite. I sincerely fear the motivation of the cancer clinics that I’ve passed through along this journey are profit maximising businesses playing the odds.

I don’t often think about this melanoma thing because mortality is a disconcerting bed mate. But I’m a survivor, not a victim. And it’s sad to see Dr Oliver Sacks, somebody that I have the greatest respect for as a man of science and author, fall into that unlucky few percent. He had nine good years without a sign of that cancer being present. Now a third of his liver is riddled with cancer. There but for the grace of God go I. Turns three times. Spits.

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About the Author

Steven Clark Steven Clark - the stand up guy on this site

My name is Steven Clark (aka nortypig) and I live in Southern Tasmania. I have an MBA (Specialisation) and a Bachelor of Computing from the University of Tasmania. I'm a photographer making pictures with film. A web developer for money. A business consultant for fun. A journalist on paper. Dreams of owning the World. Idea champion. Paradox. Life partner to Megan.

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