Richard Scolyer hopes the life-saving melanoma research he pioneered could treat his brain tumour.
On opposite sides of the world, Richard Scolyer and Georgina Long each took one look at a scan and their hearts sank.But these long-time friends - both leading skin cancer doctors - feared it held a ticking time bomb.
Nestled in the top right corner of Prof Scolyer's skull was a section of matter lighter and cloudier than the rest.Neurosurgeons soon confirmed it wasn't just any brain tumour, but "the worst of the worst" - a subtype of glioblastoma so aggressive most patients survive less than a year. Devastated but determined, he and Prof Long set out to do the impossible: to save his life by finding a cure."It didn't sit right with me… to just accept certain death without trying something," Prof Scolyer says.Thirty years ago, when Prof Scolyer and Prof Long met as bright, young doctors, advanced melanoma was a death sentence.Australia has long had the highest rate of the skin cancer on the planet and where many saw a daunting challenge, they saw potential. " when I was doing the cancer block the most challenging patients to see were the ones with advanced melanoma. It was heartbreaking," Prof Long says.Today, it's near impossible to overstate their impact on the field. Anyone who gets a diagnosis or treatment for melanoma worldwide does so because of the work pioneered by the Melanoma Institute that they now lead.Over the past decade, their team's research on immunotherapy, which uses the body's immune system to attack cancer cells, has dramatically improved outcomes for advanced melanoma patients around the world. Half are now essentially cured, up from less than 10%. That breakthrough - or as Prof Long calls it, "penicillin moment" - is now being applied to many other cancers, saving even more lives. It has made the duo national treasures. Almost every Australian would know someone impacted by their work and this year they've been jointly named as the Australians of the Year.They bonded over frustration at the cases they couldn't crack, the highs of life-changing discoveries, a love of exercise, and a lofty ambition of reaching zero melanoma deaths in Australia. "We're very different but very similar in that sort of… roll up your sleeves, get things done way," Prof Long says. Prof Long and Prof Scolyer both represented Australia at the 2019 World Triathlon Championships in Switzerland Eyes shining, the medical oncologist rattles off a list of qualities - brave, honest, upbeat, driven - which make Prof Scolyer the dream colleague and friend.And so, after she received that fateful call from Poland last June - where Prof Scolyer was on holiday when a seizure triggered his diagnosis - she spent the night crying.But then she spent the morning plotting - poring over textbooks, researching clinical trials, and firing off emails to colleagues globally. Glioblastomas, found in the brain's connective tissue, are notoriously aggressive and the general protocol for treating them - immediate excision then radiotherapy and chemotherapy - has changed little in two decades.Desperate, Prof Long formulated a radical plan to treat Prof Scolyer based on what had worked in melanoma, but which had never been tested in brain cancer.In melanoma, Prof Long and her team discovered that immunotherapy works better when a combination of drugs are used, and when they are administered before any surgery to remove a tumour. It's like training a sniffer dog, she explains: you give it a smell of the contraband, in this analogy the cancer cells, for it to be able to hunt them down later.Some oncologists were sceptical that the drugs would reach his brain at all, and even if they did, that his immune system would respond.Many brain cancers grow so rapidly that even a two-week delay to surgery could mean it's too late to operate, they said. Immunotherapy drugs are quite toxic, especially when mixed, so he could be poisoned. And if either of those things caused the brain to swell, he could die instantly."They were saying… 'Just let the neuro-oncology experts do their thing and be his friend'," she says.And so, under the care of Prof Long and a team of experts, Prof Scolyer became the first brain cancer patient to ever have combination, pre-surgery immunotherapy. He is also the first to be administered a vaccine personalised to his tumour markers, which boosts the cancer-detecting powers of the drugs.Weeks after that initial scan sent their lives into a tailspin, Prof Scolyer and Prof Long looked at another test result."I was blown away. In a millisecond," he says.Not only were there traces of the drugs in the tumour - proving the medication had reached his brain - there was an explosion of immune cells. And they were "activated", giving the team hope they would be attacking his cancers cells at that very moment. The average time for a glioblastoma cancer to return is six months post-surgery. But eight months on, after continued immunotherapy, Prof Scolyer is showing no signs of active cancer.The results so far have generated huge excitement.But there's also optimism that the duo may be on the cusp of a discovery which could help the 300,000 people diagnosed with brain cancer globally each year.This kind of research would usually take years - even decades - but what Prof Scolyer and Prof Long have achieved in mere months has already attracted interest from pharmaceutical companies and generated talk of clinical trials.The doctor - after whom the current protocol for treating glioblastomas is named - says Prof Scolyer's prognosis is "grim", and that it's too early to tell if this treatment is working."It's not a revolution, but it is still a step forward."But Dr Stupp says he is "absolutely" confident that immunotherapy can change the treatment of brain cancer - the science just hasn't been cracked yet.Prof Scolyer and Prof Long are also trying to resist being swept up in the buzz."A miracle could happen," Prof Scolyer says. As for the worst-case scenario, he tells the BBC he's already beaten it: "I would have died before now." Instead, he celebrated his 57th birthday in December, and another Christmas with his family - wife Katie, and his teenage children Emily, Matthew, and Lucy.But with the gratitude for each additional milestone, every clear scan, is the fear it's his last.They've had discussions about death and funerals. "He's extraordinarily resilient," she adds. But sitting in his office - surrounded by pictures of his children, tasks scribbled on a whiteboard and shelves filled with framed accolades - Prof Scolyer tears up."I love my family. I love my wife… I like my work," he says with a grimace.But giving him comfort is the idea that this research could bring meaning, some purpose, to his diagnosis. "The data that we've generated - I know it's changing the field, and if I die tomorrow with that, I'm very proud."
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