Katherine Burger Shares Melanoma Diagnosis
21st July 2016 should have been another banal, winter’s day. It wasn’t. It was the day I was diagnosed with Stage 3b Melanoma and my life irrevocably changed forever.
My name is Katherine Burger and I am now 49 years old. I am fair with multiple freckles, but I have never had many moles. I have never been too worried about my skin. Also, I have always believed and boasted about being really SunSmart – I always smother myself with high SPF sunscreen and boringly sit under a large cabana on beach holidays. I actually hate the sun!
In June 2016 , I discovered a lump on the inside of my right elbow. It was internal, quite tender and growing rapidly. My GP initially thought it was an infection in my lymph node and gave me an 8-day course of antibiotics. As I was also taking anti-inflammatories for the pain and discomfort, I thought the antibiotics had worked. But, the lump continued to grow, and after three weeks, I was shocked to see that it was a large golf ball protruding from my arm…
I went straight back to the GP, who was alarmed now, and sent me to a surgeon for an immediate biopsy. The surgeon was less perturbed and thought the enlarged node was caused from one of many non – ominous medical issues. She did opt to remove the node, as it was pretty large and painful at this point.
Four days later I got the shocking results of the biopsy….you could have knocked me over with a feather! The shock, the fear is utterly indescribable.
Although we were unsure where my primary melanoma was, it had metastasized to my epitrochlear lymph node and was therefore Stage 3 cancer. At this point, we had no idea how far it had spread, so within a week, I met my first oncologist, had multiple blood tests, a full body PET scan, a brain MRI and a liver MRI. Fortunately, it had not metastasized to stage 4, but I did need more surgery to remove the remaining epitrochlear node (which was thankfully clear of cancer).
After waiting for the shark-bite wound on my arm to heal, I started Interferon as adjuvant therapy. I needed to inject myself three times a week. Every injection made me ill with headaches, fevers, nausea, lethargy, lack of appetite. Sadly, at the time, Interferon was the only approved melanoma protocol in South Africa. However, I had researched that other, newer, and more effective immunotherapy treatments were being used overseas. So, I shopped around for another oncologist and a clinical trial. I was so grateful and blessed to find my present oncologist who put me on a compassionate access protocol of Nivolummab (known as a PD 1 checkpoint inhibitor). I had 37 infusions (two a month) before side effects got the better of me. But those infusions were my magic bullet and saved my life. I’m still here after nearly seven years!
Immunotherapy is now the only regime used for Melanoma – Melanoma is so aggressive, sneaky and evil that it does not respond to chemotherapy and radiation. Immunotherapy attempts to programme the T cells in one’s body to fight the cancer. So, the cancer is fought internally and not from an outside source (like chemotherapy). The new-age immunotherapies are groundbreaking game changers, saving many melanoma patients and radically increasing chances of survival. Advanced melanoma used to be a death sentence. It isn’t anymore. Now, it is common practice to be given them for Stage 3 and Stage 4 melanoma. The popular choice is Keytruda (very similar to what I was on) but sadly it is unaffordable for most. It costs nearly R100 000 an infusion and you need at least a dozen for there to be any effect. Top tier medical aids only pay 80% – and if you aren’t on a top plan or have no medical aid, you’ll need to fork out the whole amount yourself! It becomes way over a million rand…
I will never be totally out of the woods – the chances of recurrence are high, as melanoma can travel in the blood and lymph systems to ANYWHERE in the body and it can lie DORMANT for years. Because of this, people who have had advanced melanoma, can never donate blood or organs.
Knowing Your Body May Save Your Life
I have I learnt a lot about skin cancer and melanoma since my diagnosis. I have even started a support group for newly diagnosed patients who are reeling from the shock and horror of what’s to come. I have met many new friends in this group and am so grateful to have found people who can truly empathize with my journey.
We are led to believe that a melanoma is quite an obvious, rapid growing, misshapen, miscoloured, hideous witch-like growth! Not true! If we have to surmise where my primary was, it was a small lump I had removed a couple of years ago from my wrist. It came back benign, but I had it removed because it irritated me. It looked like a little, unassuming wart. Melanomas can look like any lump or bump, so that’s it’s so important to know our bodies and watch for changes. You should do a skin self-examination every few weeks. Most importantly, this is why EVERYONE should have an annual skin check by a dermatologist.
Melanoma does not just inflict its wrath on fair skinned people either. Incidences of Melanoma are on the rise for ALL skin types. So, if you are dark skinned, you cannot be smug – Bob Marley died of melanoma. Melanoma is highly treatable and has an excellent prognosis if it is caught EARLY.
One person dies of Melanoma every hour in this world. It has the most rapid statistical growth of any cancer in the world. It afflicts young and old, and 100 000 new cases were diagnosed in the USA alone this year. It is literally seen as an epidemic in Australia, the melanoma capital of the world. We are a close second with our harsh, unforgiving African sun. The sad part is more and more young people are afflicted with melanomas and are dying from this disease – yes, children and teenagers. Having just 5 sunburns in your life doubles your chance of melanoma.
Being Sun Smart is not just about purchasing a high SPF sunscreen. It is about re applying that sun screen every 30 minutes. It is about using enough of the sunscreen and not just small amounts, to save money. It is about making sure that your WHOLE body is COVERED with the sunscreen. It is about always wearing a UV protective hat outdoors. It is about making sure your kids only run on the beach with a full costume and rash vest. It is about NOT lying and baking in the sun, but sitting under an umbrella. It is about knowing that you can still burn on a cloudy day. It is about caring for the largest organ in your body…
Remember, there is no such thing as a safe tan. Just a slight discolouration is still skin damage. I would rather be pale and alive, wouldn’t you?