Tuesday 24 October 2017

Skin Cancer: The shady side of sunshine

Being diagnosed with skin cancer was just the beginning of John Breen's tough, personal journey. Fortunately he found faith and healing along the way.

John Breen pictured near his home in Tramore, County Waterford. Picture: Dylan Vaughan
John Breen pictured near his home in Tramore, County Waterford. Picture: Dylan Vaughan

When John Breen's kids head outdoors on a hot summer's day, they are slathered in protective suncream. The reason for this is both simple and extremely serious: John himself has had to fight long and hard to deal with the consequences of skin cancer.

John (38) grew up in Tramore and, as a child, he played GAA, soccer, squash and basketball. When he was 13, thanks to his older brother's influence, he became an avid surfer. After school, he studied construction management at the Waterford Institute of Technology and it was during his time there that he met Deirdre Farrell, his future wife.

While she became a banker, he worked hard in the building industry. Five years after they met, they married, and today they have two children, Sarah Grace (8) and Leo (5). However, shortly after Leo was born, the Breens' happiness was shattered when John was made redundant. Deirdre had already stopped working some years previously so she could care for their daughter; Deirdre had also been affected by a stroke during an operation and needed to recuperate.

John recalls that experience. "Now, suddenly, I was out of a job. This had also happened in 2004, but then I'd managed to find work quickly - but not the second time around. So I resigned myself to having a break and enjoying the kids."

One of his New Year's resolutions in 2009 was to get a mole on his leg removed. A subsequent biopsy revealed it was a melanoma - the most serious form of skin cancer. According to the Irish Cancer Society (ICS), "melanoma is a cancer of the cells that make melanin - melanin is the pigment that gives your skin its colour." It says one of 
the most significant risk factors is 
over-exposure to sunlight and using tanning lamps and beds. Fair-skinned people are also more susceptible, and, since John is naturally pale and can recall times as a child when he suffered sunburn, he was doubly at risk.

Because melanomas are malignant, doctors at Cork University Hospital (CUH) decided that more tissue from his leg and a lymph node (or gland) needed to be removed from his groin. Upon examination, microscopic traces of melanoma were found, so it was decided to remove the remaining glands to prevent any possibility of the cancer spreading further.

"I was optimistic, as they had only found tiny amounts of the cancer and because they had removed the lymph nodes," John remembers. Nonetheless, he was careful to have frequent scans, and in 2010, when another small mole appeared, it was quickly removed without incident.

So all went well until early 2012, when a lump appeared in the area where the lymph nodes had been removed. John was admitted to hospital as a day patient so the lump, which appeared to be quite small, could be removed. However, when he woke up, he was shocked to learn that what they could see and feel on the surface was just the tip of a proverbial iceberg. "A big melanoma had wrapped itself around a muscle in my groin," he says. "When they removed it, they had to take a good scoop out of the muscle."

Just a few months later, John was dealt another blow when doctors discovered a further melanoma - this time on his backbone. Because it was located in a very sensitive area, it could not be removed surgically.

Up until that point, John had coped bravely with all that had gone before; the redundancies, battling to run his own building-related business, Deirdre's stroke and the various cancer scares; but now his courage failed him and he began to wonder if he would live to see his much-loved children growing into adulthood.

Around this time, a friend told him about a faith healer in Portlaoise and urged him to give it a try. John did, and he was so bowled over by the experience. Consequently, he began to believe that, with God's help, he would beat cancer.

Meanwhile, doctors in Cork explained to John that, in his case, conventional chemotherapy wouldn't help. So they sent tissue samples to Germany to see if a very specific form of treatment would benefit him. Sadly, the results were negative. Finally, it was decided to try Ipilimumab (Ipi), a very specific drug that helps the immune system destroy cancer cells.

This drug had become available only recently, thanks to the efforts of the late Cathy Durkin, who had campaigned for the health services to make this relatively expensive form of treatment available to people such as John, who needed it. And though the brave, noble mother of three lost her own battle with cancer in July 2012, her legacy very definitely lives on.

Just a few months after her death, John received the first of four doses of Ipi, which were administered at three-week intervals. Soon after, he was floored by a serious side effect of the drug when he developed sarcoidosis.

"In my case," says John, "it affected my lymphatic system. It made me terribly tired and I lost my appetite and that made me lose a lot of weight. But once it was diagnosed, I was put on steroids and almost immediately felt better."

In February of last year, John had a scan and there was very little change in the growth on his back. Three months later, he had another scan and not only had the melanoma not grown, it had actually "died". It was an unbelievable moment for the Breens and John has the highest praise for the doctors and nurses who care for him at CUH.

Rosemary Scott, health promotion officer at the Irish Cancer Society, says: "More women get melanoma but more men die from it. Follow the Irish Cancer Society's SunSmart Code and check the UV index daily at cancer.ie. We advise people to seek shade from 11am to 3pm; to wear hats and protective clothing, wraparound sunglasses and suncream with a SPF of at least 15 - SPF 30 for children."

John says he and Deirdre are very careful to keep their children protected from the sun at all times, even though Leo has the sort of skin that doesn't burn easily. "You just cannot be too careful," he cautions.

Anyone who is concerned about skin cancer, or any type of cancer, should call the Irish Cancer Society's National Cancer Helpline, tel: (1800) 200-700

Sunday Independent

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