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David Bateson, 49, was first diagnosed with melanoma, a type of skin cancer, in December 2019. By August 2021, it had spread to his liver, lungs and spine. Thanks to immunotherapy treatment, David has gone from having aggressive cancer to having no evidence of disease in his body. He explains why he now has hope for the future and a new-found appreciation of life…
In 2019, I noticed a scab on the crown of my head. I have since learned that, despite having a full head of hair, I should have worn a hat more often to protect my skin from the sun. The scab kept bleeding and I assumed I must have banged my head. After three months it hadn’t healed, so I went to the doctor. I was given a steroid cream, but when it still hadn’t cleared up after a week, I was referred to a dermatologist. By now, the scab looked like a bubble on a sheet of bubble wrap.
I was pretty relaxed about it at this point. You just don’t think that anything bad will happen to you. The dermatologist did a shave biopsy and I thought nothing of it. But a few days later, I got a call to say the results were in and that I needed to make an appointment to come back immediately. The urgency about it alarmed me. I realised it must be cancer – and the one form of skin cancer I knew I did not want was melanoma. I had read enough about it to know that this diagnosis would be very serious.
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My wife, Lisa, came to the hospital with me and we were given the news that I’d dreaded: it was melanoma. I felt numb and shocked. I knew it was bad, but I am a naturally optimistic person and I was hopeful that if the lesion hadn’t spread too deeply, I would still be alright. Dr Google is not your friend, but researching online had given me some awareness and I knew my prognosis depended on how deeply the cancer had penetrated.
Just before Christmas, I had the lesion removed. They took as much of it out as they could. At this point we did not tell the children what was going on. We did not want to alarm them until we knew the full picture. Needless to say, it was a very tough Christmas.
In early January 2020, I got the results. The lesion was over 5mm thick, which meant there was a chance it had spread to my blood stream. I was gutted. This was bad news and the outlook felt full of doom and gloom. The decision was taken to do a wide area incision to remove any cells around the original site. They also took lymph nodes from my neck to check whether the cancer had spread.
‘I was determined to face it head on’
I was at work when I took the call telling me about my results. No cancer cells had been detected in the surrounding tissue or lymph nodes. The relief was enormous. My consultant warned me that just because it hadn’t spread now did not mean it would not do so in future. There was a chance that cancer cells could already be in transit but were currently undetectable on a scan. But I did not want to think about this possibility. I chose to clutch on to the positives and threw a party to celebrate the good news.
I decided to crack on with living and returned to normal life. Over the next few months, despite the Covid lockdown, I went back to work and put everything behind me. I played football, golf, had beers with the lads. I was just an average guy.
But eight months later, I noticed that one of the lymph nodes in my neck was swollen. It felt like a frozen pea. I spoke to my consultant who sent me straight for an ultrasound. The radiologist was a lovely man and when I asked him what he was looking for, he said that if he could see black inside, it was not a good sign. As he hovered over my lymph node, the screen showed that it was quite clearly black inside. It was not ideal, but I was determined to face it head on.
I had 50 lymph nodes removed from my neck, of which five or six were found to be cancerous. This meant that I had moved from having stage 1 cancer to stage 3. The strategy was to attack my neck area – this was done with radiotherapy. I had treatment daily over a three-week period and it was rough, leaving me unable to swallow for a time. In a bid to prevent the cancer progressing to stage 4, I also had major surgery to remove numerous lymph nodes in my neck.
I was told they had got everything out and in late 2020, I was given the all-clear. It had been a rollercoaster few months, but now I could crack on with my life. It was happy days. I just had to have three-monthly check-ups and surveillance scans.
‘I started planning my funeral’
But a routine scan in August 2021 revealed the cancer was back. I remember having a Zoom call with my consultant on 20 August, my birthday, and as soon as I saw her face, I knew something was wrong. She told me the cancer had spread to my liver, lungs and spine.
Melanoma kills so many people. It is an extremely aggressive cancer and once it takes hold, it can be very hard to treat. I was gutted at the news. How was I going to come back from stage 4 melanoma? My consultant told me that surgery was not an option. Now that the cancer had spread and was classed as stage 4, it was inoperable.
I searched online and I could see that statistically, my chances of surviving were slim. I felt I was done. I started planning my funeral, sorting my life insurance, writing my will, making sure that my family would be cared for. I got my head into a space where I was living three months at a time. I had to enjoy myself as much as I could. I made sure I spent lots of time with the family, took holidays and made memories.
I knew people who had died from melanoma and I know that I would have died too, if it wasn’t for the treatment I was offered. My consultant suggested I tried a new immunotherapy combination, and I started this in September 2021. It was my last hope and I was pinning everything on the treatment working. After nearly two years of living on a rollercoaster, I knew this was my last throw of the dice.
‘Immunotherapy saved my life’
My consultant explained that there was a 40 per cent chance of getting a reaction where we would see my body start to fight the cancer cells. There was less of a chance that I would get a totally all-clear outcome. But it was worth the risk for me. For the first three months of the treatment, I was on a combination of nivolumab and ipilimumab in a bid to kick my immune system into action. Then I spent two and a half years taking nivolumab every four weeks.
I was very lucky. Early on, my body started to react. With every scan, there were no new cancer sites detected. My disease had moved from aggressive to stable. There was a slight reduction in the cancer tumours, although at one point, the lesion on my spine was found to have grown. To address this, the immunotherapy treatment was temporarily stopped and I had intense radiotherapy. The side effects made me very unwell, including problems with my liver. I worried that my body was rejecting the immunotherapy. But once the radiotherapy was complete, I resumed the immunotherapy and continued with it until December 2023.
It was scary to stop the treatment. While the evidence has shown that two years is the magic amount of time to be on immunotherapy – there is no evidence to suggest it does any better after this – it had become my comfort blanket. I was used to being on the drugs and living life from scan to scan. It was working to get rid of my cancer and it felt beautiful to live like this.
In that time, I started to do a lot of fundraising in a bid to give something back. I had a renewed purpose and an appreciation of life that I wish I’d had before. I had built up so much resilience since my original diagnosis and I started to give talks to raise awareness around melanoma and the dangers of exposure to the sun.
‘Without research and drug development, I would not be here’
In January 2024, a scan revealed no evidence of disease. Since then, I had three-monthly scans for nine months, and now have them every six months. These have all thankfully been clear – there is no sign of disease in my body. I am back to running, playing football and working. I have been in remission for 18 months and I feel really well.
Of course, I have been to dark places, but I now feel positive and optimistic about the future. I am well aware that without research, new treatments and drug development, I would not be here. This particularly hit home recently when I met a young woman whose dad had died of melanoma in 2016. He didn’t have a chance, but new treatments since then have meant that I did. If it weren’t for people developing new treatments all the time, I would have been done for. You can never give up hope because new developments mean more people like me will survive.
There is no doubt that immunotherapy saved my life. There is no other way of putting it. Maybe I was lucky – I am physically fit and have a positive frame of mind. But whatever the reason, I am still here. The survival statistics for people with stage 4 melanoma were once shocking, but immunotherapy, which allows the body to fight the cancer cells itself, is so clever. Enabling your own body to fight the cancer is a great way to beat the disease. If we can get this to work for more cancer patients and for different cancers, we will see more and more people surviving.
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