This week I went for one of my follow up appointments that I’ve had every 4 to 6 months for the last 11 and a bit years. On moving to London, I deliberately asked my gp to refer me to Guy’s to a specialist clinic for people with familial melanoma as my brother Paul received a good service when he was their patient. I used to oddly enjoy going, throughout medical school and especially whilst working, it gave me a chance to take sick leave without the drawback of being unwell. I’d always go to Borough market beforehand usually getting the “mothership” deal at PieMinister. Then wait for the consultant very content due to a ball of pie, mash, mushy peas, bacon flakes and gravy pleasing the insides. Then after waiting a while, to be reminded that I was free of secondary cancer plus a chance to review all my moles. Whilst going through the pictures of my whole body playing a game of spot the difference, more times than you’d expect I’d have the same boxers on. I’d stand there wondering if they think I ever change. Due to this thorough check up over the years I’ve got to know my consultants well and vise versa.
This appointment was very different they knew my story from letters from the Marsden and they’d discussed me in their MDT meeting*. So I summarised where I was at. The consultant and specialist skin nurse were very empathetic with a look of just quite how sorry they both were for me. They also looked a bit helpless after all the years of follow up we had collectively failed to find anything early. But as melanoma is so aggressive I guess this happens a reasonable amount. The consultant checked my skin for anything new and that was it, we both agreed it was pretty pointless checking lymph nodes and an abdominal examination. She offered a second opinion with their oncologists if I ever need one and a psychotherapist, but I politely declined. I’ve seen two psychotherapists now who both offered good advice and felt I was dealing with the diagnosis as well as could be expected.
Overall it made me nostalgic for what it used to be like.
*multi disciplinary team meeting it’s a broad term from a meeting with the therapists, nurses and doctors on a elderly care ward wondering how on earth we’d be able to get the long stayers safely discharged. To a cancer MDT where in my case dermatologists, oncologists, pathologists, radiologists, specialist skin nurses and a variety of others all meet, to discuss cases. It’s actually not a well advertised process that the NHS does, and it does it well, with many patients seemingly unaware that they’ve been discussed at such a meeting. As you’d expect this level of expert input improves outcome and standards.