1 00:00:09,900 --> 00:00:13,420 Three o'clock in the morning, when you can't sleep, 2 00:00:13,420 --> 00:00:16,020 is the very worst time to come down into your office 3 00:00:16,020 --> 00:00:17,420 and start Googling. 4 00:00:17,420 --> 00:00:18,860 HE CHUCKLES 5 00:00:18,860 --> 00:00:22,980 It's when everything looks the bleakest. 6 00:00:22,980 --> 00:00:27,020 The worst thing you can do is - melanoma, images. 7 00:00:27,020 --> 00:00:28,380 Oh, dear. 8 00:00:28,380 --> 00:00:29,460 Oh, my God. 9 00:00:30,460 --> 00:00:32,380 Oh, Christ. 10 00:00:32,380 --> 00:00:35,660 Oh, that's horrendous. 11 00:00:36,980 --> 00:00:39,020 God, that looks like nothing. 12 00:00:39,020 --> 00:00:40,460 That's a melanoma. 13 00:00:43,740 --> 00:00:45,660 I'm George McGavin. 14 00:00:45,660 --> 00:00:48,780 I'm a scientist and broadcaster. 15 00:00:48,780 --> 00:00:53,220 I've led an amazing life of adventure, studying the science 16 00:00:53,220 --> 00:00:55,100 of a natural world. 17 00:00:55,100 --> 00:00:59,060 Now, suddenly, I'm the one under the microscope. 18 00:00:59,060 --> 00:01:03,420 Six months ago I was diagnosed with malignant melanoma - 19 00:01:03,420 --> 00:01:05,140 skin cancer. 20 00:01:05,140 --> 00:01:09,220 It's just impossible to understand that a mutation in one, 21 00:01:09,220 --> 00:01:13,940 single cell in your heel could potentially kill you 22 00:01:13,940 --> 00:01:17,180 in one year. I mean, it just doesn't compute. 23 00:01:17,180 --> 00:01:21,620 But incredibly, as I was diagnosed, a drug was licensed for use 24 00:01:21,620 --> 00:01:25,700 by the NHS that could potentially save my life. 25 00:01:25,700 --> 00:01:26,980 Look at that. 26 00:01:26,980 --> 00:01:30,300 As a scientist, I want to discover all there is to know 27 00:01:30,300 --> 00:01:33,380 about my cancer, and the drugs that could kill me. 28 00:01:33,380 --> 00:01:36,180 We think it is a new way to think about cancer treatment. 29 00:01:38,260 --> 00:01:39,660 That is my tumour there? 30 00:01:39,660 --> 00:01:41,100 This is your tumour. 31 00:01:41,100 --> 00:01:42,380 Oh, look at it! 32 00:01:42,380 --> 00:01:44,620 The question is, will these drugs work? 33 00:01:45,780 --> 00:01:50,140 This is the story of my year living with a life-threatening cancer, 34 00:01:50,140 --> 00:01:54,620 and the extraordinary new science that could save my life, 35 00:01:54,620 --> 00:01:57,140 and the lives of thousands like me. 36 00:01:58,340 --> 00:02:02,740 I want to know everything about it, and I want to know it now. 37 00:02:19,460 --> 00:02:20,660 Hello. 38 00:02:20,660 --> 00:02:23,100 Darling, I suppose the first thing you want is tea? 39 00:02:23,100 --> 00:02:25,180 Yes. I'll put the kettle on. 40 00:02:25,180 --> 00:02:28,940 It's November 2018, and for those around me, 41 00:02:28,940 --> 00:02:32,540 the news of my diagnosis is still sinking in. 42 00:02:32,540 --> 00:02:36,460 Amy's very special to me and I don't want to upset her, 43 00:02:36,460 --> 00:02:40,060 I don't want her to be anxious. 44 00:02:40,060 --> 00:02:46,300 Like any parent, you want to protect anybody who is close to you. 45 00:02:46,300 --> 00:02:49,420 I've told her enough that she has to know. 46 00:02:49,420 --> 00:02:51,820 I haven't told her exactly how I feel about it. 47 00:02:53,020 --> 00:02:59,620 Because Amy will do all the worrying and more without me 48 00:02:59,620 --> 00:03:00,900 helping it along. 49 00:03:01,820 --> 00:03:04,500 I must show you foot, actually. 50 00:03:04,500 --> 00:03:06,700 There's a nice scab now. 51 00:03:06,700 --> 00:03:08,020 Oh, gosh. 52 00:03:08,020 --> 00:03:09,140 It's just hanging off now. 53 00:03:09,140 --> 00:03:10,260 Oh, man, yeah. 54 00:03:13,020 --> 00:03:16,980 It's such a relief that you don't have to have more scooped out. 55 00:03:16,980 --> 00:03:18,860 That's not, that's not sure. 56 00:03:18,860 --> 00:03:21,700 I mean, if there's any trace of the cancer anywhere else 57 00:03:21,700 --> 00:03:23,900 up here or somewhere else... 58 00:03:23,900 --> 00:03:26,540 I mean, I'm assuming it'll be fine. 59 00:03:26,540 --> 00:03:28,180 Yeah, I'm sure it will. 60 00:03:28,180 --> 00:03:29,420 Can I have my sock, please? 61 00:03:41,740 --> 00:03:44,300 We haven't really talked about, kind of, prognosis 62 00:03:44,300 --> 00:03:48,060 and what the future is looking like. 63 00:03:49,580 --> 00:03:52,260 I'm rather afraid to ask, to be honest, cos I'm not sure 64 00:03:52,260 --> 00:03:56,260 I want to hear that I've got a finite amount of time 65 00:03:56,260 --> 00:03:57,220 left with him. 66 00:03:59,300 --> 00:04:00,340 Clever girl. 67 00:04:14,940 --> 00:04:18,660 Three months ago, I had surgery to remove a cancerous tumour 68 00:04:18,660 --> 00:04:19,740 from my heel. 69 00:04:21,780 --> 00:04:25,780 So there was a big, big hole in my foot, took about six weeks 70 00:04:25,780 --> 00:04:28,660 to properly heal up. 71 00:04:28,660 --> 00:04:31,740 Well, this is how it looks now. 72 00:04:31,740 --> 00:04:35,780 So that's 12 weeks post operation. 73 00:04:37,700 --> 00:04:41,700 Cancer, if it stays in the one place, is fine, and you can 74 00:04:41,700 --> 00:04:44,500 generally hack it out and end of story. 75 00:04:44,500 --> 00:04:49,420 Once it starts to spread and move elsewhere, 76 00:04:49,420 --> 00:04:52,660 then you're in a whole new ball game. 77 00:04:52,660 --> 00:04:56,540 Cancer is described in stages from one to four. 78 00:04:56,540 --> 00:05:00,740 Stage one cancer starts when genetic changes or mutations in a single, 79 00:05:00,740 --> 00:05:04,900 normal cell cause it to start dividing uncontrollably, 80 00:05:04,900 --> 00:05:07,580 forming a cell cluster called a tumour. 81 00:05:07,580 --> 00:05:10,180 But it stays within the same tissue. 82 00:05:11,860 --> 00:05:17,860 And once that happens, it's a cancer, that's it and it won't die. 83 00:05:17,860 --> 00:05:21,300 Stage two cancer is a more advanced or aggressive tumour 84 00:05:21,300 --> 00:05:26,540 that has a higher risk of breaking out from the original tissue. 85 00:05:26,540 --> 00:05:30,220 A cancer become stage three when cells from the tumour break 86 00:05:30,220 --> 00:05:33,700 off and get trapped and grow in the lymph nodes. 87 00:05:33,700 --> 00:05:37,260 Lymph nodes are the body's natural filtration system, 88 00:05:37,260 --> 00:05:40,780 trapping and removing toxins and foreign invaders. 89 00:05:42,660 --> 00:05:46,460 Eventually, these mutant cells migrate into the bloodstream, 90 00:05:46,460 --> 00:05:49,580 invading distant organs throughout the body, 91 00:05:49,580 --> 00:05:52,140 forming secondary tumours. 92 00:05:52,140 --> 00:05:54,420 This is stage IV cancer. 93 00:05:54,420 --> 00:05:56,420 Untreated, this is deadly. 94 00:06:04,740 --> 00:06:08,420 As for me, I've recently been told I'm stage III, 95 00:06:08,420 --> 00:06:12,460 which means the cancer has spread to my lymph nodes. 96 00:06:12,460 --> 00:06:16,940 The good news is, only a few weeks ago, pioneering new drugs 97 00:06:16,940 --> 00:06:20,980 were approved by Nice and made available for NHS melanoma 98 00:06:20,980 --> 00:06:22,180 patients like me. 99 00:06:26,060 --> 00:06:27,100 Bye. 100 00:06:30,940 --> 00:06:32,940 It's a big day for me. 101 00:06:32,940 --> 00:06:36,460 I'm on my way to meet the oncologist in charge of my case. 102 00:06:37,660 --> 00:06:38,740 I'm late now. 103 00:06:40,260 --> 00:06:43,460 The drug treatment I'm about to begin is completely different 104 00:06:43,460 --> 00:06:46,660 from what would have been given to people with malignant melanoma 105 00:06:46,660 --> 00:06:48,420 until just a few weeks ago. 106 00:06:49,940 --> 00:06:52,660 Hack, poison and burn, that's what we had to do 107 00:06:52,660 --> 00:06:54,660 with cancer for decades. 108 00:06:54,660 --> 00:06:59,180 I mean you've got to hack it out, you've got to poison it with drugs 109 00:06:59,180 --> 00:07:02,540 that also poison you, or use high energy beams 110 00:07:02,540 --> 00:07:03,700 to fry it out. 111 00:07:03,700 --> 00:07:07,260 Well, all of these things have left people with some horrific side 112 00:07:07,260 --> 00:07:10,100 effects, and have not always been effective. 113 00:07:10,100 --> 00:07:15,020 But we are now on the cusp of a revolution in cancer treatment, 114 00:07:15,020 --> 00:07:19,180 where we've got drugs and techniques available which mean people 115 00:07:19,180 --> 00:07:22,340 with terminal cancer can survive for decades. 116 00:07:23,980 --> 00:07:25,540 Welcome to St Luke's. 117 00:07:25,540 --> 00:07:28,860 My name is Tim Crook, I'm the melanoma physician here. 118 00:07:28,860 --> 00:07:32,540 In other words, my job is to treat melanoma with drugs. 119 00:07:32,540 --> 00:07:35,540 Now, if we were sitting here a couple of years ago, 120 00:07:35,540 --> 00:07:40,020 even a year ago, the orthodoxy is surgery, 121 00:07:40,020 --> 00:07:41,860 surgery, surgery. 122 00:07:41,860 --> 00:07:43,940 And luck. And then luck. 123 00:07:43,940 --> 00:07:47,420 Now, we have actually a number of effective treatments. 124 00:07:47,420 --> 00:07:51,660 I would be very hopeful that we can shrink this disease down. 125 00:07:51,660 --> 00:07:54,620 Right. The treatment consists of taking one of the drugs, 126 00:07:54,620 --> 00:07:56,700 dabrafenib, the actual BRAF inhibitor, 127 00:07:56,700 --> 00:08:00,140 is taken twice a day and the complimentary drug, 128 00:08:00,140 --> 00:08:02,580 the potentiating drug, if you like, trametinib, 129 00:08:02,580 --> 00:08:04,180 is taken once a day. 130 00:08:04,180 --> 00:08:07,460 If I said, that's a black spot, I'm just going to ignore 131 00:08:07,460 --> 00:08:10,820 it completely, how long would you think I would have? 132 00:08:10,820 --> 00:08:12,420 A year. 133 00:08:12,420 --> 00:08:13,980 Whoa! 134 00:08:13,980 --> 00:08:16,580 I was shocked, actually... Right. 135 00:08:16,580 --> 00:08:19,340 ..absolutely shocked. I didn't think he'd say that. 136 00:08:19,340 --> 00:08:23,140 It felt a bit like being punched in the stomach, you know? 137 00:08:24,580 --> 00:08:26,500 What? 138 00:08:26,500 --> 00:08:27,540 Yeah. 139 00:08:31,100 --> 00:08:34,620 He's, you know, pressing quite hard there. 140 00:08:34,620 --> 00:08:36,140 He is pressing quite hard. 141 00:08:37,500 --> 00:08:40,620 The drugs I'm going to get have powerful side effects 142 00:08:40,620 --> 00:08:44,140 that can impact the ability of the heart to pump efficiently. 143 00:08:45,140 --> 00:08:47,260 What's that, what's that? 144 00:08:47,260 --> 00:08:51,460 So before I get my eager hands on the drugs, I need a checkup to see 145 00:08:51,460 --> 00:08:54,180 if my heart is strong enough to handle the treatment. 146 00:08:56,020 --> 00:09:00,100 Hey, hon, you've actually seen inside my heart now. 147 00:09:00,100 --> 00:09:02,340 It's not that attractive, actually. What? 148 00:09:08,220 --> 00:09:09,700 All working... 149 00:09:09,700 --> 00:09:11,380 That looks pretty good. 150 00:09:11,380 --> 00:09:14,060 Yes. For a 64-year-old? 151 00:09:14,060 --> 00:09:15,100 Think so. Yeah. 152 00:09:16,500 --> 00:09:17,540 Thank you very much. 153 00:09:19,740 --> 00:09:20,940 And we're off. 154 00:09:22,820 --> 00:09:26,620 With my body given the all clear, it's time to pick up the drugs - 155 00:09:26,620 --> 00:09:29,220 and not a moment too soon. 156 00:09:29,220 --> 00:09:34,340 One week's supply of one of the drugs is £1,000. 157 00:09:36,220 --> 00:09:40,540 I've had very bad luck in having the disease at all, 158 00:09:40,540 --> 00:09:43,700 but of course very good luck in that I've had it now. 159 00:09:45,580 --> 00:09:52,500 The very two drugs that I need are only authorised for NHS use 160 00:09:52,500 --> 00:09:55,780 just a couple of weeks before they were prescribed to me. 161 00:09:55,780 --> 00:10:00,300 I mean, that is, you know, that's the golden ticket. 162 00:10:02,100 --> 00:10:03,500 Oh, no, no. 163 00:10:03,500 --> 00:10:06,100 Oh, dear. 164 00:10:06,100 --> 00:10:08,580 I'm not going to get stressed this time. 165 00:10:08,580 --> 00:10:11,780 No. Come on, you morons. 166 00:10:11,780 --> 00:10:13,420 I'm dying of cancer here, come on. 167 00:10:14,900 --> 00:10:16,140 Not really, well... 168 00:10:20,540 --> 00:10:23,340 Of this one, of the Tafinlar and then you are taking 169 00:10:23,340 --> 00:10:26,820 the dabrafenib and the trametinib, you take one tablet, 170 00:10:26,820 --> 00:10:29,500 once a day. Yeah. Possible side effects... 171 00:10:29,500 --> 00:10:32,700 Nausea, pyrexia, rash and vomiting. 172 00:10:32,700 --> 00:10:33,740 Lovely. 173 00:10:36,460 --> 00:10:38,540 That's the directions. 174 00:10:38,540 --> 00:10:41,020 How much is that lot, I mean how many thousands of pounds? 175 00:10:41,020 --> 00:10:43,220 That's about £7,000. 176 00:10:43,220 --> 00:10:45,140 That's what I thought it was. 177 00:10:45,140 --> 00:10:49,460 It's horrendously expensive, but... it's reassuringly expensive. 178 00:10:49,460 --> 00:10:50,500 Maybe. 179 00:10:53,020 --> 00:10:55,700 They hand you some pills and they say you take five 180 00:10:55,700 --> 00:10:59,340 of these pills over the day, and you keep taking it for three 181 00:10:59,340 --> 00:11:02,340 months and we'll check you after three months, 182 00:11:02,340 --> 00:11:04,060 and that should do the trick. 183 00:11:04,060 --> 00:11:06,420 It's almost like - are you sure?! 184 00:11:13,180 --> 00:11:14,220 Ugh. 185 00:11:19,780 --> 00:11:21,540 This is actually the hard bit. 186 00:11:21,540 --> 00:11:24,700 I have to take the pills on a completely empty stomach. 187 00:11:27,460 --> 00:11:28,940 One of those, two of those. 188 00:11:30,100 --> 00:11:33,340 These two very expensive drugs I'm taking are called 189 00:11:33,340 --> 00:11:36,340 dabrafenib and trametinib. 190 00:11:36,340 --> 00:11:41,620 Luckily for me, these drugs are all free on our wonderful NHS. 191 00:11:41,620 --> 00:11:49,500 Targeted drug therapy is where drugs are engineered to target a gene 192 00:11:49,500 --> 00:11:50,700 problem in a cell. 193 00:11:52,340 --> 00:11:56,580 Normal cells receive signals from the body to say when the cell 194 00:11:56,580 --> 00:12:00,580 should grow and divide, and when it should die. 195 00:12:00,580 --> 00:12:04,460 Sometimes the signal pathway inside the cell goes wrong 196 00:12:04,460 --> 00:12:09,140 as a result of a genetic mutation and the cells divide uncontrollably, 197 00:12:09,140 --> 00:12:11,020 forming a cancerous tumour. 198 00:12:12,260 --> 00:12:15,860 Targeted drug therapy blocks the signals inside the cell, 199 00:12:15,860 --> 00:12:18,220 so the cancer cell dies. 200 00:12:18,220 --> 00:12:22,100 The great advantage of this therapy, is that it has very little effect 201 00:12:22,100 --> 00:12:23,420 on healthy cells. 202 00:12:24,620 --> 00:12:28,180 It's really sweet, so it's not like taking a chemo drug 203 00:12:28,180 --> 00:12:31,740 and going, "This is toxic, guys. Poof!" 204 00:12:31,740 --> 00:12:34,580 You know, It's going to kill you and a few other things as well. 205 00:12:34,580 --> 00:12:38,420 It's going, "Oh, yeah, I can see that's a problem with that protein, 206 00:12:38,420 --> 00:12:40,260 here's the drug - finished." 207 00:12:42,700 --> 00:12:44,500 And that's it, basically. 208 00:12:52,460 --> 00:12:56,580 There's always that little doubt that there could be cells 209 00:12:56,580 --> 00:13:01,860 in there that are going, "Yeah, we are just waiting for you, buddy. 210 00:13:01,860 --> 00:13:05,100 "We are going to hang about until this is all over and then we're going to go - pow!" 211 00:13:06,060 --> 00:13:07,100 Yeah... 212 00:13:08,380 --> 00:13:09,420 ..you don't know. 213 00:13:11,540 --> 00:13:15,700 I won't have a coffee for a whole bloody hour until I can switch 214 00:13:15,700 --> 00:13:16,820 the machine on. 215 00:13:16,820 --> 00:13:21,060 I think I'll switch it on a bit early just to warm it up. 216 00:13:23,740 --> 00:13:26,900 Ah, that's almost enough. 217 00:13:28,220 --> 00:13:30,660 Just to... HE SNIFFS 218 00:13:39,620 --> 00:13:43,220 The scientist in me wants to know more about this cancer. 219 00:13:44,660 --> 00:13:48,700 So I'm going to the pathology lab where the tissue from my heel 220 00:13:48,700 --> 00:13:50,540 was originally diagnosed. 221 00:13:52,540 --> 00:13:56,620 This is a bit of a strange day, I mean this is something very few 222 00:13:56,620 --> 00:14:00,580 people will ever get to do, is to come face-to-face 223 00:14:00,580 --> 00:14:03,100 with the tumour that could have killed you, 224 00:14:03,100 --> 00:14:05,260 or it indeed may, I don't know. 225 00:14:06,380 --> 00:14:10,220 People will say, "How can you find your tumour interesting?" 226 00:14:10,220 --> 00:14:13,340 But it is interesting, it is an interesting thing. 227 00:14:13,340 --> 00:14:17,140 Every single day this pathology lab at the Royal Surrey Hospital 228 00:14:17,140 --> 00:14:22,100 is processing and analysing samples from over 350 people, 229 00:14:22,100 --> 00:14:25,980 all nervously waiting for their life-changing results. 230 00:14:25,980 --> 00:14:28,540 And it was here that my tumour was analysed 231 00:14:28,540 --> 00:14:30,700 by Professor Martin Cook. 232 00:14:30,700 --> 00:14:32,620 Don't touch anything. Don't touch a thing. 233 00:14:33,780 --> 00:14:36,020 Wow, this is where it all happens? 234 00:14:36,020 --> 00:14:37,340 Yeah. 235 00:14:37,340 --> 00:14:41,140 So this room is where my tumour and indeed anybody else's 236 00:14:41,140 --> 00:14:42,180 would have come? 237 00:14:42,180 --> 00:14:44,180 Indeed, in this sort of container. 238 00:14:45,980 --> 00:14:49,940 It's a piece of skin, and you can clearly see there is 239 00:14:49,940 --> 00:14:51,100 something abnormal there. 240 00:14:51,100 --> 00:14:52,860 That is a raised tumour. 241 00:14:54,460 --> 00:14:57,580 The pathologist cuts a piece of the tissue and places it 242 00:14:57,580 --> 00:15:02,420 in a small frame filled with paraffin wax, called a block. 243 00:15:02,420 --> 00:15:04,700 This is absolutely fascinating. 244 00:15:04,700 --> 00:15:08,740 Technicians then slice off a three micron thick sample - 245 00:15:08,740 --> 00:15:12,220 that almost 20 times thinner than a human hair. 246 00:15:12,220 --> 00:15:16,220 This is then carefully placed on a glass slide for analysis 247 00:15:16,220 --> 00:15:18,100 under a microscope. 248 00:15:18,100 --> 00:15:21,900 When my tumour was actually cut out, I had to wait two weeks. 249 00:15:21,900 --> 00:15:24,620 Of course, it's a worrying time because you're thinking, 250 00:15:24,620 --> 00:15:27,780 "What's happening, why aren't I hearing anything?" 251 00:15:27,780 --> 00:15:30,060 Well, of course, this is why you are not hearing anything 252 00:15:30,060 --> 00:15:34,740 because it has to be cut, embedded, dried out, 253 00:15:34,740 --> 00:15:39,420 sectioned, stained and only at that point can you get 254 00:15:39,420 --> 00:15:42,460 the expert eye on it to say, "That's what it is." 255 00:15:44,580 --> 00:15:49,300 And everybody here is sectioning bits of humans. 256 00:15:49,300 --> 00:15:52,620 Yeah, yeah. This has been a real eye opener for me, yeah. 257 00:15:52,620 --> 00:15:53,660 Tremendous. 258 00:15:55,260 --> 00:15:59,180 I am desperate to come face-to-face with my adversary. 259 00:15:59,180 --> 00:16:00,620 This is your tumour. 260 00:16:00,620 --> 00:16:03,260 Hold on, that is my tumour, there? 261 00:16:03,260 --> 00:16:05,420 That's your tissue, there. 262 00:16:05,420 --> 00:16:08,020 Oh, look at it, look at it. Embedded in paraffin. 263 00:16:08,020 --> 00:16:09,500 Look at it! 264 00:16:09,500 --> 00:16:13,980 Yeah, it's a bit of an odd feeling staring at your potential killer. 265 00:16:15,340 --> 00:16:17,300 It was small, yeah. 266 00:16:17,300 --> 00:16:23,340 Totally innocuous little mark, bruise, lump. 267 00:16:23,340 --> 00:16:24,580 Yeah. 268 00:16:24,580 --> 00:16:26,060 But it's deadly. 269 00:16:26,060 --> 00:16:27,940 You sneaky little devil. 270 00:16:29,060 --> 00:16:31,020 This was the first biopsy. 271 00:16:31,020 --> 00:16:34,820 You can see the small black bits, these are cells which 272 00:16:34,820 --> 00:16:38,100 shouldn't be there. Oh, yeah, look at that. My goodness, yes. 273 00:16:38,100 --> 00:16:42,180 Those black bits are cancerous melanocyte cells. 274 00:16:42,180 --> 00:16:46,820 These normally produce melanin, that's the pigment in our skin. 275 00:16:46,820 --> 00:16:50,340 The mutated ones are now dividing uncontrollably. 276 00:16:53,540 --> 00:16:57,060 So, you took a look at this and you knew immediately? 277 00:16:57,060 --> 00:16:59,460 Yeah, I knew this was invasive melanoma. 278 00:17:01,140 --> 00:17:02,940 You can probably... 279 00:17:02,940 --> 00:17:06,140 Are you OK? No, I'm... I'm quite... 280 00:17:08,340 --> 00:17:09,820 Tell me if I'm being too... 281 00:17:09,820 --> 00:17:15,660 No, it's fantastic, I'm just a bit...overcome, really. 282 00:17:17,460 --> 00:17:22,820 Acral lentiginous melanoma, which is a form of this disease. 283 00:17:24,220 --> 00:17:25,220 Very rare. 284 00:17:26,660 --> 00:17:31,220 While almost 90% of melanomas are caused by exposure to the sun, 285 00:17:31,220 --> 00:17:33,980 my melanoma isn't linked to the sun at all. 286 00:17:34,980 --> 00:17:37,420 I thought, well, that's something at least. 287 00:17:37,420 --> 00:17:40,380 I don't have a common cancer. 288 00:17:40,380 --> 00:17:42,900 Let's have something really special. 289 00:17:42,900 --> 00:17:44,020 Hmm. 290 00:17:45,780 --> 00:17:50,820 Now, I want to see how this tumour has moved from stage I in my heel 291 00:17:50,820 --> 00:17:53,180 to stage III in my lymph nodes. 292 00:17:56,140 --> 00:17:57,340 James. 293 00:17:57,340 --> 00:18:00,940 The radiologist on my case, James Crawshaw, will show me 294 00:18:00,940 --> 00:18:03,660 a road map, the PET scan. 295 00:18:03,660 --> 00:18:05,660 Is that me? That is you, yeah. 296 00:18:05,660 --> 00:18:07,500 Radioactive you. 297 00:18:07,500 --> 00:18:11,340 Good to put a human face to the scan, actually. 298 00:18:11,340 --> 00:18:13,860 Yes, that's what he looks like. My goodness. 299 00:18:13,860 --> 00:18:16,900 That's quite a beautiful thing, isn't it? Yeah. 300 00:18:16,900 --> 00:18:20,700 This is recognisably me, every detail. 301 00:18:20,700 --> 00:18:24,340 I haven't seen inside myself before, but I have now. 302 00:18:24,340 --> 00:18:25,780 Bit like an airport body scanner. 303 00:18:25,780 --> 00:18:28,620 Yeah, but it's me, all right, absolutely. 304 00:18:28,620 --> 00:18:32,900 My heart, kidney, liver, lungs. Wow. 305 00:18:32,900 --> 00:18:36,220 And what it is, is we're effectively injecting you with some radioactive 306 00:18:36,220 --> 00:18:39,180 sugar, and the tumours also need sugar. 307 00:18:40,220 --> 00:18:43,100 We start down the bottom, actually. This is your foot. 308 00:18:43,100 --> 00:18:44,740 That's it. 309 00:18:44,740 --> 00:18:47,780 Look at that. On this fused image we are looking for purple. 310 00:18:47,780 --> 00:18:51,700 Purple, right. We are coming up the leg, heading towards the groin now. 311 00:18:51,700 --> 00:18:57,340 So we come onto a purple, bright, purple... 312 00:18:57,340 --> 00:18:58,540 That's below it? 313 00:18:58,540 --> 00:19:02,180 That bright thing is a lymph gland that's got too much activity 314 00:19:02,180 --> 00:19:03,660 in it to be normal. 315 00:19:03,660 --> 00:19:06,060 So that's the first one we come to. So that's one node. 316 00:19:06,060 --> 00:19:08,220 Then we are looking how high up they go. 317 00:19:08,220 --> 00:19:10,060 There's another one, yeah. 318 00:19:11,540 --> 00:19:16,180 You are pretty sure it's only here, it hasn't gone further up? 319 00:19:16,180 --> 00:19:18,660 As far as we can tell, it's not gone beyond that. 320 00:19:18,660 --> 00:19:20,580 Why is that, do you think? 321 00:19:20,580 --> 00:19:22,700 Just the timing, really. 322 00:19:22,700 --> 00:19:25,900 In three months' time I will have another PET scan. 323 00:19:25,900 --> 00:19:29,500 By then, I hope that with targeted drug therapy, 324 00:19:29,500 --> 00:19:33,420 my lymph nodes will be clear of any purple spots. 325 00:19:33,420 --> 00:19:36,060 But there is absolutely no guarantee. 326 00:19:36,060 --> 00:19:40,060 When I come for my next PET scan, what would you expect to see? 327 00:19:40,060 --> 00:19:44,220 I'd expect these lymph glands to be cold. 328 00:19:44,220 --> 00:19:49,140 That's what we hope to see with you, is none of these hot spots anywhere. 329 00:19:51,900 --> 00:19:55,260 There are no absolutes in this, all you need is one cell, 330 00:19:55,260 --> 00:19:58,180 one cancer cell to have gone somewhere else, 331 00:19:58,180 --> 00:20:03,660 but at least it's a good indication that I'm not glowing... 332 00:20:05,660 --> 00:20:07,260 ..like a Christmas tree. 333 00:20:14,060 --> 00:20:17,260 The cancer cells have now started to move around my body, 334 00:20:17,260 --> 00:20:20,940 away from the original tumour site in my heel. 335 00:20:20,940 --> 00:20:24,540 That means my cancer has metastasised, and if it gets 336 00:20:24,540 --> 00:20:27,660 as far as my vital organs, it could kill me. 337 00:20:29,540 --> 00:20:33,140 As a biologist, I know the process of migrating tumour cells 338 00:20:33,140 --> 00:20:37,900 must be complex, but what actually happens at a microscopic level? 339 00:20:39,220 --> 00:20:42,500 Here at the Institute of Cancer Research in London, 340 00:20:42,500 --> 00:20:47,180 Dr Chris Bakal is pioneering some extraordinary scientific experiments 341 00:20:47,180 --> 00:20:48,780 to help us understand. 342 00:20:50,420 --> 00:20:52,620 That is a mutant melanoma cell. It's a melanoma cell? 343 00:20:52,620 --> 00:20:55,500 A melanoma cell undergoing the process of division. 344 00:20:55,500 --> 00:20:58,740 That's real, that's what was happening in my tumour? 345 00:20:58,740 --> 00:21:01,580 Exactly, that's what's happening in your tumour a lot. 346 00:21:04,020 --> 00:21:06,660 Cancer is really a process of uncontrolled division 347 00:21:06,660 --> 00:21:10,460 where a handful of mutations allow the cell to divide uncontrollably, 348 00:21:10,460 --> 00:21:11,740 on, and on, and on. 349 00:21:13,980 --> 00:21:16,700 This microscope allows us to get up close to your cancer cells, 350 00:21:16,700 --> 00:21:20,180 really see individual cancer cells that are part of the tumour. 351 00:21:20,180 --> 00:21:22,260 So the green cells are the cancer cells. 352 00:21:22,260 --> 00:21:24,660 Those are the ones causing the disease. 353 00:21:24,660 --> 00:21:25,740 That's quite pretty. 354 00:21:27,820 --> 00:21:32,740 Remarkably, Chris has used my own tumour to create these images. 355 00:21:32,740 --> 00:21:34,980 To help see the cancer cells more clearly, 356 00:21:34,980 --> 00:21:38,700 he has engineered them to express green fluorescent protein 357 00:21:38,700 --> 00:21:40,500 on their membranes. 358 00:21:40,500 --> 00:21:43,060 This green cell here is searching its environment, 359 00:21:43,060 --> 00:21:45,540 trying to hunt for food, trying to hunt for oxygen, 360 00:21:45,540 --> 00:21:47,700 because likely it's running out of both, to see 361 00:21:47,700 --> 00:21:49,740 if there is a way to escape. 362 00:21:49,740 --> 00:21:51,740 That's a bit creepy. It is creepy, yeah. 363 00:21:51,740 --> 00:21:54,020 This is quite creepy, so these little cells are going, 364 00:21:54,020 --> 00:21:57,140 "We are going to go, we are going to eat. 365 00:21:57,140 --> 00:21:59,660 "Let's move." They might be trying to find a way out, and that's 366 00:21:59,660 --> 00:22:02,260 how they might, for example, move to another site in your body. 367 00:22:03,540 --> 00:22:04,940 HE SHUDDERS 368 00:22:06,220 --> 00:22:07,700 I mean, this is amazing. 369 00:22:07,700 --> 00:22:09,860 This one here is sort of stuck. 370 00:22:09,860 --> 00:22:14,420 Using a tiny silicon maze, only a tenth of a millimetre long, 371 00:22:14,420 --> 00:22:18,580 Chris has devised a remarkable way to show how malignant melanoma cells 372 00:22:18,580 --> 00:22:20,300 spread through the body. 373 00:22:23,620 --> 00:22:25,060 These... Oh, my goodness. 374 00:22:25,060 --> 00:22:28,340 These are mutant melanoma cells trying to squeeze through tight 375 00:22:28,340 --> 00:22:30,660 little spaces in this maze we've set up. 376 00:22:30,660 --> 00:22:33,140 That one's away, it's off. 377 00:22:33,140 --> 00:22:36,660 The spaces in the maze are minuscule, smaller, in fact, 378 00:22:36,660 --> 00:22:38,980 than the cell's own nucleus. 379 00:22:38,980 --> 00:22:41,540 A normal cell could not possibly squeeze through here. 380 00:22:41,540 --> 00:22:44,900 Melanoma cells are able to completely squeeze themselves, 381 00:22:44,900 --> 00:22:48,020 and squeeze their entire nucleus, their entire genome to squeeze 382 00:22:48,020 --> 00:22:49,460 through this tiny little pore. 383 00:22:49,460 --> 00:22:53,700 So these normal skin cells which have become mutated, 384 00:22:53,700 --> 00:22:55,940 can suddenly get anywhere they want? 385 00:22:55,940 --> 00:22:57,260 Exactly. 386 00:22:57,260 --> 00:23:00,300 These are the world's first microscopic images 387 00:23:00,300 --> 00:23:03,020 that show how melanoma cells spread. 388 00:23:04,220 --> 00:23:05,780 This really looks alien to me. 389 00:23:07,900 --> 00:23:11,420 Chris hopes that they will help him with his next big idea. 390 00:23:11,420 --> 00:23:15,060 By targeting the shape shifting abilities of cancer cells, 391 00:23:15,060 --> 00:23:17,660 could we stop cancer spreading? 392 00:23:17,660 --> 00:23:20,060 Can we think of drugs, can we think of therapies 393 00:23:20,060 --> 00:23:23,700 that block these shape changes, that frees the cancer cells 394 00:23:23,700 --> 00:23:25,180 in one single shape? 395 00:23:25,180 --> 00:23:27,780 If they can't move, they can't spread. 396 00:23:27,780 --> 00:23:29,940 It's a simple idea, in a way. 397 00:23:29,940 --> 00:23:33,740 You can then just simply cut them out easily without there 398 00:23:33,740 --> 00:23:35,580 being any risk of them having spread? 399 00:23:35,580 --> 00:23:38,340 We think it's a new way to think about cancer treatment. 400 00:23:41,820 --> 00:23:47,140 If he can crack this, that will change how we can treat 401 00:23:47,140 --> 00:23:48,740 cancer in an enormous way. 402 00:23:48,740 --> 00:23:51,380 Not just skin cancer, other cancers. 403 00:24:01,140 --> 00:24:04,260 As with all cancers, it's not just me that needs to cope 404 00:24:04,260 --> 00:24:05,580 with this disease. 405 00:24:05,580 --> 00:24:09,900 It impacts my family, as well, especially my wife Lois. 406 00:24:10,900 --> 00:24:16,580 Lois is an incredible individual who has this 407 00:24:16,580 --> 00:24:21,060 somewhat misplaced view of my invincibility. 408 00:24:22,460 --> 00:24:24,260 There's my head. 409 00:24:24,260 --> 00:24:25,580 My foot. 410 00:24:25,580 --> 00:24:28,580 I said to her, "Aren't you worried about me?" 411 00:24:28,580 --> 00:24:29,900 And she goes, "No! 412 00:24:31,060 --> 00:24:33,300 "Nothing is going to happen to you." 413 00:24:33,300 --> 00:24:37,100 I had a sign of cancer there and there. 414 00:24:38,300 --> 00:24:40,300 And there. That's the nodes. 415 00:24:40,300 --> 00:24:42,060 Yeah. 416 00:24:42,060 --> 00:24:45,260 My heel was the bit where it started. Your heel, yeah. 417 00:24:45,260 --> 00:24:51,540 We have 35 billion cells in us, and most of the time it's fine. 418 00:24:51,540 --> 00:24:54,700 There are mechanisms to tweak bits, to kill certain bits 419 00:24:54,700 --> 00:24:57,420 that shouldn't be there, get rid of them, to alter bits 420 00:24:57,420 --> 00:24:59,020 of DNA, repair that. 421 00:24:59,020 --> 00:25:01,260 I mean, it's an amazing bit of machinery. 422 00:25:02,900 --> 00:25:04,780 Very unhappy face. 423 00:25:04,780 --> 00:25:08,580 But, you know, not surprisingly out of 35 billion cells, 424 00:25:08,580 --> 00:25:13,220 one of them might just go a bit rogue, and that's it. 425 00:25:14,300 --> 00:25:20,180 I reckon inside that shape is 35 billion grains of sand. 426 00:25:20,180 --> 00:25:25,660 Yes. And it started in one, 427 00:25:25,660 --> 00:25:27,500 one grain of sand. 428 00:25:27,500 --> 00:25:29,300 One cell. 429 00:25:29,300 --> 00:25:31,580 That was the one that went rogue. 430 00:25:31,580 --> 00:25:34,860 And then it went up my lymph vessels, and my blood vessels 431 00:25:34,860 --> 00:25:38,980 and it got trapped in my lymph nodes, thank goodness. 432 00:25:38,980 --> 00:25:42,580 And in about five minutes that's just going to get cleansed. 433 00:25:42,580 --> 00:25:44,300 Washed away. 434 00:25:44,300 --> 00:25:45,740 This is it. 435 00:25:45,740 --> 00:25:47,260 Oh, no. 436 00:25:47,260 --> 00:25:48,340 Come on, waves. 437 00:25:49,380 --> 00:25:51,100 This one's coming in - yes! 438 00:25:51,100 --> 00:25:52,780 Oh, there it goes. Yes! 439 00:25:54,460 --> 00:25:55,620 It just got you. 440 00:25:57,140 --> 00:25:58,140 It's the one. 441 00:26:06,140 --> 00:26:10,020 These drugs I'm taking are targeting a mutation in the cancer cells 442 00:26:10,020 --> 00:26:11,940 in my body. 443 00:26:15,100 --> 00:26:17,420 But as a scientist, I want to know more. 444 00:26:20,340 --> 00:26:23,380 I want to know what my specific mutation is, 445 00:26:23,380 --> 00:26:27,180 what it does, and how on Earth they discovered drugs to target it. 446 00:26:34,500 --> 00:26:38,220 This is the very hi-tech Wellcome Sanger Institute. 447 00:26:40,140 --> 00:26:43,260 Today I'm meeting its director, Sir Michael Stratton. 448 00:26:43,260 --> 00:26:45,220 Sir Michael. Morning, George. 449 00:26:45,220 --> 00:26:46,900 Very nice to meet you. 450 00:26:46,900 --> 00:26:50,020 Without him, the targeted drugs that I've been taking would not 451 00:26:50,020 --> 00:26:54,700 exist, because he discovered a key mutation in what is called 452 00:26:54,700 --> 00:26:55,820 the BRAF gene. 453 00:26:57,940 --> 00:27:01,940 The BRAF gene is one of the genes in our bodies that regulate cell 454 00:27:01,940 --> 00:27:04,380 growth, turning it on or off. 455 00:27:05,500 --> 00:27:10,900 When we discovered the BRAF gene, the mutations in BRAF were exactly 456 00:27:10,900 --> 00:27:14,100 the sort that stick it in the on position. 457 00:27:14,100 --> 00:27:18,260 And that's what I've got, in my tumour - it's full-on, 458 00:27:18,260 --> 00:27:21,460 foot on the floor, accelerate, divide, divide, divide? 459 00:27:21,460 --> 00:27:23,100 Exactly that. 460 00:27:23,100 --> 00:27:25,860 And so the thought immediately comes to mind, 461 00:27:25,860 --> 00:27:30,540 well, can we get a drug into it that will then switch it off? 462 00:27:30,540 --> 00:27:32,660 I really want to see how this happens. 463 00:27:32,660 --> 00:27:36,260 I've got so many questions for you now, my head 464 00:27:36,260 --> 00:27:37,740 is spinning with questions. 465 00:27:40,540 --> 00:27:44,220 Stratton was looking for a minute change in the DNA 466 00:27:44,220 --> 00:27:45,620 of melanoma patients. 467 00:27:47,220 --> 00:27:51,340 So, in one of 35 billion cells in the human body, 468 00:27:51,340 --> 00:27:56,660 in one chromosome in that cell, and in one strand of DNA, 469 00:27:56,660 --> 00:28:00,020 was the mutation of the BRAF gene. 470 00:28:00,020 --> 00:28:02,460 A simple change in code. 471 00:28:02,460 --> 00:28:04,340 One letter of code. 472 00:28:06,140 --> 00:28:08,980 And that there is what caused my cancer. 473 00:28:11,860 --> 00:28:15,500 To find that minute change, what he needed was the huge 474 00:28:15,500 --> 00:28:19,100 processing power of super powerful computers. 475 00:28:19,100 --> 00:28:24,060 This is our sequencing facility with our fleet of machines. 476 00:28:24,060 --> 00:28:27,460 These sequencing machines are capable of running the billions 477 00:28:27,460 --> 00:28:32,340 of calculations required to analyse the DNA from tumours, and create 478 00:28:32,340 --> 00:28:35,780 a readable code to identify the mutations. 479 00:28:36,860 --> 00:28:41,740 If we compare ourselves to, let's say 20 years ago, 480 00:28:41,740 --> 00:28:46,740 we can sequence DNA approximately a million times faster 481 00:28:46,740 --> 00:28:48,980 and a million times cheaper. 482 00:28:48,980 --> 00:28:52,740 And all you can hear is a little gentle hum. 483 00:28:55,540 --> 00:29:00,020 Together, the machines produce billions of DNA code sequences 484 00:29:00,020 --> 00:29:02,180 in just minutes. 485 00:29:02,180 --> 00:29:05,780 The sequencing helps figure out which gene mutations 486 00:29:05,780 --> 00:29:07,260 cause which cancers. 487 00:29:11,580 --> 00:29:16,580 Understanding how a cancer works leads you to new treatments. 488 00:29:17,620 --> 00:29:21,580 How do we use this information to develop the next generation 489 00:29:21,580 --> 00:29:25,180 of drugs, and the generation after that, and the generation after that? 490 00:29:25,180 --> 00:29:28,020 But we should be optimistic that this will be achieved. 491 00:29:32,700 --> 00:29:36,300 And the first generation of the very drugs that I am on now 492 00:29:36,300 --> 00:29:39,500 produced some startling results. 493 00:29:39,500 --> 00:29:42,220 This is the sort of thing that we're seeing. 494 00:29:42,220 --> 00:29:46,820 On the left-hand side you can see the person with all those lumps 495 00:29:46,820 --> 00:29:47,940 in their skin. 496 00:29:47,940 --> 00:29:52,100 And on the right, the same person a few weeks after... 497 00:29:52,100 --> 00:29:53,300 A few weeks? Yeah. 498 00:29:53,300 --> 00:29:59,060 The cancer, basically, goes to sleep and sort of dissolves away. 499 00:29:59,060 --> 00:30:02,100 We are very pleased, because we saw pictures like this. 500 00:30:02,100 --> 00:30:03,940 You know, this is why we are here. 501 00:30:03,940 --> 00:30:09,260 All of these things are the products of our imagination as human beings 502 00:30:09,260 --> 00:30:13,420 and it's a tribute to the power of the human mind. 503 00:30:16,500 --> 00:30:19,860 BRAF was just one of the cancer-causing mutations 504 00:30:19,860 --> 00:30:22,620 that Michael and his team identified. 505 00:30:22,620 --> 00:30:28,100 They also found two other mutations - one called BRCA2, 506 00:30:28,100 --> 00:30:32,580 that causes some breast cancers, and another called ERBB2, 507 00:30:32,580 --> 00:30:34,660 behind some lung cancers. 508 00:30:34,660 --> 00:30:39,180 The Sanger Institute hope that by analysing even more cancer 509 00:30:39,180 --> 00:30:44,980 genome sequences, they will discover yet more genetic mutations leading 510 00:30:44,980 --> 00:30:47,780 to more targeted drug therapies like mine. 511 00:30:49,220 --> 00:30:54,060 We are able to arrive at the point now, for the first time in human 512 00:30:54,060 --> 00:30:58,180 history, where a collection of allied diseases, 513 00:30:58,180 --> 00:31:01,820 they are now beginning to yield their secrets. 514 00:31:12,060 --> 00:31:15,060 It's very encouraging to see the ground-breaking science 515 00:31:15,060 --> 00:31:17,020 behind the very drugs that I am on. 516 00:31:18,260 --> 00:31:22,380 I've only been on them for a month, and as the year draws to a close, 517 00:31:22,380 --> 00:31:25,580 I still feel very lucky to be on them at all, 518 00:31:25,580 --> 00:31:27,260 because they are so new. 519 00:31:32,460 --> 00:31:34,660 But I'm not out of the woods yet. 520 00:31:34,660 --> 00:31:39,140 In the meantime, though, it's important that life should go on as usual. 521 00:31:40,420 --> 00:31:44,060 I love my family, and although you are having a nice, 522 00:31:44,060 --> 00:31:47,580 jolly party or lunch, there's always that thing 523 00:31:47,580 --> 00:31:49,380 in the back of your mind. 524 00:31:49,380 --> 00:31:52,020 You think, "This might not happen again, this might be one 525 00:31:52,020 --> 00:31:55,020 "of relatively few meals I have." 526 00:31:56,060 --> 00:31:57,060 Look at that. 527 00:31:58,860 --> 00:32:03,580 You very quickly realise that it's not your death that is 528 00:32:03,580 --> 00:32:09,220 at all important, but the effect is on your family. 529 00:32:09,220 --> 00:32:13,060 They are the ones who are going to have to go on without you. 530 00:32:13,060 --> 00:32:16,140 Now, they might be absolutely fine and I hope they are, 531 00:32:16,140 --> 00:32:17,660 if it ever happens. 532 00:32:17,660 --> 00:32:21,860 But that's the sort of thought that begins to crowd in on you... 533 00:32:36,260 --> 00:32:37,980 ..after dark, that's, that's... 534 00:32:45,180 --> 00:32:47,220 Have you made a New Year's resolution? 535 00:32:47,220 --> 00:32:49,020 Erm, no. 536 00:32:49,020 --> 00:32:50,700 I have. 537 00:32:50,700 --> 00:32:53,500 Have a guess. Not die of cancer? Correct. Hey! 538 00:32:53,500 --> 00:32:57,180 Not dying of cancer, that's the only one, I think. 539 00:32:57,180 --> 00:32:58,420 That's the one, yeah. 540 00:32:58,420 --> 00:33:00,620 Ah! Ahhh! 541 00:33:00,620 --> 00:33:02,180 I'm absolutely sure... 542 00:33:02,180 --> 00:33:04,540 You naughty girl! 543 00:33:04,540 --> 00:33:07,020 ..when I go, they'll be fine, I know it. 544 00:33:07,020 --> 00:33:10,380 There'll be bad times, just like for me in the last year, 545 00:33:10,380 --> 00:33:12,100 there have been very bad times. 546 00:33:12,100 --> 00:33:15,860 And it's at those times you think about this, and you think about 547 00:33:15,860 --> 00:33:16,900 how they'll cope. 548 00:33:16,900 --> 00:33:21,180 I could see them having a Christmas party sometime hence, 549 00:33:21,180 --> 00:33:24,220 say if I died, and they'll be laughing and drinking and saying, 550 00:33:24,220 --> 00:33:26,820 "Wouldn't it be great if George was here, 551 00:33:26,820 --> 00:33:29,180 "he'd have done this, he'd have done that." 552 00:33:29,180 --> 00:33:32,300 And that's what will happen eventually. 553 00:33:42,500 --> 00:33:43,900 It's the end of January. 554 00:33:45,980 --> 00:33:51,460 Only a few weeks of the first cycle of my targeted drug treatment left, 555 00:33:51,460 --> 00:33:53,860 and time for another PET scan. 556 00:33:55,900 --> 00:34:00,380 This is really the big one for me, this is the important one. 557 00:34:00,380 --> 00:34:05,660 Because if these eye-wateringly expensive drugs I've been swallowing 558 00:34:05,660 --> 00:34:09,660 for the last three months are doing their job, 559 00:34:09,660 --> 00:34:15,860 they should see a very much reduced evidence of any cancer cells. 560 00:34:15,860 --> 00:34:17,420 There should be, hopefully none. 561 00:34:20,140 --> 00:34:22,500 I mean, I haven't thought about it. 562 00:34:22,500 --> 00:34:24,860 I don't want to think about it. 563 00:34:25,980 --> 00:34:28,540 I think it'll be all right so I'm just hanging on to that, 564 00:34:28,540 --> 00:34:30,220 I'm just saying yes, it's going to be fine. 565 00:34:31,260 --> 00:34:32,500 It'll be fine. 566 00:34:34,260 --> 00:34:35,340 It'll be fine! 567 00:34:41,620 --> 00:34:43,900 Are you epileptic? Do what? 568 00:34:43,900 --> 00:34:45,260 Epileptic? No. 569 00:34:45,260 --> 00:34:47,140 Claustrophobic? No. 570 00:34:47,140 --> 00:34:48,300 A-1. 571 00:34:48,300 --> 00:34:50,580 PHONE CHIMES Oh, go away. 572 00:34:56,260 --> 00:35:01,300 I really, really hope that this PET scan will show the bits 573 00:35:01,300 --> 00:35:04,660 that were glowing before are not glowing now. 574 00:35:04,660 --> 00:35:06,380 That's the best I could hope for. 575 00:35:09,460 --> 00:35:13,740 Because the scan has to be analysed by my radiologist and then discussed 576 00:35:13,740 --> 00:35:16,380 by my medical team, it will be two weeks 577 00:35:16,380 --> 00:35:17,980 before I hear anything back. 578 00:35:19,780 --> 00:35:23,180 You are going to think thoughts like, "I hope it's not there, 579 00:35:23,180 --> 00:35:26,500 "I hope it's gone away. I hope it's not as big as it was before." 580 00:35:29,180 --> 00:35:33,420 OK, perfect. We are just at your hips. 581 00:35:33,420 --> 00:35:34,460 OK. 582 00:35:40,020 --> 00:35:42,740 I'm now officially ravenous. 583 00:35:49,260 --> 00:35:52,860 As I take my pills, I'm thinking if the scan shows 584 00:35:52,860 --> 00:35:56,540 the targeted drug therapy has not worked and the cancer has spread, 585 00:35:56,540 --> 00:35:58,900 where else can I turn? 586 00:35:58,900 --> 00:36:02,260 Amazingly, there is another relatively new option. 587 00:36:04,500 --> 00:36:07,540 It takes a radical approach, different from anything 588 00:36:07,540 --> 00:36:11,180 that has gone before, with even more astonishing results. 589 00:36:12,900 --> 00:36:14,740 It's called immunotherapy. 590 00:36:16,500 --> 00:36:19,780 A treatment that stimulates the body's immune system 591 00:36:19,780 --> 00:36:21,380 to kill cancer cells. 592 00:36:24,180 --> 00:36:29,420 For a long time, cancer was regarded as being not something 593 00:36:29,420 --> 00:36:32,460 that our immune system could handle. 594 00:36:32,460 --> 00:36:34,860 Because, they argued, it was too much like us, 595 00:36:34,860 --> 00:36:36,420 it was part of us. 596 00:36:36,420 --> 00:36:39,260 So the immune system wouldn't attack it. 597 00:36:42,300 --> 00:36:46,300 But in America, there was a determined molecular biologist 598 00:36:46,300 --> 00:36:49,620 who believed that there had to be a way around this. 599 00:36:49,620 --> 00:36:53,460 So I've come to Houston, Texas to meet the man who, 600 00:36:53,460 --> 00:36:57,500 just weeks before I arrived, was awarded the Nobel prize 601 00:36:57,500 --> 00:37:00,180 for his work, Professor Jim Allison. 602 00:37:01,740 --> 00:37:04,420 It's not every day you get to meet a Nobel prize-winner. 603 00:37:06,380 --> 00:37:11,340 It was almost universally thought that any hope of immunotherapy 604 00:37:11,340 --> 00:37:13,540 was just not going to work. 605 00:37:13,540 --> 00:37:15,980 But he doggedly stuck with it. 606 00:37:15,980 --> 00:37:18,620 He said, "No, it's going to work, it's going to work. 607 00:37:18,620 --> 00:37:21,660 "And the reason, there is something that we are not seeing." 608 00:37:21,660 --> 00:37:23,620 And eventually he found it. 609 00:37:25,100 --> 00:37:28,180 Professor Allison, your ground-breaking research 610 00:37:28,180 --> 00:37:32,100 for the benefit of numerous patients and all humankind. 611 00:37:38,580 --> 00:37:40,820 Jim, can I call you Jim? 612 00:37:40,820 --> 00:37:42,380 Yeah. 613 00:37:42,380 --> 00:37:44,380 Great to meet you, thank you very much. 614 00:37:44,380 --> 00:37:46,980 I have to say, Jim, this is as close I am ever 615 00:37:46,980 --> 00:37:49,580 going to get to a Nobel prize. 616 00:37:51,020 --> 00:37:53,380 Oh, yeah, George C McGavin, great. 617 00:37:55,020 --> 00:37:58,620 When did you first get interested in cancer? 618 00:37:58,620 --> 00:38:00,460 Because of my family history... 619 00:38:03,820 --> 00:38:06,100 ..I always had cancer in the back of my mind. 620 00:38:06,100 --> 00:38:08,540 This is the whole family actually, my grandparents there, 621 00:38:08,540 --> 00:38:10,420 then there is my mom. She had cancer? 622 00:38:10,420 --> 00:38:13,020 She died of lymphoma, he died of melanoma, 623 00:38:13,020 --> 00:38:15,300 he died of lung cancer. 624 00:38:15,300 --> 00:38:18,140 He died of prostate cancer. 625 00:38:18,140 --> 00:38:20,540 And you haven't been spared either? 626 00:38:20,540 --> 00:38:22,220 No, no, I haven't. 627 00:38:22,220 --> 00:38:24,420 I'm on my third cancer now. 628 00:38:24,420 --> 00:38:25,940 Your third? 629 00:38:25,940 --> 00:38:29,180 The general view was that immunotherapy wouldn't work 630 00:38:29,180 --> 00:38:32,460 because these cancer cells were basically our cells, 631 00:38:32,460 --> 00:38:33,940 just gone rogue. 632 00:38:33,940 --> 00:38:35,220 But you said no, no. 633 00:38:35,220 --> 00:38:40,500 My feeling was, I'm pretty sure T cells can do something about cancer. 634 00:38:40,500 --> 00:38:43,660 So we probably got about 100 million different T cells in your body. 635 00:38:44,940 --> 00:38:47,980 T cells are part of the immune system. 636 00:38:47,980 --> 00:38:51,340 They travel through the body like a cellular army, 637 00:38:51,340 --> 00:38:54,260 detecting infected or cancerous cells. 638 00:38:54,260 --> 00:38:56,260 When they find them, they destroy them. 639 00:38:57,740 --> 00:39:01,780 So now you've got the army of the immune system? 640 00:39:01,780 --> 00:39:03,780 But you need hundreds of thousands of them, 641 00:39:03,780 --> 00:39:08,060 or millions even, to go deal with the problem. 642 00:39:08,060 --> 00:39:11,540 You've got to get the troops in the field in large numbers. 643 00:39:11,540 --> 00:39:16,380 But what Jim discovered is that cancer cells have a cunning way 644 00:39:16,380 --> 00:39:20,340 to fool the T cells' checkpoints, sending out proteins that say 645 00:39:20,340 --> 00:39:23,580 "We are normal cells, don't kill us." 646 00:39:23,580 --> 00:39:28,180 Jim realised that checkpoint inhibitor drugs, seen here in blue, 647 00:39:28,180 --> 00:39:32,300 could block this process, allowing the T cells to 648 00:39:32,300 --> 00:39:37,140 recognise it as a rogue cell, and go ahead with destroying it. 649 00:39:37,140 --> 00:39:41,260 This was a completely new way of thinking about cancer treatment. 650 00:39:41,260 --> 00:39:44,060 Rather than targeting the cancer itself, 651 00:39:44,060 --> 00:39:47,940 it was unleashing the body's own immune system to do the work 652 00:39:47,940 --> 00:39:51,380 for it, and the first cancer to respond to this radical 653 00:39:51,380 --> 00:39:54,020 new therapy was melanoma. 654 00:39:54,020 --> 00:39:58,100 I mean, that is an amazing breakthrough point. 655 00:39:58,100 --> 00:40:00,220 But anyway, there was a trial, a phase one trial, 656 00:40:00,220 --> 00:40:02,940 and there were three objector responders. 657 00:40:02,940 --> 00:40:04,580 One of them I know, was a woman. 658 00:40:04,580 --> 00:40:07,420 We gave her one injection, and within a few months 659 00:40:07,420 --> 00:40:08,780 all of her tumours went away. 660 00:40:08,780 --> 00:40:13,500 She is 18 years out now from that single injection, 661 00:40:13,500 --> 00:40:14,740 all her tumours went away. 662 00:40:14,740 --> 00:40:19,140 I met her in 2011, and still tumour free. 663 00:40:19,140 --> 00:40:22,980 You know, we were crying and everything. 664 00:40:22,980 --> 00:40:27,180 You can take a melanoma patient who have mutations 665 00:40:27,180 --> 00:40:29,180 in BRAF, this molecule... 666 00:40:29,180 --> 00:40:31,380 That's mine, I've got that one. 667 00:40:31,380 --> 00:40:34,660 ..and you can treat that and the tumours will go away. 668 00:40:34,660 --> 00:40:36,740 Yeah, well... For a little while. 669 00:40:36,740 --> 00:40:40,300 Oh, OK. But you're saying that might not work? 670 00:40:40,300 --> 00:40:42,700 It might, but there is a good chance it's going to come back. 671 00:40:42,700 --> 00:40:46,260 At least I've got immunotherapy up my sleeve. 672 00:40:46,260 --> 00:40:51,460 People need to know that, you know, cancer is not a death sentence. 673 00:40:51,460 --> 00:40:55,140 The people that make it three to four years are going to probably 674 00:40:55,140 --> 00:41:01,060 make it for ten, 15, 20, whatever. 675 00:41:01,060 --> 00:41:04,340 That's when we can start thinking about using the C word. 676 00:41:04,340 --> 00:41:07,420 The C word and it's not cancer, it's cure? 677 00:41:07,420 --> 00:41:09,620 Exactly. The C word! 678 00:41:15,500 --> 00:41:19,180 The first drug that was made out of this work was a thing called 679 00:41:19,180 --> 00:41:24,620 ipilimumab, and it had absolutely miraculous results. 680 00:41:24,620 --> 00:41:28,260 I mean, individuals who were terminal, suddenly 681 00:41:28,260 --> 00:41:30,740 the cancers were just vanishing, were just going. 682 00:41:32,500 --> 00:41:35,780 Across campus from Dr Allison, one of his colleagues, 683 00:41:35,780 --> 00:41:39,020 Dr Sharma has been taking his extraordinary theory 684 00:41:39,020 --> 00:41:40,300 to the next level. 685 00:41:40,300 --> 00:41:43,940 Well, we feel that the immune system is very powerful, and if we learn 686 00:41:43,940 --> 00:41:46,780 how it worked we could do a better job of curing patients. 687 00:41:46,780 --> 00:41:49,580 And clearly we are doing that in a small subset of patients. 688 00:41:49,580 --> 00:41:51,900 We need to do it in a larger group of patients. 689 00:41:51,900 --> 00:41:54,420 We're going to start seeing all these different combination 690 00:41:54,420 --> 00:41:58,620 therapies so that we can help raise the tail, the survival tail, 691 00:41:58,620 --> 00:42:01,620 for more and more patients, and more and more tumour types. 692 00:42:01,620 --> 00:42:04,620 These things that have been developed for skin cancer 693 00:42:04,620 --> 00:42:08,500 like I've got, are also applicable to lots of 694 00:42:08,500 --> 00:42:09,580 other cancers, yeah? 695 00:42:09,580 --> 00:42:12,340 Yes, T cells are just soldiers of the immune system. 696 00:42:12,340 --> 00:42:14,980 So when you target those T cells and you unleash them, 697 00:42:14,980 --> 00:42:17,420 they can go and do their job, so they can do their job 698 00:42:17,420 --> 00:42:19,860 in a melanoma patient, they can do their job in a kidney 699 00:42:19,860 --> 00:42:21,500 cancer patient, for example. 700 00:42:21,500 --> 00:42:23,540 So Dewey Stringer, he is one of those patients 701 00:42:23,540 --> 00:42:25,340 who had stage four kidney cancer. 702 00:42:25,340 --> 00:42:28,180 Well, that's bad? That's very bad. That's the very end of the line? 703 00:42:28,180 --> 00:42:29,340 Yes. 704 00:42:29,340 --> 00:42:31,260 How are the toxicities? I know you've had some 705 00:42:31,260 --> 00:42:32,980 with the immune checkpoint therapy agent? 706 00:42:32,980 --> 00:42:34,860 I'm still here. That's great. 707 00:42:34,860 --> 00:42:37,660 And because of immunotherapy treatments now, Dewey 708 00:42:37,660 --> 00:42:41,900 has had four years plus in terms of survival, and the last year, 709 00:42:41,900 --> 00:42:44,740 he's had no disease on his scans, really. 710 00:42:45,860 --> 00:42:49,500 It's clear to me now that immunotherapy is a very powerful, 711 00:42:49,500 --> 00:42:52,580 pioneering new treatment that is going to be applied 712 00:42:52,580 --> 00:42:55,140 to lots of other cancers. 713 00:42:55,140 --> 00:42:56,620 Not just skin cancer. 714 00:42:58,860 --> 00:43:00,500 HONKING Let me in. 715 00:43:02,380 --> 00:43:03,540 In the wrong lane. 716 00:43:05,500 --> 00:43:07,580 There was something Jim said that actually makes 717 00:43:07,580 --> 00:43:10,140 me slightly worried. 718 00:43:10,140 --> 00:43:13,420 They basically said, yes, it's good that you are on these 719 00:43:13,420 --> 00:43:15,740 drugs, George, but it could come back. 720 00:43:18,740 --> 00:43:23,020 But at least I now know that if it comes back in the future, 721 00:43:23,020 --> 00:43:24,460 I've got immunotherapy. 722 00:43:35,420 --> 00:43:40,500 Immunotherapy, it's certainly doing incredible things and some people 723 00:43:40,500 --> 00:43:42,940 may indeed be cured. 724 00:43:42,940 --> 00:43:46,380 The thing about cancer is, it can do pretty much anything 725 00:43:46,380 --> 00:43:47,420 it wants to do. 726 00:43:49,260 --> 00:43:52,540 We have certainly opened the door, certainly opened the door. 727 00:44:03,460 --> 00:44:05,180 You know, it's easy when you are in places 728 00:44:05,180 --> 00:44:09,140 like this to forget you've even got cancer. 729 00:44:09,140 --> 00:44:11,180 I've just forgotten all about it, this is just... 730 00:44:12,780 --> 00:44:14,180 ..so breathtaking. 731 00:44:24,060 --> 00:44:27,780 Back in the UK, the shock waves of Dr Allison's extraordinary 732 00:44:27,780 --> 00:44:32,180 discoveries are also being felt by a unique group of melanoma 733 00:44:32,180 --> 00:44:35,940 patients at my very own hospital here at the Royal Surrey. 734 00:44:37,540 --> 00:44:41,260 You've all had that moment when you suddenly have the dawning, 735 00:44:41,260 --> 00:44:42,660 or the realisation. 736 00:44:42,660 --> 00:44:44,380 What was your first thought? 737 00:44:44,380 --> 00:44:47,940 Everyone here has been diagnosed with stage IV melanoma, 738 00:44:47,940 --> 00:44:49,860 that's a stage further than me. 739 00:44:49,860 --> 00:44:52,340 There cancer has spread to their vital organs, 740 00:44:52,340 --> 00:44:56,540 which until very recently, was a terminal diagnosis. 741 00:44:56,540 --> 00:45:00,380 Yet, amazingly, all the patients here have had extraordinary 742 00:45:00,380 --> 00:45:02,700 responses to Dr Allison's drugs. 743 00:45:05,180 --> 00:45:08,740 I had a PET scan, and I was kind of glowing like a Christmas tree, 744 00:45:08,740 --> 00:45:12,540 and then went on to ipilimumab straight away, immunotherapy. 745 00:45:13,540 --> 00:45:17,660 A support group like this would never have happened before. 746 00:45:17,660 --> 00:45:19,580 Because if you were stage IV, you would be dead. 747 00:45:20,860 --> 00:45:22,980 That means that the drugs are working. 748 00:45:24,020 --> 00:45:26,060 You had a stage IV? 749 00:45:26,060 --> 00:45:27,940 So, like, in your brain as well? 750 00:45:27,940 --> 00:45:31,380 Brain, lungs, erm, breast. 751 00:45:31,380 --> 00:45:33,540 You were a stage IV? 752 00:45:33,540 --> 00:45:35,740 You were a stage IV? You were a stage IV? 753 00:45:35,740 --> 00:45:37,900 This is it, you know. 754 00:45:37,900 --> 00:45:41,580 Were you told - there isn't anything...? 755 00:45:41,580 --> 00:45:45,700 Yes, five minutes after I was told, I was with my wife... 756 00:45:51,740 --> 00:45:53,740 We have tissues. 757 00:45:53,740 --> 00:45:55,300 I found that hard. 758 00:45:58,460 --> 00:46:02,980 Because, at that point, it's in the family, it's not just you, 759 00:46:02,980 --> 00:46:04,100 it's everybody involved. 760 00:46:07,060 --> 00:46:11,580 Before I made this film, I would have rather pooh-poohed 761 00:46:11,580 --> 00:46:13,220 support groups, actually. 762 00:46:13,220 --> 00:46:17,940 But it's very, very true - a problem shared is very much 763 00:46:17,940 --> 00:46:20,460 a problem halved, or reduced. 764 00:46:20,460 --> 00:46:22,780 But look at where I'm... Look at where I am now. 765 00:46:25,540 --> 00:46:28,900 Just under one year ago, Lisa Roberts was diagnosed 766 00:46:28,900 --> 00:46:32,020 with a melanoma that had spread to multiple organs, 767 00:46:32,020 --> 00:46:34,020 including her brain. 768 00:46:34,020 --> 00:46:36,780 Even, you know, you'd have those days at work where everything 769 00:46:36,780 --> 00:46:39,460 was stressful and you could get caught up in that. 770 00:46:39,460 --> 00:46:42,580 Now I don't. I think I take a step back and just think, 771 00:46:42,580 --> 00:46:46,140 "It's just today, things will be better tomorrow." 772 00:46:46,140 --> 00:46:48,460 When I first got diagnosed, I wasn't really interested 773 00:46:48,460 --> 00:46:51,260 in a group, I didn't really like talking about it. 774 00:46:51,260 --> 00:46:52,900 I didn't want to talk about it. 775 00:46:52,900 --> 00:46:54,700 At the beginning I was on immunotherapy... 776 00:46:54,700 --> 00:46:57,900 Ipi Nivo, right? Yeah, Ipi Nivo and everything was swelling. 777 00:46:57,900 --> 00:47:00,780 This was a couple of weeks, and I had a lump on my arm. 778 00:47:00,780 --> 00:47:02,100 That's a huge red lump. 779 00:47:02,100 --> 00:47:05,260 And that was me celebrating that it was shrinking. 780 00:47:05,260 --> 00:47:08,540 So you had lumps in the brain, your shoulder, intercostal muscles, 781 00:47:08,540 --> 00:47:10,500 the lungs, the liver, pancreas, thigh. 782 00:47:10,500 --> 00:47:12,300 That's a lot to put up with? 783 00:47:12,300 --> 00:47:16,540 Yeah. Being positive for yourself, at least... 784 00:47:16,540 --> 00:47:19,860 It doesn't necessarily fight the cancer, but I'm very sporty 785 00:47:19,860 --> 00:47:24,660 and very competitive, and for me, I had to say, this is a battle 786 00:47:24,660 --> 00:47:27,260 and I'm going to win and I'm very determined. 787 00:47:27,260 --> 00:47:28,900 That's just the way I cope with it. 788 00:47:28,900 --> 00:47:32,940 I think everyone's different, some people will just say, 789 00:47:32,940 --> 00:47:36,340 "Right, let the science take over and heal me." 790 00:47:36,340 --> 00:47:38,980 But then they believe, again, that through that they believe 791 00:47:38,980 --> 00:47:42,140 it's going to happen, because they're believing in the medicine. 792 00:47:43,980 --> 00:47:47,500 Lisa still has one small tumour remaining in her brain 793 00:47:47,500 --> 00:47:49,340 and her treatment is ongoing. 794 00:47:49,340 --> 00:47:51,580 But there is a long road ahead. 795 00:47:51,580 --> 00:47:53,900 You know, when you get a cold or you get ill, 796 00:47:53,900 --> 00:47:56,940 you recover in a week or two and you are just so used to that, 797 00:47:56,940 --> 00:47:59,300 that illnesses don't last a long time. 798 00:47:59,300 --> 00:48:03,020 So I really struggled with the fact that it's coming up to a year 799 00:48:03,020 --> 00:48:05,260 and I still have the disease. 800 00:48:07,660 --> 00:48:12,060 Ten years ago, there was absolutely nothing that could be done. 801 00:48:12,060 --> 00:48:14,780 If you got that disease, malignant melanoma, 802 00:48:14,780 --> 00:48:15,980 they would just say, 803 00:48:15,980 --> 00:48:20,100 "Well, we're very sorry, there's nothing more we can do." 804 00:48:20,100 --> 00:48:24,460 And that is, that's my hope for the research that's being done 805 00:48:24,460 --> 00:48:28,140 and there's some fantastic research which will go on, and on, and on. 806 00:48:28,140 --> 00:48:30,020 My hope is that they will never... 807 00:48:35,020 --> 00:48:36,260 ..have to say that again. 808 00:48:43,140 --> 00:48:47,660 It's the end of three months of drug therapy, and today I will find out 809 00:48:47,660 --> 00:48:52,140 if these pills have put my cancer into remission, and potentially 810 00:48:52,140 --> 00:48:53,180 save my life. 811 00:49:02,660 --> 00:49:06,180 This is, this is quite an important day. 812 00:49:06,180 --> 00:49:10,900 This is the one where I will get the results of the PET scan. 813 00:49:12,460 --> 00:49:15,660 I'm just a bit nervous about it all. 814 00:49:20,140 --> 00:49:23,980 Yeah, I just want to find out what the results were. 815 00:49:28,700 --> 00:49:33,540 If these drugs have worked really, really well, then all the cancer 816 00:49:33,540 --> 00:49:36,660 will be gone. That's the best possible outcome. 817 00:49:37,820 --> 00:49:40,260 This is all the very latest in treatment, 818 00:49:40,260 --> 00:49:44,700 so success with these new drugs in my case could be yet another huge 819 00:49:44,700 --> 00:49:47,540 step forward for the future treatment of others. 820 00:49:56,740 --> 00:50:01,180 The whole team meets - the surgeon, the pathologist, 821 00:50:01,180 --> 00:50:07,700 the oncologist, everybody involved in my case meet and they discuss me, 822 00:50:07,700 --> 00:50:09,860 and of course, I'm not able to be there. 823 00:50:09,860 --> 00:50:14,820 I could find out something that will change my life completely today. 824 00:50:17,260 --> 00:50:22,300 Worst case scenario, it could be in my lungs or in my other 825 00:50:22,300 --> 00:50:23,700 organs or my brain. 826 00:50:25,940 --> 00:50:28,340 Morning, team. Welcome. 827 00:50:28,340 --> 00:50:32,260 So, at MTT today we are discussing George McGavin. 828 00:50:32,260 --> 00:50:34,620 Ralph, you first met this gentleman. 829 00:50:34,620 --> 00:50:41,180 He presented in July with a black nodule on the back of his right heel 830 00:50:41,180 --> 00:50:46,300 and he had a biopsy, followed by removal of the lump. 831 00:50:46,300 --> 00:50:50,340 And that came back confirming a melanoma of 832 00:50:50,340 --> 00:50:51,940 2.5 millimetre thickness. 833 00:50:53,100 --> 00:50:56,220 This is the first excision from the foot, 834 00:50:56,220 --> 00:50:57,900 because the thick keratin layer. 835 00:50:59,260 --> 00:51:01,100 And it's quite large, it's conformed. 836 00:51:03,180 --> 00:51:06,380 The PET scan, got a bit of uptake in his right heel. 837 00:51:06,380 --> 00:51:09,260 He's also got at least groin nodes. 838 00:51:09,260 --> 00:51:11,900 I think the highest most node is this one here, 839 00:51:11,900 --> 00:51:14,940 just anterior to the vessels. 840 00:51:14,940 --> 00:51:20,780 Classically we have operated in situations like this, and at 841 00:51:20,780 --> 00:51:23,940 the moment, we are really trying to decide a way forward, aren't we, 842 00:51:23,940 --> 00:51:25,700 that's best for the patient? That's right. 843 00:51:25,700 --> 00:51:28,100 And are you seeing him today to talk to him about his results? 844 00:51:28,100 --> 00:51:30,540 Yeah, that's been a big part of the treatment decision here, 845 00:51:30,540 --> 00:51:31,700 what George wanted. 846 00:51:40,260 --> 00:51:43,260 Hello. Tim, hi. Welcome back to the clinic, George. 847 00:51:43,260 --> 00:51:45,500 Good to see you. Thank you very much. 848 00:51:45,500 --> 00:51:48,140 Please come in and have a seat. Thank you. 849 00:51:49,300 --> 00:51:51,740 How are you doing? Well. 850 00:51:53,860 --> 00:51:56,100 "George, how are you?" 851 00:51:56,100 --> 00:51:58,180 "Well, we've looked at it..." 852 00:51:58,180 --> 00:52:00,220 Just tell me! 853 00:52:00,220 --> 00:52:02,460 You've had a scan, as you know, which tells us 854 00:52:02,460 --> 00:52:03,980 how well you've done. 855 00:52:03,980 --> 00:52:07,740 So, I'm really pleased to give you some good news, 856 00:52:07,740 --> 00:52:11,260 which is that you've had what we call in the trade 857 00:52:11,260 --> 00:52:13,740 a metabolic complete response. 858 00:52:13,740 --> 00:52:17,100 Which is that all the lymph nodes, they've all returned 859 00:52:17,100 --> 00:52:19,100 to a normal appearance. 860 00:52:19,100 --> 00:52:23,180 Now this is a very, very encouraging initial response, well done. 861 00:52:28,260 --> 00:52:29,700 That's as good as you could do. 862 00:52:35,780 --> 00:52:39,420 There's lots to talk about, but from my perspective, 863 00:52:39,420 --> 00:52:43,940 you've done the hard part, which is to get into what can only 864 00:52:43,940 --> 00:52:45,300 be called a complete remission. 865 00:52:46,940 --> 00:52:50,180 There is no metabolically active disease left. 866 00:52:50,180 --> 00:52:54,900 That... That's almost unbelievable. 867 00:52:54,900 --> 00:52:58,060 So, what... What next for me? 868 00:52:58,060 --> 00:53:01,740 Orthodoxy says you should stay on the tablets, 869 00:53:01,740 --> 00:53:05,620 or consider surgery. Can I stay on the tablets? 870 00:53:05,620 --> 00:53:09,740 You can. But - normal life. Thank you so much. 871 00:53:11,340 --> 00:53:12,500 Great stuff, well done. 872 00:53:16,140 --> 00:53:18,260 I'll see you in a month, yeah? 873 00:53:18,260 --> 00:53:20,020 Thank you so much. Brilliant, brilliant. 874 00:53:35,060 --> 00:53:39,300 PHONE RINGING 875 00:53:39,300 --> 00:53:41,100 Don't go to answer phone. 876 00:53:41,100 --> 00:53:42,660 PHONE RINGING 877 00:53:42,660 --> 00:53:44,420 Hello. Hi, darling. 878 00:53:45,540 --> 00:53:47,540 Hi, how are you? 879 00:53:47,540 --> 00:53:52,140 Very, very good, the results are fantastic. 880 00:53:52,140 --> 00:53:54,420 Oh, my God. Yeah. 881 00:53:54,420 --> 00:53:57,140 Valentine's Day, happy Valentine's Day, 882 00:53:57,140 --> 00:53:59,340 I forgot to buy you a card. Yeah, happy Valentine's Day. 883 00:53:59,340 --> 00:54:03,620 Don't be daft. But I think this is better than a card. 884 00:54:03,620 --> 00:54:07,580 I think this is much, much, much more exciting news. 885 00:54:07,580 --> 00:54:10,980 THEY LAUGH 886 00:54:12,860 --> 00:54:14,860 Spring has arrived early for me. 887 00:54:14,860 --> 00:54:17,500 Oh, George, that's really good news. 888 00:54:17,500 --> 00:54:19,500 I'm in the clear. 889 00:54:19,500 --> 00:54:20,780 Gone, absolutely gone. 890 00:54:22,260 --> 00:54:25,340 When I reported this, I knew you'd be over the moon. 891 00:54:25,340 --> 00:54:27,060 Yeah, incredible. 892 00:54:29,500 --> 00:54:30,860 Wow! 893 00:54:30,860 --> 00:54:33,500 That's it, you can't get any better than that. 894 00:54:33,500 --> 00:54:34,940 Hello. Hello, it's me. 895 00:54:34,940 --> 00:54:38,140 Yeah, I'm here. Brilliant news, I'm in the clear. 896 00:54:38,140 --> 00:54:39,220 The best. 897 00:54:40,780 --> 00:54:43,700 Oh, Daddy, I'm so pleased. 898 00:54:43,700 --> 00:54:46,420 That's just fantastic, it's the best news I could hear. 899 00:54:46,420 --> 00:54:50,220 Don't start crying because I'll start. 900 00:54:50,220 --> 00:54:51,660 It's fine, it's all good. 901 00:55:01,380 --> 00:55:05,060 Over the past 12 months, I have been diagnosed with cancer, 902 00:55:05,060 --> 00:55:08,380 had a tumour removed, been told that my cancer had spread 903 00:55:08,380 --> 00:55:13,060 to a stage that, left untreated, could have killed me within a year. 904 00:55:13,060 --> 00:55:17,220 I've consulted with scientists behind the new targeted drugs 905 00:55:17,220 --> 00:55:20,100 and I've met the man responsible for the greatest breakthrough 906 00:55:20,100 --> 00:55:23,100 in cancer research in a century. 907 00:55:23,100 --> 00:55:25,220 Those are cured. Those people are cured. 908 00:55:28,020 --> 00:55:32,220 And now I'm back on a familiar trip to the hospital. 909 00:55:34,420 --> 00:55:37,340 Once again, early in the morning, but this time I'm going 910 00:55:37,340 --> 00:55:38,580 to a nice scan. 911 00:55:50,740 --> 00:55:51,980 Isn't that an amazing sound? 912 00:55:54,020 --> 00:55:55,900 Head. 913 00:55:55,900 --> 00:55:58,940 Look, we got a fantastic headshot there. 914 00:56:03,260 --> 00:56:05,100 Come on, small fry. 915 00:56:05,100 --> 00:56:10,380 By the time this child is your age, and almost certainly by the time 916 00:56:10,380 --> 00:56:15,860 it's my age, the sorts of cancers today which are now 917 00:56:15,860 --> 00:56:19,900 a death sentence, won't be. It'll be, "Yeah, we can fix this." 918 00:56:19,900 --> 00:56:21,860 It's moving so fast. 919 00:56:21,860 --> 00:56:26,540 I'm in the clear. It's the best news I could possibly have had. 920 00:56:26,540 --> 00:56:33,060 Cos to know that I can, you know, head off and have this little one 921 00:56:33,060 --> 00:56:37,340 and not be worrying about you, and know that you are going to be fine, 922 00:56:37,340 --> 00:56:39,620 and you're going to be here. Yeah, for a while. 923 00:56:39,620 --> 00:56:42,460 Everyone has to go sometime. Well, everyone has to go sometime. 924 00:56:46,460 --> 00:56:47,500 Love you. 925 00:56:49,020 --> 00:56:50,260 All right. 926 00:56:52,900 --> 00:56:53,940 Yeah. 927 00:57:10,020 --> 00:57:13,860 I think when you have cancer, it's like you've been in these dark 928 00:57:13,860 --> 00:57:17,780 woods, and suddenly after a drug treatment or a trial or something, 929 00:57:17,780 --> 00:57:20,460 you're in a clearing in the woods, and all the trees have gone back 930 00:57:20,460 --> 00:57:23,620 and you are going, "Oh, yeah. Yeah, yeah this is OK." 931 00:57:23,620 --> 00:57:26,980 And then you might head on again and the trees might close in. 932 00:57:28,860 --> 00:57:34,140 So currently, I am in a nice, sunlit clearing in the woods. 933 00:57:37,940 --> 00:57:40,620 I've been very, very lucky. 934 00:57:40,620 --> 00:57:45,060 I've had the benefit of the latest science at an incredible time 935 00:57:45,060 --> 00:57:47,700 in the evolution of cancer research. 936 00:57:51,180 --> 00:57:55,820 But when my cancer comes back, if it comes back, he says it will, 937 00:57:55,820 --> 00:57:58,220 there'll be something else. There will be something else. 938 00:57:58,220 --> 00:58:01,020 I am going to die at some point, 939 00:58:01,020 --> 00:58:04,820 but it's not going to be of skin cancer. 940 00:58:04,820 --> 00:58:06,860 Of that, I am pretty sure.