Carl Horrobin watched his daughter Alana open her presents last year fearing he’d never see another Christmas. The 41-year-old had been diagnosed with skin cancer, which had spread to his lungs and he was facing a grim prognosis.
But 12 months later, Horrobin is looking forward to 2019 with optimism after having “the best possible response” to immunotherapy treatment, which uses the patient’s own immune system to target and destroy cancer cells.
The accountant underwent the treatment at Clatterbridge Cancer Centre in Merseyside, which has become the first place in the country to launch a standalone immunotherapy service with dedicated nurses to deal with the specialised, but controversial, new treatment.
It had all started for Horrobin when he noticed a large freckle on his elbow had turned into a mole. He had it checked out by his GP, but was reassured it was probably a wart. But around 18 months later, Horrobin decided to see a specialist again, after being urged by a colleague who had experienced something similar.
Horrobin was referred to a dermatologist, who sent it for a routine biopsy. Not long after, Horrobin, who lives with his wife, their four-year-old daughter and his 12-year-old stepson, was given the news: it was melanoma, a form of skin cancer.
“Like many people, I wrongly thought melanoma was not as bad as other cancers,” he says. “But actually, when it comes to survival rates, it is one of the worst.”
Horrobin had to have surgery and a reconstruction of his elbow following his diagnosis in 2016, as well as the removal of some lymph nodes from his armpit. Six months later in September 2016, he was dealt another blow when he found a lump on his shoulder which also turned out to be cancerous.
After that, Horrobin had six monthly scans and this time last year, he was given the bombshell news the melanoma had spread to his lungs. In January this year, it was confirmed he had Stage 4 lung cancer.
“I knew the prognosis was very dire,” he says. “Last Christmas was very emotional.”
Horrobin was offered immunotherapy treatment at Clatterbridge Cancer Centre. The treatment doesn’t work for everyone and can have horrific side effects.
Immunotherapy is a relatively new type of cancer treatment which is described as a “game changer”. It works by harnessing the patient’s immune system so it targets and destroys only cancer cells.
But the treatment is also controversial, as it doesn’t work for everyone and around half of patients don’t respond at all. It can also cause hepatitis, colitis and disrupt the patient’s ability to make hormones.
Early studies are showing that the one-year survival rate for people with melanoma has gone from 20% to 80% with combination immunotherapy.
Clatterbridge Cancer Centre felt they needed a dedicated immunotherapy service as the needs of patients undergoing the treatment are very specific compared to other cancer patients.
The standalone service will allow them to deal with the side effects better as well as carry out research into how it can be successful for more patients.
Feeling he had nothing to lose, Horrobin began combination immunotherapy treatment every two weeks from February. “After two treatments, I was hit by brutal side effects like a sledgehammer,” he recalls.
“The main one was orbital myositis – an inflammation of the muscles around and behind the eyes. My eyes were bulging and the pressure felt like they were going to pop out of my head. I looked like Kermit the Frog.”
Horrobin also suffered aching joints and was diagnosed with the start of rheumatoid arthritis. He spent time in hospital and had steroids.
Since then, he has continued to have immunotherapy and to his amazement, three scans have now revealed there is no evidence of cancer in his lungs.
Horrobin said: “When I was first diagnosed, all I wanted was to see my daughter start school in September. Now I hope to see her finish school – that’s how much my horizons have been stretched by this treatment.”
He added: “I hesitate to use the word ‘cured’ as I know the cancer could come back. But to know the melanoma in my lungs has disappeared is a miracle. The horrendous side effects were worth it to still be here today.
“It has been a hell of a year but to end the year with this news is wonderful.”
Experts at Clatterbridge say Horrobin’s response to the treatment has been quick and highly successful, and they are carrying out further research into the treatment’s side effects.
Dr Anna Olsson-Brown, clinical research fellow and deputy chairman of the immunotherapy committee at Clatterbridge Cancer Centre, says until this form of treatment, treatment options for melanoma in particular were very limited.
She told HuffPost UK: “Up until four years ago, melanoma had a very poor prognosis and an overall survival rate of around seven months.
“Chemotherapy does not work on melanoma so immunotherapy offers the biggest change in treatment in melanoma ever.”
She explained the immunotherapy drugs themselves don’t have an effect on the cancer but they activate certain cells within the immune system which attack and control the cancer.
She said: “Immunotherapy is actually encouraging the patient’s own body to fight the cancer.”
She added that Horrobin had experienced the “best response to immunotherapy you can have”, but warned that the treatment doesn’t work on everybody, although research is ongoing.
Rose Gray, policy manager at Cancer Research UK, told HuffPost UK: “It’s very exciting to see developments in immunotherapy which have transformed outcomes for some patients with advanced cancer who haven’t responded to other treatment.
“But immunotherapy sadly doesn’t work for everyone and some patients can have severe side effects.
“That’s why ongoing research and trials are helping us determine exactly who they might work for, as well as how to minimise the side effects, so that more patients can safely benefit in the future.”