Richard Scolyer: Melanoma doctor's high-stakes gamble to treat his brain cancer

Eyes shining, the medical oncologist rattles off a list of qualities - brave, honest, upbeat, driven - which make Prof Scolyer the dream colleague and friend.

"He's a delight," she surmises.

And so, after she received that fateful call from Poland last June - where Prof Scolyer was on holiday when a seizure triggered his diagnosis - she spent the night crying.

"I'm grieving… I'm thinking my friend is going to be gone in 12 months."

But then she spent the morning plotting - poring over textbooks, researching clinical trials, and firing off emails to colleagues globally.

Glioblastomas, found in the brain's connective tissue, are notoriously aggressive and the general protocol for treating them - immediate excision then radiotherapy and chemotherapy - has changed little in two decades.

Survival rates have fared similarly. Still, only 5% of all patients live beyond five years.

Desperate, Prof Long formulated a radical plan to treat Prof Scolyer based on what had worked in melanoma, but which had never been tested in brain cancer.

In melanoma, Prof Long and her team discovered that immunotherapy works better when a combination of drugs are used, and when they are administered before any surgery to remove a tumour.

It's like training a sniffer dog, she explains: you give it a smell of the contraband, in this analogy the cancer cells, for it to be able to hunt them down later.

Prof Scolyer jokes that trying the treatment was a "no brainer".

But it comes with huge risks.

Some oncologists were sceptical that the drugs would reach his brain at all, and even if they did, that his immune system would respond.

And they worried the experiment could kill him faster.

Many brain cancers grow so rapidly that even a two-week delay to surgery could mean it's too late to operate, they said. Immunotherapy drugs are quite toxic, especially when mixed, so he could be poisoned. And if either of those things caused the brain to swell, he could die instantly.

At home colleagues quietly shared fears Prof Long's emotional ties were clouding her judgement.

"They were saying… 'Just let the neuro-oncology experts do their thing and be his friend'," she says.

"[But] he needs us… We have all this depth of knowledge, it's our duty."

But there's also optimism that the duo may be on the cusp of a discovery which could help the 300,000 people diagnosed with brain cancer globally each year.

This kind of research would usually take years - even decades - but what Prof Scolyer and Prof Long have achieved in mere months has already attracted interest from pharmaceutical companies and generated talk of clinical trials.

Roger Stupp, though, is more tempered.

The doctor - after whom the current protocol for treating glioblastomas is named - says Prof Scolyer's prognosis is "grim", and that it's too early to tell if this treatment is working.

"Promising is a difficult word… Encouraging, I would call it," he tells the BBC from Chicago.

"It's not a revolution, but it is still a step forward."

He wants to see Prof Scolyer reach 12 months, even 18, without recurrence before he'll be persuaded.

But Dr Stupp says he is "absolutely" confident that immunotherapy can change the treatment of brain cancer - the science just hasn't been cracked yet.

"We need to get out of our silos and look at what worked in other tumour types," he says.

Prof Scolyer and Prof Long are also trying to resist being swept up in the buzz.

The best-case scenario is that Prof Scolyer is cured, but they call the odds of that "miniscule".

"A miracle could happen," Prof Scolyer says.

As for the worst-case scenario, he tells the BBC he's already beaten it: "I would have died before now."

Instead, he celebrated his 57th birthday in December, and another Christmas with his family - wife Katie, and his teenage children Emily, Matthew, and Lucy.

 But with the gratitude for each additional milestone, every clear scan, is the fear it's his last.

"It's tough," Prof Long says of treating her friend.

They've had discussions about death and funerals. "He's extraordinarily resilient," she adds.

But sitting in his office - surrounded by pictures of his children, tasks scribbled on a whiteboard and shelves filled with framed accolades - Prof Scolyer tears up.

For all his outward positivity, he admits he's also scared and soul-crushingly sad.

"I love my family. I love my wife… I like my work," he says with a grimace.

"I'm pissed off. I'm devastated… I don't want to die."

But giving him comfort is the idea that this research could bring meaning, some purpose, to his diagnosis.

"The data that we've generated - I know it's changing the field, and if I die tomorrow with that, I'm very proud."

Source: BBC News