Richard Keyes’ Story

Richard was one of the healthiest people in our group of friends and colleagues.  He loved playing football on a Saturday morning, and was a member of a cycling club for a while.  He cycled to and from work EVERY day, all year round, and in all weathers.  And yes, I worried for his safety, especially during the winter when it was dark and icy.  But he wore the fluorescent yellow, and put his lights on, and thought nothing of it.

In 2009 we became parents, and Richard was immensely proud to become Daddy to our beautiful son Morgan.  As soon as Morgan was big enough, Richard was able to share his passion for cycling.  First, by having a child seat added to his crossbar, which was followed by a trailer bike, progressing to cycling side by side shouting out to “KEEP PEDALLING”!  It was a passion I found best to keep away from, unless I wanted to be shouted at – encouragingly.

Richard had always been very careful when in the sun.  He was the one who would wisely sit in the shade, while I laid out with a good book working on my suntan.  He would take prolonged rests indoors between the hours of 12 and 3 whenever we were abroad on holiday.  And he loved walks in the woods on glorious sunny days, when I would prefer to be relaxing in the sun on a picnic blanket, preferably horizontal.

So it seems extremely unfair that in 2012 he was diagnosed with malignant melanoma on his left shoulder.  What had resembled a blood blister, no bigger than the nail on your little finger, was actually skin cancer.  Even the GP had told us it was safe, due to the fact that it was symmetrical and all one colour.  What it actually turned out to be was 4mm deep and not as innocent as it looked.  The dermatologist was not happy, and he was referred to Royal Surrey Hospital, where he had further skin and some lymph nodes under his arm removed.  A very ‘old school’ Consultant then gave him the all clear with the warning that due to its initial depth it very well may return, in which case it would be very grave news indeed!  We took that warning with a pinch of salt, and decided that was not a path we would be heading down.  Thank you very much, but no thanks!  And we got on with our lives.

Richard was still very careful in the sun, and still very active cycling and playing outside with Morgan.  When on the beach on holiday, he would smother himself in sun screen, wear a UV t-shirt and hat, and take breaks out of the sun under a parasol.  I still worked on the suntan!

Then unbeknown to me, at the end of January 2016, Richard started feeling shakes in his right hand, and went to the GP for advice.  On the 5th February 2016 our lives changed.  Richard was sent for a blood test, and feeling unwell but making it back to work, he asked me to take him to A&E.  Not realising the seriousness, I fully expected the doctors there to send us home with a ticking off for wasting their time over shakes brought on by hunger.

Richard was diagnosed with a brain tumour, and in the following weeks, a further 5 tumours were found around his insides, ranging from a lung tumour, one near the spleen and three others in muscle.  It’s fair to say that we were somewhat shocked and in despair.  Having received the warning in 2012, we knew the outlook wasn’t good.

However, we hadn’t yet met the new, improved, modern, and very positive Oncologist who was about to change our view of Malignant Melanoma.  Six days after Richard was diagnosed with the brain tumour we were told to get over to Royal Surrey Hospital to talk to a Dr Ajaz.  It was a lovely sunny Thursday afternoon, and we were shown into a bright sunny consulting room.  Dr Ajaz literally breezed into the room with an air of calm and control.  He clearly told Richard about the many drugs that he had at his disposal to switch Richard’s cancer off – it was just a matter of finding the right one to do the job.  So while they sent his original biopsy off for testing, he would now be going to St Georges Hospital for brain surgery.

Within a matter of days we then met an equally positive neurosurgeon called Mr James Laban.  Within two weeks of being diagnosed, we not only met two brilliant positive doctors, but the brain tumour had been completely removed and Richard was still intact!  He had a little reduced sensation and co-ordination in his right hand, but otherwise he was still the same person, and feeling somewhat relieved.

Some science fiction worthy radiotherapy followed up in the Royal Marsden in Chelsea, which clearly was a necessity, but train journeys up to London and back when you’re feeling fragile are not the best.

And then it was back to Dr Ajaz, to be told that Immunotherapy was the way forward.  Richard was put on Pembrolizumab, once every three weeks, and it was to be for two years.  Every three weeks on a Monday we looked forward to visiting Dr Ajaz and his clinical nurse specialists, Delia and Kate.  They provided just as much therapy as the drug itself, which was administered each following Tuesday.  Each of those Mondays was like being sprinkled with Fairy Dust.  We would turn up feeling all flat and apprehensive, and go away feeling all was great with the world.  It was all going to be alright.

At the end of July, Richard had to be taken off the Pembro, as his immune system had overreacted and started attacking the part of his bone marrow that creates white blood cells.  Instead of just chasing the melanoma cells, his immune system was being naughty.  Something we had been warned about.  However, following scans we were told in the middle of August that Richard’s tumours were all gone.  He was lucky, he was a responder and the treatment had worked.  We were sent home, with a next appointment date at the end of November.  We went home and celebrated, and sent Thank You letters to those we felt had helped ease what could have been a horrible time.

Two weeks later Richard was playing in the garden with Morgan while I was doing something in the kitchen, and I was watching them enjoying themselves.  Richard kept looking at me, and I kept watching him, and I realised he actually looked really unwell.  For the first time, he actually looked like he had something wrong with him – which was odd!  He had looked completely fit and healthy all the way through his treatment, and suddenly he looked grey and tired, and not right.  I contacted Delia and Kate, and they recommended a blood test.  His red blood cells had dropped, and he was taken into East Surrey Hospital for a blood transfusion and further tests.  A stomach tumour was found to be causing internal bleeding.

We were back into the care of Dr Ajaz and his team.  Stomach surgery was to follow, and back onto the Pembro with the hope that no further immune reactions would occur.  In the middle of October Richard had half his stomach removed via keyhole surgery.  The pre-op scan showed a new tumour, on his Liver.  This was shortly accompanied a few weeks later by the news of a second brain tumour.  Now, it was just a waiting game for the immunotherapy to build back up and start doing its job.

But, something in Richard’s cancer must have changed.  On the 13th January 2017, Dr Ajaz had the awful job of having to let Richard know that the immunotherapy was not working.  Richard’s cancer had metabolized in the blood, and the Liver tumour was growing at a rapid rate.  There was nothing more that could be done for him.  Dr Ajaz apologised for not being able to save him.

Five weeks later, on Saturday 18th February Richard passed away peacefully with me by his side.

He fought very bravely, and stubbornly at times, never complaining, never once using the word pain.  To him, it was just uncomfortable.

Without the immunotherapy, and without Dr Ajaz and his team, Richard would have lost his life at least 6 months earlier.  We packed in a lot of extra socialising and memory making in those last 12 months – just in case!

I know who I can thank for those extra memories, and those extra special photo opportunities.

Thank You!