Natalie Fornasier, 26
Living with skin cancer
Melanoma was never something I thought could happen to me, and yet that’s the very cancer I’ve been fighting on and off for six years.
A misconception a lot of Australians believe is that you need to be a certain skin tone (pale), with certain colour hair (red) and a specific shade of eye colour (blue) to only be affected by melanoma or skin cancer. This is not true.
It happened to me, a young and healthy girl with olive skin, brown hair, and hazel eyes.
Let me be clear when I say that cancer doesn’t discriminate.
My mother is from Chile. She came here when she was sixteen, and one of her first memories was of how different the sun felt on her skin. It burned. My father is first generation born Australian, to two Italian migrants. As a product of my parents who both have olive skin, it was believed no matter the regular skin checks that I had when I was young, or my mother’s obsessive sun safety measures, or the record that there was no melanoma in my family history, that I would be safe. That I wouldn’t contribute to the statistics, that I would live a normal life and enjoy my twenties like every other true blue Australian.
In October 2014, I was told I had stage III metastatic melanoma at 20 years old. This meant that the cancer had spread from its original point (a mole on my toe that began to give me grief just a few months prior) to the lymph nodes in my groin. Such a diagnosis turned my life upside down – no twenty-year-old is prepared to hear those words, especially when you’ve been told all your life that this cancer is mainly sun related.
I had a hard time accepting it – and to this day I still can’t wrap my head around the fact that I live with such a frightful diagnosis. After multiple surgeries in 2014, one of which included a full lymph-node dissection and an amputation of the toe where the mole was, I was in the clear. Just as quickly as this journey had started, it stopped. I had to learn how to live as someone who had a stage III cancer diagnosis hanging over their head, a new condition called lymphoedema (swelling of a part of the body) and somehow make sense of life, when life had lost all sense of meaning.
For four years, I hustled to put the pieces of my life back together as best as I could. I changed university degrees, lost and made new friends, lived overseas for eight months and I fell in love. Only for all of that to come crashing down when I hopped off the plane at Sydney International Airport after an eight-month whirlwind of an exchange, which were the best months of my life. Over that time, while experiencing the culture of my heritage, and giving in to allowing myself to enjoy life - I finally came to peace with my cancer diagnosis, but I was very aware that it could come back at any time. I wasn’t naïve. I knew the statistics – if you got to five years, you were likely to be okay. Not completely in the clear, but it was a good sign. By 2018, I was in my fourth year of remission. A little nudge in my stomach however, told me to be weary. For some reason, I had always suspected that my dance with this cancer wasn’t finished. Sadly, I was right. I had come home to only be told after a routine scan, that my melanoma had returned and this time, it was in my lungs.
Melanoma isn’t just a skin cancer as so many believe. It’s more than that. It’s like every other cancer that creeps up on you and makes you question every tether to the earth. I asked my oncologist how it was possible for it to pop up there as only one millimetre had deposited into my lymph nodes. She told me melanoma is a smart, dormant type of cancer. All it takes is one cell to travel around the body, for years, until it decides to latch onto something (an organ, in my case) and then wake up.
In May 2018, I was diagnosed as a Stage IV cancer patient. I was 24 and I was terrified. Cancer in an organ is never a good thing, but a cancer that doesn’t respond to chemotherapy was even scarier. My doctors told me that a lot had changed in the world of melanoma during the four years I was in remission. The advancements in treatment options had exploded; immunotherapy was extending the life expectancies of patients by the hundreds and had everyone in the medical community on the edges of their seats brimming with excitement. It was an easy choice; immunotherapy was the drug for me.
If only it would be that easy. Due to the nature of immunotherapy being so new, it’s impossible to determine whether my fertility would be affected. Generally speaking, stage IV melanoma isn’t common for young people. No one could tell me if it would affect my ability to have children; something cancer made me realise I want even more. So, we decided to do IVF. It was insane. I had six days to complete a full cycle, most women get 5-6 weeks. It was successful, with a good amount of eggs but during that time we needed a new scan to confirm measurements before I started immunotherapy. Unfortunately, the scan showed that my tumours had grown rapidly, thus placing me in the ‘aggressive’ category of tumour growth.
My immunotherapy plan had to change, which went from having a success rate of about 70% to 50%. The next two years, up until this very day, I’ve had my limits pushed to the furthest extent. Between immunotherapy working for a while, to not working at all, to hospitalisations once every three months and having to undergo the most extensive surgery of my life, to then going back on a different type of immunotherapy and all the breakdowns in between: it's been the hardest years of my life.
Melanoma has taken my twenties away from me. There’s no denying it. Unlike my friends who could focus on their careers, I am career-less. They’re out having fun, I’m at home hugging the toilet bowl from nausea. This isn’t a pity contest, it’s just my life. The only life I’ve known. It’s important for me to say that I did everything right. I wore SPF, was sun safe, I didn’t tan or burn my skin in my teens, I got my skin checked.
To this day, my team aren’t exactly sure how it came about – all they know is that this mole was genetically dispositioned to transform into this malicious melanoma, which is responsible for the statistic of being the most common cancer in 15-39-year old’s. I’m thankful I spoke up when I did about the mole, because who knows what could have been. I’m thankful that despite all the statistics on paper telling me I’m not supposed to be here right now, I am, and I’m determined to keep it that way.
Cancer, no matter what form, catapults you headfirst into a club no one wants to be a part of. A club where everyone is aware of the main currency in life: our health. Our health is all we have; it is literally the single most important facet of our lives and we need to protect it. To look after it with every fibre of our being. Skin cancer and melanoma doesn’t discriminate. Your skin is looking to you to be its best and only advocate – so we must do just that.