Dr Chris Boberg talks about melanoma care

10 July 2020

Category: College and members

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College Fellow Dr Chris Boberg is back for his second feature, but this time, we get an inside look into his representative work with the Melanoma Network of 麻豆视频入口 (MelNetNZ) and the Ministry of Health鈥檚 Melanoma Standards Working Group.

Dr Chris Boberg
Dr Chris Boberg in his practice.

Can you share a bit about your specific role with these groups?聽

鈥淚鈥檓 the co-chair for MelNetNZ, which was launched in 2009 and is a forum for all health professionals working in melanoma care to share knowledge, discuss equity, and how to best optimise care for melanoma patients across 麻豆视频入口. We meet monthly and host the biennial two-day Melanoma Summit, which is highly successful at getting people across 麻豆视频入口 together to present the latest updates and current research on this cancer.

鈥淚 am also a member of the Ministry of Health鈥檚 麻豆视频入口 Melanoma Standards Working Group which came together in 2012 under the umbrella of MelNetNZ. This group is really superb 鈥 it鈥檚 multifactored and covers the full spectrum of NZ clinical leaders in melanoma care 鈥 everything from key melanoma health professionals including general practice, oncology, surgical, nursing and researchers 鈥 with the shared mission of implementing quality care standards and quality indicators聽 for melanoma patients. Early detection and dermoscopy in practice are my areas of expertise. We are now engaging with the newly established Cancer Control Agency to evolve quality indicators and we hope to publish both the recently updated melanoma standards and the key quality indicators during the second half of this year.鈥

What sparked your particular passion for melanoma care?聽

鈥淢y passion started early as a med student. I became curious about how this little spot can kill people and do it so quickly. In the 80鈥檚 we didn鈥檛 have the technology to figure these things out just yet and we were reliant on a good keen clinical eye. Dermoscopy came up clinically in the late 90鈥檚, and we鈥檝e only figured out how to use it well during the last decade with the advent of the now famous Chaos and Clues algorithm 鈥 a supported decision to excise a suspicious lesion.

鈥淲e can now easily teach a doctor Chaos and Clues and the fundamentals of dermoscopy over a two-day course and there are opportunities for revision, advanced learning, and updates. If melanoma is picked up at the early non-invasive 鈥榠nsitu鈥 stage, it鈥檚 very survivable.聽

鈥淚t鈥檚 really neat that this has all evolved over the course of my career, and that I鈥檝e been able to champion dermoscopy and early detection in 麻豆视频入口 and now teach it to our young GPs. As you can imagine I鈥檝e become really wrapped up in all of this 鈥 once started - you just can鈥檛 shut me up!鈥

What have been your key learnings or experiences having been a GP rep on these groups?

鈥淏eing involved with these groups has validated the absolute importance of GPs on the front line to be able to identify early cancer symptoms - any cancers, but especially skin cancer. No one should die from melanoma. It is no longer a lofty goal as we can now detect it early, and GPs play a huge role in that."

Have you encountered any challenges during your time with the group?

鈥淲e鈥檝e had challenges in both groups that we鈥檝e had to overcome, but that鈥檚 what it鈥檚 all about. Learning how to become an equal voice, as a GP, on a multifactored working group, involving the complete spectrum of specialities; covering melanoma care in 麻豆视频入口 was both fun and rewarding. For example, it was a challenge introducing Keytruda to 麻豆视频入口 as a potential treatment option for melanoma.

"In 2017 we were seriously lagging behind the world not having access to immune therapy for melanoma. When we held the 麻豆视频入口 Melanoma Summit in 2018 we invited Professor Antoni Ribas as a key note speaker (he is one of the key global researchers in immune therapy and melanoma - based in UCLA) and we facilitated his communication with the Minister of Health. This eventually led to it being seriously considered and after a few months, adopted as a treatment.鈥

Do you have any advice to members interested in becoming a College representative?

鈥淚f you鈥檙e really passionate about an issue, don鈥檛 be afraid to step forward. Start networking and talking to people. You are a dedicated GP already and you will make a difference. There are plenty of groups like this 鈥 be prepared to give your time for the common good, and to advocate for general practice. We, as GPs, make massive contributions to healthcare every day. It鈥檚 about getting out there and sharing our narratives. I just love being a GP and taking on these challenges.鈥

Do you have any advice for a College representative going to their first meeting?

鈥淲hen I started on my first Spot Check Project in 1988, I thought, 鈥榳hat the hell do I know about health promotion?鈥櫬 However, in 1990 I was invited to represent the College on the National Cancer Society Health Promotion committee. I met wonderful people who were understanding and helpful. We had vibrant discussions. I became an expert in the Ottawa Health Promotion Charter and I learnt so much from one of the members over time - Betsy Marshall. She became the first Executive Officer when MelNet NZ was set up in 2009 and made a huge contribution.鈥

鈥淪o my advice is, don鈥檛 be afraid. Educate yourself on the way, talk to people, and always promote the virtues of our profession and advocate for it. You can also get a reference group or two together and get advice from them; discuss the issues and seek feedback at your regular cell group. If you are doing something special like this, your colleagues always like to have a sense of involvement with you. Talk to older guys like me! - I鈥檓 happy to do that.鈥澛

Are there any resources from the programme or group that you鈥檇 recommend to members?

鈥淕Ps can join for free, and you鈥檒l be updated on upcoming summits and key papers released on melanoma care. The Ministry鈥檚 draft standards are rolling out soon too."

鈥淲e really want to encourage all GPs to train in dermoscopy. It鈥檚 easy to learn in just two days. There鈥檚 .

鈥淔inally, the gold standard service is full skin checks for high risk people. Also, most GPs can learn basic surgery incisions, and it鈥檚 fun!鈥

On a final note, is there anything else you鈥檇 like to share with members?聽

鈥淚鈥檇 encourage members with a special interest in skin cancer to join the . We鈥檝e got 38 members (growing rapidly) who are dedicated GP Skin Cancer Fellows. It has a training and credentialing structure and all that jazz. I love supporting the focused skill set training and quality standards in this area, and it鈥檚 what 麻豆视频入口 has to have. For me at this age, this society is just great and a wonderful outcome.鈥