[00:00:07] Dr Sanjaya Senanayake: Hello and welcome to Behind the Curtain with myself Dr Sanjaya.

[00:00:12] Dr Sanjaya Senanayake: In today’s episode, I am honoured to be joined by two exceptional individuals, Professor Jane Dahlstrom and Professor Richard Scolyer, who have dedicated their careers to groundbreaking research and to advancing our understanding of cancer treatment.

[00:00:27] Dr Sanjaya Senanayake: The conversation was recorded in January of this year, before Richard received the heartbreaking news that his recent surgery had revealed that his brain cancer has returned. I was saddened to hear this and my thoughts are with Richard and his family.

[00:00:45] Dr Sanjaya Senanayake: Jane and Richard share a profound, ongoing professional and personal relationship, one that has been built on mutual respect and years of collaboration.

[00:00:55] Dr Sanjaya Senanayake: One of Richard’s recent achievements—being named one of the 2024 Australians of the Year, alongside Dr. Georgina Long—is a testament to his tireless dedication and incredible impact on the world.

[00:01:09] Dr Sanjaya Senanayake: I am deeply grateful to have had the opportunity to sit down with Jane and Richard. It was a privilege to hear about the incredible things they’ve achieved throughout their lives.

[00:01:20] Dr Sanjaya Senanayake: Please welcome Richard and Jane.

[00:01:31] Dr Sanjaya Senanayake: So I'd first, I'd like to introduce Professor Richard Scolyer. Also, Professor Jane Dahlstrom. Now, I could spend the whole interview talking about all their titles and awards and achievements, so I won't do that, but I'll very quickly tell you about Richard to start off with. He's a Senior Staff Specialist in pathology at Royal Prince Alfred Hospital. He's the Co-Medical director of the Melanoma Institute in Sydney, and he's a Professor at the University of Sydney with the Medical School. He's also the highest ever published scientist in the world in melanoma pathology, and has been rated the highest ranked melanoma pathologist worldwide, so pretty impressive.

[00:02:19] Dr Sanjaya Senanayake: He also got the Officer of the Order of Australia in 2021, before becoming Co-Australian of the Year last year with his colleague, Professor Georgina Long. And next to him - actually, this sounds like a title fight, doesn't it? Next to him, in the other corner we have Professor Jane Dahlstrom, who has been a Senior Staff Specialist at Canberra Hospital in Pathology. She's kind of retired and well, we'll touch on that as well, but she wears a number of hats. She's been acting head of the Canberra Clinical School, so a medical school at the university. She's currently Chair of the Australian Medical Council. With, uh, the medical school accreditation section.

[00:03:06] Dr Sanjaya Senanayake: She also has Australia Day Awards with Honors, with an OAM. So, she's a member of the Order of Australia. So welcome to both of you and wow, how impressive you both are.

[00:03:19] Jane Dahlstrom: Thank you Sanjaya.

[00:03:22] Richard Scolyer: Yeah, great to be here, Sanjaya. And um, fantastic. Yeah, it is embarrassing when you read out all those sorts of things. But anyway, we're happy to have a chat.

[00:03:31] Dr Sanjaya Senanayake: Now. Of course, we do this podcast for people, and we interview people who've got connections to Canberra. People may not realise, Richard, that you do have a connection to Canberra. May I ask when you first encountered the Canberra health system?

[00:03:48] Richard Scolyer: Oh, well, to be honest, I first encountered it when I was a medical student.

[00:03:54] Richard Scolyer: I came up and did a term in paediatrics at the old Canberra Hospital, um, Royal Canberra Hospital, which no longer exists. And then subsequently, left and finished medical school, did a whole lot of different years doing various things, and then decided I wanted to become a pathologist. And yeah, luckily for me, I was offered a position at the Canberra Hospital.

[00:04:23] Richard Scolyer: I'm not sure if it was called Woden Valley or the Canberra Hospital at that stage when I arrived and um, that's when I met Jane, we're actually working in different areas. I'd decided I wanted to be a tissue pathologist or anatomical pathologist it was sometimes called. And at the time they had offered me a job in hematology, and I didn't actually realise that ‘til I arrived in Canberra.

[00:04:23] Richard Scolyer: But for me, it actually made a difference to my career. I'm not sure I would've stuck with it in the same way if it hadn't worked out like this. It was just through luck. We had this incredible head called Professor Peter Herdson, who was yeah, the head of what was called ACT Pathology, and he took us under our wings and inspired us to push our careers. And Jane and I worked closer and closer together over the subsequent, well, three or four years. And yeah, Jane has incredible skills and she'd done a PhD before she started doing Pathology. And there's not many people like this in the field. Perhaps a few more now than, than back then. And she's got amazing skills on how to do research. And I feel very fortunate that we crossed paths, and she was willing to put a hand out to teach me and to do research. And also, we pushed each other along to, to get great skills in tissue pathology. And I think that's really helped both of us and our colleagues at the time.

[00:05:58] Dr Sanjaya Senanayake: And it's wonderful that you've maintained that friendship over the decades as well.

[00:06:04] Jane Dahlstrom: The wonderful thing about medicine is that you have, it's a great basic degree, and then it's what you do with it. And so, we've met in terms of being examiners for our college or on various committees or we've been involved in both lecturing at scientific meetings and, we've even published together. So, it's been a real wonderful journey to have had such a great colleague to really be able to connect with over such a long time, even though we haven't lived in the same jurisdiction for probably, I don't know, is it 30 years now? 20 years?

[00:06:43] Richard Scolyer: Probably, yeah, pushing up to 30. But yeah, you know, Jane had a lot of skills that I didn't have and had experience, and it changed my life. And I don't think I've had the same impact on Jane as what she's had on me. She had skills I didn't have and very kindly supported and encouraged me to, to push down various fields.

[00:07:05] Richard Scolyer: So, yeah, I can just take my hat off to her, admire her, and I can never thank her enough for what she's done and, and become a dear friend and close colleague over decades.

[00:07:18] Dr Sanjaya Senanayake: And, Jane, you actually, as Richard was saying, you came into pathology training, having before or having had a PhD from the John School of Medical Research.

[00:07:30] Jane Dahlstrom: Yeah, so I actually came to Canberra in 1985 and as a junior doctor with a young family of four. Yes, that's right. And what happened was that I did my junior doctor years, and I actually had two of the consultants, really make an effort to mentor me. I didn't really know what I wanted to do, but I had this desire – I love answering questions and I, I really wanted to do some research, but I couldn't think about how I'd do it. And there was an academic surgeon called Dharam. Pal Dhall, and a general practitioner called Linda Welby, and both of them said the same thing. You know, you've got a wonderful research institution across the river – I was at Woden Valley Hospital then – in John Curtin School. Why don't you go and have a chat to some of the academics there? And there's a quite a few clinical academics over there at the time. One in particular, Neville Ardlie, and it was actually through the encouragement of the doctors here at Woden Hospital, now Canberra Health Services, that I actually did my research and then I continued to work part-time in casualty and also in ICU while I was doing my PhD.

[00:08:48] Jane Dahlstrom: So, it supplemented my income a bit, which was great. And then it was, while I was doing my PhD, I met some pathologists and I knew that that was the career for me. So that's how I actually started my journey into pathology.

[00:09:05] Dr Sanjaya Senanayake: And again, that was my question. I always, I tend to ask our guests why they've veered into a certain career in medicine.

[00:09:12] Dr Sanjaya Senanayake: So, Jane has told us about her reasons. Richard, what sent you to pathology? Why didn't you become a surgeon, a GP, physician, an ophthalmologist. What was it about pathology that attracted you?

[00:09:22] Richard Scolyer: It took me pretty… a while to figure that out. So, I think I did for four or five years of clinical work before I went into pathology, but we had incredible teachers in pathology at the University of Tasmania where I went to medical school and they inspired me. And in fact, I think at that time the percentage of medical students that went into pathology from Tasmanian Medical School was higher than any other part in the country. And I think that reflects the great teaching and inspiration that they provided. So anyway, it was some years, but every term that I went to in clinical medicine, I was going to be an emergency medicine physician and an internal medicine physician, paediatrician, all these things.

[00:10:15] Richard Scolyer: But yeah, in the end I actually met a pathologist called Bastiaan de Boer in Adelaide, and he was saying what a great career it was, and I remembered that from medical school. So, I was at overseas actually at the time, and one of my uncles was living in Canberra and, sent me over an application and that was how it turned out, fortuitously for me that I got to Canberra and got inspired by Jane and others.

[00:10:45] Dr Sanjaya Senanayake: Wonderful. Now, look, it's a bit, well, a little bit like my path, I was veering into various subspecialties until I hit on infectious diseases and sometimes it can backfire when you find an inspiring figure because they're so inspiring you think ‘I want to be like them’. But then, and there was a neurosurgeon I was very inspired by, and I was, I even started studying for my surgical primaries, but then I realised I was really clumsy, and you can't drop brains and things. So, that's not a good idea. So, I finally found what I was suited for.

[00:11:19] Dr Sanjaya Senanayake: And now Richard: we can't of course, interview you without talking about the amazing couple of years you've had, and I think most people listening to this will have a fair idea of what happened. But we'll just start with the, the co-director… being co-director of the Melanoma Institute.

[00:11:40] Dr Sanjaya Senanayake: How did you step into that role? Because that's not something a pathologist necessarily thinks: I'm going to be a co-director of the Melanoma Institute. What was it about melanomas that fascinated you and made you take on that position?

[00:11:53] Richard Scolyer: Well, I think at the Royal Prince Alfred Hospital where I still work, I moved here in 1998 after leaving the Canberra Hospital, there was what was called the Sydney Melanoma Unit was part of the hospital and it's the largest melanoma treatment and research centre in the world. So, there was a lot of opportunities then that my mentor here was a guy called Stan McCarthy, ultimately Professor Stan McCarthy. And he and I got on well, and I guess he'd liked the knowledge that I'd acquired in Canberra from Jane and the other great team of specialists who gave us great teaching that he wanted me to be close to him and work closely with him. And he was sent thousands of cases from around the world each year. So, I got involved in that. And then when I got a job as a staff specialist, there was this, you know, this idea that, well, that I would be following in his footsteps.

[00:12:55] Richard Scolyer: And then within about two weeks of me starting, he went on holidays and I had hundreds of consultation cases coming in that no one else in the department could deal with. So, it made me learn pretty quick smart. Um, to learn about the challenges in melanoma pathology and, how to sort them out. Anyway, for the cases where I didn't know the answer, I just held onto them ‘til he got back from leave and, we signed them out together. But anyway, that's how it all got started for me. And then I learned a lot about pathology, started doing research in that area because there's so many opportunities.

[00:13:37] Richard Scolyer: We had a large database, we had great cases. There was many cases that we struggled to make a diagnosis. We found that 5% of patients who were referred to the Melanoma Institute who were given a diagnosis of melanoma, didn't in fact have melanoma. So, we needed to make a difference. And prevention's, obviously, number one, and early detection is really important because most people will be cured, but once it had spread around your body, back then most people would, would die within a year. And, yeah, five years survival rates were less than 5%. So, you know, there's a lot of opportunities to do research with a great database. I guess I was involved and principally leading the melanoma tumour bank and that provided a lot of opportunities to do world first research and team up with people. So yeah, there's a lot of opportunities to make a difference and use the research skills that Jane had had initially taught me, to get more and more into that.

[00:14:45] Richard Scolyer: And that's how, yeah, it all started. And then ultimately, I guess given my knowledge, expertise and, camaraderie, or maybe that's not the right word, but, leadership in the field and respect people had for me to become the head of a unit that's the Sydney Melanoma Unit was called and then it became Melanoma Institute Australia. So, it was 1st of January, 2017, that Georgina and I took over, as the head from a surgeon called John Thompson who'd mentored me and, yeah, had a great team of people who were passionate about doing things. You work together and you can make a big difference.

[00:15:29] Dr Sanjaya Senanayake: Of course, by 2017, immunotherapy had become established so I think that 5% or less than 5%, five year survival had become around 55%, which is, I guess not brilliant, but is a heck of a lot better than what it was.

[00:15:47] Richard Scolyer: Well it is now, but back then it wasn't. Yeah, it definitely improved with the instigation of, first of all targeted therapy in about 2010, and then subsequently immunotherapy. So, you know, things that improved greatly. But yeah, up to the level that you just mentioned is about where we're at now, and that's, continued to keep getting better over the last, whatever it is, seven or eight years since we took over as the heads.

[00:16:16] Richard Scolyer: But the messages for the community are prevention is better than cure, so follow the SunSmart rules. Early diagnosis of melanoma: most people are cured. So more than 95% of people, if you've recognised your melanoma early, so something new or changing on your skin, go and see your doctor so it can get taken out. And then, unfortunately for, about 5% of patients melanoma spreads around the body. And up until 10 or 15 years ago, all of those, nearly all of those patients would die. But we're now curing more than 50% and, we're aiming to get to zero deaths from melanoma. So, we've still got some more work to do.

[00:16:56] Dr Sanjaya Senanayake: Oh, no, that's fantastic. And I'm sure the Institute will keep up its amazing work. And of course, Richard, last couple of years have been tough for you. You were diagnosed with a glioblastoma and, I believe it happened while you were at a conference in Poland, wasn't it? Of all, all places that the diagnosis was raised as an issue?

[00:17:20] Richard Scolyer: Yeah, that's exactly right. I was incredibly fortunate. My wife was with me. In truth, I probably travel overseas maybe 10 or 12 times every year to present lectures and things. And, the reason I went to Poland was a good friend of mine who works at Harvard, who'd gone to medical school in Poland, had put on a series of courses and he always wanted me to lecture at them. And for the last hurrah he wanted to put one on in Poland.

[00:17:49] Richard Scolyer: So yeah, we went over there and, you know, and I think it was the day after I'd done a days-long series of lectures that we climbed some mountains and then had a seizure and turned out to be, I had a glioblastoma and yeah, unfortunately it was the worst of the worst subtype of glioblastoma and average survival, 12 months; average time to recurrence, six months. And the treatment path that I went down where I didn't receive the normal chemotherapy that's given as part of treatment, Temozolomide, the survival for the subtype I've got drops in half. So yeah, six months was the median survival and three months to recurrence, so I feel pretty lucky that I'm still here and able to have a chat that I think I'm a bit over 20 months out now.

[00:18:45] Dr Sanjaya Senanayake: Look, you look great, and I'm so happy that you've had this part of your journey has been successful. So, it's wonderful and inspiring as well.

[00:18:56] Richard Scolyer: Sanjaya can I just say, because it's really important to you know, spread this idea or to make it clear that I am one patient. We've generated some science from my tumour that's, about to be published in Nature Medicine, but to actually prove whether or not the treatment I've had works, it must be done in a clinical trial. So that's the next step. But, you know, there's hope based on the fact I'm still here in the science that's come out, but it really doesn't prove it until you do a clinical trial.

[00:19:33] Dr Sanjaya Senanayake: That’s right. N equals one. Exactly. And look, Jane, I'll just bring you in as well as, as you know, many of our listeners have got health care backgrounds, but not everyone does. And one thing, in fact, very close relative of mine who was diagnosed with prostate cancer is very well educated, but no medical background was surprised when he realised that the cancer in the prostate cancer wasn't the same as the cancer in the breast cancer.

[00:20:03] Dr Sanjaya Senanayake: There's a lot of people actually think that, because we talk about, I guess as a community, we talk about the big C cancer, the cure for cancer. A lot of people think it's, it's one process, but though there are similarities, they are different. So, Jane, just as a professor of pathology, do you mind just giving us some basics about what's similar about… what cancers have in common and say how a melanoma and a glioblastoma are different?

[00:20:32] Jane Dahlstrom: Richard would be the expert about melanomas and glioblastomas being different. But look, just in general principles, when we talk about a cancer, we are talking about a neoplasm and it's undergone, a bunch of changes at the molecular level. And, whilst even something can look similar at a molecular level, it can be quite different. And that actually results in differences in the way it behaves and the treatments it responds to. Um, so it is cells that have mutated in ways and for some people there's an inherited risk, but for many people it's something environmental and probably a combination of the two.

[00:21:21] Jane Dahlstrom: I don't know, Richard, if you'd like to elucidate a bit more because obviously it's a question you must get asked all the time with the research that you've been doing and also the treatment modality that you've chosen.

[00:21:35] Richard Scolyer: No, I think you've summarised it really well, Jane. Um, for most cancers, we don't know what causes them. Skin cancer is the obvious one where we do know it's caused by ultraviolet radiation. So, we need to push that messaging out to all Australians to, try and avoid the sun in the middle of the day and follow the SunSmart rules. But yeah, there's some cancers that we know causes a smaller percentage of the cases… there's causes, for a smaller percentage of the cases, but many of them we still don't know.

[00:22:12] Richard Scolyer: Um, yeah, and they're all so different. They progress in a different manner. They respond differently for different treatments and, occur at different times of people's lives. So there, yeah, hundreds of different types of cancer and it's getting more and more complex the more we learn about the molecular makeup of and pathogenesis of cancers.

[00:22:37] Dr Sanjaya Senanayake: Look, you've been Australian of the Year with your colleague, professor Georgina Long. Tell me what that was like as an experience. What's it like to be Australian of the Year? What did you get to do? Who did you meet? What did you enjoy most?

[00:22:53] Richard Scolyer: Ah, gee! We could talk all day on the podcast, but first of all, it's an award that was not just for Georgina and I, it was for the team of people that we lead and the things that have been done to make a difference. And I guess as the heads of the Melanoma Institute was why we got this honour. I'd hate to be a judge of it: you meet the others, state winners and in New South Wales, the New South Wales finalists and they're incredible and they work in so many different fields. It's, yeah, just blows your mind, makes you very proud to be Australian, that there's so many people doing incredible things to help our community.

[00:23:35] Richard Scolyer: Um, but being awarded this, it's a great opportunity to spread the word and what's important for us, as we've already discussed, melanoma and skin cancer are major problems for our country. We have the highest incidence of melanoma in the world. It's the second most common cancer in men, and third most common in women.

[00:23:59] Richard Scolyer: It's caused by sun exposure in more than 95% of cases. And so, we get one Australian diagnosed every 30 minutes. And, despite these breakthroughs in treatment, still one Australian dies every six hours. So, we've still got work to do to get to our goal of zero deaths from melanoma. So, this has been a great opportunity, particularly to sell the, well not sell, but to educate people about prevention is better than cure and the importance of early detection. And you also mentioned, who do you get to meet? God, it's been amazing. I've been to places I'd never thought I'd get to. In fact, you must know as a physician, there's this meeting called ASCO, where there's like 50,000 people in Chicago where they have it each year. And I was supposed to be doing a lecture there and then an opportunity came to go out to Western Queensland to visit a tiny little town where there's a dinosaur museum that one of the Local Hero Australian of the Year had set up. So yeah. I went out there instead and it was just wonderful yeah, meeting amazing Australians and seeing parts of Australia that I'd never been to before, just, yeah, it's been fantastic.

[00:25:16] Dr Sanjaya Senanayake: And of course, now you've handed, I guess, handed the torch over. You and Georgina have handed the torch over to Neil Danaher. I saw photos from the 2025 Australia Day Awards, I think you, with Mark Taylor and Neil Danaher. Now, what is Tubby Taylor doing in that photo?

[00:25:34] Richard Scolyer: Well, Mark Taylor was actually Australian of the Year, so it was a real privilege to meet him and, well, that photo was taken actually before it was announced that Neil Danaher was the Australian of the Year, and he's incredible guy. Like I remember as a kid, Aussie rules football was my passion. And, to see him playing, he became captain of Essendon at a young age. He was a great player. He subsequently went on to become coach of Melbourne and yeah, did really well.

[00:26:09] Richard Scolyer: But now that he's got motor neurone disease, this nasty progressive neurological disease, I guess there's a similarity with me, too, to have a neurological disease, but for him to do what he's done to raise awareness and raise incredible amount of funding. I think they said something like $115 million to do research to try and improve outcomes for patients with this disease and understand its pathogenesis in a better way, to try and make things happen. So, I can't take my hat off more to him and to see him in person and to have interactions with him were, yeah, were a great honour and yeah, thrilled to see him as the next Australian of the Year.

[00:26:57] Dr Sanjaya Senanayake: And I'm, I'm sure he'll carry himself well and continue that, that wonderful advocacy that he's been performing for so many years.

[00:27:07] Dr Sanjaya Senanayake: Now we are coming to the end and I want to raise the issue of retirement. So, Jane, you are sort of kind of retired, but now those of you who can't see Jane because it's a podcast and haven't met her, if you're thinking of retirement, some little old lady hunched over playing bingo and going down to the club to play with the pokies that is not Jane Dahlstrom… sort of energetic, vibrant person in front of me. And I just want to touch on the opportunities medicine gives you so that if you do decide to pull the plug on one aspect of your work, that you can do others. So maybe, Jane, do you want to talk about it? Because it sounds like you're doing a heck of a lot of stuff even though you are officially retired.

[00:27:59] Jane Dahlstrom: Yes. Um, I think medicine's a great basic degree, and then it's what you do with it. And I think one of the fortunate things I had by having my career pretty much entirely within the Canberra Health Services, has been that I have had lots of opportunities to do other things, to get involved in education through the various roles I had with the ANU School of Medicine and Psychology, to get involved with my own professional college as an examiner and involved in various committees and also with the research that I've been involved with, and then the outreach work that we talked about before with Richard.

[00:28:50] Jane Dahlstrom: And what happens is with all of those different opportunities, then comes other opportunities. And so, growing out of the opportunities that I've had in education and leadership with various roles was then the opportunity to take on more recently the Chair of the Medical School's Accreditation Committee with the Australian Medical Council and other opportunities, such as being on editorial boards of journals and so forth. So, I think life is what you make of it. And whilst I may have made the decision to finish my active clinical role, many of the other interests I have are continuing. I mean, I essentially decided to retire for family reasons.

[00:29:40] Jane Dahlstrom: I wanted to commit more time to my mother and my grandchildren, and, have more capacity, I think just to do the things that give me great joy. And, I mean, medicine is such an amazing career and I can't imagine ever, not having some active role in some way that I actually can draw on, and perhaps it will not be directly in medicine, but perhaps some other community work. Like what we see with so many wonderful Australians and, like what we've seen recently with the Australian of the Year Awards.

[00:30:21] Dr Sanjaya Senanayake: As you say, medicine gives you the opportunity to put your finger in so many pies and help the community in so many ways. And I'm glad that you are continuing to do all these things and both of you, as I said, are so remarkable.

[00:30:38] Dr Sanjaya Senanayake: But another remarkable thing is that you were given the Jane Dahlstrom Lecture Oration at the ANU annual lecture. Look, I have the Sanjaya Senanayake memorial lecture, which is basically something I just name myself for a fourth-year lecture on febrile travellers, but you of course have an official lecture oration named after you, which is wonderful and very deserving. And of course, who was the inaugural speaker for the Jane Dahlstrom Lecture Oration at the ANU?

[00:31:15] Jane Dahlstrom: Of course. My wonderful colleague, Professor Richard Scolyer. When I was asked who I would like to invite if they were available, the first person I thought of was Richard. And he was wonderful as always in terms of promoting pathology, promoting the importance of what we do, giving back to the community every day. And also, just revealing just the extent of the kind of research that's happening in the area of melanoma which hopefully people found very encouraging. I'm sure they did. In fact, the feedback I got was that, it was a fabulous lecture, Richard. So, thank you.

[00:31:59] Dr Sanjaya Senanayake: Professor Richard Scoyler, Professor Jane Dahlstrom. It's been a pleasure talking about your wonderful careers and your wonderful friendship that started off in in Canberra and has benefited so many people. So, thank you for being on the podcast.

[00:32:15] Richard Scolyer: Sanjaya, that's our pleasure. Can I just add one thing as we sign off and that's to the people who are listening to us.

[00:32:27] Richard Scolyer: One thing that I said at the, I think it might've been at the National Press Club, but it's for young people who are launching their careers: think big, be bold, be courageous and work together with a team of people, and doing this as a community, you will achieve great things. So don't let fear hold any of us back.

[00:32:53] Dr Sanjaya Senanayake: Wonderful words, wonderful advice that's timeless, I believe so, thank you so much, Richard.

[00:33:06] Dr Sanjaya Senanayake: Thank you for listening. I hope you'll join us behind the curtain for our next episode where we'll delve into the story of another of our fantastic health professionals here at Canberra Health Services. If you're interested in starting an exciting career with us, head to our website to join Team CHS, and that website is www.canberrahealthservices.act.gov.au/careers.

[00:33:57] Dr Sanjaya Senanayake: I acknowledge the Ngunnawal People as traditional custodians of the ACT, the land I’m recording on, and recognise any other people or families with connection to the lands of the ACT and region.