Kevin Packham is a tall, lean 63-year-old who loves to throw his golf clubs into his car and head to a local course to play a round.
It's one of the few pleasures he has left, after undergoing radical surgery to remove tumours from his abdomen.
"I can't jog, I can't run, I can't play football anymore," he told SBS News.
"I have no spleen, two parts of my colon were taken out. The doctors shaved the diaphragm, a bit from the liver and peritoneum."
Kevin Packham recovering after mesothelioma surgery. Source: Supplied / Kevin Packham
His type of mesothelioma is rare — so rare that it's detected in only a few hundred people each year in Australia.
"I was diagnosed with peritoneal mesothelioma, which means that at some stage I ingested asbestos," he said.
Peritoneal mesothelioma affects the peritoneum, a membrane lining the abdominal cavity and organs, including the liver and intestines. As with other types of mesothelioma, peritoneal mesothelioma is related to prior asbestos exposure.
Cost of mesothelioma in Australia. Source: SBS News / Leon Wang
He told SBS that learning of his condition — and its poor prognosis — was the worst moment of his life. The average survival period is 12 to 18 months.
"It's not easy, and I won't forget that morning when the gastroenterologist told me the diagnosis. You go into panic mode thinking 'I can't leave my wife, my kids, my grandkids'," he said.
What followed was nine hours of surgery, and a month in hospital learning to walk again.
What does surgery involve?
"They say it's probably the toughest surgery that you can have," he said. "It's called a full cytoreduction."
Complete cytoreduction is used to remove cancer in the body. In Packham's case it required a large cut to the abdomen.
During the operation, surgeons found the tumours had reached stage three — far more advanced than first thought.
Kevin Packham had to learn to walk again after his surgery. Source: Supplied / Kevin Packham
All through the ordeal, his wife Jo, 57, was by his side.
"I gave him a card that said: 'You won't walk this journey alone'," she said.
"We were together side by side, hand in hand. And everything that he went through, I was right there with him."
Kevin said: "Without the amazing support of my family and the medical team, I wouldn't be here today."
Kevin Packham's wife Jo remained by his side. Source: SBS News / Spencer Austad
What is mesothelioma?
Mesothelioma is a highly aggressive type of cancer caused by exposure to the carcinogen asbestos, and most often affects the lining of the lungs.
Patient survival rates are usually very poor, according to Australia's Asbestos and Dust Diseases Research Institute (ADDRI).
Dr Anthony Linton from ADDRI. Source: SBS News / Spencer Austad
"Unfortunately, for the majority of patients with mesothelioma, we don't identify their disease until it is already very well established."
Australian reported cases of mesothelioma. Source: SBS News / Leon Wang
There's hope on the horizon
At a lab in Sydney's west, Linton and his team are working on detecting mesothelioma early before it has spread too far, by analysing blood samples using a process similar to the COVID-19 PCR tests.
A PCR is a medical test using the polymerase chain reaction technique, to detect small quantities of DNA specific to a disease-causing organism in blood or other body fluids.
"The PCR has many applications over many years," Linton said.
A mesothelioma test being demonstrated at the ADDRI lab. Source: SBS News / Spencer Austad
"We have identified a number of candidate genetic markers that offer hope that they may be able to be used to diagnose patients with mesothelioma as an adjunct to, or instead of the diagnostic surgical procedures."
How wide-reaching could these tests be?
The tests could eventually be used to target high-risk groups in a range of settings, according to ADDRI scientific researcher Ben Johnson.
"The hope is that we can apply this technique in the clinical setting to diagnose asbestos-exposed individuals at an earlier stage," Johnson said.
"We could then establish pop-up clinics in areas that are known to have a history of asbestos use so that we could target individuals that are likely to be at high risk of developing mesothelioma.
"Patient survival outcomes are likely to be significantly improved if treatments can be administered earlier."
ADDRI research scientist Ben Johnson. Source: SBS News / Spencer Austad
"So many of our patients who were exposed as young men or young women are now being diagnosed at age 50, 60, 70 — many decades after their initial exposure," Linton said.
"Asbestos and asbestos-related diseases are really very much an Australian problem as a result of a long history of use of this material in many industries over many, many decades.
"As a result, we have a real obligation to do further research in this country."
Asbestos at risk occupations Source: SBS News / Leon Wang
When will the PCR tests be available?
Australian research is backed by the Biaggio Signorelli Foundation, which has so far donated more than $1 million.
Biaggio Signorelli migrated from Italy and became a successful businessman before dying in 2008 from mesothelioma.
His son Paul has set up a foundation in his father's memory to raise awareness of mesothelioma.
"I am passionate about this because many families have lost loved ones to asbestos disease," he said.
"So, my promise to my father and my promise to the foundation is to help find a cure, treatment and raise awareness for asbestos-related cancer."
Biaggio Signorelli migrated from Sicily. Source: Supplied / Biaggio Signorelli Foundation
Meanwhile, he says the ADDRI research is helping to support clinicians in Australia and worldwide.
"Asbestos has been banned in Australia for the last 20 years, but is still widely used throughout the world, particularly in Southeast Asia," he said.
"We are working very closely with governments there, assisting clinicians to better diagnose asbestos-related diseases, and working on legislation to eliminate of asbestos entirely."
Global Asbestos Exposure statistics. Source: SBS News / Leon Wang
The future for Kevin Packham
Packham hopes that earlier diagnostic testing will one day help to reduce the 90,000 lives lost globally each year from asbestos-related diseases.
"If I had an early diagnosis, it would've changed things dramatically for me. The operation may have potentially been a lot less radical," he said.
Packham is making the most of time with his family and plans to travel to France and Africa later this year.
"Every day is a blessing, and we appreciate every birthday Kevin gets to celebrate," his wife Jo said.
Kevin Packham and his wife Jo love to travel. Source: Supplied / Kevin Packham
"There's not a day goes by that I don't think about the cancer, it doesn't go away," he said.
But at this stage he remains well, and wants to be an inspiration to others.
"I hope so. I hope to be a role model for a very long time," he said.
World Cancer Day is marked on Sunday 4 February.
