When Paul Spiteri Lucas received a phone call from Mater Dei at 5.30am telling him to go to hospital, he knew his wife Emanda had passed away.

Paul drove to hospital with his son, Sam, aged six. 

“Mummy is now with the angels,” Paul told his son as the two hugged her and said goodbye. 

“That was the hardest part of the whole experience,” says Paul.

Emanda died in August, aged, 35, after a three-year battle with melanoma.

The 41-year old has shared his story to raise awareness about melanoma – skin cancer that can be caused by sun exposure – to ensure “others don’t go through what we went through”.

His message is for people to protect themselves and their children from the sun by wearing sun protection and staying out of the sun during strong hours and to check any skin irregularities immediately.  

Paul and Emanda met in Valletta – their home town for which they share a deep love. Photographs of the capital line a wall in the home they shared since they got married in June 2015 – after a grand proposal during the 2013 airshow when Paul dropped to his knees while the Red Arrows left a smoky trail in the shape of a heart. The couple had their son Sam in September 2018.

The Spiteri Lucas family at their favourite feast of St Paul in Valletta.

In 2021 a mole on Emanda’s right arm started playing up – it would occasionally bleed or ooze pus. Initially, she thought she might have hit it against something. She waited a couple of months before going to get it checked in April that year.

We used to tell Sam that mummy had a small injury

Her doctor referred her to hospital and it was removed the following day through a skin graft that involved removing the mole and a patch of skin around it.  

“The removed tissue was tested and, two days later, they called her in to hospital and we were told she had melanoma,” Paul says.

The mole on Emanda’s right arm started playing up in 2021

Doctors carried out further grafting in the same area to remove any other cancerous cells and Emanda started a year of immunotherapy pills. 

Meanwhile, she carried out regular PET scans and MRIs – approximately every three months - to monitor the cancer. 

After completing the year of immunotherapy all was quiet for about a year. But then, in April 2023, she started suffering from breathlessness. One day they were in Valletta and, by the time they walked from City Gate to St George’s Square, she was struggling to breathe.

She went to the health centre while Paul took their son home. Doctors told her to go to hospital as she had water in her lungs. 

In hospital, scans showed a tumour behind her right lung, close to the heart. It was leading to the liquid build-up. It had grown in the time between the scheduled three-month check-ups.

She underwent two procedures: one to remove the water and the other to attach an indwelling pleural catheter (IPC) – a tube placed into the chest to remove fluid from around the lungs. 

She started a new course of immunotherapy and Paul helped her drain the liquid from her lungs through the tube at home. 

This went on for about a year. 

“Sam was four years old. We used to tell him that mummy has a small injury, that she cannot play certain games or swim,” Paul recalls.

This lasted until October last year – when the tumour shrank to the point that it stopped causing liquid to build up in the lungs. The tube was removed. The treatment had worked on that tumour. 

She didn’t speak up so as not to worry us

Saying goodbye

But the bad news kept coming in and after further scans in November 2023, they were called in again. This time they were told she had three spots in the brain.

The couple went to London in December for targeted radio treatment called a gamma knife and flew back to Malta on Christmas Eve to be with their son. In January she started a new form of immunotherapy that involved taking €10,800 worth of pills a month, provided with support of the Malta Community Chest Fund.

Scans carried out in May showed that the chest tumour had practically disappeared but the spots in her brain were increasing in size. The plan was to return to the UK.

In August, follow-up scans showed “multiple spots” in her brain. Emanda was to start radiotherapy and then chemotherapy. 

Meanwhile, she started suffering from strong headaches. Paul recalls the last hours in detail.

“The Thursday before she died, she left work early to rest. She spent Friday resting and by the evening she was feeling nauseous. On Saturday morning we went to hospital. Scans showed there was pressure in her head and she was given medication to control nausea and another to help reduce inflammation in the brain.

“By 1.30pm she was no longer in pain, but she was tired. I left and went to pick up Sam while her father stayed with her. At about 4pm we returned with a smoothie. She was tired but otherwise okay. 

“I left at about 7pm to take Sam home and settle him. Our parents left as well. At about 8.45pm we called her – she was having a shower and said she will call back…. At about 9.30pm we video-called her to tell her goodnight.

“At about 5.30am I received the call telling me to go to hospital because she was in a bad state,” he recalls.

Emanda suspected she would never experience her son's first Holy Communion.

When Paul and Sam arrived at Mater Dei Hospital Emenda was already dead.

“It looked like she was asleep. After about 10 minutes I asked people to leave and took Sam in.

“He didn’t exactly realise what was happening. I told him everything. 

He saw her and he hugged her. It was the most difficult part,” says Paul, wiping tears: “I wanted to give him closure”. 

Looking back at those difficult months, Paul thanks everyone for the immense support he got and is still getting from family, colleagues, friends and even Sam’s school.

“The thing with Emanda was that she could withstand pain. She did not speak up so as not to worry us. I think she used to hide things from us. Now I know that, she spoke to certain friends. A friend later told me she knew she would not see Sam do his Holy Communion…

“After we left hospital on the day she died we went to my brother’s house. Sam asked me if mummy was coming. I reminded him she was with the angels. Now he stopped asking if mummy is coming back. All we can do is remember her, see photos of her. I want to keep her memory alive,” he says.

Consultant clinical oncologist Kelly Mifsud Taliana, who was Emanda’s oncologist, joined Paul’s call for awareness and prevention: 

“Be aware of any moles that are new or have changed… speak as early as possible as the earlier we can detect and treat melanoma the better the outcome. Treatment in melanoma has improved significantly in the past years and we can treat more patients successfully. However, if we treat melanoma at an early stage the outcomes are much better,” she said.

Malta has seen a substantial rise in melanoma cases over the last few decades, averaging around 70 to 75 new cases annually. About one in eight patients diagnosed with melanoma do not survive the disease.