IT IS NOT necessarily always death that is the scariest part, but the thought of leaving loved ones behind.

A terminal cancer diagnosis is in all ways devastating and each patient will be cope with the news in different ways.

Some are able to maintain a sense of optimism even in the darkest of hours, looking to a future where others are spared the same fate.

Even if it is too late to save his life, an inspiring Alva man last week hailed the approval of a treatment for advanced kidney cancer, hoping it will spare other families from heartache.

Paul Dornan, 60, maintains a positive outlook despite receiving palliative care and opened up to the Advertiser about his diagnosis after the treatment was approved in Scotland in what is a world first.

He welcomed an announcement that the Scottish Medicines Consortium has accepted use of cabozantinib (Cabometyx) in combination with nivolumab (Opdivo) as a first-line treatment.

More than 1,000 people are diagnosed with kidney carcinoma in Scotland each year, with no one cancer the same.

For Paul – who was told by doctors 18 months ago he only has a year to live – the important thing is that clinicians are becoming equipped with yet another tool in the fight against the disease.

Father of three and granddad of two, with another addition to the family scheduled to arrive any moment, Paul is also raising awareness of the importance of an early diagnosis.

Since it was discovered he has chromophobe advanced renal cell carcinoma – a rare type of kidney cancer – more than four years ago, the Alva man has also been hoping to shatter stigmas to encourage men not to ignore early signs.

Paul went under the knife soon after the discovery but continued to suffer from secondary cancers.

He told the Advertiser: "Every patient has their own cancer, it's specific to their DNA and sometimes the drugs work, sometimes they don't.

"You've got to keep on finding new treatments and new drugs that come through and give more and more people the opportunity to recover."

With Cancer Research UK forecasting that one in two people will develop cancer at some point in their lives, the subject is important for Paul.

He added: "They expect this particular drug combination to help 230 patients in Scotland per year, which is really good.

"But you've got to remember, those 230 patients – they are the individuals – you've got to think of their families, their friends, their workmates and all these other people cancer affects.

"So, it's not 230, it's hundreds or maybe even a thousand."

Indeed, a diagnosis for an individual can send ripples across their circles of loved ones.

Paul said: "I understand what's happening to me and I've come to terms with it.

"But it's very difficult for all of those people who are in your circle of friends and family to cope with that because they are helpless.

"Every drug that comes along, every patient that is benefited by these new drugs – it has a long-long list of other people who are also benefitting from it."

Paul's cancers are advanced and he has been dealt a bad hand.

If a fairly rare kidney cancer was not enough, he also developed a brain tumour so rare he only found one other person in the world in the same boat: a woman in California.

The Alva man has undergone a whole range of treatments, including clinical trials. Yet, he remains positive and cheerful, feeling lucky that he has a close and supportive family around him.

Paul added: "I was given about four years four-and-a-half years ago. Then last year when they found these brain tumours I was told, realistically, 6-12 months – here we are, 18 months later."

He was not prepared to just sit down with his head in his hands and is currently able to live a full life, even if there are "moments that are not very pleasant".

It was his wife Angela who insisted he goes to see the doctor after he discovered a tiny bit of blood in his urine.

He had other symptoms before that and reckons he could have been cured had he visited the GP then.

The 60-year-old said: "If you think you've got something wrong, go to the doctor.

"The doctor will always rather tell you: 'it's no problem, you are fit and healthy' than tell you: 'why didn't you come here six months ago with this – it's too late'."

Paul agrees the decision to recommend cabozantinib in combination with nivolumab – a move welcomed by biopharmaceutical company Ipsen – puts Scotland at the forefront of cancer care.

He was on a similar combination treatment last year and while it has not worked for him, he knows others who have responded extremely well.

Paul added: "The more drugs that are put into the armoury for the oncologists, doctors and clinicians to fight this and give people the best chance they can [the better] – it's so-so important."