March 18th 2019
Tomorrow I find out the verdict on my latest scan.
Crucially this is going to tell me whether the radiotherapy I had in the autumn has worked or not.
If it has worked then I may yet have a chance of getting rid of the inoperable cancer in my pelvis. However, for reasons I’ll explain later I’m fairly sure that this is not going to be an option. Don’t despair though as I have already put plan B into action and plans C and D are not far behind!
First though I feel like I need to recap because I’ve not written about my most recent treatment; the pelvic radiotherapy.
Radiotherapy was first mooted as a treatment for me right after my surgery 21 months ago.
I remember being woken up by the surgeons telling me the operation had been a success and they had removed all the cancer. It had been a close shave though both figuratively and literally. They had actually shaved the cancer off the iliac vein in my pelvis. The euphoria of still being alive made me grin insanely for days despite the post-operative discomfort.
I felt like I’d won the world. Later once the pathology report came back, I learnt that what they anachronistically term ‘a positive margin’ meant there was a high chance the cancer would grow back. That is anything but positive.
Never mind though, because the chemotherapy would mop up the cells left over and then radiotherapy would disinfect my pelvic area.
But after 3 months of chemo they discovered metastatic cancer in my lungs and that necessitated another 6 months of even harder chemotherapy.
The potentially compromised pelvic area was side-lined in the face of the known cancer. After 10 months the window for post-operative radiotherapy had passed and I didn’t argue this because it was a relief not to have that ordeal to contend with.
But all this time despite the onslaught of chemo those little bastardy cells that weren’t quite shaved close enough were still there and dividing. And last September, 15 months after my surgery, I found out that they had grown back. They had always been there at a microscopic level but it was only now they were big enough to appear on the resolution of scans. My oncologist told me there were two inoperable lesions in my pelvis; 8mm and 15mm. Specifically, in an area called the “peri-rectal fat”. Not very pretty sounding. Deep inside my pelvis nestled in between my rectum and my ovaries I have fat and it has got cancer.
So now I have the incurable metastasis in my lungs and the inoperable recurrence in my pelvis. And I’m fat inside. Dark days.
So onto the radiotherapy. I was to get the book thrown at me. A lifetime’s dose of radiotherapy aimed at my pelvis. My oncologist told me there was a 10% chance that this could get rid of the cancer down there completely. I am cocky enough to think I might just be in that ten per cent. My story has to have a good ending, right?
In October I started 5 weeks of radiotherapy. This is what I did for every weekday for five weeks:
Amazingly the whole experience is less than 2 minutes. The machine whirs round me for 50 seconds one way and then 45 seconds the other while the tinny radio plays in the background. It shoots out invisible photon beams from different angles that theoretically converge at the targets in my pelvis and “obliterate” them.
Each day I arrive half an hour before my appointment and I am told to do a pee then drink 3 cups of water. Apparently, this is so my bladder and the rest of my pelvic organs are roughly in the same position every time they get nuked. I try to quell my sceptical thoughts but really you have to wonder how scientific is this?
I lie back on the slab and pull my pants down. From once being terribly body shy, I’m now pretty inured to strangers having full frontal view. I could probably get a job in an Amsterdam window.
Sometimes the radiographers poke and prod me into the right position. But others they don’t. Maybe I’ve managed to lie down perfectly first time. Or maybe they are running late for their 12-minute slot. Sometimes they x-ray me to make sure my organs are still in the right position. Sometimes they don’t.
I lie back and listen to the music as the big magnets circle around me nuking my insides. It is remarkable how quickly this has become normal.
I can’t see or feel a thing, which is alarming. It begs the question is this actually doing anything? Or – what else might be nuking us in our environment without us realising?
One day I thought the machine sounded a bit more clackety than usual. I put it down to my ever-present neurosis.
The next day the machine was broken and I was in a different treatment room for two days.
I’m finding it difficult to believe in my treatment wholeheartedly and I’m deeply worried about it. I can see so many ways that this is not ideal. For a start the planning was done weeks if not months prior. They mapped out the inside of my body based on one image. But your bowels are a mobile organ and move around every time they digest something. So what are the chances that they are still lined up accurately to the millimetre?
I wonder if I should be trying to banish these suspicious thoughts. Of course they are going to be doing their job to the top of their ability to every patient every day.
But it is a production line for better or worse. There are 6 treatment rooms working from 0815 in the morning till 1830 in the evening. Each patient has a 12-minute slot and at peak production rate there could be 500 people processed a day.
There are all different types of cancers being nuked. It’s like a box of chocolates. You never know what you’re going to get. Many people are getting pelvic radiotherapy like me; I’ve met prostate, bladder, cervical, ovarian and womb cancers. There is a lot of chat amongst this cohort about bowel movements. Some people are hospitalized because of the side effects of the treatment. But I seem to be faring a lot better than most in terms of side effects. I hope it is working.
Everyone I see is older than me. Once an old man nearly made me cry as he berated his misfortune in getting cancer. I wasn’t upset for him though, I wanted to say to him: “You are lucky! You have had a long life!!” Another lady did make me cry when she told me how she had watched her daughter die of cancer just months before she herself was diagnosed with advanced cancer. The Beatson’s corridors are a sad place to spend time in.
Fast forward 4 months and I am on the eve of finding out whether it has all worked. My scan was last week and on Thursday I was discussed by the colorectal experts at the multi-disciplinary meeting. Tomorrow my oncologist will tell me the verdict. Only I have been a bit sneaky. I went to my GP on Friday and got a copy of the scan report.
I’ve been sitting on this news all weekend because I didn’t want to wreck it for everyone around me. Because it is not good news at all. But like I said I have a plan B and a plan C and even a plan D. And I’ll tell you about these in my next blogs. Meanwhile I am feeling well and certainly don’t feel like I’ve got incurable cancer.