High Noon
This marks the end of 3 months of tests and consultations and the end of part one of my journaling of my life with cancer. It’s a bit of a tear jerker….
The classic 1952 western has a memorable theme featuring the line ‘I do not know what fate awaits me’. Gary Cooper’s marshal Will Kane watches the clock tick towards the 12 noon confrontation with his fate, in the form of Ian Macdonalds’s Frank Miller. My high noon came at 12 o’clock on Wednesday 6th September.
Three months after lump-gate at the end of May and after two months of tests, we headed into Musgrove Park hospital’s Beacon Centre to meet with the consultant oncologist who is going to direct my care.
Musgrove Park is a higgledy-piggledy mixture of buildings of various ages; with some original US Army World War Two buildings merging into modern buildings of many eras and an enormous building site on one side. The Beacon Centre is quite modern and I think post -dates reinforced autoclaved aerated concrete (there’s a temporal touchstone for future historians, 2023 – the year our public buildings fell down because we built them out of Wheatabix rather than those pesky expensive actual building materials) Good to know the roof won’t fall on my head.
Well, not the actual roof….
You know by now that I am a fan of the NHS people. Lovely reception staff sign me in and on the dot of 12 noon an HCA calls my name and in we go. I am weighed and measured, this will be happening regularly from now on. For the record, 66kg and 170cm. I finally meet my ‘named nurse’, actually they all have names and there are only two of them on the Colorectal team and I have spoken with both of them several times already. We go into the consulting room and meet the oncologist.
Prior to this meeting, I had been advised to write down all the questions I could think of and make sure that I asked them. I did write down questions and had every intention of asking them. I have never been swept away in an avalanche but in hindsight, this feels like a good description of how I felt later. At the time, it felt like I was in the room having a coherent adult conversation with other adults. Afterwards, the cold enveloping, sensation deadening sense of being buried under an avalanche of life-threatening information.
So, what did we learn?
All the tests have identified the type of cancer and where it is located. The oncologist has agreed a plan with all the other specialists. It has been complicated.
The good news is that cancer has not been found anywhere else. Just the anorectal area and the righthand side groin nodes. I am young (interesting description for a 59 year old?) and fit.
The not so good news. Actually, the bucket full of bad news is;
Surgery is unlikely as both cancer sites are difficult to work on. The anorectal area is too close to the outside and there really is nothing to remove without cutting my bottom off. Further inside and a section of the colon/intestine pipe can be removed and the two ends rejoined. The groin lymph nodes are surrounded by big veins and arteries and it is very hard to completely remove them; cancer is like bindweed, leave a bit behind and it will regrow. The plan is to reduce the tumours with systemic chemotherapy and then consider radiotherapy, if this works.
I understand this to be a control rather than elimination mission. Keep it in its box. Like the Northern Iraq no-fly zone to protect the Kurds from Saddam.
The cancer will probably try and breach the no-fly zone once the mission is over.
And….
The cancer is mucinous. Mucinous cancer may not respond to the chemotherapy. If the cancer gets into my liver, game over.
The question I needed to ask but didn’t need the answer to; ‘I am 60 on my next birthday, will I get to be 70?’
‘No’
I didn’t push any further on this timescale.
In Paddington Two, Mrs Bird says to the wicked Phoenix Buchanan (Hugh Grant’s finest role) ‘don’t bring a knife to a gun fight’
We don’t have the gun in this fight.
We also don’t have a white flag.
Will Kane beat the odds and Phoenix was locked up. And we have at least one very good knife wielder on our team.
Three months of chemotherapy starts on Monday 18th September. The drug is Xelox or Capox. Administered by a drip on day one, followed by a fortnight of tablets, then a week off and repeat three more times. Then a scan. By Christmas we will know if we have reduced the tumours or if the cancer has spread.
An update in real time; my named nurse has just called. This was a truly helpful call. Yes, the cancer is really quite serious and difficult to treat. But…because I am so young (they keep saying this!) and fit they are pulling in all the help they can to tackle it. They are treating me as a ‘pre-surgery’ patient, Neoadjuvant therapy. Reduce the tumours and then see if surgery is practical. Doctors in Bristol are also in the loop and people are looking at my DNA.
I am a planner. I like to be organised. I am getting things ready, and I mean exit ready. 48 hours on and I think I am still in a state of shock. At times I feel absolutely fine, last night I slept well and this morning I rode my bike. But I am very conscious that I have limited time, how much, we don’t know. I want to tie up loose ends. I am also working on the future, our building project and buying a telescope for bird watching. I think a 70th birthday party would be rather cool.
A tough and uncertain time is coming.
But unlike Marshal Kane, I am not walking down main street alone.
(8 Sept 2023) (end of part 1)
