Welcome to part three. For ‘Lord of the Rings’ cognoscenti, this is ‘Return of the King’. Well, we will see…We left part two with the end of three months of chemotherapy on Thursday 7th December 2023. Where are we at 5.25am on Wednesday 21st December, the shortest day of the year and 4 days short of Christmas?
We (the Responsible Adult and me) met the consultant on Wednesday 13th December at 9am (OK, not 12 noon, humour me) Accompanied by two of the Colorectal nurses, the consultant took us through the results of the previous weeks MRI and CT scans, what they meant and next steps.
Unanswered questions at the end of part two; have we kicked seven shades out of the cancer, or has it left Blakey marks on other organs? The short answer is the cancer won this round. All three tumours have grown a bit. In the rather confined areas where they reside, relatively small increases may well cause problems – such as obstructing the exit from my bottom. And I can feel the enlarged lymph node at the top of my right leg all the time now. On the upside, there is always an upside, believe me there always is, the cancer has not spread to any other organs. Yet. And, huge plus, no more chemotherapy.
What’s next? To be ‘cured’ of this cancer, I will need surgery to remove all three tumours. The primary cancer located on the junction of my anus and rectum, the right-hand groin lymph node and the right-hand pelvic lymph node; this third tumour is buried deep in my pelvis. Best outcome for the surgery is that all the cancerous tissue is removed, and I have a colostomy bag fitted; unlike some bowel cancers, mine does not allow for a tidy bit of pipe shortening. I feel quite squeamish about the external pooh-bag, but it has been pointed out to me that, young children manage these. If it comes to this, I am sure I will be just fine.
However, the surgery is really complicated and beyond the skill set of our Somerset NHS teams. The consultant has referred me to St Marks Hospital in Harrow, North London. This is the national bowel cancer centre of expertise. I have seen the referral letter, the pertinent sentence may be;
‘I do not know whether there would be a surgical option that you would consider to clear all of his disease given his young age, fitness and no evidence of metastasis?’
I may be misreading between the lines here, but I am understanding this to say that I am only being considered for this surgical option because I am comparatively young, very fit and the cancer has not spread.
If the cancer spreads to other organs, what then?
Back to the upsides. Me getting cancer was simply bad luck. Most likely just some duff genes. Being comparatively young is also just luck; bad luck to get this difficult to treat cancer so young but youth gives me a better chance and, maybe, gives the medics more incentive to treat me? They must triage patients in some way.
And my fitness. I have always been very physically active. I love being outside and getting tired. Many people will understand this. I think it is good for our souls to be out in nature. ‘Experts’ tell us of the benefits of being outdoors and how physical exercise will keep us healthy. ‘Lifestyle gurus’ will even sell us ‘forest bathing’ sessions, and if this gets more folk out in nature and helps their mental and physical health, well, I wish them success. 25 years ago, we moved to the northern edge of Exmoor National Park, and we really appreciate how lucky we are to live here and benefit from miles of free to access countryside and coast.
My physical fitness is not luck. But neither has it been some kind of evangelical campaign. It’s simply the result of me discovering the joy of being outside and being physically active. If this helps me survive cancer, great; and if not, well, I enjoyed every minute of walking those hills, sitting on tree stumps with a coffee and getting caked in winter mud when out on my mountain bike.
So, lets keep this upbeat stuff going...
In a minute or so…
The consultation meeting with the medical team ended with them expressing their regret that the chemotherapy outcome was so poor. I could see that they were genuinely upset by this. It must be hard to have to share this kind of news. I hope our medical and other emergency service people really get the emotional support that they need.
Up we go. Before having this meeting scheduled, we had booked a couple of days away in the really lovely city of Wells. Located on the lower slopes of the Mendip hills and overlooking the Somerset levels, Wells is England’s smallest city and somewhere we have visited many times. It has also become our bolt hole of normality. Just an hour or so from home, close enough to be accessible and far enough to be a welcome change.
We had our bags in the car boot, and we drove straight from the meeting out to, and across the Somerset levels. The weather was winter fair, no rain! If you don’t know the levels, they are a very historic landscape. Close to sea level and prone to winter flooding and dotted with slightly higher ground – zoys, mumps and tors. Pretty villages occupy the high ground and precarious looking cottages and farmsteads are spread thinly over the lower levels.
We drove past Burrow Mump and stopped at the Avalon Marshes centre. This is King Authur country, Glastonbury Tor visible for miles and somewhere, maybe, Camelot? We bought a picture of the starling murmuration (I’ll explain that later) and drove onto Wells – spotting two glossy ibis on the way.
We spent two days in Wells, Staying at the Swan Hotel, an old coaching inn close to the cathedral. A little bit of luxury. We did a bit of shopping, visited the cathedral and walked the illuminated gardens of the Bishop’s Palace. In the cathedral we were alone in the transept when a school choir unexpectedly did a very short rehearsal for their carol concert. Their voices filling that vast space was truly beautiful. We returned later and by chance were able to listen to a visiting choir from Singapore.
On our journey home, we spent the afternoon at Ham Walls. This is the site of old peat workings; Peat was dug from the Levels in huge quantities for fuel and for enriching soil in gardens and in agriculture. Some peat is still being taken from the Levels, although now we have realised the significant role that peat plays in carbon capture and there are many projects underway to preserve and regenerate peat bogs.
Ham Walls and neighbouring Shapwick are now very special nature reserves. The old peat workings flooded to create a network of pools and marshland. And all easily accessible along an old railway line that links the reserves to Glastonbury.
In the winter, the reserves provide overnight accommodation to hundreds of thousands of starlings. An individual starling is a smallish bird with surprisingly iridescent feathers. Small families visit our garden through the summer. 300,000 starlings arriving at one time is quite another matter. The marshland reedbeds provide safe overnight accommodation. Sometimes, the birds fly directly into the reedbeds and sometimes they don’t. Sometimes, they take time deciding where to roost and they fly in huge groups of varying size, creating smoke like patterns against the twilight lit sky. This is a murmuration. A beautiful to see natural phenomenon Free of charge and available right here in England every winter. We were treated to some spectacular manoeuvres lit by an unexpected sunset as the day’s clouds lifted completely away. The birds finished by flying straight towards us, dropping into the nearby reeds where they fussed and fidgeted until the sun finally set. The sound of 300,000 pairs of tiny wings is amazing. And then, as we walked back to our car, another birdwatcher drew our attention to a very bright star; this was Saturn and through his telescope we could see the rings and four of it’s moons. Saturn is 900 million miles away, amazing to see this so clearly. It also has 146 moons. What a great day, how can we be miserable when we get to do things like this?
I have overrun my target two sides and need to finish this. One of my journal rules is to write as contemporarily as possible. And I need to get this entry written before the inevitable distractions of Christmas. My prognosis remains uncertain and precarious, dependent on a London based surgeon’s assessment of the likelihood of surgery being successful. I am conscious that I am looking down the barrel of my mortality. Life is an arc (OK, call it a rainbow if you are into unicorns!) and none of us really knows the length of theirs. What I do know is that this is a wonderful World and I appreciate this. Between now and January’s radiotherapy, I will be out there as much as possible, building my fitness back, watching the sunsets, and possibly the sunrises, and enjoying the company of some great, and very ordinary, people.
21 December 2023
