Eleven days post treatment update

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This group has been fantastic......thank you for your shared knowledge and experiences.

Just wanted to share some of my experiences of treatment (abroad) and chemoradiation with a new stoma.

I have cancer in my anus, but my tumour is at the start of the rectum. It has spread into the fatty bit outside the rectum and gone into lymph nodes. 

Prior to treatment I was unable to go to the toilet, lost over 12 kilos and was experiencing terrible pressure in my anus in the last weeks.

Surgeon suggested a stoma and operation was performed a few days later. Absolute life saver and I was able to get ready for chemoradiation mentally and also gain weight.

Date was set to start treatment and my radiology Dr was appointed. He explained all the treatment in detail and made it very clear I would feel pain and this was normal. He told me he was here to help and to come and chat if I needed anything.

No creams, no anti sickness tablets and no painkillers given out. If I needed something, he wanted me to come and discuss it with him.

Radiotherapy started and then the machine broke down, repairs and we got going again, a little late.

I travelled 3 hours a day down country roads for treatment, so my backside was in a lot of pain.

My first recommendation would be a post operation type cushion. Bought mine from Amazon and it really helped.

Creams, I was told none, but used Strata XRT. Expensive, but goes a long way. I am still using once a day post treatment.

I used the cream pre treatment, small amount and made sure it fully dried. I came home showered and used it again.

I did not have any painful burns until day 25. If I was applying again I would make sure I put it up to my coxicks. 

At the weekends I also used a wound protection cream from the baby section in Lidle. Made by lupilu, baby bio calendula. I used to slather this on when my bottom was so sore pre stoma, did the same at the weekends and am still using now.

I also used QV cream on the rest of my body, twice daily.

After my 30 sessions I had burns and in 4 areas they looked like cigarette burns. From my anus to my coxicks was trying to split, but cream and epsom salts baths stopped it from happening.

I was nervous to do salt baths during treatment so I waited. If I had my time again, I would start on day one of treatment. I bought pure Epsom salts, they are also hyper allergenic....from Amazon.

I wore period hipster knickers and pads. From the first week the mucosa ran like a tap, especially at night. In the last few days that has reduced significantly.

In the first week of treatment the pressure reduced significantly. I had inflammation, edema and a severe stricture in my anus (hence stoma). Everything started to feel more relaxed. My anus has appeared again, it was so tightly closed I could not use a cotton buds to apply cream.

A small lump also appeared near my anus pre treatment, in the first week it disappeared. One of the cigarette burns at day 25 seemed to be in the same place. My surgeon told me it was likely to be cancer and he hoped it would disappear after treatment.

I had a chat with my Doctor after session 25 and the increased pain. Up till that point I had taken a few paracetamol to help me with the travelling.

He offered ibroprofen, they can upset my stomach so not keen. He them offered NASIDs, soluble as I had been suffering sickness and nausea. Again, I didn't want to take them as I feel they can stop wounds from healing. I continued with the occasional paracetamol and for me distraction has always been my way to manage pain.

The Doctor also recommended lidocaine. I used it a night and it took the edge off and let me get some sleep.

The burns and soreness are getting better each day and I am continuing with salt baths and lots of cream.

I think out of all the treatment the chemo early morning on a Thursday was the most nerve racking. Bloods taken at 7am, then wait for treatment. Cisplatin is very toxic and I had spoken to other patients who had had the treatment stopped.

I managed the full 5, my kidney's managed thank goodness as there did not appear to be an alternative.

After the first session of chemo I thought my head would explode, but it went away without medication. I felt sick after the session and it remained through the whole of the chemo. Ginger and mint teas helped, but by session 4 I was struggling to eat and drink and the 3 hour journey each day was a killer.

I spoke to the Doctor week one and he told me it was very normal. We had another chat week 4 and he prescribed tablets with clear instructions not to take for more than 5 days.

I read the side effects and didn't want to take any. I had my 4th chemo and took one tablet after the session, sickness eased. I took a further tablets on the Saturday and the sickness reduced significantly. Last session I took the tablet pre chemo, reduced sickness and one tablet on the Saturday.

I didn't take anymore sickness tablets.

Chemo and a stoma can be fun. Lots of liquid output, morning noon and night. I was up sorting out mucosa or emptying my stoma bag. It blew up like a wind sock on chemo days and was difficult to change due to loose output.

I used certain foods to thicken things and when that didn't work I took a couple of imodium week 4 and 5. My concern was I was not drinking enough, so imodium helped.

About a week after chemo I felt tired and needed more rest, but my energy and appetite started to come back.

During all the treatment I have tried to eat a balanced diet with lots of protein. A new stoma restricts my diet, but homemade soups full of nutrients have helped to get me through.

I new going into this treatment that I had to say mentally strong. A normal routine has really helped me do that. It didn't matter that I was slower, had to have a few rests.

I cooked fresh food each day, did some gardening, washed clothes and ironed. My partner would drop me off away from the hospital and each day I would have a little walk. I walked around the garden at night looking at the flowers and it made me feel normalish and in control. It's also my way of distracting myself when I am in pain.

Eleven days post treatment I work for a few hours, then rest for a few hours. Back on vitamins and introducing new foods to my stoma. 

Not sure if this happens in the UK but at my discharge meeting with my radiologist Doctor I got to see my tumour pre treatment and post treatment. I was asking questions and he asked me if I would like to take a look on the computer, I had no idea they took new images each day. 

So not surprised I couldn't go to the toilet pre treatment, the tumour had totally blocked my rectum. It was a big black shadow with a tiny gap. My last session the tumour was dying, holes were appearing and it was like a cloudy sky. Again around the fatty tissue was becoming cloudy. Even my untrained eye could see a difference.

It was nice to see a change, but I still have a long way to go before I am out of the woods.

Wishing everyone the very best day possible.

Ally xxx

  • Thanks for this Ally, great post and really interesting. 

    All the best for your future healing, please stay in touch with this group.

    xx

  • Hello Ally

    This is such a fascinating account, I know there can differences in the delivery of treatment (even within the uk) but this is probably on a new level, with very little offered in the way of creams or painkillers.  I am sorry, I am eaten up with curiosity, would you mind sharing where this treatment was?!  No problem at all if you would rather not.

    It must have been so gratifying seeing the tumour shrinkage on the screen.  I had a sigmoidoscopy quite a few months after treatment and was given a picture taken by the camera.  My anal passage and rectum (where my tumour was too) were absolutely clear but did show proctitis which is normal after treatment.

    Wishing you the best of results when you have your follow-up scans and I hope you have a good recovery.

    Irene xxx

  • Morning Irene

    I received my treatment in a private hospital in Bulgaria. Very poor country, but exceptionally quick access to Doctors.

    The hospital was immaculate, lots of very well trained efficient nurses and auxiliary staff and so friendly. 

    Again lots of Doctors available during treatment and if you need to see another specialist during treatment, again they make a call and it's normally immediate. Operations like my stoma can be done in days, so it does not delay treatment.

    The Doctors are all trained in Europe and most speak excellent English. Lots of the nurses have trained in Spain and Germany, less English but we managed very well.

    What surprised me most about chemoradiation, is you stay in hospital for 5 days, receive your treatment and go home at the weekend. The rooms are modern with private bathroom and you share with 2 others.

    They were quite shocked that I was travelling 3 hours a day. For my own sanity I needed to be in control and have my own routine at home.

    One of the big differences here is access to opioid medication. It's available in hospital in liquid form, but they do not prescribe tablets. If you need that level of pain relief, it's patches, only certain chemists can dispense and they are strictly managed. This is the same process for end of life.

    The nurses on the ward would have checked my skin if I had needed it and got a Doctor involved, but they wait for you to be proactive. For me that worked, as again I like to be in control.

    The radiologist team were lovely, but a very different role from the UK. They make sure your treatment is delivered and they were very professional, but my radiologist Doctor was there to look after my health.

    The Doctors have an office and you can knock any time for support. My Doctor went on holiday for 2 weeks, he told me any of his colleagues were available to support, just knock.

    What is very different from the UK is the layers of admin staff. My Doctor at discharge told me, you are incharge of your own health, we don't chase you, you must be proactive. You get all your notes and full access to all medical procedures and you must contact Doctors directly. I have my surgeons telephone number and he thinks it's perfectly normal to contact him direct.

    I visited my GP last week and he is speaking to another Doctor about my urethra stricture and small nodule they found in my lung....so lots more medical stuff to look forward to.

    I also have an update for the group regarding my HPV tests that were done pre chemoradiation. I think for me it confirms that active HPV has spread from my vagina to my anus and most likely menapause has triggered it.

    Sorry for the War and Peace Irene.

    Ally xx

  • Ally

    Thank you so much for telling us all this, not war and peace at all!  I was so interested as during Covid I broke my wrist badly walking down a mountain track in Spain and had treatment at a rural public hospital in Andalucia.  As the Xray show multiple breaks I had the fracture 'reduced'.  This entailed little nooses around the fingers whilst two doctors leaned back and pulled like a tug of war, they had injected me many times in the wrist so I didn't feel pain apart my arm on the sharp edge of the trolley.  I watched my fingers turn black and had to avert my eyes.   And the doctor (not another department) proceeded to set the wrist in plaster before sending me back to have it X-rayed again to make sure the break had been reduced.  As it was broken in three or four places, I was warned that it may have to have metal plates but when I had it X-rayed a week later it wasn't necessary.  My wrist is absolutely fine now - testament to the quality of treatment in a small rural hospital.  

    I left the hospital five hours later still in a gown that didn't tie up the back, (the medics had cut my top and bra off), to all the masked relatives waiting outside where my husband was waiting for me.  I hadn't had a drink for five hours and downed a bottle of hot cola which had been sitting in the car.

    But this shouldn't be about me, I felt i owed you a explanation for my curiosity.

    It is really interesting about the control of opioid drugs in Bulgaria but on reflection, although the radiation burns are very painful the worst experience is emptying the bowels and certainly having a stoma avoids that.  But my mind boggles at the journey to the hospital, I still have cushions strategically placed round the house and car and I am well over three years down the line!

    If you read my notes you will see I also had a spot on the lung and after chemo/radiotherapy had two lung ablations which, fingers crossed appear to have done the trick apart from a small area of inflammation in one lung which they assure me isn't cancer.  Happy to share my experience of that should you need more information.

    I think stenosis of the uretha can be a common side effect of treatment - it can take lots of stopping and starting to empty my bladder, and I have at least 3 - 5 nightly loo visits. 

    I wish you the very best of luck in getting the lung sorted out, please let us know how you get on.

    Big hug (and another thank you for being so open)

    Irene xx

  • The gown is making me laugh Irene.

    I went for a gyne procedure under anesthetic pre cancer treatment. The gown only had one tie, so I couldn't close it. The auxiliary nurse came to the rescue and wrapped me like a mummy for my journey to surgery.

    When I arrived the room was full of staff and my Dr was operating in the next theater. They asked me to strip and I stood there for a couple of minutes totally starkers, nobody paid any attention. I was asked to get onto the bed and eventually a sheet was provided.

    So pleased your wrist got sorted and it reminds us that the UK once had small rural hospitals with basic equipment but Doctors with great around knowledge.

    My GP in Bulgaria is third generation, with a daughter newly qualified. He grew up in the hospital and works as a GP but also hospital work....he knows everybody.

    You are also very correct about the stoma and having to go to the toilet. I had that experience pre treatment for several weeks, physically and phycologically it was traumatic as my anus had totally closed. I still didn't take meds because I was concerned about the constipation, diarrhea cycle.

    Everybody needs to make choices that are right for them regarding meds and I think the medical staff need to keep patients fully informed of the benefits and draw backs of pain relief.

    Thirty years ago my father went through radiation with no cream or pain relief, his oncologist was totally blaze about his pain and offered no support. I think there is a balance to be achieved for all patients, but it takes time each day and I think medication has now filled the gap.

    The group and you personally have given me great info and hope......so I am sure I will be back asking more questions.

    Ally xxx

  • Thank you Mrs Vanilla xx

  • Ally

    I think in Europe they are far more open, I was lying on the trolley naked to waist until they found me a gown and this room was the same, lots of staff, men and woman coming in and out.  Frankly I couldn't have cared less, I was in so much pain.  No one gave me a second glance!

    I am pleased that you managed so well, and were given so much in the way of explanation, the mind boggles about your father though.

    Irene xx

  • Yes, I would have loved to see what was going on in there!!

  • Hi  ,

    Thank you so much for sharing this account of your journey so far, it made for interesting reading, it’s always interesting to read how people’s diagnosis & subsequent treatments are managed in other countries because as Irene has already touched upon even here in the UK it can vary from hospital to hospital & even consultant to consultant. 

    The first time I visited Bulgaria was approximately 32 years ago & outside of the newly built holiday resorts I was struck by the overall poverty so I’m really pleased to hear that the hospital facilities & the medical care you have received have been so good. 

    I hope you get to see someone soon concerning the lung nodule & issue with your urethra & they can offer a solution to both. 

    Sending lots of healing thoughts your way for your continued recovery. Please keep us updated. 

    Nicola 

  • Thank you Nicola for the great support you give everybody, through this excellent group.

    All those years ago at the end of communism, Bulgaria would have looked very bleak. Thankfully today, some have access to good modern hospitals. 

    The new hospitals are normally funded by drug companies, so I was surprised when they did not push drugs on me at the beginning.

    My lungs node and urethra are firmly back in my sights. When my GP comes back from holiday he is looking into further scans to check the lung node and urethra which were both pre radiotherapy.

    My rectum cancer had broken out and was very locally invasive, so needed action. I am hoping the systemic chemo has kept the other bits quiet for a while.

    A chat with oncology next week and hopefully a plan of attack in the next few weeks.

    My notes say I am palliative, but I don't pay any attention to that prognosis because of the amazing shared stories on the Macmillan sites.

    Watch this space, I will be back with another Bulgarian mini series.

    Ally xx