I had managed to block out of my mind the impending appointment with the oncologist, but by last night it was front and centre. Being a pessimistic sort, I was playing worst case scenarios in my head. I mentioned this to my wife over dinner, and unfortunately planted the same depressing thoughts in her mind. Still, today was a big day. After almost 3 months we would finally have a proper, grown-up conversation about chemotherapy.
We sat down with the consultant and the senior colorectal nurse (the latter who I had only spoken to previously, but never met). As a start point I got to tell my story again, albeit just the highlights, and then was asked what my understanding was of my condition. I managed to nail it, down to the number of lymph nodes that were impacted. And then came the sucker punch.
Previously we had been advised the condition was "likely not curable", now the consultant amended the assessment, dropping the "likely" and replacing with "certainly". I had mentally prepared for this news, but it still shook me. I looked over to my wife, now wobbling. The problem was the spread to two secondary organs (liver and lungs), and this state means that prognosis is not good. Previously suggestion had been made of possible liver surgery to remove the cancers, but the sprinkling about the lungs meant that there was no surgical path to treat that.
The worst case scenario in my head was that there was nothing they could do, and so they were not bothering with chemo. However, this was not the case and we then discussed the proposed treatment plan, being 8 cycles over a 16 week period. And this being scheduled to kick off in a matter of weeks. The likely side effects were also raised, including the likelihood of being as bald as a salmon in no time at all. I did request a cold cap, figuring it was worth a try. I don't have a great deal of hair, but it would be nice to keep what's there.
The consultant also noted that the hospital were always looking at possible clinical trials, and indicated that I may well be eligible to get on one at the end of the first cycle set. In all honesty I am happy to give anything a shot if there is a chance it might help.
After the meeting we had some form filling and a chance to sit with the colorectal nurse. As mentioned in various prior posts, these nurses are heroes. She had been a nurse for 37 years, and launched this specialist team 20 years ago. She clearly believed in the NHS, believed in treating patients with dignity and compassion in equal amounts, was a great comfort to us both as we both went off the ledge slightly.
As a final stop, I had to give yet another blood sample, and also get the chemoport flushed for the 1st time since insertion. The first draw of blood looked decidedly murky (sitting in the port for 3 months meant it wasn't the freshest) , and was discarded. Thankfully the next batch looked in a better state.
So, on balance, not the best of days. But, today marks the start of treatment. And who knows what might be around the corner. As my boss put it a few weeks ago, new developments can happen at any time, the key is to being alive when they do happen. The consultant noted that an average survival period is 2-3 years. The goal is therefore to be as stubborn, yet positive, as possible, and be undecidedly not average (in a good way).