“So it all comes down to this”, that’s how I felt as I sat waiting with my friend in the small consulting room on that January afternoon. It was nearly a year to the day that I been unofficially told I had cancer. Of course it didn’t really just come down to this meeting. If we had been given a different answer to the underlying question, “Can you operate to remove my tumour now?” , then I would have gone back to my lovely oncologist and we would have come up with a different plan. Perhaps more chemotherapy, a different cocktail this time, or we could have looked at clinical trials, the private option, what is on there that I can’t access on the NHS? Or maybe a second opinion. London hospitals first and then perhaps The Christie in Manchester? But the importance of this moment was not lost on me. As my oncologist prepared me after inconclusive scan reports the week before, she was positive. She had to be really. Although there looked to have been very little response to the treatment, my tumour had not grown and importantly there was no sign of metastatic cancer ( secondary cancer, when the original cancer mutates to a new site). ” They have to take you” she said “because if they don’t then we are kind of running out of options..” Her words encapsulated my deep seated fear, we both understood that although my cancer is treatable, I need this operation for a curative outcome. The problem with my tumour is not its size, it’s the location. The tumour ( after all this time I really need to name it) is very low down in my rectum. One of its edges is very close to the iliac artery which is hugely important because it helps supply the blood to the legs and pelvis. When surgeons go into operate they are looking for clear resection margins which in layman terms means they need clear edges of non cancerous cells around the tumour so that they can be sure of taking the cancer out and not leaving any behind. Five weeks of chemotherapy tablets and pelvic radiotherapy at the same time in the spring time of 2016 followed by six months of horrid intrusive IV chemotherapy later in the year had not really made much impression on shrinking the tumour away from that edge. So when people asked me what date or when the operation was going to be, they were blissfully unaware that there was a very real possibility that there could actually be no surgery. That can happen. A surgeon is only going to operate on a patient if they can see a possible positive outcome. They had sent me away before who was to say it could not happen again. And so it was that we sat waiting on that January afternoon.
The weeks leading up to the meeting had been been challenging. When I was first diagnosed I understood I was going to face a physical challenge but I had no idea of the psychological challenge ahead. As one of the many wonderful patients I’ve met during this period of my life once pointed out “ Cancer challenges you to be at your most psychologically intelligent when you feel at your weakest physically” I’ve identified with those words many times during the past year. In some ways I find times of treatment easier to navigate. You have your treatment plan in place. You know where to be at different times on different days on different weeks. You go through the motions, doing all the things that are asked of you in the hope that the radiation or the poison that is being pumped into you is working its magic. Killing the bad cells even if the good cells take a battering too. However it is the time between treatments, waiting for scan results and then whether they will be good enough for another hospital to operate on you, that I’ve found the most difficult.
One of the ways I’ve learnt to deal with the mental challenge of living with cancer is by trying to live my life in a more mindful way. I’m still learning new skills and I certainly don’t profess to being an expert on this but it’s amazing how living life in the present without focusing on the regrets of yesterday or the potential for tomorrow can help. Whilst in treatment one of the many amazing nurses in my chemotherapy unit shared with me a poem that another patient had given to her. It was all about living life in the present. He told her it was the only way he had managed to get through this treatment. The poem moved me greatly and so I asked her to photocopy it for me and it now sits proudly on my bookshelf. It was a timely reminder of how being mindful can help you in times of adversity. So in the week proceeding my meeting I concentrated on staying as much in the present as I could. Controlling what I could control, which was how I dealt with this situation.
So when the moment came, although I felt nervous I also felt strangely calm. It helped that the consultant was the same surgeon that I had met for the first time in June. He is without doubt one of the most amazing people I have ever met. Not only he is clearly one of the best surgeons in the country, he also has a real holistic approach. He sees you as a person not just a patient. We caught up on how I had found my treatment, how I had managed my life through this period and my genetic condition that pre disposes me to the cancer. He talked me through my response or lack of it to the treatment and why my tumour in particular is located in such an awkward place. When at last I was able to ask the question that had been sitting with me for so long he gently took his glasses off and looked me straight in the eye “ Yes we are going to operate on you”. “Finally” I thought, “ I can begin to look forward.”