Cancer is a fearful word for many, especially those who grew up in an era when such a diagnosis was a virtual death sentence. Men pay little heed to their health, unlike women. Until, that is, a man encounters severe symptoms and a serious threat to life, his life. Part of the cause for these fears and men’s reluctance to seek out health care, I believe, is a lack of knowledge and a hidden modesty.
After passing a large amount of blood which reoccurred periodically over a four or five week period and suffering highly irregular bowel movements for about the same time, I reluctantly dragged myself off to my very busy local GP. A bloke I’d had as little to do with as I possibly could over the preceding few years.
Vince is a lovely bloke, a man’s man and easy to talk with. His only liability was being in a line of work I found I wanted little to do with. Now I needed him. He was warm and a little philosophical. After going through all the symptoms and assorted seemingly irrelevant questions he dryly quipped, “Blokes, – up to 40 you think you’ll live forever, then you decide you want to and you come here looking for advice, but do little. Then at 50 you do something about it but only after you suddenly find you’ve contracted something that can kill, which could have been avoided if you’d taken the advice offered at 40”.
It was said with a wry smile. We both knew he was right. He held the evidence: my entire medical history in his hands. I didn’t feel at death’s door and said so. Vince was very kind. “You will if you don’t do as I bloody advise.” Knowing I’d been a complete dill I nodded and meekly submitted. Vince rang “his” specialist and arranged an immediate colonoscopy.
Fear was my greatest emotion. I’d lived through the era when cancer was a certain death sentence. Within days and having followed the dieting, abstinence and drug regime I presented at the local private hospital and paid the $350 bill up front. A bill for tests followed, all but $50 was covered by Medicare. The staff were beaut, including the admissions and clerical, but especially the female anaesthetist.
On awaking after the “service” I was fronted by the specialist, another lovely bloke, but given his line of work, I just didn’t seem to be able to regard him as a man’s man. He broke the bad news to me: “a lower bowel cancer … rectal cancer”.
It was a terrible shock, even though I’d prepared myself for such an eventuality. All I could say was, “will it spread?”. Gently I was told all cancers can spread, and having realised the real intent behind my vague question he added, but if people follow the procedures most will survive cancer. However his manner made me realise, even through the mists of anaesthesia, it was serious and surgery was not just a possibility but was going to be an eventuality.
The specialist referred me to the local public hospital and a colorectal surgeon. My appointment was within a week. I said I’d prefer private but I was given some very good advice. Cancer treatment is given priority in the public system and unless I really wanted to spend at least $15,000 I was probably better saving my money for something else. My northern English and Scottish heritages kicked in and frugality won out over a need for privacy. Public it would be.
I had my appointment in the Colorectal Oncology Department two weeks before Christmas. Examination confirmed a cancer but not its size, whether attached to the bowel wall or organs adjacent to the bowel, or its spread to the lymph system or other organs.
The examination was conducted, not by the specialist, but by a newly qualified surgeon, the surgeon’s registrar. Yet another lovely bloke, a youngish man from an Asian background, he had a very gentle manner. Again he was frank as any man would want and he explained all the possibilities, from removal of the cancer and a small part of the bowel, through to removal of a large part and “reshape” of the bowel; removal of large part of the bowel and the anus and the need for the dreaded “bag”; removal of part of the bowel and part of liver, the need for chemotherapy and radiation treatment; the possible spread to the lymph nodes or other organs; and finally the possibility of not doing anything – which of course would result in death. Everything was explained … in detail.
I needed a CT scan immediately and later a sigmoidoscopy. Those would reveal the probable extent of the cancer. There was a two-week wait for a CT scan in the public hospital. I made an appointment at a private hospital for the next day. Its cost $550 but carried a Medicare rebate of over $400. Two days later I underwent the sigmoidoscopy in the public hospital.
The surgeon attended and when he visited me later, he explained the size of the cancer and its probable spread. He diagnosed a stage two cancer with the possibility it may have spread or was getting ready to spread to the lymph system. He made an immediate appointment for the oncology, chemotherapy and radiation departments. The surgeon was a distant sort of chap and was very clinical. I imagined he was very busy. I respected and liked him immediately.
My treatments were planned and scheduled. The oncologist, a youngish Asian woman, was reserved and private. We eventually broke down our age and sex barrier and became respectful of, and warmed to, each other. It was from her I learned I needed to listen to my body and from her I learned most about cancer, its development and its treatment.
My simple questions never once annoyed her and she was always straightforward and plain in her answers. Her treatment involved a seven-day infuser (a pump) renewed each Wednesday for six weeks. I saw her periodically during my treatment, usually only when something appeared amiss. Two weeks after the start of the chemo I was to receive 28 days radiation, five days a week with two Friday “rest” days.
My radiation oncologist was another Asian woman, oldish. She had a great sense of humour and we often shared a joke … usually at my expense. She was forthright and decent. I held her in the highest regard.
Two days before the Christmas break all was settled, my treatment would begin on January 31, 2007. I shared my bad news with my family and friends on Boxing Day. During this break I researched as much as possible, on the Internet, about my condition.
I’ve kept a day-to-day diary of events as they unfolded. In the interests of “men’s health” and as an intimate appraisal of our much criticised health system I’m going to share the “ride” and the details. That’s only fair. After all you’re paying for the largest part of it.
I’ve never had health insurance. I’ve put and kept money aside instead. I’ll let you know when it runs out.
My first treatment was a course of chemotherapy. I attended an introductory course on January 8, 2007, with my son. The course explained all I needed to know about the application of chemo, its effects, the staff and surroundings. Others were present. I spied a brochure describing catheters and quickly picked it up. To my horror the co-ordinator spotted me and said “Keith you won’t need that, you’re getting a pic-line”. That to my relief, I discovered much later, was a line feeding into me and not one draining me. My embarrassing secret was safe.
My first appointment was January 31, 2007. Here I learned about the insertion of a “pic line”. A line was thread into a vein on my upper arm and extended to my heart. “That must have been bloody hard job, too small to find easily”, was a common quip among so-called friends. Later a seven-day chemo infuser was attached. It contained the treatment and a pump fed it into me at a rate of 0.5ml/hr for a week. It was hung on a cord around my neck.
I felt trapped. I suppressed a panic attack. My son was with me again and both he and I just didn’t want to be in the Oncology Day Care. There were too many sick people there.
I was only there for 20 minutes and was able to recover my composure after walking in the hospital gardens and talking with him about the events and feelings of the morning. It is something we do regularly now. Talking together … I’ve found at 22 he’s sensitive and a real manly bloke. He’s quite special.
I went to chemo every Wednesday for six weeks. Each visit I had the obligatory blood tests and a brief visit to an oncologist. They often changed and I only saw “my oncologist” twice in that period. I suffered no great side effects from the chemo at all, apart from a very mild dose of nausea and one dose of diarrhoea. My oncologist had anticipated those and had prescribed medicines for both. The nausea I got over easily but took four pills for the other. I over-dosed and suffered constipation for a few days. I have had no problem since.
After the initial six weeks my oncologist met me and I was told that since I had handled the chemo so well I would be rewarded by continuing the treatment till the end of the radiation. Some reward indeed. I have still not got over my aversion to attending Day Care simply to have the infuser changed. I found a method of putting the pump in my pocket. That greatly alleviated my feeling of being trapped. The Day Care unit is an awful place and it was only the nursing staff that made it tolerable. I made little contact with other patients, most seemed sick, all seemed to be undergoing quite different treatments. Seldom was there any laughter in that place.
I started the radiation after two weeks of chemo and had daily doses.
My initial appointment involved tattooing the target points. The radiation treatment is scary. I was laid on a table, in an isolation room, had the machine lined up and as all the radiation therapists left I was told not to move. I can still hear the giggles of the women as I pointed out that since the machine was targeted at a fraction above my groin it was extremely unlikely I would dare move or even breathe.
The radiation therapists were all quite young and I felt they enjoyed my good humour. I had witnessed during the treatment that the other patients were treated with great dignity and tenderness. I’d still had no side effects and felt well. I behaved as I felt. However the last three radiation treatments did cause substantial tiredness. At the outset I was assigned a nurse. She was an absolute treasure. With her I discussed all aspects of my treatment and it was she who attended my annoying sore spots. I had weekly appointments with my radiation oncologist.
Up to this point I found the nursing staff, dieticians, therapists, physios, doctors and specialists exceptional people. They were friendly, caring and good humoured. Never once did I feel embarrassed or had any aversion to discussing any aspect of my cancer or its treatment. All contributed in different ways to my overcome my modesty. They undertake a difficult task well.
My only criticism … a few of the administrative staff were inattentive and amateurish. It was at their hands I was left waiting in oncology, on two occasions, once for four hours and once five hours.
I had my appointment with the surgeon. We discussed many things. He described all the options regarding my tumour removal. So much is still quite “up in the air” and much will be decided on the operating table. I know at the end of the day if I come out with a tube from my left side I’ll be having a temporary bag and if on my right … well I’ll never be buying toilet paper again. One of the worst scenarios, after a premature death, is I may lose my reproductive and sexual ability. Although that is apparently no great loss as I’ve often been reassured I was never any good it anyway!
I had my final radiation a week or so ago. They also disconnected my chemo and removed the pic-line. Everyone got a little personal bag of Easter eggs. For the first time I was allowed to wait in the TV lounge. I spoke briefly with a woman whose brother was receiving treatment for throat cancer. During our talk, about literature and sailing, another cancer patient quipped that the more he asked about his cancer, the more he knew and the easier it became to handle the whole situation.
It was a basic truth. I simply agreed and acknowledged the sad look in the eyes of my new friend. During the last eight weeks I’d become pretty self-absorbed but that look stung me with a realisation of how lucky I really was. She had intimated earlier, unbeknown to the other patient, her brother was deaf.
My op is scheduled for May 11, 2007. I’ll be in the public hospital for at least a week, with at least a month for recovery on discharge. And thanks to my surgeon that date allows my son to run my business without disrupting his mid year exam study for exams. Sometimes understanding and a little empathy has great rewards.
Keith Kennelly 5th April 2007