I qualified in medicine in 1956 so my medical knowledge, when I retired in 2001, was largely derived from my experience during those years of practice.
In June 2003 I was diagnosed with bowel cancer. I was lucky - the entire tumour was surgically removed 'a cure', you might say. And indeed my annual follow-up CAT scans after that were all negative - until the one I had this year - four years after the original operation. The radiologist was very apologetic, "Richard, I think there may be something a bit suspicious in your liver".
At this point I want to quote from a well-known textbook of medicine published in 1995 - only twelve years ago. 'As a rule, the presence of liver secondaries indicates incurable disease'. In a limited number of cases where there is a single metastasis, surgical removal of the part of the liver containing the tumour may be possible.This is associated with an approximately 25% chance of a five year survival.'
This accurately reflected the state of my knowledge when I was given the news. I genuinely believed that I had just received a sentence of death.The shock was all the greater because after four clear years I really thought I had got away with it. So when I went to see my surgeon a few days later I was expecting a somewhat depressing discussion. I was therefore astonished when he simply said 'we shall have to remove it' and immediately referred me to Professor Karanjia at Guildford. Five days later I was operated on and the liver tumour was completely removed. No chemotherapy was required. I am now back to a normal state of health.
The first is that even after successful removal of a primary bowel cancer, liver secondaries can occur, sometimes, as in my case, after quite a long period. Annual post-operative checks are therefore essential.
The second is that thanks to the new surgical techniques now available for their removal, they are no longer a sentence of death. If an (admittedly elderly, but reasonably well-educated) physician like me was unaware of this good news, then it is likely that a large proportion of the population might also be similarly unaware.
The third is that with these new techniques five-year and even ten-year survival rates that would have been unimaginable ten to fifteen years ago can now be achieved. These rates will continue to improve where patients can be encouraged to present at earlier stages of the disease.
The final message is that safe and complete removal of these liver tumours depends not only on the skill of the surgeon, but also requires the use of a range of highly specialised, complex pieces of equipment which are now an essential part of the process. Unavoidably, these are expensive but their use, in conjunction with the advanced surgical methods now available, means that 'A sentence of Death' is now rapidly being transformed into 'A Message of Hope'.
It is this that makes the support of the Liver Cancer Surgery Appeal so vitally important and so well justified. The more funding that becomes available to finance these exciting advances, the sooner we shall all see bowel cancer changed from a killer into a successfully treatable disease
Professor Richard Rondel MB FRCP
No life, however short is wasted - they say and I will always be so proud of him and grateful for the love and care he gave to us all.
Life was normal, pretty good in fact. My husband had stepped down from the daily grind, being of retirement age, and planned to do some freelance work. But then came the trip to the doctor’s. “I’d better go ahead and have that colonoscopy – I’ve already put it off far too long. Will you give me a lift to the hospital and pick me up when I ring?” Then, the phone call. “The consultant doesn’t like what he sees. He wants an immediate scan – can you come?”
So, sitting together at his desk. Yes – it’s a tumour: yes – it’s cancer; and yes – it does mean an immediate operation. And so began the fall down the black hole. The shock, the silent hug, the tears. The feeling of guilt – was it stress, was it diet, why didn’t I nag my husband to go to the doctor earlier? Fear, apprehension and sorrow were all mixed. And anger that it should happen to him. We live a modest life style and he’s a loving honourable chap. Worse was to come.
The operation revealed that the cancer had spread from the colon to the liver. However, because the liver can regenerate, surgery again could be the answer. Diagrams were drawn, procedures explained and we now had a new plan of action – another operation and chemotherapy. “We’re going for cure!” was the phrase.
Once again, the long waits to go down for surgery. The bright smiles and the peck on the cheek as you see your husband wheeled through those forbidding doors into the theatre. Another long wait – an 8 hour operation this time – before you hear that all is well. The shock of the High Dependency Unit – the tubes and wires and monitor screens. Wanting to be there, but not wanting to be in the way. The journeys 3 and 4 times a day to and from the hospital until the best journey of all when I could take my husband home once again – wonderful.
Chauffeur, secretary, nurse, I’ve become them all. Company while waiting for appointments and a second head to remember what was said; learning routines I’d never even heard of – like flushing the Hickman line or changing chemotherapy bags; and finding and preparing food, not only to tempt a wounded gut back to life but also to appeal to a sore mouth and tongue that, thanks to chemotherapy, will not let things taste the way they should. There have been highs – the first Christmas when tests showed all clear. There have also been bad lows – being torn between misery and frustration when after 5 operations we were told that no longer were we going for cure, it was now “containment”.
But it hasn’t been all bad, far from it. From the start we have felt free to do what we can when we can. It might be a decision to take off for the day, or even 2 days, in the car. It might be a trip abroad, which we have done several times – chemotherapy and all!
Life goes on. Even with cancer, you have a life to live. I would give anything to wish it away but I look at my husband now and I not only give thanks for all the skilled dedicated super people who have cared for and helped him, but I marvel at what the human frame can stand – he looks so well!
Dark thoughts do strike especially at night but I feel full of hope.