Cancer Ward III: Chemo, Op, Chemo

“Its an ill wind that blows nobody any good.” ― English proverb

Having fixed a date for my operation (March 15th 2012), the usual procedure in the UK is to proceed with some cycles of chemotherapy, in my case three cycles. A cycle is a period of 21 days, starting with one day in the hospital as an outpatient attached to the relevant chemical drips, and followed by the remaining period on cytotoxic (cell-killing) tablets. The side effects vary with the patient, but in my case were minimal. Unfortunately, the effects on the tumour were apparently minimal too, with no discernible reduction from its original large size (10 cms) at the end of the treatment. But it gave some guarantee of removing any outlying seeds of malignancy (metastasis). For example, some baso-carcinoma spots on my face – a very mild and non-lethal type of wart, seemed to disappear. But as my oncologist (Professor Hochhauser of UCLH) remarked, this is rather like a by-product of the NASA Space program producing a Teflon frying pan.

The actual operation, performed at St Marys Hospital by a 12-person team including 4 surgeons led by Professor George Hanna, lasted 11 1/2 hours. The operation was the venerable (1946) Ivor Lewis Oesophagectomy procedure which involves using part of the stomach to remodel the oesophagus. This was completely successful. I then spent some 3 days in Intensive Care, plus a further similar period in High Dependency and finally after about 9 days left for home.

It is normal practice in the UK to follow – at a decent interval! – the operation by a further series of adjuvant chemotherapy, just in case the surgeon has missed something, much to his annoyance but presumably suggested by the oncologist to put the surgeon in his place. I tolerated this series much less than the earlier pre-op series, being somewhat debilitated by the effects of the operation. And due to a depressed food intake – a gourmet appetite with a Gandhi capacity - I was not replacing good cells, such as blood haemoglobin, as rapidly as the chemo was killing them, and this necessitated blood transfusions.

One accidental effect of the operation was incidental bruising of a vocal cord which left me with a hopefully temporary but fairly long-term voice problem. But with my sinister gruff voice, bald pate and newly acquired black leather jacket, I now resemble mafia godfather Don Corleone, finally eliciting overdue respect, nay fear, from my family.

So it is an ill wind that does not blow some good.