“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.
Showing posts with label Cancer. Show all posts
Showing posts with label Cancer. Show all posts
Friday, 10 August 2012
Thursday, 9 August 2012
Cancer Ward II: Analyses
“Everybody has got to die, but I have always believed an exception would be made in my case.” ― William Saroyan
After the first tentative diagnosis, “probable malignant tumour”, the National Health Service burst into frenzied action like a newly-mobilized panzer division. Consultation followed test followed consultation as surely as day follows night, but with greater frequency.
First test after the gastroscopy was a CT , or computerized tomography, scan. Just as a single radar sweep can detect all the aircraft in a plane, so a single X-ray can detect the suspect objects in a plane of the body. By mathematically integrating a series of such planes – a process called tomography – a three-dimensional image can be built up revealing tumours within the body. Pure mathematicians often like to boast that their subject is essentially useless – but quite the opposite is the case.
A similar tomographic technique is used in the more sophisticated PET (positron emission tomography) scan. Recently the Large Hadron Collider (LHC) in Geneva has been in the news – especially regarding the search for the elusive Higgs particle, which – if it exists – may go some way to explaining how particles get their mass, and the asymmetry between the numbers of particles and anti-particles in our world. An anti-particle is, roughly speaking, the opposite of a particle; if the two should meet – they would mutually annihilate in a burst of energy. That is why we do not come across anti-particles in the ordinary course of events – they have to be produced artificially in accelerators like the LHC. However, the Institute of Nuclear Medecine at University College London Hospital (UCLH) has its own accelerator – in which I was placed while positrons – the anti-particles of electrons - bombarded my body, annihilating themselves against the electrons which were preferably excited chemically in tumours by injection of a glucose derivative. The energy bursts – in the form of photon pairs (light particles) are then detected and integrated by the same tomographic technique as in the CT scan to get a 3-dimensional image of the tumour.
This combination of mathematics, physics and chemistry is truly an impressive achievement of modern science.
Various further analyses followed, including an EUS (endoscopic ultra-sound) – which is essentially a small camera which when swallowed uses sound waves to map the extent of a tumour. But surgeons are never really happy until they explore your interior visually – and this soon occurred with an abdominal laparoscopy – or keyhole surgery – used to get a human’s eye view on a TV monitor of the interior.
After all these tests there seemed little doubt about the diagnosis, cancer of the oesophageal-gastric junction, but it seems that its operable, and at the very least, the scientific approach adopted by modern analytic techniques is something that appeals to me, after a lifetime working in science.
However, as Woody Allen said, “I don't want to achieve immortality through my work…I want to achieve it through not dying.”
(To be continued)
After the first tentative diagnosis, “probable malignant tumour”, the National Health Service burst into frenzied action like a newly-mobilized panzer division. Consultation followed test followed consultation as surely as day follows night, but with greater frequency.
First test after the gastroscopy was a CT , or computerized tomography, scan. Just as a single radar sweep can detect all the aircraft in a plane, so a single X-ray can detect the suspect objects in a plane of the body. By mathematically integrating a series of such planes – a process called tomography – a three-dimensional image can be built up revealing tumours within the body. Pure mathematicians often like to boast that their subject is essentially useless – but quite the opposite is the case.
A similar tomographic technique is used in the more sophisticated PET (positron emission tomography) scan. Recently the Large Hadron Collider (LHC) in Geneva has been in the news – especially regarding the search for the elusive Higgs particle, which – if it exists – may go some way to explaining how particles get their mass, and the asymmetry between the numbers of particles and anti-particles in our world. An anti-particle is, roughly speaking, the opposite of a particle; if the two should meet – they would mutually annihilate in a burst of energy. That is why we do not come across anti-particles in the ordinary course of events – they have to be produced artificially in accelerators like the LHC. However, the Institute of Nuclear Medecine at University College London Hospital (UCLH) has its own accelerator – in which I was placed while positrons – the anti-particles of electrons - bombarded my body, annihilating themselves against the electrons which were preferably excited chemically in tumours by injection of a glucose derivative. The energy bursts – in the form of photon pairs (light particles) are then detected and integrated by the same tomographic technique as in the CT scan to get a 3-dimensional image of the tumour.
This combination of mathematics, physics and chemistry is truly an impressive achievement of modern science.
Various further analyses followed, including an EUS (endoscopic ultra-sound) – which is essentially a small camera which when swallowed uses sound waves to map the extent of a tumour. But surgeons are never really happy until they explore your interior visually – and this soon occurred with an abdominal laparoscopy – or keyhole surgery – used to get a human’s eye view on a TV monitor of the interior.
After all these tests there seemed little doubt about the diagnosis, cancer of the oesophageal-gastric junction, but it seems that its operable, and at the very least, the scientific approach adopted by modern analytic techniques is something that appeals to me, after a lifetime working in science.
However, as Woody Allen said, “I don't want to achieve immortality through my work…I want to achieve it through not dying.”
(To be continued)
Subscribe to:
Posts (Atom)