Cancer: An Update

Back in September I wrote about Dad and finding out he had Cancer for the second time. This time, as many will recall, he had double the amount in his throat; a lump either side.

At the time there was a lot of unknown and with it a lot of “possible” theories and outcomes from the consultant to allow us to brace ourselves for the future.

We were told that oropharynx cancer has two stages. The first, caught early and restricted to one place, can be treated with either Radiotherapy or Chemotherapy. The second stage, where it has spread to other places, is a bit more complicated and, to be honest, a little hazy.

It had remained unknown if the opposing throat lump was a secondary result and spread or a random act of “bad luck”. The third lump, above his neck and behind his ear, although a tumour came back as benign. What they made clear was that it wasn’t great news and ultimately it would result in a lot of difficult stages and months ahead.

The plan was to run a “Hail Mary pass”, with only a small and hopeful chance of success, of both Radiotherapy and Chemotherapy. This alone would mean that dad would lose weight, lose his hair and would make him lose his ability to taste. There was the risk that he may be too underweight already to cope with the treatment so they may have to stop it if it drops to dangerous levels. This treatment would make him tired and he would be left with severe pain.

This treatment ended in December.

The entire time dad tried his hardest to stay perky and often put on a brave face with an “I’ve had it before and won so I am sure it will be fine”. I was often confused if this was a brave face move, living in a world of denial or something he truly believed; ultimately I decided not to look too deeply into his feelings and, believing it at face value, accepted the attitude. I think this may have been my own personal denial rather than seeing anything bad from it.

Over the proceeding month’s dad, as predicted, lost a lot of weight, changed his hair cut, including his beard, because of hair loss, lost his taste, found swallowing difficult and was hit with exceedingly high levels of tiredness and sickness.

To counter some of this he had a peg fitted (Percutaneous endoscopic gastrostomy) this is usually to help with feeding. A narrow tube is placed through the skin, directly into your stomach. The tube can be used to give you your medication, liquid food and nutrients directly into your stomach. The procedure involves the use of an endoscope (a thin, flexible tube with a bright light on the end) being passed through your mouth and into your stomach. After the procedure you can use the tube to feed or still eat and drink as normal if you are able to.

He had several “shakes” that were high in calories to help maintain his weight and after the use of these he had stabilized his weight rather than him losing so much that he would be in a dangerous situation.

One thing that never happened, much to my pleasure, was the need to cut his tongue or even have a portion of it removed.

Yet, despite it all, dad still remained optimistic.

So what was the prognosis after therapy?

Well, here is the difficult part. I/We don’t actually know.

Dad met with his consultant, after taking a blood test to measure certain levels and markers, to see what would happen.

This, however, caused some concern and a few raised eyebrows. That is as much as we were told because there are a few things that are confusing to everyone involved.

Dad, despite his protests and so called “attempts” remained a smoker. He was smoking anywhere between 20 – 30 cigarettes a day. He claims to have dropped that to only 4 a day. That does sound impressive but let’s be totally honest; dad has a shit poker face and terrible excuses.

The entire time he was under treatment he would go and “potter” upstairs or in the loft. Initially I was under the impression that he was “working his way through his difficult moments” and yet he would go a few times a day. He also cancelled the paper boy delivering the paper and would walk every day to go and get it; the newsagents, by the way, sold his favourite brand of cigarettes. He also, despite it being autumn and winter, started working in the greenhouse.

Here is the bottom line. In the 35 years I have known this man he has never gone upstairs to do anything other than put the decorations back or go to sleep. He has never walked to the shop and has always driven his car and he was renowned for being a gardener that preferred to watch the football than be productive outside. If that isn’t enough reason to doubt him the ashtrays we found in the loft, bedroom, garage and greenhouse are the firm evidence we needed. Yet, probably through his worry of our disappointment or maybe his own self-denial, he still claims that he has cut down to 4 a day.

The consultant, however, did the test and confirmed what we thought and his levels were of a high smoker.

Anyway, back to the blood test, with an inconclusive, for us, result they have immediately requested a full body scan. This has brought us up to today.

My brother, sister in law and my dad are under the impression that this full body scan PET (positron emission tomography) is the final clearance from the specialist. I, on the other hand, see the test as something else.

The blood test to check his levels made the specialist request the scan. This would imply that the results of the test were NOT what they expected for someone who had just undergone the intense therapy treatment. Dad was clearly smoking heavily throughout which from my understanding really hampers the chance of success. Full body scans are usually used  in this way to find where cancer is hiding or lurking. This makes me think that there is still either cancer remaining or cancer elsewhere and they are looking for it.

I suppose part of this is my natural worry in these scenarios rather than the positive outlook but I can’t seem to shake the feeling; if the treatment worked the blood test would have showed it (That is what happened when he had prostate cancer and got the all clear; so why not now?)

The specialist has also felt it necessary to point out that there will be no further treatment after the scan. This, again, raised questions of which I naturally asked why. Why wouldn’t there be further treatment? Their answer, in my opinion, was clear; “With your father’s age and his continual smoking if cancer is found he would not be a candidate”; something I am fully in support of! Why on earth waste NHS funding and money on a man who didn’t try to stop smoking and save his own life? Sounds cold but I totally get it.

I suppose the only way we will fully know is in a few days’ time when they give us the result of the scan.

Either way, whatever the result, I am sure dad will continue to stay optimistic and positive as he has this entire process.