It’s been a tough couple of days since I received the biopsy report. The phrase that keeps on leaping out at me is ‘high grade’, scattered liberally amongst all sort of nasty-sounding long words – hypochromatic, eosinophilic cytoplasm, karyorrhectic, even the cancer type, myxofibrosarcoma – which all mean absolutely nothing to me. As I am avoiding the internet, I will have to wait until I see Prof Khong again for enlightenment. But there’s a couple of days to kill…
My conversation with Prof Meirion Thomas (my surgeon from the Marsden) has left me feeling extremely anxious, not least the demand I hot-foot it back to London. Not to mention his cross examination of the Singaporean methodology…I tell myself that surgeons are well-known to be a bit gruff; later Prof Khong laughs when I tell him this.
Now come the questions: should I have gone back to London straight away? Would it have saved time? would it have stopped the cancer spreading to teh lungs and other soft issues (the biggest worry)? Deep breaths, Vic, calm down. I have to remind myself that it was not clear until AFTER the biopsy and PET scan that the tumour was malignant, so these thoughts are counter-productive. All the same, once JP has left and I am on my own, these anxieties niggle away and I envisage the little spindle cells wriggling their way through my blood stream like a sperm seeking an egg.
A couple of stiff drinks and some Nordic Noir are pretty successful distractions. However sleeping is becoming increasingly difficult and the pain-killers seem to do no good at all. The stocking seems to be growing increasingly tight as I imagine the tumour growing within its confines.
In the meantime my phone rings constantly and emails ping around, lots of good advice and loving thoughts alleviate the underlying fears which, along with the pain, interrupt my sleep. No Ross to reach out for…he is in Korea.
So time for a bit of pampering: spend an hour topping up the tan by the pool, but as I can’t get my leg wet it’s too hot to stay for long! Then off to see a friend, who I have been helping with various articles on fans, so we escape into a world of Chinoiserie and the French court while we sip home-made barley water. Can’t do a pedicure as one foot is bandaged and they will only remove all varnish as soon as I step into hospital; anyway its too far to walk and too near for a cab. So as I settle for a cut and colour, I can’t help wondering if this is the last time I will have hair to indulge in such a way. I’m thinking of asking Louise’s friend Robyn Coles to design a special post-chemo hat for me; if she can make the princesses Beatrice and Eugenie look nice I’m sure she can sort me out.
‘Oh, what you done to your leg?’ asks Alvin the androgynous hairdresser. ‘Don’t ask,’ say I, ‘cancer but I don’t want to talk about it’.
‘OK, la, we talk about nice things…’. And utters not another word the whole two and a half hours. The word cancer has that effect on people.
Conversely taxi drivers here are delightful, full of concern and ‘God Bless’.
Which brings me on to the God question. I am delighted that so many people believe and are praying for me; even if I don’t share that belief I am sure that every positive thought helps me. Please keep all your prayers, positive vibes, messages, comments and love flowing my way…
Finally we get to the debrief appointment. For the first time in my week of private medicine in Singapore we are running on time. As ever, Prof Khong is straightforward and honest, and explains everything to me in great depth.
To summarise: it is a high grade tumour and very fast growing. I don’t ask the stage number as I don’t want to scare myself and know that everyone is different so it is meaningless. More significant is the replication rate of the mitosis, which is ‘bad’ at 26. Anything over 10 is a cause for concern. He thinks it has not been there for very long, less than the 6 months he originally guessed.
I ask him what he would do if I was his patient. Operate immediately he says, and then do radiotherapy. These tumours – there are several ‘extremely rare’ present, one of which he has not seen before – do not normally respond to chemo, so he would not automatically do it since the tumour is contained. But other doctors may decide to zap any rogue cells on a ‘just in case ‘basis. He reassures me that it is possible that some cells might have already ‘spawned’ but they are so tiny that they wouldn’t show up for at least 3 months, the time it takes for them to reach 1mm when they can be picked up on a scan. ‘And in those early stages, its very treatable.’ The delays I have been angsting about are put into perspective.
He further explains that the big challenge facing the surgeons is the proximity of the tumour to the main vein, and how they remove it without damaging the main flow and losing it: there are three veins forming the vascular tree in the lower leg, can they damage one and survive on the other two is the question? He draws me a lovely diagram. Skilled stuff. In order to do this effectively he thinks that the English surgeons may want to do a CT Angiogram as it would help them be precise. They cannot rely on an MRI taken two weeks ago as the tumour is growing so fast.
I had taken the precaution of checking out my anticoagulation injection kit: imagine my horror when I remove the protective sheath to discover a needle one and a half inches long! The last ones I had were like an insulin pen. This is in fact my major concern today: it’s funny how anxiety can channel itself into something so seemingly irrelevant in the scheme of things. Hmm, they don’t do those in Singapore…so I am trying to work out if I have enough courage to jab myself inflight, as well as before and after… WAH! Am making contingency plans never fear…my bravery has its limits!
Now I have visions of being arrested and executed as a drug trafficker before I even get off the ground. I will be boarding the flight with a fully primed sharp and a load of the painkiller oxycontin, a highly addictive prescription drug which kills thousands of people each year in the US. Phof Khong is highly amused when I verbalise this fear. ‘You’ll be OK – no white powder,’ he reassures me.
After much hanging around (Singapore loses out to Switzerland on efficiency I’m afraid), I now have my MRI scan on disc and the biopsy slides, so I am all set for the next stage of my journey. There’s thunder and lightening outside,the oxy is kicking in and I feel mellow and relaxed as I write this…bring it on!
November 29, 2013 at 11:02 am
Gotta laugh or else you’ll cry, and I am …
November 29, 2013 at 11:05 am
Laughing I hope because I have a way with words…
November 29, 2013 at 7:00 pm
Much as I wish you weren’t going through it, you write so eloquently that it’s really… I don’t want to say it’s NICE to read, because of course it’s not, but it’s very interesting and giving me insight into my patients’ journeys (oncology is one of the major specialisms of the hospital I work at).
I’m really grateful that you are sharing the details of this whole nasty business with us. But I shall be even happier when these posts have concluded and we’re back to hearing about your fabulous every day life.
You can do this! Before long you will be looking back on it as an annoying interruption to your travels. The offer, of course, still stands to help you with anything that falls within in my skill set.
November 30, 2013 at 7:25 am
I still remember my hairdresser asking me how I was one day – “I’ve got cancer” I replied bursting into tears…. “a large white wine for my lady” he shrieked with panic in his eyes… once he got over shock he was lovely and gave me a pre chemo head shave… Can empathise with your worry about cancer cells spreading – I found it helpful when somebody told me that everyone has cancer cells in their body and normally immune system keeps them under control..so focussing on building up immune system essential – (hope I’ve got this right – am sure your oncologist friend will correct me if not) Think you will be en route for London by the time you see this – am sure there will be a feeling of relief as you get “home” to your lovely friends. Imagine you will be off to Marsden on Monday when your treatment plan will be clarified – keep us posted Vicky – we are all travelling this journey with you and wishing you the best outcome. Love and hugs.. Janet xxxx