Chemo preparations - Tests & new date

Well, in the last 2 days i've completed all the Chemo preparations bar one.
I've had blood samples taken (by Claudia at the breakfast table), and sperm samples (don't go there!). I've taken an audio test (pictured.. !?!) and signed the consent forms for the Chemo to begin.

Tomorrow i have a 4hr kidney function test and then that should be it.

We've also heard today that my chemo start date has been moved forward a week to the 6th May (from the 13th). Well done Nurse Jo!! This is great news, although i feel a lot needs to be prepared in that time, particularly at work.

Our church family have organised us a long weekend at Lee Abbey (where Claudia and i met) for a bit of rest and recreation before my cancer treatment begins. Bless them!! We'll be back on Monday.

After-breakfast practise

Not that we're pushing him or anything...

More scenes from yesterday at the BRI

The kind consultant (you'll see her briefly in the video) at the BRI allowed me to take some pictures before the US-Endoscopy.
The bright light is the end that they pop down your throat. You can see the depth markers and i guess the chunky bit at the top is the Wii endoscopy "console".

Before i had all these tests, i had no idea what it would be like to be there, and that made me uneasy.
I'm sure these images will terrify some, but my care has been so professional, caring and "human", that what would have seemed like a nightmare-ish series of tests/clinics etc before, has turned out to be manageable (after all).
Prayer has been a hugely important factor in all this.
Claudia and i have felt "carried" by the many many people holding us up in their minds/hearts.
Thank you! Thank you and thank you God!


A truelly professional piece of filming... if you listen carefully, there are strange sobbing sounds in the background.

Plugged in, sedated and in charge of a baby...

Ultra Sound Endoscopy.... a fresh look

I'm still full of sedative from the Endoscopy as i type this (as you can see, when i came round), so i'll keep it short.

My appointment at the Bristol Royal Infirmary (BRI) this afternoon confirmed that the tumor is Stage 2.
This means i will need both Chemo and Surgery to sort it out.

Today the RUH hospital in Bath contacted us with a provisional start date for Chemo: 13th May.

I feel disappointed, strangely relieved to finally know what's going on inside me, but mostly knackered.

Family pics

Meet the Oncologist...

Hospital waiting rooms are odd enough. The oncology out-patients was no exception. Psychic magazines, 2nd hand book jumble sale, hairdresser and a secretary who offers neck massages (didn't get one).

The Consultant Oncologist who met us (approaching imminent retirement), had an air of contented distraction. He informed us that before Chemotherapy, there are a number of extra tests to go through.
One of the drugs they'll be using, Platinum-based, causes potential harm to kidneys and sense of hearing, so these are both checked out. And then there's sperm banking...

Oddly the consultant hinted that we were looking at a 1- max 2week wait. A chemotherapy nurse informed us later that it would be at least 3 weeks! I'll need to get Nurse Jo on the case.

Decision day

I told Nurse Jo, i'd let her know after the 2nd Friday MDT meeting what i had decided. The outcome of the meeting, (where all my test results were available) was much the same as the week before.
Indecision as to whether to recommend chemotherapy.
They did however suggest doing a repeat Ultrasound endoscopy on the 29th April... Good news (of a kind).

My decision: I requested preparing for Chemotherapy (Stage 2 treatment) until the results of the Endoscopy were known.

To my mind there are 4 outcomes.
1. Tumor is definitely Stage1 – therefore only surgery needed.
2. Tumor is definitely Stage2 – therefore both chemo and surgery needed
3. Tumor results still unconclusive – therefore proceed with chemotherapy.
4. Tumor gone – therefore no chemo or surgery needed and a lot of thanking God to do.
This would be new territory for some, but i'm very comfortable with this.

Repeat Endoscopies and Mackerel

Struggling with the decision to be made, i had a moment of inspiration (in the shower).

To repeat the UltraSound Endoscopy test. This would be the best way of getting up close to the tumor, to measure it again.
During the 1st test, the "scoper" suggested that swelling from recent biopsies might have exaggerated the estimated staging of the tumor towards Stage2. This was nearly 3 weeks ago now.
If things have settled down, this might be a good opportunity to take a second look.

On calling Nurse Jo, she said the consultant would have thought of it, if it had been a possible option, but promised to mention it at Friday’s MDT meeting.

By mid-afternoon i couldn't think straight, i had to get out.
I packed my rods, drove to chesil beach and caught 36 mackerel!
That was a perfect end to the day.

About Surgery

Its a tough one to comprehend, but i'm told the only way to surgically remove my Oesophageal cancer is a radical operation called a sub-total Oesophagectomy.

This involves removal of most of my Oesophagus and a portion of my stomach.
What remains of my stomach is moved up into my chest, stitched together into a tube and attached to the top 5cm of what remains of my Oesphagus.
(Louis will have a longer Oesophagus than mine!!)
It is a 5 hour key-hole surgery operation, not without its dangers and complications.

I will be in hospital for about 2 weeks, recovering at home for a month or two and in all it may take upto 6 months to get back on track, learn to eat again etc. My diet might be very different and i'll have to eat less and more often to avoid feeling full straight away.

Those of you who remember me as a slow eater... you aint seen nothing yet!

About Chemotherapy

My treatment would involve 2 rounds of chemotherapy, each being 3 weeks in length. Week 1 in hospital. Weeks 2&3 at home.

By the end of week 2 my immunity would be at its lowest, giving me another week to recover before the 2nd round begins.
There would be a 4-6 week interval between the end of chemo and surgery.

This would give me as long as possible to recover strength before the tumor can start rebuilding itself.

During the treatment, 2 chemicals would be administered, during week one of each round.
I am told that it’s a treatment that would only result in mild to moderate hair loss… hmmm.

April 21st - Consultant Clinic... the choice

A group of specialists had a multidisciplinary team (MDT) meeting on the 17th to discuss my staging test results.
My cancer is very small, but they couldn't agree on whether it was Stage 1 or 2 (there are 4 stages of development. Stage 4 is bad).

Stage 1 would only require surgery. Stage 2 would involve 2 rounds of Chemotherapy and then surgery. This was the first time that chemotherapy had been mentioned. Bad news.

They cannot categorically prove that my Tumor is Stage 2, so the decision of which treatment path to follow is ultimately mine to make. Thanks guys.

At early Stage 2 development, there is a 15% chance of cancer cells having spread to the lymph nodes nearby. In early cancer the Chemo has a high probability of dealing with these cells and maybe shrinking the tumor‘s size to make it more easily removable. So chemo has a good chance of helping.

I had till Friday 24th (the day of the next MDT meeting) to decide.
In case I decided to go for chemotherapy, they had already booked me an appt to see an Oncologist on Monday 27th. to start the process.

April 16th - Staging test3 - PET Scan

What its like: A radio-active injection followed by CT Scan, inside the trailer of a lorry.

What they look for: Cancer spread affecting lymph nodes.

What they found: No evidence of cancerous activity in lymph nodes. Good news.

Although the radio-active glucose had a half-life of 120 mins, i was considered a hazard to children and pregnant women for 6 hrs after the scan, so i stayed with my parents that night.

About the lorry.. apparently these scanners cost so much, that hospitals share the cost by hiring the scanner (lorry and driver) for a day a week.

Surprise 38th Party

I don't know HOW she did it. It must have taken ages to organise and involved dozens of surrepticious phonecalls, pillaging my mobile address book, secret shopping trips and a juicy fib to deliver me to the party without suspecting a thing.

Thinking i was going for a quiet meal with friends, we dropped by our church office (a last minute request) on the pretext of "signing some important paperwork for an upcoming annual meeting". With my churchwarden's hat on, and mind on other things, i was totally unprepared for a crypt full of local friends, family and funky music. Unbelievable. I love surprises, and this was a stonker of one.

April 8th - Staging test2 - UltraSound Endoscopy

What its like: A BIG swallow.. A 50 minute look down – 3 Endoscopies in one sitting (lying). See below.

What they look for: 1. After initial orientation, 2. Tumor position, size and thickness are measured using UltraSound. 3. Further biopsies are then taken.

What they found: Whilst the tumor was identified as being very small, swelling from previous biopsies made it difficult to determine the tumor’s actual size. The results suggested a possibility of Stage 2. Mixed news

Those 50 minutes could have been hell-on-earth, had it not been for the fabulous sedation and a lovely nurse stroking my head and saying encouraging things throughout...

April 6th - Staging test1 - CT Scan

What its like: drinking a jug full of "contrast" and then being scanned by an over-sized doughnut.

What they look for: evidence of widespread distribution of cancer around the body (secondary cancers)

What they found: the scan revealed no trace of cancer apart from a slight thickening of the Oesophageal lining just above stomach. Good news.

Apparently, the amount of radiation from a CT scan is equivalent to travelling to the moon and back – whatever that means…

Psalm 27

We found this most amazing psalm. It has given us so much strength.
We sometimes read it together at breakfast. I often read it before going to bed.

"The LORD is my light and my salvation— whom shall I fear?
The LORD is the stronghold of my life — of whom shall I be afraid?"

Written by (king) David at a time when he was on the run and under attack.
He talks about fear, security, future hope and belonging.
These are all things that have been swimming round my head having been confronted with my own mortality. Its so very weird.

v13 says - "I am still confident of this: I will see the goodness of the LORD in the land of the living."
I'll buy into that!!

To read the whole of Psalm 27 go to this link - http://www.biblegateway.com/passage/?search=psalm%2027;&version=31;

April 2nd - Diagnosis... a label

What I was told: I have a very early form of Intramucosal Adenocarcinoma or Oesophageal Cancer. A monstrous heaviness overwhelmed me when i heard that particular word.

What they found: Cancer cells were found in only 1 of the 10 biopsies taken.
At this early stage the consultant seemed confident that the cancer could be dealt with by surgery alone. He added that it was a minor miracle that it had been found at all.

I was introduced to a “nurse specialist” (Jo), who would be my contact with the hospital and would coordinate my ongoing tests/treatment.

Further “staging” tests were then booked to identify tumor’s development.

I now have a new label over me. Pete, husband, dad, son, brother, 3d animator... cancer.
Its so weird.