Final summary Tuesday 14th June
All clear messages mean that there is no detectable cancer and that, with caution, I am free of rectal cancer through the removal of the offending part of my colon. For security there is a long term plan reducing over five years with a series of periodic scans and medical checks. I have to say that my treatment throughout. in the French health system, has been impressive. We are both relieved and grateful. I wonder if there is a research department into rectal cancer to which I can create a fund. I must enquire. 6th July 2022.
Monday 28th March 2022 Oncologist Consultant appointment at the hospital Eugene Marquis
Woopee ! All treatments now completed and 'Oncky' (Dr. Sour, my oncologist) gives me the clear until another scan prior to a shorter stay in La Sagesse Hospital on the 28th April where the surgeon (Dr. Metzler) will dive in to restore my colon to its rather shorter self and the removal of the temporary stoma.
Apparently I may have a rather loose performance for a while whilst things settle down. (ie I need to plan for loo visits in any excursions from Body and Soul that we may wish to make, post operation.)
Wednesday 2nd February 2022 at La Sagesse
Appointment with the anaesthetist 11am ( Mr. Gauthier) then followed by the hospital nurse...all as expected. Lots more forms and disclaimers !! Young and delightful. Nurse did ECG on me with lots of electrodes etc. Result OK I think ! All on time and well done. Back for lunch on board.
Tuesday 11th January 2022
Saw Dr. Metzler (Surgeon) who seemed pleased with the 50% reduction process from the radiation treatment and chemo. The operation date proposed was given as Monday 21st of February (Check-in on the Sunday 20th).
He confirms that the operation is going to be as planned. (see diagram below re 5th Jan visit.)
Dates now arranged:
- Thursday 27th Jan 11 am 1st floor at la Sagesse. Meeting with Stoma therapist - how to use it.
- Wednesday 2nd Feb 11am Meeting with Anaesthetist - take in details of medication and other forms to be filled in, signed by me.
- Saturday 12th/13th Feb - start special diet
- Sunday 13th Feb start taking 'oral Impact' x 3 a day up to and incl. 20th Feb.
- Monday 14th Feb. Blood test. Local nurses already warned that once at home, they will need to visit. 9am to ad noon.
- 16th, 17th 18th drink at least 1 litre of water per day. 18th - CPR test today to be sent by email to the Sagesse by email. 9.30am Centre near library. Will get call today from hospital re eta.
- Saturday 19th Feb. A sachet of Citrafleet to be taken in a glass with warm water at 2pm - take yoghurt and clear soup. Between 4 and 10 drink at least 1.5 litres of water....or liquid without milk. At 8pm take another Citrafleet and another litre before bed. Use hair remover cream to remove all body hair including pubic area.
- Sunday 20th Feb. sign in to hospital at a time to be confirmed on the 18th. by the hospital.
- Monday 21st Operation. Visitors allowed upon awakening but only one...same one each day.
Wednesday 5th January 2022
We saw the Oncologist (Dr Sour) - together with a visiting female student doctor who was in the consultation to 'learn how it was done'. All smiles as Dr. Sour read the latest results of last week's MRI and scan, from his computer screen. Apparently the offending tumour has been reduced in size by 50% - Hooray!
He was indeed happy, even surprised, with this progress. We answered all the health questions regarding the 18 weeks of chemo....how I felt during and just after the finish date etc. All appears to be going to plan and I am to look forward to our next visit to the Surgeon (Dr. Metzler) on the 11th Jan. who will give us the date for the 5 hr operation to remove the rest of the problem.
With the tumour bits (50%) he takes out, there will be a biopsy which will help them (the team) plan continued treatment. I will be fixed up with a stoma (bag) attached to my left hand side, connected to the colon. This is to remain 'in use' for several weeks, with special nurse supervision, before it is removed with a much smaller (say 1 hr) operation to restore the remaining plumbing to normal use, as per the diagram of my colon below which shows (1) The whole colon before op. (2) the bit to be diverted with stoma and (3) the final reconstruction.
There are , of course, long term routine check-ups over the following five years. I will be happy with what additional years of life this will give me and eternally grateful for the marvellous hospital team that has made it all possible.
Friday 30th December 2021
The end of the chemo treatment was marked by a hospital scan and an MRI scan on this same day - With Lucie, (my essential aide without whom I would have become hopelessly entangled in all the complicated hospital-French bureaucracy) - I drove in for the first appointment complete with all the documents and some chemicals required from the local pharmacy.
I was required to have completed a 'self administered' douche, at home, an hour before the first scan. Details unnecessary and too embarrassing to describe!
We arrived at the hospital an hour early because of a traffic-jam warning we received from the hospital which turned out not too troubling; time for a coffee from the hospital drinks machine before the first scan which was preceded by a '4 way' blood test and an infusion of some clear liquid through a pump which I held in my hand throughout the procedure. I noticed a 'not unpleasant warming' of the body as I was 'posted' head first through the scanning machine which took a few minutes with just my trousers off.
The MRI scan was booked concurrently to follow the first treatment but in a completely different area of this huge hospital complex which is currently undergoing major re-construction. It is destined to become Europe's largest hospital facility by 2027. This meant that I had to be wheel-chaired by an orderly, across what amounts to a building site, through a complicated route, to a separate building for the MRI. (I was not allowed to walk there, which would have been easier) Lucie followed this chaired route which winded between two tall building cranes, through car parks, over bumpy curbs and down narrow passage ways and had to endure a very boring 1 hour and a half wait in the waiting room whilst I endured the MRI which started with another infusion into the same arm.
This was followed by an insertion of a gel into my rectum and then a very boring and noisy head first insertion into another amazing machine. I was instructed to remain absolutely still for 25 minutes , lying on my back with earphones to drown-out the grinding noise, sounding like bread being sliced, with unspeakable rock music. I managed to achieve this but for an irresistible tickly cough, half way through. This meant that I was given an extra 4 minutes of the scan. All the staff were marvellous throughout this process. It was, after all, though at times unpleasant, very interesting for me. Obviously not so for Lucie who was glad to get to Lidles for a last new years eve shop, whilst not feeling very well herself. We were home by about 5 pm after refuelling in Evran Carrefour.
(only to find that some youths had stupidly detached two neighbouring moored boats - not ours - it was getting too dark to do much about it - other than what our lock keeper was doing - this was the second time to report to the Mairie)
Monday 13th December 2021
My sixth and final day of 'in- hospital infusion' marks the beginning of the last cycle of chemo treatment - all went well as usual and I was able to say final goodbyes and thanks to the nurses who have treated me since 30th August. Now there are 14 days of pill taking ending 27th December before seeing the oncologist Dr Sour after having various scans
- then I see the surgeon Dr Metzler who decides the date of the operation to remove what is left of the tumour. If all goes well....I should be free of this thing by early spring 2022. Can't wait!!
Monday 6th December 2021
I'm now in the first day of my free week after completing the fifth cycle of pill taking (14 days of Xeloda pills (3 in morning and 3 in the evening). Looking forward to a blood test on Thursday and to the beginning of the 6th and last cycle of chemo which begins with the infusion at the hospital and a consultation. 'Time flies when you are having fun', they say, and I can say it also flies when you are not!
I'll then be free of pills on the 27th December and be told, after a further consultation, when to expect the operation to remove the tumour. This will mean a 10 day hospital recovery from the surgery (takes 5 hrs).
My weight has dropped to 92.5kls from around 97kls. My default weight is around 94kls. ( when fit and healthy). I'm told to drink more of the liquid food they have prescribed. I will obey.
Thursday 25th November
Sadly, the end of my pill free week for cycle 4 - but am now into the 5th cycle of Chemo and on day 4 (of 14), back on my daily dose of pills, having had my consultation progress check and my usual chemo injections for cycle 5 (Monday) at hospital. This time I slept almost throughout the 2 hr procedure with my book on world geo-politics by Tim Marshal unopened on my lap. Lucie drove me home via various shops and we were back home by around 4.30pm.
This consultation, again, was with a different doctor, a blonde lady who seemed competent enough. No change prescribed for my chemo treatment.
I feel very tired as expected and have lots of 'pins and needles' in my hands and in my throat when touching and drinking anything cold. Piano playing is badly affected. My weight and appetite have returned and as recommended I am being careful and a little apprehensive. But, only cycle 6 to go before they decide what and when to operate.
Sadly, we are in for a quiet Christmas it seems.
Sunday 7th November
Nice day with horse steak for lunch, baked spuds and cheese and chicory
sauce. Dose of pills now down 25% to three pills twice per day.
Feeling better on lower dose prescribed.
Symptoms: Nausea (slight but persistant), pins and needles in hands and
feet. Watery eyes as if sore through too much reading. Light coloured poo.
Must keep taking the liquid food prescribed.
Overall tiredness and fatigue.
Tuesday 2nd November
Consultant appointment at the Eugene Marquis hospital and the start of my
fourth cycle of chemo treatment.
Appointment with the consultant doctor covers all the changes that I have felt to date and she adjusts the doses according to what she hears from me. This time she reduces the Xeloda dose from 8 pills per day to 6 pills per day in the hope that I will not feel so tired and nauseous all the time. Presumably she gets advice to do this from the Oncologist and before my 2 hr infusion session is scheduled to begin. The infusion takes 2 hours and we get home by 4 o'clock.
I also get a visit from the dietician doctor who advises me (insists!) to keep taking the liquid food prescribed for me. This is because I have lost weight rather faster than hoped because of my failing appetite. The general idea being to keep me as strong as possible before the necessary operation which is to follow the 6th chemo cycle.
Present symptoms include....
Unless they are going to make allowances for the Christmas Holidays, it looks as if Christmas day actually lands in the last three days of the 6th cycle treatment. So I don't expect to be visiting rellies this Christmas but maybe well enough to enjoy the New Year celebrations before my operation at a later date (as yet undecided)
Tuesday 26th October 2021: (2nd pill free day of third cycle)
Glad to have a break from pills. The third cycle of the treatment is over this coming Sunday. The effects of the treatment seem to be getting noticeably more tiring, but I hope the next three cycles (the 4th 5th and 6th) will not be any worse than to-date. But bring it on!
Friday 15th October 2021: (my 5th day of third cycle)
Doctor's appointment for both of us (Dr. Prise Tinteniac) resulted in some more prescriptions for both and a certain confidence in my progress through the chemo so far. Good blood pressures etc and "nothing to. worry about". All is apparently as expected.
Thursday was not a good day and I took lots of naps. Today is much better, It seems that the four Xeloda pills that I take in the morning make me feel a bit crappy as they kick in ...with pins and needles in hand and feet, slight nausea etc which gradually wears off during the day, The four pills of Xeloda that I take before bed do not bother me as I am then well asleep.
Monday 11th October 2021:
We have really enjoyed having family visitors - (Jake, Moo and Clive and families then Lucie's daughter Sophie - still more to come) Such support and unity has been both touching and curative ...lots of love and thanks to all for their efforts in getting here. It was never going to be easy because of Covid restrictions. Friend Anita has also given much valued support to us both.
16.45 Just home from my third chemo session and consultation from Eugene Marquis Hospital in Rennes (09.20) - with a beautifully tall, sun-soaked French doctor who was standing-in for Dr Bettina, my usual equally attractive, consultant. They all seem so young, maybe its the uniform thing? Lucie relaid all the happenings of the last 14 days of pill taking - she makes notes of everything and I would find it virtually impossible to cope without her - I was briefly examined and was found to be 'all there' ! (no - really! ?) Good blood pressure etc. More medication recommended for bowel/ constipation problems.
We were called then for treatment in one of the many highly equipped treatment rooms...quite a lot of delays and waiting, but all under great control as usual. Lovely pair of nurses - Manon and 'Lucile?' applied all the fixtures and liquids - I asked why they preferred the forearm for the vein injection and not the more obvious veins on the inside elbow....answer was simply so that I was better able to rest the arm flat for 2 hours...oh well, there you go. The nurse (L) (a left-hander too) had three shots at it before succeeding which she did with grace, consummate skill and profuse apologies. A very talented nurse and good humored too.
Met the other two men in the ward, all comfortably fixed on special chairs with full electronic self- adjusting controls...lots of pipes and hanging bags of liquids all bleeping away. 'Toni' was a retired English teacher - great chat for around 2 hours, with Lucie present most of the time. We really liked him. I did not sleep at all this time. He says he will read my blog ! ....ah at last a possible fan? maybe he will get in touch....maybe he's a journalist too?
Philip is French speaking and very pleasant but obviously less involved with the repartee. (yes - terrible isn't it? - though I speak quite a lot of French I still don't understand what they are saying ! - maybe that has always been the case, even in English - now there's a thought ! Less introspection please. OK.
I was visited also by a very nice lady dietician who gave lots of advice to Lucie about my diet which is supposed to keep my weight up to normal (now 94klgms as indeed I was when in Kuwait i 1989 +) I thought I ought to lose weight - No?....back to the beer then! This time I couldn't face the hospital lunch provided as I have recently lost my appetite for food. Liquid foods in bottles are provided by her to take home.
I drove back - perhaps unwisely - but this time with less traffic - we both feel strangely tiered and my eyes are puffed up and demanding that I should close them. The injected arm feels very sensitive to touch - sort of pins and needles. This will pass quickly enough and is no bother.
Lucie produced a delicious creamy mushroom pasta dish for supper all of which I ate with relish, as if by magic, with a small glass of home brew...there really can't be much wrong.
...and so, to the third cycle of "cancer killing" pill taking, starting with an anti vomit pill for each of the first three days. So far so good, but I do sometimes feel knackered and always physically weakened.
Friday 1st October 2021:
On my 12th day (of 14) in my second cycle. Things seem much the same as the last ( the first cycle) though I have had a few tummy problems but better now. Might have been the steak tartar I had a few days ago, although that was delicious ! 2 more days and then a week off before starting again with the injection at the hospital. Thus onward with the third cycle..oh joy!
Wednesday 23rd September 2021: (Happy birthday Judy !)
My condition and side effects now are similar but perhaps a little more distinct in terms of the pins and needles in the fingers, lips/mouth, throat. I am expecting this feeling to subside as previously experienced.
I feel much weaker this time and notice this mostly when I try to lift heavy objects - like water containers, gas cylinders and such. My eyes also seem to be very watery and tired, as if I'd been reading typeface which was too small.
My appetite is lower than normal, despite Lucie's excellent and healthy dishes.
There is a distinct improvement in my bowel movements which has lightened my mood!! Does this mean the rectal tumor is diminishing as wanted? I wish!
I'm trying to keep to 1 bottle of my home-brew beer per day - they have allowed me one glass of red wine per day or the equivalent. Cuh!
I'm now on day 4 (Thurs) of my 2nd (of 6) chemo, pill taking cycles, having had the second injection of Oxaliplatine at the Eugene Marquis Hospital in Rennes on Monday. I should have had a blood test on the Friday before this but I forgot to do this and Lucie had to arrange one for Saturday. For reasons which we still don't understand, they did receive the results but decided I should get another test that day at the hospital, which resulted in more than an hour's delay to the 2 hour injection treatment.
We are both increasingly impressed by the treatment and service and especially in the electronic connectivity between the team of many doctors treating me. They are always well informed through the computer technology at their disposal.
We said goodbye to Jake, Rosemary and Emily after supper (Monday) - they had to leave - in their new electric car - at 3am (Tues) in order to reach their pre-booked train passage from Calais.
Wednesday 8th September 2021:
I'm on day 10 of my 1st chemo, pill taking, cycles which started with the 2hr injection of Oxaliplatine at the Eugene Marquis Hospital in Rennes on Monday 30th August.
The most noticeable adverse effect of the treatment are periods of almost overwhelming fatigue to which the only option is to rest. Being in retirement I am able to do this as required. I go to sleep quickly and have cat-naps, literally curled up with one or other of our pet cats. Lovingly, Lucie fits in to this new phenomenon and is able to "do her own thing". I feel lucky to eat her lovely food..
Gradually my body appears to be getting used to the treatment and I have noticed a definite improvement in bowel activities and sleep patterns. This has a knock-on affect to my mood and I no longer suffer so much bloating.
Today I weighed 93 kilos which is very encouraging because I started the treatment at 97.5 Kilos. But I do feel weaker when performing simple routine tasks, like checking the engine and batteries. I was grateful with the help from Alan and Harry when setting up our winter 'conservatory' sheeting around the poop deck.
I notice too an improvement in my sleeping and there is less tingling in my fingers. So far there is no feeling of nausea. There is no pain anywhere.
I am sea-swimming and exercising at least four times per week.
Tuesday 31st August 2021: Pills, pills and more pills
So far so good - just a few 'pins and needles' in fingers and toes especially when touching cold things. Could it improve my piano playing? (best be optimistic?)
I wish I could share (with all (both) my blog readers!) just some of the pills I have to take in order to make my age-dwindling body work in some acceptable manner - but I can't without upsetting the the local Evran pharmacists who seem to know and care about my cancer as much as I do. They presumably get paid for the services they provide for the doctors who prescribe medicines for people like us who gratefully receive them all free of charge.
The system appears to work well, to say the least, as far as we are concerned. I have the advantage of a French wife, Lucie, without whom I would not get through all the well versed bureaucracy involved.
By describing them below you will understand my drift:
Xeloda 500 mg Each day I take 4 pills after breakfast and 4 after dinner. These stop cancer cells from reproducing and reduce the tumor growth.
Loperamide 2mg to alleviate diarrhea caused by the Xeloda (max 8 per day)
Aprepitant 125mg (just 1 before 1st chemo treatment.) Not sure what for
Aprepitant 80mg (just 1 after breakfast on second and third day only) Ditto.
Metoclopramide 10mg (alleviates nausea max 3 per day, as and when)
(the above does not include heart pills - regulators and thinners already prescribed for my mini stroke 2 years ago nor the liquid Oxaliplatine they inject into me on the first day of each of the 6 cycles in hospital nor does it include all the drugs Lucie has to take for her painful condition now mostly under control)
Monday 30th August 2021: Day 1 chemo at Eugene Marquis Hospital.
A proper blog tomorrow when, literally, it all sinks in - but for now, both Lucie and I were so impressed by my treatment that it could be said, we both thoroughly enjoyed the experience and have come away with a sense of relief in the delightful, cheerful reception and informative treatment from an excellent team of doctors and nurses. All questions and fears allayed and an even more optimistic and clearer idea of what lies ahead.....
....whilst Lucie claims petrol expenses, I get lunch and an hour or two's "kip and drip" ( that's my invention !) whilst watching the Olympics on the tele. Tomorrow I will describe the side effects if any. Watch this space!
Friday 13th August the last and fifth radiotherapy sessions.
Click on this line for full details of rectal cancer by MacMillan
Without events worth telling, I wished them all "Mercy et bon continuation". I'm still free of any new nasty effects. Maybe I'm more tired than normal. Not sure. But yippee I have three weeks free of treatments ahead and before Chemo begins. ( 6 months to go ! oh Joy?) Lucie has accompanied me on these daily trips to Rennes and has claimed the petrol allowance already. Thus - end of first stage. QED.
Side effects are as follows:
Side effects of radiotherapy from the MacMillan people
"Side effects depend on:
- the dose of radiotherapy
- whether it is external or internal
- whether you have chemotherapy as well (chemoradiation).
Side effects usually begin a week or two after starting treatment. They may continue to get worse for a few weeks after treatment, before beginning to get better. Side effects usually improve gradually over the next few weeks or more.
Smoking can make side effects worse. If you smoke, try to give up or cut down. Drink at least two to three litres of fluid a day. Water is best. Drinks containing caffeine and alcohol can make bowel and bladder symptoms worse.
It is important to tell your radiographer, cancer specialist or specialist nurse if you have side effects. They can give you advice on how to manage them and prescribe treatments that can help. It may take some time to recover, particularly after longer courses of radiotherapy or chemoradiation. Look after yourself by getting enough rest and gradually increasing your physical activity. This will help with your recovery.
Sometimes some side effects do not completely go away. Sometimes side effects develop months or years later after treatment. These are called long-term or late effects. Tell your specialist nurse or cancer doctor if side effects do not get better, or you notice new side effects. There are many things that can be done to help.
We have more general information about the side effects during pelvic radiotherapy treatment.
Tiredness
Tiredness (fatigue) can continue for weeks or a few months after your treatment has finished. You might be more tired if you have to travel to hospital each day. If you are also having other treatment such as chemotherapy or surgery, this can make you even more tired.
Try to get as much rest as you can, especially if you have to travel a long way for treatment. Balance this with some physical activity, such as short walks, which will give your more energy.
Skin reactions
The skin in the area that is treated may:
- redden
- darken
- feel sore or itchy.
Your radiographer or specialist nurse will give you advice about looking after your skin. If your skin becomes sore or itchy or changes colour, tell them straight away. They can give you advice and treatments if needed.
Skin reactions should get better within 4 weeks of treatment finishing.
During your treatment, you are usually advised to:
- wear loose-fitting clothes made from natural fibres, such as cotton
- wash your skin gently with mild, unperfumed soap and water and gently pat it dry
- avoid rubbing your skin
- avoid wet shaving
- avoid hair-removing creams or products, including wax
- follow your radiotherapy team’s advice about using moisturisers
- protect the treated area from the sun.
Bowel changes
You may experience problems with your bowel such as:
- loose stools (poo)
- constipation
- needing to poo urgently and more frequently
- cramping pains in your tummy or back passage
- passing a lot of wind.
If you have diarrhoea, your specialist will prescribe anti-diarrhoea tablets to help.
If you have tummy cramps or constipation, tell your cancer doctor or specialist nurse. They can prescribe things to help.
Tell your specialist nurse or radiographer if you have any incontinence. They will give you advice on coping with this. They will also explain how to look after the skin in that area.You may be advised to make changes to your diet during radiotherapy. Bowel side effects usually start to improve about 2 weeks after radiotherapy finishes. Sometimes they may take a few months to get better.
Bladder changes
Radiotherapy can irritate the bladder. You may feel like you need to pass urine (pee) more often. You may also have a burning feeling when you pass urine.
Always tell your radiotherapy team if you have any side effects during, or after your course of treatment. There are drugs that can improve bladder side effects and help you feel more comfortable.
Try drinking at least 2 to 3 litres (3½ to 5½ pints) of fluids a day. Try to drink more water and less drinks that may irritate the bladder. These include drinks containing caffeine, such as tea, coffee, drinking chocolate and cola. You should also try to drink less alcohol, fizzy drinks, acidic drinks (orange and grapefruit juice) and drinks with artificial sweeteners (diet or light drinks).
Hair loss
Most people lose their pubic hair. It should grow back after your treatment finishes, although the hair loss may be permanent."
Thursday 12th August Fourth session
Same as yesterday though went to Lidls Combourg for weekly shop and some tools from Weldom's.
Wednesday 11th August Third session
Nothing to report and no side affects so far. Same treatment exactly as the first and second sessions. Left B&S 11.55am Back at 2.00pm. The radiologist let me see the screen with a picture of my rectum and what they were doing with it!....Very interesting and completely marvellous !
Tuesday 10th August Second session
Nothing to report and no side affects so far. Same treatment exactly as the first session.
Monday 9th August First of the 5 days of radiation. Treatment starts now.
Left B&S at 12.40pm with Waize GPS guidance to Eugene Marquis Hospital...Department C. Light traffic. Arrived too early so we dosed in the car for nearly an hour.
Actual treatment took a little more than half an hour from 2.05 pm with Lucie in the waiting room until, say, 2.45pm when we left to go home.
I was made to lie down on a paper covered tray on my back, shirtless and with pants discretely hiding lower parts with an exact position dictated by last week's scan and markings. All very efficient as I have come to expect.
Bull's - eye !
Lots of white machinery, each the size of a small refrigerator, buzzed and wheezed and spun quietly about me as I lay there, hardly daring to breath, for 20 minutes. We now have my timings for the rest of the 5 days...each day the times are different (see below).
No need for me to describe each session again, unless there are any unexpected developments. It was in no way an ordeal, but I will record any adverse side affects if I get any.
We were back on board B&S at 3.30pm
Tuesday 10th 4.05 pm
Wednesday 12.55pm
Thursday 12.15pm
Friday 2.15pm
Sunday 8th August The annual Evran Port Festival
Saturday 7th August Rained all day
Friday 6th August I Did a lot of Blogging, Lucie goes to Dinan to get some chutney and jam with Anita who is not well but no-one knows why. Weather ridiculous for summer norms.
Thursday 5th August Long lunch at Shelly and Mick's Mill House (my previous brewery location)
Wednesday 4th August Rained all day
Tuesday 3rd August Rained all day
Monday 2nd August Rained all day
Sunday 1st August Took a car trip to explore Bas Bout on the coast and ended up having lunch at the cafe at Lehon ex- presbytery just under Abbey walls.
Saturday 31st July 2021 With 9 days to go before beginning the 5 days of 15 minute radiation, a fry-up of the offending rectum, we take a break to see a friendly couple in St Malo who have just moved to a new house. (Vincent and Isabel)
Friday 30th July Following yesterday's appointment with the radiologist Dr. Gnep and having another scan -
Incredibly, I have already received by mail, a large envelope of new dates to put in the diary, some instructions for blood tests and some prescriptions for drugs/medicines that I must get from our local Pharmacy. As one can see, they are anticipating my survival with some appointment dates booked in January 2022 ! This is very reassuring.
Important dates for the diary: From the above mail.
Blood test (Creatine) to be booked for 22nd Dec 2021 (prior to scan)
30th Dec 2021 Scan at Eugene 1.15pm
5th Jan 2022 at 2.20pm Dr. Sourd (Onky!)
11th Jan Meet 9.00am Dr Metzler to be confirmed at La Sagess.
Now it's the 29th July - Thursday - things are going well and we are off to the Eugene Marquis Hospital for my appointment (at 9.45am) with the radiologist, Dr. Gnep who will be telling me his plan for my 5 days of radiation treatment. This hospital in Rennes is some 46 kilometers from our Evran home so we are off at 8.10am, expecting traffic. Thank goodness for our old Peugeot which has been so quiet and reliable so far.
To our surprise and delight, the hospital receptionist, after admitting us, informed us that we should claim our petrol expenses at 30 centimes per kilometre (say 92 kms per day x 5 x 0.30 Euros) We are more than impressed by my treatment in the French system, so far, - we can't help comparing the likely NHS equivalent, although this may indeed be unfair.
This very nice young doctor again, who also had quite good English (and of Cambodian origin) sat us down and explained all about the radiation treatment that he had now booked to start on the Monday 9th August at 2.15 pm. This to be followed by 4 identical sessions of radiation lasting approximately 15 minutes each time. The possible side affects were also described but did not seem to be too arduous.
He also explained very well about the reasons for the scan that was about to take place just after this interview with him, (at 11.30am) in another section of the same department of radiology. This scan was to mark exactly, on my lower tummy, where the tumor lay - presumably for the exact direction, the target for the radiation during this 5 day period (now starting on the 9th Aug.) and, possibly, (I surmise) for the surgeon later on when the offending tumor was to be removed. I now sport a few very important semi permanent tattoos in the relevant places.
We finished the morning in time for an excellent lunch with friends 'My' and Jean-Pierre - in their garden and in perfect sunshine.QED.
Summary of Treatments proposed:
Many consultations tests - scan - MRI (all now completed)
Final consultation before treatment starts with radiologist 29th July
Radiation:
5 consecutive days of 15 mins radiation
Rest period 1 week +
Chemotherapy cycles
First of 6 chemo. (Oxaliplatine) 2hr injections followed by:
14 days of pills (Xeloda) at home
1 week recovery time
to be repeated six times as chemotherapy above
Post treatment will include another series of scans prior to an operation to remove the rectum and the sessiles and to put in a temporary stoma.
Finally (around May 2022 ?)
A smaller operation to remove the stoma and reconnect the colon
blood tests throughout to check levels of red and white blood cells, proteins etc
Awaiting 29th July to be given the start date for the 5 days radiation (yikes !)
The above summary shows the oncoming stages of the treatments that have been put together by the team of specialist doctors for my sake and to which I have agreed to follow.
Diary to date
Wednesday 21st July First appointment with Dr. Samuel Le Sourd ( Cuh! They get younger every day !) at the Centre Eugene Marquis which is a new hospital venue for us - additional to the three hospitals with which we have already, unfortunately, become familiar. It appears that this venue deals for the most part with cancer treatments - radio-logical and chemo-graphical.
Consultation with the Oncologist and blood test: dated above.
Diagnostics reveals :
This included a colonoscopy which was originally planned for January 2020 but was deferred to May 2021 because of covid 19. This revealed that there was a rectum tumour of some 10 to 15cms together with two 'sessile' (A sessile polyp is one that is flat and does not have a stalk - For this reason, sessile can be more challenging to find and remove during a colonoscopy,) both of which were deemed non-cancerous. An operation was planned to remove all three issues.
There is a planned path of treatment in terms of both radiography and chemotherapy, the first of which was to be five consecutive days of 15 minute radiation treatments, followed by 2 or three weeks recovery time before the chemotherapy program was to be started.
The Chemotherapy: Much to our shock, it seems that my chemo treatment is to be spread over 6 x three week cycles, each beginning with a 2 hour injection of Oxaliplatine to be carried out at the hospital. Then 14 days of home-based pill taking ( Xeloda total 8 per day after meals am and pm) and another 7 days recovery time. ( ie Each of the cycles is to be 3 weeks including the 7 day recovery period)
We were sent to another part of the hospital for a blood test to check the health of my liver which has got to be healthy enough to process all the drugs with which it will be required to deal.There will be regular blood tests throughout.
The next step from this initial consultation with the Oncologist ('Onky' for short !) is to meet with the radiologist Dr. 'Death' (Who ?) (Wednesday 29th July) to be told what to expect from him and when to start this consecutive five days of treatment (to be followed with 2 to 3 weeks recovery before starting the Chemo..... )
After the end of all the radiation (5 days + 2 to 3 weeks recovery) and 6 cycles of chemo (XELODA pills ?) as described above there will be a further scan and an IRM before the operation to remove the offending items and the installation of a temporary stoma - and then after one additional month's recovery - the coup de grace ! - a further operation to reconnect what's left of my (left side) colon to the anus and remove the stoma. (Yippee !)
So from start to finish the whole process will last approximately 30 weeks plus some time for my body to get used to the recent intrusion (Oh joy !) Starting date to be advised.
The possible side affects (vary from person to person and circs.)
During treatment:
Diet white bread low fibre. Nausea, immune-vulnerability, acute tiredness, cold, cracking skin, pins and needles. Loss of hair? Diarrhea. Depression? Avoid alcohol although apparently no causal link to my condition ! Inform close blood relatives, over 50, of the probable genetic link. They should have a colonoscopy in order to be safe.
After treatment:
Diarrhea (a permanent tendency.)
Monday 15th - 19th July Went for several days of sea swimming at a new place to us - St Jacut - Good to be back in the water - stayed in sea doing all strokes and over long distance around distant moored boats and buoys. Bit choppy on first day which made breast stroke more difficult but 19th (mon) was glorious and flat calm. Not good sailing weather - not enough wind to blow out a candle but great swimming .Tired but on form after swim but otherwise fit as a fiddle.
Enjoyed a couple of pints (150 cl = 2.7 pts ie 2 x 75 cl bottles of my new brew after returning to Evran - brewed from malt extract - English Ale from Brouwlands) Dry hopped using Citra hops given to me by Paul and Claudine, soon to be the new owners of the port cottage that Anita currently is renting.
Have ordered more brewing supplies from Brouwlands. (3 x 1.5kg tins of malt extract English ales). Need to check supplies of yeast culture ( type 1968 preferred).
Wednesday 14th July (Bastille day !) A bit shocked and disappointed but recovering - it would have helped make the summer visitors (if any) more enjoyable re Jake, Clive, Moo, Nick, Rob Judes and the Blairs etc that is....if the "blockage" allows.....poor Lucie !
Tuesday 13th July Dr. Metzler rang to cancel (defer) any operation, having discussed the case with his team and deciding that the tumor was too big and that "chemo/radio" therapy was to be the first step in order to reduce the size of it. This treatment would last for three/four months including the actual final operation/procedures. Details of this to follow forthwith.
Question: What is to be done if my condition continues to worsen meantime?
Wednesday 7th July Dr. Metzler (La Sagesse Hospital) appointment to summarise all that's going on. Confirms cancer of rectum - a tumor first identified by the earlier routine colonoscopy - from the latest MRI - and all other tests so far. He suggests Monday 19th July for an operation to remove rectum and also the two other benign "cesilles"/polyps on right side of colon. Temporary stoma required from left colon. To be discussed with his team and confirmed asap. There appears to be no spread of the cancer into other organs but maybe to some of the surrounding tissue.
There would be a smaller operation to re-attach the remaining colon (left) to the anus and the removal of the stoma.
Question;
My defecation difficulties are getting worse from what appears to be a rectal blockage through which the stool exudes (passes) through to my anus.