Friday 23 June 2023

Here we go, here we go, here we go…

After one set of blood tests, two incomplete colonoscopies, a CT scan and what felt like an agonising wait of almost three months since the GP put me on a 2 week wait urgent referral for cancer screening, at last things are moving forward.  

We met the consultant surgeon yesterday morning, talked through what had happened (or not happened, as the case may be) and looked at the CT scan in detail.  Although not confirmed by biopsy, the expert radiologists and surgery team are as sure as they can be that the thickening of my bowel wall is cancer.  This can only be confirmed 100% by examining tissue samples, but having tried and failed twice to take biopsies due to a stricture which prevented camera access during two colonoscopies, and there being no other guaranteed way to confirm cancer, they think that its now time for action.  

I’m pencilled in for surgery on 5 July, less than a fortnight away.  The operation is called a “high anterior resection”.  It will remove the area of the bowel on the left descending colon where it’s thickened, a safety margin of 5cm above, the blood supply to that part of the bowel and the associated lymph nodes.   It will also remove the stricture lower down in the sigmoid colon, and the bit of bowel in between the stricture and suspected cancer.  The way blood supplies run to this part of the bowel will dictate the extract location of the lower cut; there’s a limit to how far the alternative supply from below can travel upwards, against gravity.  There should be enough colon remaining after the resection to allow the two cut ends of bowel to be joined up without the need for a stoma/colostomy bag.  

The surgery will be done laparoscopically i.e. keyhole, and may be assisted by robots depending on which operating theatre they are allocated for my case.   As it hasn’t spread, cutting out this length of bowel should remove any cancer completely, so no need for chemotherapy or radiotherapy after.  It should be a complete cure.  

I won’t elaborate on the risks of surgery which are many and varied, right up to the very worst case scenario of dying on the operating table.  But I’m fit for my age, with no comorbidities of significance in relation to this surgery, and the team are very experienced.  They perform this operation frequently.  I will be in good hands.  

Of course, they may find on examining the removed bowel that there’s no cancer there at all and this drastic surgery was unnecessary.  But I’m prepared to take that risk as the alternative - cancer growing and spreading/metastasising, the associated treatment with chemo and poor prognosis  - is too horrible to contemplate.  

Keyhole surgery has faster recovery times than open surgery. I should only be in hospital 3-5 days and will be encouraged to get up and start moving as soon as possible.  The first couple of weeks back at home will be the most difficult with pain and tiredness, and I will need support.  I’m lucky to have family and friends ready to rally round!  No heavy lifting for six weeks, during which time I should start feeling better and stronger.  All being well, I’ll be back to normal in a couple of months.  I hope so anyway, as I’m already thinking about what I’d like to do then.  But if all goes to plan, the biggest delight will be the safe arrival of my first grandchild in mid-September.  That will be a huge incentive to get well quickly!
 
My pre-op assessment is next week.  I’m busy sorting out post-op support arrangements in the meantime, cancelling some appointments that are currently booked in on 5 July and beyond, and making tentative arrangements to meet up with some UK friends from mid August onwards.  It could all go belly up if the operation is bumped to a later date, but I’m trying to stay positive.  




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