“It’s nasty.”
These were the very words which were imparted to me at diagnosis as my groggy mind, pumped full of sedative and morphine, tried to make sense of what I could see on the screen. A bloody mass presented in high definition, in all its glory, being tugged apart by the biopsy forceps. In retrospect, the room had fallen silent, and phone calls were being made. To the cancer specialist nurse. To the CT scanner for an urgent CT. To my husband. This is the point at which your world disintegrates around you, crashing down with the loudest bang you will ever hear.
The disbelief, of being blind-sided by this meteorite. It seems so foreign.
Yet one in two of us will get cancer.
Being a family doctor, one could say I should have known better. But I felt sure that my symptoms could have been attributable to piles and irritable bowel syndrome (IBS). I was, and would like to think I still am, a fit and healthy individual with no risk factors and no family history of any cancer. I didn’t look or feel unwell, having completed an 8-km assault course only the weekend before. But with the benefit of hindsight, things maybe were just not quite right ...
If I go back to the beginning and set the scene, I probably had what I thought were new-onset IBS symptoms approximately nine months before my diagnosis – constipation requiring laxatives intermittently, some urgency in needing to go to the toilet, and occasionally some fresh blood on the toilet paper. But since childbirth six years ago, a little blood every now and again on the toilet paper from a previous pile was not that unusual.
Tiredness was also a feature, but I expected nothing less as a part-time doctor, mother of two energetic children, running a household and, quite frankly, I can’t remember the last time I wasn’t tired. I had seen my GP for that reason nine months prior to diagnosis, and all my blood tests were normal then, and things were left at that point, with nobody thinking any more of it.
Four months prior to diagnosis, the constipation and occasional blood on the toilet paper was becoming more intrusive. I started to experience an increasing feeling of incomplete bowel emptying (like I hadn’t finished a poo properly), after I’d gone to the toilet. The blood became more noticeable, initially on the paper, but then in the pan, and in July 2018 my bowel habit was, for want of a better expression, frankly explosive. I knew that something was wrong. I finally spoke to my husband about my symptoms as I felt that things weren’t settling. We both agreed I would go to the doctor to seek further help.
By this point, the summer holidays were in full swing, I had been examined, and further blood tests had been requested. I commenced a prescription for regular laxatives and suppositories for presumed piles and possible IBS, and actually I thought my symptoms slightly improved.
However, by the end of August whilst we were having our family holiday in Italy, things became progressively worse, I noticed that I was really quite fatigued. I was tiring and short of breath when running shorter distances than usual, I honestly felt like a sloth running backwards. I thought it was the effects of the scorching conditions I was attempting to run in, so thought nothing more. I was treating myself to afternoon siestas, and then falling asleep by eight thirty each night, apparently messaging friends about how fatigued I felt.
Despite indulging in every Italian carbohydrate possible, looking back at pictures now, I am convinced I started looking slimmer, despite eating more lavishly while abroad. I found myself rushing to the toilet in the early hours of the morning and on the final day, the blood spatter in the pan was alarming. I braved showing my husband and from the look on his face, I knew immediately I had to go back to my doctor.
My tumour was (thankfully) deemed operable, and I underwent a laparoscopic anterior resection and a total mesenteric excision. The decision was made to give me a temporary ileostomy (stoma) from a surgical safety perspective, to allow the surgical join to heal where the tumour had been removed.
My husband tells me that time stood still for him as he paced the corridors in the hours I was away from him in theatre. I, on the other hand woke up bleary-eyed in the recovery room with beeping machines surrounding me, unaware of my fate. My hand slowly moved towards my belly, knowing I had to firstly find out whether surgery had taken place and secondly, whether there was a stoma. Through the curtain my surgeon’s head appeared. He smiled, the tumour was gone, removed in its entirety, and the relief was palpable.
Yet this was just the beginning.
Condensed and extracted from Everything you hoped you’d never need to know about bowel cancer by Dr Anisha Patel, which is out now (Sheldon Press £16.99).
If you are concerned about your health, it's always recommended to book an appointment with your GP to discuss diagnosis and treatment. You can find your local GP here.
Find out more about bowel cancer at https://www.bowelcanceruk.org.uk/.
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