Chemo, Radiation and Surgery

You never know how you would react to these kinds of news. In movies, characters always seem to just go into shock or anger. I was neither. I was calm. I was collected. I was collecting information. I asked them a few questions about what is next, what are the alternatives. I was if anything in the ‘negotiating’ phase. I was told there would be another CT and MRI, this time directed at the area the abnormal cells were found in, and that we will know more afterwards, but there will be an oncologist involved and a referral to the Cross Cancer Institute.

I told my wife later that day. She felt devastated. She said she felt it was a possibility before and she was asking for more cancer testing, which was true, but between the Xrays, CT, MRI, and colonoscopy that I had undergone there weren’t more testing to have been done. She yelled, she punched the table, she screamed, she cried. It was a very emotional moment for us. We hugged and promised each other we will fight it together, that together we can overcome it, make it through, survive. We knew this was just the beginning, we just didn’t fully realize how much and beginning to what.

The CT and MRI results came back quickly and even though they were mostly a repeat of tests done just a few days earlier, now that they were looking ‘in the right spot’ the tumor was found. It was a large circular tumor around my rectum, it’s like the tumor was a leg warmer on the outside/internal tissue of the rectum. They said that the biopsies probably kept missing the tumor by a few millimeters each time. A total proctocolectomy would in fact be needed. A Proctocolectomy is a type of surgery that takes around 5 hours where my entire colon, rectum and anus are removed and I am given an ileostomy instead - the end of my small intestine will come out of my skin and empty into a synthetic bag that sits on my hip and that I have to manually empty on a regular basis. It’s a long surgery with a couple of weeks recovery, involved. But first - chemotherapy and radiation.

Chemo isn’t fun. No, really, it’s worse than that, and radiation treatment is even worse. I was put on a regiment of daily radiation followed by oral chemo, for 5 days of every week for 7 weeks. Every day I had to show up at the cross cancer institute (a wonderful facility filled with dedicated and caring people who deserve our support, funding and donations), and have my lower pelvis radiated to reduce the tumor, in addition to taking chemo in pill form twice a day to reduce the tumor’s ability to regrow. I found out just how horrible chemo was pretty soon. The chemo made me constantly nauseous and kept me feeling sick with little appetite. The radiation caused skin burns both on my internal tissue and on the external skin that kept me up at night. I was taking narcotics to stave off the pain, and using specialized pads to keep my burnt skin hydrated. Those were some very horribly sick and painful weeks. Still, for the sake of recovery it was worth it. It was not easy, but I got through the double therapy over 7 weeks. Two weeks after I finished the radiation and the chemo the pains started finally to subside. The surgery was booked for 6 weeks after that.

Having major surgery is always a complicated ordeal. Not less so a proctocolectomy. I woke up in the recovery room 7 hours after going down. I realized quickly that the operation was longer than first expected (initial estimates were 5 hours). I was admitted to the surgical ward and only found out later from the surgeon what happened - during the operation he noticed some white dots on the inside of my peritoneal sac (a sac inside the abdominal cavity, down to the pelvis. basically it’s a tissues that goes around my intestines). The surgery was stopped while they had some samples biopsied and given a quick pathology. The surgeon started removing the dots he could see when the initial pathological report came back that the dots were benign, so he continued the operation from there. Hence the delay. Followup was scheduled for a month later.

Things were looking good. I was released a couple of weeks later, I started my recovery and adjustment to a new life with an ileostomy. I was released from the surgical ward two weeks later and started my slow recovery. The plan was to recover from surgery, and then if all the scans and reports look good, go back to work and then have regular blood markers and CTs for the following 5 years until I am ‘clear’ of cancer. Everything seemed to be getting better, until it didn’t.

My first indication that something was wrong was that when I called the surgeon’s office for a copy of my surgery report or pathological report they wouldn’t send me one. They would ‘pass the message’ but then I wouldn’t hear from anyone. I knew something was up, that something was found, I just wasn’t sure what and to what extent. We met the surgeon around a month after the surgery. ‘is it a good news/bad news kind of story?’ I whimsicaly asked, unfortunately, it was. The deeper pathological report came back and the dots were in fact cancerous.The Cancer, basically, had metastasized.