Monday, May 08, 2006

The original email

As most of you have heard by now, I have recently (Tuesday) been diagnosed with esophageal cancer. Many of you have sent me your good wishes and you all have my sincerest thanks for that. Also, most of you have asked in a moment of weakness and pure emotion to be kept up-to-date with my progress, so I’m going to send occasional email updates to you all. I hope you won’t be excruciatingly bored by these; I’ll try my best to keep them interesting but we are talking hospitals and bodily functions here! I realize this email won’t be everybody’s cup of tea, so please let me know if you’d rather not be included, or just hit the Delete key when they arrive.

The problem, as it shall henceforth be known, showed up initially as a sudden difficulty in swallowing food. At first I put this down to the fact that I tend more towards inhaling food rather than chewing it 32 times before swallowing, as my dear old mum used to tirelessly exhort; alas to no avail. However, as it began to happen more frequently, I went to the doctor. She sent me first of all to get a “barium swallow”, which comprises drinking about a quart of thinly mixed spackle/polyfilla (US/UK conversion technique here) and having an x-ray while doing so. The radiologist told me rather dismissively that he didn’t really see anything and to chew my food more. However, on closer and later examination, allied with my going back to my doctor and grumbling that the problem was still apparent, I gained an appointment for an endoscopy (wiggly tube that can see into areas where the sun doesn’t shine). The endoscopy was carried out last Tuesday, the diagnosis made on the spot without waiting for the biopsy results, and I was suddenly on the cancer train, hurtling along seemingly out of control.

The problem is a 3 cm tumor in the lower esophagus, just before it joins the stomach. It’s seemingly a pretty nasty little bugger. If you go and Google it (from the verb “to Google”) and then uncritically read everything you find, it makes you want to open a vein on the spot. However, there are some great sites among the chaff and Kath and I began a quick study. Some of you will know that by a horrible coincidence, Kath’s mum is currently receiving treatment for the same cancer. Unbelievable.

So, I’m now on the train which is barreling along, but is actually very well directed, as trains on rails often seem to be. The process by which this disease is evaluated and the relevant treatment chosen is very proscribed. Not surprising really I suppose but when you don’t normally dabble in the medical black arts and you are suddenly forced to by circumstance, the efficiency of the process takes your breath away. So I left you all at Tuesday with a visual endoscopy. Move along just two days to Thursday and I’m having a consultation at Beth Israel with a guy with the biggest job title you’ve ever seen – it includes the words thoracic, oncologist, surgeon, and chief. Chief eh? I automatically trust him. So he lays out all the options on the table for treatment, prognosis, possible problems, possible clinical trials, forbids me from Googling – some hope! Friday (yesterday) I had an ultrasound endoscopy and a PET/CT scan (look it up), both of which were designed to evaluate the spread of the tumor. The result is generally good news. Although the tumor is clinically a stage 3, it is seen in only one lymph node and has not spread to any other organs. So I believe I will be undergoing a course of chemo and radiation therapy (not sure why they would call that therapy really) followed by surgery to cut the blighter out. There’s also a possibility of taking part in a clinical trial for a cancer drug, but we know little about that yet.

The support of family, friends, acquaintances, and colleagues is amazingly helpful and Kath and I are truly grateful to you all. Thank you so much.



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