review time

After the completion of the chemotherapy, I had another MRI and CT scan to let the clever doctors review progress and plan the next steps in the treatment plan (which was scheduled to be 6 weeks of intensive radiotherapy).

The only feedback I had during the three months chemotherapy was that the ‘cancer markers in my blood were down (from 10 to 5)’ which I took as good and welcome news but it didn’t really tell me much about the state of the problematic lump in my backside.

The doctors told me that the chemotherapy had ‘been beneficial’ and there was evidence that the centre of the tumour was ‘necrosed’ (dead). When I said it was strange, the central core had been affected and not the edges, the doctor explained that the central area was blood rich and as the chemotherapy attacks rapidly growing cells, this actually made sense. Although the size of the tumour was unchanged (8 cm), the doctors also seem pleased with the way I had tolerated the chemotherapy with relatively few side effects which meant the frequency and dosages didn’t need modifying with only two delays of one week each.

To summarise, the doctors confirmed that we are still on course for a ‘curative solution’ – curing the cancer not just treating the symptoms and we will continue now with external beam radiotherapy. The sole purpose of this targeted radiotherapy is to reduce the size of the tumour in order to give the subsequent surgery to remove the tumour the best possible chance of complete success.

In fact, the doctors stressed that it is not necessarily the size, per se, of the tumour that matters. It is the areas around the edges and borders with other organs that is crucial. As the doctor said, ‘We need 5mm to be able to safely remove all of the tissue. If we get more, than that’s even better’.

I asked what the best and worst case scenarios were. The worst was ‘no reduction but this was unlikely’ while the best outcome was that the tumour would shrink away to nothing, negating the need for surgery. My ears pricked up at this prospect as this was the first time, this had been aired. However, the oncologist immediately urged caution and said this was a ‘20% chance’ but not for my type of ‘mucin producing tumour which doesn’t tend to respond as well to radiotherapy’.

The next stage was a planning session for the radiotherapy where the radiologist would perform another CT scan and etch three small markers (tattoos) which enable them to align and aim the laser beam accurately into the correct area for the 30 days of radiotherapy.