Oncologists
A cursory Google about “what to expect at your first medical oncology appointment” throws up words like “harrowing”, “brutal”, and “overwhelming”. I can tend to be overly optimistic at times, but I really didn’t see how an introductory appointment could be that traumatic. I already had the one where a doctor told me in a serious voice: “you have cancer”. I already had the one where a different doctor told me it has spread to my liver (just one tiny spot, but…you don’t want it to have spread); then how he would approach treating it- shrinking it with radiotherapy and chemo, then cutting it out. What the treatment will do to me (we’ve all seen the cancer movies: I’ll be tired, and sick, and sore). I’ve been injected with a substance so radioactive it was contained in a special box so the doctor injecting it never had to touch it (it doesn’t make your pee glow in the dark — everyone asks). I’ve undergone an MRI (and had to lie completely still for an hour) with the most horrible head cold and cough I’ve ever had. I already had the appointment where I got tattooed with permanent guide marks (tiny blue dots) on my pelvis and hips, to ensure that I’m lined up in exactly the same spot every day for my 25 days of radiotherapy. That one was just really awkward because I had to lie on a table with my foo out while two radiation therapists peered intensely at my nether regions, drawing crosses with different coloured marker pens.
Medical oncologists are basically chemo doctors, dealing with how to poison the cancer out of you (as opposed to radiation oncologists, who deal with zapping the cancer out of you with radioactive beams). On Friday morning, after getting a few vials of blood taken (apparently, chemo docs will be monitoring my bloods pretty closely, since I already have a form to have more blood taken next time I go in) I sit in a packed reception lounge where I am the youngest person by a good 30 or 40 years. The radio in the lounge is playing a banger playlist: Hold The Line, One I Love, Burning Down The House. Nothing too harrowing so far. There’s even a basket full of knitting needles and yarn in the corner, and a laminated sign inviting patients to help knit “granny squares” to be sewn into blankets for a good cause.
My doctor, when he emerges, is young and earnest with twinkly eyes. The first question everyone asks me about my various doctors when I am describing how they explained everything clearly, or how they started out with a funny joke, or how they seemed stressed and overworked but still spent as much time with me as necessary: “YES, BUT WAS HE GOOD LOOKING?” This one…yeah, he’s alright. My surgeon has good arms, according to my boyfriend; this doctor looks like he has a great skincare routine. He ushers me into his office. He’s lovely and friendly and runs through the familiar litany of questions I am getting very used to answering at every new appointment: what symptoms sent me to the doctor? do I have any pain? family history? and so on and so forth.
“What do you understand about your condition and your treatment?”
The treatment timeline I’ve been given by my doctors up until now would take me, approximately, to the end of this year, leaving me a summer holiday to recover, and the opportunity to swan back to work next year, maybe minus a bit of my liver and with a new and shiny butthole but otherwise, largely unchanged.
Yeah. That was optimistic.
My earnest chemo doctor nodded encouragingly as I spoke. Then his brow furrowed and he asked me: “how much info do you want? All of it? Or just what you need to know?”
I want all of it, I told him. I want to know everything.
Apparently, I’m a bit of a celebrity in the weekly cancer seminar; the subject of long animated conversations and strong debates between treatment teams about how best to approach killing the asshole that is trying to kill me.
“You’re in for a long haul,” he said. He launched into a long and involved analogy, comparing cancer to a weed that throws off seeds that can sprout and grow in different gardens. Chemo is weedkiller that kills the weed, and the sprouts, and hopefully, any seeds that are hiding, unseen, waiting to sprout. Because my cancer has already spread to one site, the doctors are paranoid about the chance of unseen “seeds” just waiting to sprout somewhere else. STAGE IV CANCER, THE GIFT THAT (THEY ARE SCARED) KEEPS ON GIVING.
So, I’m going to be getting a lot of chemo. The first course isn’t a full course — only 5 weeks, only pills. That’s to boost the radiation therapy I’ll be getting at the same time. Monday to Friday, 5 days a week for 5 weeks. Amid all the other possible side effects (nausea, diarrhea, fatigue, red, peeling skin), it’ll knock out my ovaries —so no babies for me, and push me into early menopause. So the nappies that my bosses included in the gift basket I got as a leaving gift from work — I guess as a hilarious joke about having bowel cancer? Yeah, I didn’t laugh. I can’t believe I have to say this, but probs not a great idea to make jokes like that to people with even DIGESTIVE issues, let alone something that literally requires lasers and poison to hopefully kill.
Then surgery. Then probably a 9 week course of full chemo — the stuff you see in the movies, that makes you lose your hair, hooked up to a drip of toxic fluid for hours at a time. Then more surgery. Then more chemo.
Twinkly eyed doctor looks serious. “You’ll be in treatment for at least a year”.
I start radiotherapy in a couple of weeks. Let’s get this show on the road.
