Surveillance and Surgery

I have a cancer surveillance CT scan next week. This will be the second scan since my recent surgery to remove a tumour. The first scan in November was, thankfully, clear. The second is worrying because any cancer cells that may have been left behind by the procedure have had time to grow and are likely to show up on the scan. My fingers and toes are crossed. Although, whatever happens, I know I’m going to end up back in hospital.

If I get the all clear, as I fervently hope, I will then be scheduled for surgery to repair a problem that was caused by the very major surgery I had in 2011. This opened me up from neck to groin and a very dangerous tumour that had grown from my left kidney into my vena cava and almost as far as my heart was safely removed. The surgery involved three teams of surgeons, took seven hours and I had three blood transfusions. It saved my life but a mistake made by one of the surgeons left me with a problem, a hole in my diaphragm on the left side. Since then my stomach has become embedded in my diaphragm and has been pressing onto my left lung.

Due to the dangerous nature of the tumour, I was told that I had only a 30% chance of surviving the first couple of years. On top of that, it was a very difficult and slow recovery, physically and emotionally, from the big operation. I was certainly not ready to have more surgery to repair the hernia. And by the end of those oppressive two years I had become used to managing the hernia problem. Years of running and mountaineering had left me with strong lungs, so only having the use of one and a half lungs meant that I was still capable of many activities. I also learned that I mustn’t try and combine eating with doing any activity, as a filled stomach severely handicapped my breathing.

Then I developed late-onset asthma. My pulmonary specialist’s theory was that I had always had very mild asthma, which was masked by my high level of fitness. And my asthma had become exacerbated by my lung being under stress due to the hernia. I began to use inhalers and again adapted to this limitation. Then I talked to a thoracic surgeon about the repair of the diaphragmatic hernia. He explained that this was major surgery, my ribs would be split open on the left side and the stomach delicately cut away from its attachments to the diaphragm, then the diaphragm would be repaired with a polypropylene mesh. I would need around ten days in hospital, followed by three pretty painful months of recovery.

I was mulling over this uninviting option when I had the first of my cancer recurrences, eighteen months ago. The hernia repair was put on the back burner whilst I had the first abdominal surgery to remove the tumour. In hospital my left lung collapsed due the overinflation of my stomach which pushed up through the hole in the diaphragm like a balloon and compressed the left lung. I was told I must have the hernia repaired as soon as I had recovered from the abdominal surgery.

But, last June, at the point of being scheduled for the thoracic surgery, I had my second post-surgical cancer surveillance scan. This showed that the tumour had regrown from the same site. I then went in for more abdominal surgery to remove the tumour and had another lung collapse. Late last year I met the thoracic surgeon again and agreed to have the surgery to repair the hernia.

If my scan is all clear, I will soon be going in to the Royal Victoria Hospital for major surgery. If it is not, then I will be going in for whatever treatment is required. It is a time of great anxiety and poor sleep. I seem to have regular nightmares in which I am being stabbed or bitten. It’s not easy for either of us. We go forward one day at a time.