19 November 2009

My battle with cancer - part two

Jean Meiring, a 28-year-old Capetonian doing a graduate law degree at Cambridge University in the UK, discovered he had testicular cancer in January. He had surgery and has started


Jean Meiring, a 28-year-old Capetonian doing a graduate law degree at Cambridge University in the UK, discovered he had testicular cancer in January. He had surgery and has started chemotherapy. This is the second edition of his column on his battle with the disease.

I had cleared the first hurdle in the process of recovery: the malign testicle had been removed. Not only was this step very significant symbolically, but it was, of course, also important practically.

As I had gauged from the conversation with my friend’s dad, the cancer researcher, testicular cancer is so highly treatable, partly because the root of the rot, as it were, the testicle in question can be isolated and cut away relatively easily. In other forms of cancer, this is – understandably – not possible to the same degree.

While still recovering in hospital after the surgery, I met the oncologist who would be treating me. I immediately warmed to her: her manner was down-to-earth and direct. She examined the results of the cat scan and the other X-rays of my chest, and told me that my chances of survival were high. In other words, all my prognostic factors were positive. This, obviously, cheered me up no end.

Poetic name
She also indicated that I would probably need four courses of chemotherapy, each lasting three weeks - a total of three months. I would clock in for the first time on the Monday immediately after the operation (which I by then had learnt is called, rather poetically, an orchidectomy).

I spent a quiet weekend at home, before setting off early the Monday morning for a 9.30 appointment at the oncology unit. I did not know what to expect. So ignorant was I at that stage that I did not even have a clear idea of what chemotherapy entailed

Suburban lounge
Anyhow, I arrived at the unit, which looks far more like a suburban lounge than a hospital. The nurse who runs the unit welcomed me and steered me towards one of the three armchairs. The other two seats were occupied by middle-aged women, who were engaged in an animated conversation.

My first prejudice – that receiving chemotherapy would prove to be a deeply depressing experience – was summarily dispelled. These two patients – like all the others I would meet – were friendly and utterly cheerful. I was cast in the role of the new kid on the block, and without much encouragement my ‘elders’ started telling me what side-effects I should expect, and how best to deal with them.

There was a very real sense of camaraderie between the patients, which I found interesting and thoroughly heartening. I suppose this is the inevitable result of being grouped together with others in a (still) stigmatised minority.

At the outset the nurse drew some blood from me, wincing in feigned agony. This was sent off to a nearby clinic for inspection before the chemotherapy started. At this stage, too, I broached the, um, delicate issue of freezing sperm, with my oncologist.

Since the chances of becoming sterile as a result of the therapy is very high, it is usually advisable to have some stored. This should be done before any of the chemicals have entered your body.

Once the blood had been returned and the oncologist had checked the white cell count and the neutrophils, she signalled the green light and the therapy could begin. The nurse unceremoniously slipped a needle into a vein on the top of my right hand.

This was attached to a small transparent cylinder into which the tubes connected to the bags of chemicals would be slotted. In this way one prick per day would be sufficient to feed all the medication needed into my body. I was very relieved at this, since I am – to say the least – squeamish, and detest needles.

And so I sat for more than three hours. At the outset the nurse hooked an anti-emetic to the tubing attached to me. Afterwards, she sent a test-dose of the first drug through, and then administered the other two drugs consecutively.

Between the different chemicals she ran salt water through the vein to make sure that it was clean, and that no chemical reaction would take place between the different substances.

Then, suddenly, the first day’s chemo was finished. I went home and, since I felt a bit drained, had a lie-down for an hour or so. Later that afternoon two friends came to visit and we had a few glasses of wine. This would become something of a routine.

After the morning’s session, I would rest for a while and then watch television, go for a walk or see friends. After the second day, though, I decided that it would be a good idea to forego all alcohol for the duration of the therapy. This wasn’t suggested by my oncologist, but the simple logic that I would be eliminating another toxin from an already poisoned body appealed to me.

My chemotherapy course entails a three hour session every morning Monday to Friday, in the first week, and an hour long session on the Monday of the second and third weeks. This, I discovered, is a typical regime for testicular cancer.

The first few days I edged along, expecting the prognosticated side-effects to pounce upon me at any minute. Especially feared was the insidious monster Nausea. I had been given a supply of anti-emetic tablets, of which I could take three per day. However, I took only one every evening after dinner, entirely prophylactically. (I had also been given a number of anti-emetic suppositories, which I am relieved not to have needed ... yet.)

During most of the first week all side-effects remained absent. However, on the Friday and Saturday evenings of the first week, an unexpected fatigue, which seemed to have no sense of reason nor moderation, hit me. On the Friday I retired to bed at 10:30pm, and on the Saturday I lay down for an half hour at 10pm, after which I emerged reinvigorated.

The next day, Sunday, though, a quite startling tiredness took hold of me. I lay about all day, exerting no more energy than that which was required to get me from bed to couch and back again.

The next day was everything but a blue Monday. I felt as strong as an ox. The Tuesday (of the second week) I was again rather tired, but felt strong on the Wednesday, Thursday, Friday and Saturday.

But, on the Wednesday of the second week another unexpected problem arose. The right side of my scrotum was swollen and very sensitive. Oh dear ( ... or something slightly stronger), I thought, as I went to see the urologist again. What on earth was this?

Read more:
My battle with cancer - part one
My battle with cancer - part three


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