What I wish I’d known before radiotherapy

Are you about to start radiotherapy as part of cancer treatment? Cancer treatment of any kind can be a daunting experience, so we’ve consulted the Shine Cancer Support hive mind to ask: what do you wish you’d known before you started radiotherapy? Read on for our members’ words of wisdom! 


1. I wish I’d… checked out the treatment centre

Any hospital appointment can be stressful – especially if, thanks to cancer, you find yourself there almost every other day. Not knowing where you’re going, or what you’ll find when you get there, can add to the anxiety. Many of our Shine members said that they had been offered tours of their radiotherapy centre before treatment which helped them to prepare both mentally and physically. If you haven’t been offered a tour, it’s always worth asking for one. Don’t be shy about explaining why you would like to see the treatment area beforehand – if you think it will make it easier for you to handle the treatment, it will also make it easier for the staff to administer it. Everyone wins!

A short tour will enable you to ask specific questions about your type of treatment. Sarah, who had head and neck radiotherapy, found having to wear a mask for her treatment the most difficult bit, but she learned that ‘they can adjust it if you need it’.

2. I wish I’d… known what to wear

What you are able to wear to radiotherapy will depend on which area of your body is being treated. It’s likely that you will need to remove some of your clothing, but you may want to dress in a way that means you have to take off as little as possible. And don’t take off too much! One of our Shine members learned the hard way that she didn’t need to remove her underwear to receive pelvic radiation…

close up photography of fawn pug covered with brown cloth

It can get chilly in the radiotherapy room…

Our Shine community agreed almost unanimously that it gets very cold in the treatment room! If you need to take off your jumper and you start to feel chilly, know that you can always ask for a blanket.

3. I wish I’d… known that it would take a while

It might not take very long for you to get ‘zapped’, but you will still find yourself hanging around for a while. Shine member Becky says that ‘although treatment only takes a couple of minutes, you can be lying on the hard bed for 30mins+ while they set it all up!’ Alison says that for her treatment, ‘the waiting is even longer than chemo.’

Waiting can be particularly difficult. Pauline says ‘I wish I’d been told to leave my dignity at the door!! A group of people will be chatting away like you’re not there (but actually lying half-naked) and then they’ll be getting their protractors out and doing sums!! (“87”, “2.1”, “84.9”).’

Finally, a tip for speeding things up if you’re having pelvic radiation: let it rip! One of our Shinies says that ‘any “air pockets” in your bowels can slow down the process!’

4. I wish I’d… applied cream more effectively

You will be advised to apply creams, such as aloe vera or E45, to the affected areas to help with radiation burns. Ask your team which topical lotions or ointments they would recommend.

clear glass container with coconut oil

Keep the cream handy

Emma, who had radiotherapy for breast cancer, says ‘I wish I’d been shown exactly where the treatment would hit. I was very good at using cream, etc. where I thought it was, but I didn’t know there was a part of my neck that would be treated, and this ended up with a horrible burn that is still scarred.’ One Shine member said that her radiotherapy treatment also burned the skin on the other side of her body, which she hadn’t expected. Check with your radiotherapist about where you should apply cream, and when.

Shine member Meera wishes that ‘they’d told me to use aloe vera on the skin before the burns started, not after.’

5. I wish I’d… been warned about the side effects

If you haven’t been told already, ask what types of side effects you can expect from radiotherapy treatment. Many people experience nausea and fatigue, for example, but you might experience other side effects depending on the location of your treatment.  Fiona, who had pelvic radiotherapy to treat bowel cancer, says ‘I would definitely say that you need to plan your life so you’re not far from the loo during treatment. Especially if you have a drive to work after being zapped each morning. I got to know the petrol station loos en route really well.’ Macmillan offers a free toilet card that might be helpful in situations where a public toilet isn’t available.

Georgina, who had head and neck radiotherapy, recommends stocking up on ice cream, or anything else that might be able to soothe a dry cough, or alleviate any swallowing difficulties. If you are having other types of cancer treatment, such as chemotherapy or immunotherapy, at the same time as radiotherapy, there may be certain foods that you can’t eat. If you’re looking for something soothing to eat or drink, you might also want to ask your oncologist what they recommend.

Katherine says she wishes she’d known that ‘surgery scars tighten up after they are zapped.’ Ask your medical team if they have any suggestions for alleviating pain or discomfort from this, or from any other radiotherapy side effects.

Shine members also shared a number of long-term side effects that they hadn’t anticipated – for example, Pelvic Radiation Disease. After head and neck radiation, Shinies reported long-term effects on their eyes, swallowing muscles, and salivary glands. Ask your team whether they anticipate any long-term side effects, and what you – and they – might be able to do in order to minimise the risks.

6. I wish I’d… known how other people would react

If you’ve had any type of cancer, chances are you’ve experienced some strange reactions from friends, relatives, or the lady who lives down the road. One Shine member who received radiotherapy said that some people thought she was now radioactive, and ‘dangerous to be around’ during treatment. Others reported that people who hadn’t been through a cancer diagnosis didn’t seem to think that it was a big deal: ‘oh, it’s only radiotherapy.’

adult art conceptual dark

Other people’s reactions can be distressing

If someone you know is struggling to understand how radiotherapy treatment is affecting you, you could direct them to articles (such as this one!) that provide some background. Macmillan, Cancer Research UK, and Cancer.net have some helpful resources.

Alternatively, if you’d simply like a place to vent about the latest comment you’ve received, you can check out our private Shine Cancer Support group on Facebook and find lots of sympathetic ears!

Do you have any more tips for people about to undergo radiotherapy? Let us know in the comments! 

Moving on – with the help of broken crockery

Here at Shine HQ, we frequently see questions about “returning to normal” in our online groups. Young cancer patients rightly want to know when they’ll be able to get back to there they were before but, in most cases, there isn’t an easy answer. For many people we work with, we know that life doesn’t ever really go back to normal. That’s not to say that it can’t be good (or even better) than before – it’s just that something as big as a cancer diagnosis can leave you feeling changed. In our latest blog, Karen shares her thoughts on “moving on” – and explains how it relates to the Japanese art of Kintsugi!


Karen Myers 3

Blog author, Karen Myers

The end of active cancer treatment is a weird time. It’s all you’ve wanted since diagnosis – an end to hospital appointments, tests, treatments, side effects, surgery, pain, discomfort, feeling a little bit shit. And then, if you’re lucky, it is over. You’re told that your treatment has done it’s job, got rid of the invaders, killed those nasty cancery cells so you’re NED (No Evidence of Disease) or in remission. You’re good to go. Back to normality.

Except there’s not really a ‘normal’ after cancer. At least not the same normal as there was before. It’s a readjustment. Your energy levels, your self-confidence, your relationships, your work and social life, your body and your body image have all been knocked. With the safety net of treatment removed, you are confronted with the things cancer has left you with or taken from you. After my breast cancer surgery, which removed my entire right breast and used skin and tissue from my stomach to rebuild a new ‘foob’ (fake boob), something I’ve definitely been left with is scarring. Physical and emotional.

My physical scars are going to remind me every day, for the rest of my life, what cancer has done to my body. They’re pink and vivid, only three months after my surgery, and although I know they will fade in time, I also know they are a permanent marker of the path cancer traced across my skin and my life.

But scars don’t have to be thought of as ugly reminders of something terrible, of the price your body has paid for fighting cancer. In an attempt to see my own scars in a different light, I’ve become a bit obsessed with broken crockery and the Japanese art of ‘kintsugi’.

Kintsugi, translated as ‘golden joinery’, is focused on repairing broken items of pottery with a lacquer mixed with gold powder. By using the golden glue, those joins where the broken pieces have been put back together aren’t hidden or disguised but embraced and celebrated. Kintsugi says that the breaks, and the subsequent repair, should not be ignored, but valued as an indicator of the hard history of that item. By adding gold, that history, the cracks, the breaks and the struggle to bring about repair, make the broken item of crockery even more beautiful than before. Kintsugi recognizes the fragility of the broken piece, but also testifies to its strength by making the new bonds glow and shine, to celebrate that which is holding them together.Kintsugi

To me, this is one of the most beautiful concepts that cancer survivors can apply to themselves. Now, I’m not suggesting that everyone tattoo their surgical scars gold (although it is somewhat tempting). Instead, I’m trying to embrace the philosophy behind kintsugi as a way to accept my scars, both those visible on my skin and those hidden in my heart and mind, as evidence of both my fragility and my strength. Bodies do break and break down. The human form is fragile, even when we’re young. There’s no shame in being ill, so why should we be ashamed of the scars that mark us out as having endured? Alongside the suffering these scars, these breaks in the pottery, also show endurance, strength, resilience, determination, sheer bloody-mindedness, and, we hope, recovery. No-one asked for them but, just like a piece of kintsugi-rescued crockery, our scars are part of our cancer, and life history.

Of course, when active cancer treatment has finished, anxieties about the future still abound – we worry about the risk of recurrence, of developing secondary cancers, the impact of depleted energy resources, the possibility of resuming work and the damage done to our mental wellbeing. It’s too simplistic and insulting to assume that because we have finished treatment we can simply ‘move on’ or ‘return to normal’. But for those of us lucky enough to be officially cancer-free, the kintsugi philosophy asks us to see those emotional scars and continuing anxieties as markers of our resilience. We might not feel resilient or brave – I hated anyone telling me I was brave during treatment. I wasn’t brave. I cried and raged a lot. I got on with it because I didn’t have any choice – but the golden lacquer shows that what broke us initially was overcome. We face continuing physical and psychological challenges, but with a history of obstacles overthrown marked into our skin and our psyche. It is glued into our repaired bodies and recovering minds.

I’ve never been much of one for tattoos. But since losing my breast to cancer, I’ve been fascinated by the stunning skin-inked artwork that some women have chosen to cover their mastectomy and/or reconstruction scars. Rather than opt for nipple reconstruction or 3D nipple tattoos, these women have put their own bold, beautiful stamp on their bodies. To honour what has been lost and to shout to the world that there is beauty even in scarred and damaged tissue. For me, it seems strange that the scars I see every day will eventually be forgotten by most of the people I know, even close friends and family, because they are hidden. So I see that tattooed artwork as a contemporary body-art form of kintsugi, and it may be that is the way I reclaim my own body, my own sense of self and remind the world that I have been broken but repaired.

Moving on is always going to be hard when you bear scars. But maybe with a glint of gold in your post-cancer wounds, be it real tattoo ink or metaphorical mind-glue, you can start the process of healing and re-forming into a new, fragile but resilient, kintsugi-d you.

Karen Myers is a blogger, baker, knitter, traveller, theatre-goer and escape room addict. She was diagnosed with invasive breast cancer in July 2018 and has blogged about her experience at atozeeofbc.com.

Ten tips for handling chemotherapy

Receiving a cancer diagnosis can feel as if you are stepping into the unknown. We often receive questions about how to prepare for different types of cancer treatment – and chemotherapy is usually top of the list. We turned to our Shine Cancer Support community members and asked them to share their tips on making it through chemo and we’ve compiled them below. Knowledge is power so read on for our top ten tips…!

1. Ask what to expect from your treatment

jgc gorilla - shine-blog (900 x 600px) reduced for web

Ask what to expect – it may not be as bad as you were thinking!

Cancer isn’t one disease – and chemotherapy isn’t ‘one size fits all’ either. Before you start treatment, ask your doctor or nurse for specific details about the drugs that you’ll receive. Will you need to take tablets, or will your treatment will be given intravenously? If you need to go to hospital for treatment, how long can you expect to be there? Once you’ve had the treatment, what side effects can you expect? What should you do if you feel unwell? Will your treatment affect your fertility? It can be helpful to sit down with friends or family and brainstorm a list of questions that you would like to ask your medical team. It might sound like a cliché, but there really is no such thing as a bad question. There may well be things you’ve never heard of before (hello mucositis!) but forewarned is forearmed and it’s better to know what might happen so you can be prepared to manage it.

2. Plan your time on the ward

It can be daunting to walk into a treatment centre for the first time. Before your first treatment, you might find it helpful to know a bit more about the place where you will be treated. Does the ward have wifi, for example, or a TV? What is the visiting policy? Do you need to bring snacks or will food be provided? You can usually get answers to these questions from your specialist nurse, or by calling the ward secretary. If you have time, you could also pop your head around the door of the ward before your treatment and see what it’s like.

adult-bed-care-1498927

Waiting around can be BORING. Don’t just lie there – watch Netflix!

Shine member Neil advises looking at your data plan if your hospital doesn’t have good wifi – you might want to purchase extra in advance, or get a mobile wifi device. You don’t want to find yourself out of 4G halfway through your Netflix series!

3. Plan your journey (there and back!)

Running late can add even more stress to a situation that’s difficult enough! Take a moment to work out how to get to hospital for your treatment. Can someone drive you there, or will you need to take public transport? If you’re driving, do you need to pay for parking? Shine member Tracey recommends checking with your medical team: some hospitals offer free or discounted parking to patients who are in regular treatment. If you’re in London, consider if and when you’re going to take public transport to and from your appointments. Cancer on Board will send you a free badge to wear while TfL also provides free “Please offer me a seat” badges – don’t be embarrassed! You deserve a seat!

desk-602980_1920

Tablet and phone recommended!

4. Treat it like a long-haul flight

When asked members of our Shine community what advice they would give to others who are about to start chemotherapy, this was the overwhelming consensus: pack a bag with all the things that you’d take on a long plane journey. Books, puzzle books, a laptop or tablet, fluffy socks, and a nice jumper or cardigan were all on our list! Shine member Christine highly recommends headphones: ‘even if you don’t want to listen to music/watch something on your tablet, you might need them if you get stuck next to an annoying person…!’

5. Track your side effects

Your medical team will want to know how you are doing between treatments. Keep a notebook with details of any side effects that you experience, so that you can give accurate information to your doctor. If notebooks aren’t really your thing, you could also use try note-taking apps. And don’t be shy about mentioning side effects – a lot of things can be managed with medication or the right support. Don’t suffer in silence!

6. Get some fresh air

Shine member Samantha found getting outside to be really helpful when she was having chemotherapy treatment: ‘even on the days when you are as weak as water, a toddle in the garden or wander up and down the street will give you fresh air, confidence in moving about and sense of accomplishment.’ Exercise has been shown to benefit people with living cancer (let’s face it – exercise benefits everyone!), but it can be difficult to know where to begin. If in doubt, ask your medical team for advice. If you exercised regularly before your cancer diagnosis, you might also want to look at cancerfit.me, a new community created by doctors and athletes with an interest in sport and fitness for cancer patients. And you can also read our blogs about how running, cycling and yoga have helped Shine members through treatment.

7. Get help!

It can be difficult to cope with a cancer diagnosis by yourself. Mobilise your team! You might find it helpful to ask a close friend or family member to co-ordinate those who come forward with offers of help. Specific offers of help are often easiest to take up, but many people struggle to know what to do when they hear that someone they love has been diagnosed with cancer. If you can, make a list of things that might be helpful and share this with a friend/friends. Do you need someone to make you meals, for example? Or someone to walk your dog? Would a visit from a friend make your week? Let them know! You can direct them to our blog about ways to help a friend with cancer – and you can direct them to our post on what to say to people with cancer while you’re at it!

8. Prepare yourself for bad days

Some people sail through cancer treatment with very few side effects, while others can find themselves cowering under a duvet for days after treatment. Shine member Stewart says: ‘plan for the side effects… BUT don’t get drowned in the gloom of EXPECTING them all. Everyone’s experience is different, so know about things like the possible options for creams, gloves, hair shaving, food to ease/slow bowels, support networks etc.’ Your doctor or nurse will be able to provide you with specific information about how to treat side effects from your drugs. And, as hard as it is, remember that they won’t last forever.

9. Don’t forget the good days

More wise words from Stewart! He recommends that you also ‘plan for the time in-between.’ You may have to manage expectations around what you can do, but that shouldn’t stop you from having fun! Shine member Caroline keeps a list of things that she’d like to do on good days: ‘I have a list of new cafes or restaurants that I’d like to try, and places that I’d like to visit on day trips. They’re all options, rather than firm plans, but on good days I love to scan the list and pick out something fun to do.’

10. Listen to your body

Receiving a cancer diagnosis can make you much more in tune with your own body. Are you suddenly noticing lots of niggling aches and pains that you swear weren’t there before? Join the club! If you have any concerns about your health, contact your medical team – that’s why they’re there! If you’re feeling tired, perhaps think twice about going on that big night out and invite a friend over to spend the evening with you instead. By the same token: if you wake up in the morning and feel well, embrace it! Life doesn’t have to stop when you have cancer.

 

Cancer can make you feel lonely. If you’d like to chat to other young people with cancer and share more tips and tricks about how to cope, join our private Facebook group Shine Young Adult Cancer Support (20s, 30s & 40s). You can find out more about all the support we offer via our website.

Special thanks to Joe Hague for letting us use his photo (above!). If you’d like to learn more about his photography, please check out his Facebook page or his Go Fund Me page.

Dancing through cancer: how a new project is helping women with cancer

In a special guest post Emily Jenkins, founder of Move Dance Feel, introduces her project and writes about the work she does to support women living with cancer.


I love to dance. Be it in my kitchen, on the train platform, or (more appropriately) at a festival, I like to move. Why? Because it brings release, it’s revitalising, and it eases tensions in my mind and body. Dancing helps me to breathe better, sleep better, and feel more alive.

750_4029-LOWRES

Emily Jenkins

We are all capable of dancing, despite the self-conscious mind telling us otherwise. Far too often people concern themselves with the aesthetics of dance: how it looks, rather than how it feels.

I work with different  groups in community and arts contexts, and in recent years have specialised in an area known as Dance and Health. Using dance in health contexts is not a new phenomenon, though due to greater recognition of its benefits and connection to wellbeing it is rapidly growing in popularity.

My job is to break down preconceived ideas of what dance is, and inspire people to move in a way that feels good for them. I use creative techniques that encourage a greater understanding of and appreciation for the body, focusing on self-expression. Through shared, positive experiences, dance can promote social cohesion and help to build meaningful relationships based on trust and understanding.

Dance is a multifaceted art form which very much accommodates the multidimensional needs of people. In contrast to Western medicine, which often compartmentalises illness, dancing addresses the whole body, which in turn acknowledges the whole being – physically, mentally, and emotionally. This can have transformative effects on participants, as they get to know a part of themselves perhaps previously overlooked.

In 2016 I launched a project in East London, Move Dance Feel, providing free weekly dance and movement sessions for women affected by cancer. I established the project to explore what dance could offer in the context of cancer recovery, and to address a recognised need for post-treatment support.

My first personal encounter with cancer was in my teens, as I witnessed my grandfather wrestle with the devastating effects of melanoma. I recall visiting him shortly before he died and being very affected by how much the disease had taken him over. The image of his emaciated frame had a profound impact on me. Over time, as I supported friends living with cancer, I particularly noticed the overwhelming effects on the body, and also the mind.

MoveDanceFeel_3600-LOWRES

Move Dance Feel session

A motivation for setting up Move Dance Feel was learning that 70% of people affected by cancer report negative physical, emotional, and mental side effects between 1 and 10 years after treatment – a statistic that I found very hard to digest. At the same time, I read that physical activity proved effective in reducing the negative side effects of cancer treatment, as well as reducing the risk of reoccurrence, so I was puzzled as to why dance wasn’t being offered.

Originating at a community centre in Bromley-By-Bow with a Macmillan Social Prescribing Service, Move Dance Feel is now running in three cancer support organisations across London, providing sessions at Maggie’s Barts and Paul’s Cancer Support Centre as well. The project is for adult women (18+) with any type of cancer, including those who are supporting someone with cancer. We welcome people at different stages in their journey (pre, during and post treatment) and no prior dance experience is necessary. Participants are also welcome to bring along a female friend.

At the heart of Move Dance Feel is artistic practice, where women come together to dance instead of talk about their cancer. They meet each week to be active, creative and, most importantly, to laugh and have fun.

My favourite aspect of the project is meeting other women. As a communicative art form, dance provides insight into people’s characters and enables intimate moments of exchange. More often than not, these moments are energised and playful, but they can also be nurturing and grounding in times of instability. The nature of this exchange helps to experience a sense of belonging and can lead to feelings of self-discovery, learning from others how to help ourselves.

MoveDanceFeel_1143-LOWRES

Dancing at Move Dance Feel

My aim is to integrate dance as a permanent offer within cancer care programmes, and further evidence of its need within the public health sector. I am also in the process of setting up a performance element of Move Dance Feel to bring a sense of visibility to women who are living well during and after cancer – in the hope of inspiring others to dance (even if it’s alone in your kitchen!).


Emily will be running a taster session at our Shine Connect 2019 conference (11th May 2019). To register your interest in the conference and be notified when registration opens, click here!

If you’d like to know more about Move Dance Feel, or let others know it’s available for them, please follow Emily on Facebook or Twitter.

You can also find Emily at www.emily-jenkins.com.

Photos taken by Camilla Greenwell, www.camillagreenwellphotography.com. 

Living with incurable cancer: Talking about the future when I won’t be here for it

In this post, Shine community member Christine reflects on discussing future plans while living with incurable bowel cancer.


I have incurable cancer. It seems to create a lot of awkwardness.

IMG_0322

Christine with her parents

 

But, life goes on. I know that when I die the world will go on without me. That’s the same for each of us, though hopefully for most people that time is a long way off.

In the grand scheme of things we are all just tiny specks who exist for such a tiny length of time. Most of us will have only a very limited impact on the wider world. If we are lucky we will have some small influence on our little circles. But really, for the vast majority, the future will be no different without me in it.

I have accepted my fate, as best I can. What I find difficult is that other people make all sorts of assumptions about how I might feel, and it ends up limiting conversation.

Sometimes when a group discussion naturally gets on to future plans, people start to look at me uncomfortably. They might even try to change the subject. It is really not necessary. I don’t mind at all.

a06397d4-04b0-47af-b2f3-acf61e4e2bab

A photo from Christine’s recent holiday

I am not worrying about pensions, or mortgages, or planning a wedding. It doesn’t mean I don’t understand the importance of those things to other people, and I don’t mind discussing them, though obviously I might not have much to contribute. (Except on weddings – I have a lot of strong opinions there!)

Of course I am sad that I won’t have the future I thought I might. And I am sad for all the things I will miss. But that sadness is far outweighed by the joy of knowing that those things will happen. My loved ones will carry on living without me. They will be happy again. I am not suggesting it will be easy – far from it.

I don’t believe in a heaven, or that I will be watching over them. When I am gone, that’s it. Whatever made me me will cease to exist, and my body will return to the earth. I will live on in the memories of those who knew me, and I hope that they will continue to feel my love even when I am no longer here. Somehow I will always be a part of their lives.

Sometimes I forget that my days are numbered, and I have little daydreams about my future, the same as anyone else. To be honest even without the whole incurable cancer thing I doubt many of them would come to fruition. Few of us live the life we planned, which is often no bad thing.

I don’t mind talking about the future, either generally or people’s individual hopes and dreams. I don’t begrudge anyone their good health or their future. I don’t wish that everyone else was dying too, just to keep me company. So please don’t leave me out of your conversations or feel that you can’t tell me things.

I still want to be a part of your life while I can. And if that means planning for your future then I am more than happy to join in.

Anyone who knows me well will know that I am quite organised. I like my lists and plans. I’ve had to let go of a lot of that because cancer is so unpredictable. But now I have a whole new set of plans to make – for my funeral, my end of life care, my will. It could be a bit depressing, but actually I get quite a lot of comfort from it.

What I am trying to let go of is my desire to continue to control the future when I am no longer here. I worry about how my family will cope. At first I came up with all sorts of ideas of how I could guide them through. But the reality is that I just can’t. I have to accept that once I am gone, they will need to learn to live in their own way. I don’t get to be involved in that. If they decide to abandon the monthly smoke alarm tests and the house subsequently burns down then it will not be my responsibility.

I thought about leaving cards for all the milestones I will miss. But I don’t even know what those milestones will be. And when would I stop? It seems a bit selfish, to inflict myself on them even when I am dead. I don’t want to gatecrash, or to make them sad on what should be happy occasions. And really it’s only to satisfy my own ego. I am dispensable. Everyone will be just fine without me.

Life isn’t just about the big milestones anyway. It’s in the boring minutiae of the everyday. When I imagine the future I would have liked, it’s those little moments that I will miss. Not when we are all dressed up to go somewhere fancy or putting on our biggest smiles for a photo, but laughing because otherwise you’d cry, or finding something to smile about when you’ve had a really hard day. And actually I think, much as I’d love to be there to celebrate all the wonderful things that are to come, it’s the hard times that I am sadder about. It pains me to imagine my loved ones struggling and not being there to help them.

Of course, there’s not really anything I can do about it. I try to give everyone as much love as I can right now while I am still here, and that will have to be enough.

If you’d like to connect with other young adults living with cancer, please request to join our private Facebook group or follow us on Twitter (@shinecancersupp) or Instagram (@shinecancersupport). 

Ten years after testicular cancer

In this post, Tom Richens writes about his diagnosis and treatment for testicular cancer, and how he’s chosen to celebrate long-term remission.


The 8th of August 2008 is an easy date to remember due to its symmetry. It is also a date that I will never forget: the date that I was diagnosed with testicular cancer. I was 29 years old. Deep down I knew that something had been wrong for a long time, but I kept convincing myself that everything was OK. I had felt a persistent dull ache in my right testicle, but there were other symptoms too. I experienced acute back and abdominal pain, then fatigue. Eventually, my right testicle was excruciatingly painful and about twice the size of my left one. I went to see my GP. He immediately sent me to hospital to undergo an ultrasound, and by the end of that day I had my diagnosis confirmed: a malignant teratoma of my right testicle. The testicle had been taken over completely by the tumour.

SocialMediaReady-1

Tom, ten years on

My right testicle was removed via an orchidectomy. I was offered a prosthesis but I declined due to the increased risk of infection. As it was, I got an infection anyway. The orchidectomy was a success and the tumour markers looked clear, which was a good sign that the tumour hadn’t spread. I had been incredibly lucky.

I was referred to a clinical oncologist, who set out my options for further treatment. If I had chemotherapy there would be about 2% chance of the cancer coming back, and I would need regular check-ups for five years. If I didn’t have chemo there would be about 40% chance of the cancer returning, and I would need to have tests every two weeks for five years. There really was not a choice to be had, so I agreed to have chemotherapy.

I was put on the BEP chemotherapy regime. My treatment started on the 14th of October 2008, my wife’s birthday. Never let it be said that I don’t know how to show her a good time! Initially I experienced very few side effects, but within a short space of time I began to lose my hair and the treatment became quite debilitating. I had no energy at all and would generally alternate between sleeping and being sick. . I craved burnt and bland food – very strange for someone who has always been a great food lover.

I was relieved when I finished my treatment. However, I’d be lying if I said that I didn’t have other, less positive emotions. Anxiety that the cancer would come back was there all the time. What if that meant losing my other testicle? Deep down, I also felt a sense of insecurity as a result of the treatment. I didn’t find this easy to acknowledge at the time. Eventually I went to see a counsellor, and this proved to be really helpful.  I could open up about what having cancer had really meant to me. I would say to anyone: it is no shame to feel insecure, anxious, or even angry. Talking about it is not a sign of weakness, but actually a sign of great strength. I know that as blokes, we don’t like doing that!

I had regular check-up appointments for five years: first at three-monthly intervals and then less frequently, until I was seen on a yearly basis. There were always nerves before my appointments, but I knew that the medical staff would pick up anything sinister.  After a few minor bumps in the road, after five years I was officially discharged. It was a fantastic feeling, and time for the celebrations to start!

I always felt that it was really important to mark key milestones in my remission. My wife, my step-children and I enjoyed a fabulous holiday to Egypt in 2009 to mark one year of being ‘all-clear’. We probably wouldn’t have gone if it weren’t for what had happened the previous year, and we had a terrific time. They deserved it more than I did really, as their love and support throughout my treatment was amazing. When I was discharged after five years, we had a great night celebrating, and then my wife and I took a spa break at a beautiful hotel in the Cotswolds. Finally, as this year marks ten years since my cancer diagnosis, I have decided to embark on a photo shoot. I have never been a particularly self-confident guy, but the photoshoot really represented how far I had come and I got progressively braver as the shoot went on! I could never have imagined that I would have been brave enough to do something like this, so it really was a final piece of closure.

SocialMediaReady-2

Ten-year anniversary photo shoot…

I often get asked if having cancer changed me. Overall, I would say I am the same person as I was ten years ago, but there are certainly some subtle changes and lessons I have taken on board. I still worry about work at times, but I always make far more of an effort to ensure family and friends come first. Having cancer gave me the impetus to do things that I would never have considered previously. I organised a charity cricket match in 2010 that raised approximately £5000 for Cancer Research UK. It took eight months of hard planning but when it all came together it was a fabulous day. I also ran the London Marathon in 2016 to raise money for the same charity. It was damn hard work, but the most wonderful and rewarding experience. I would never have considered it had I not had such a burning desire to give something back after my own cancer experience.

As a cancer survivor you will never forget your diagnosis or treatment. However, I think that it is important to look forward in life. For me, the raw emotion of having cancer has subsided over time. I would never say that I was lucky because getting cancer isn’t lucky but today, life as a survivor is pretty damn good. Value every day and enjoy life.

 

The photos of Tom Richens were taken by Khandie Photography, and are reproduced here with permission from the photographer.

Website – www.KhandiePhotography.com

Facebook – www.facebook.com/KhandiePhotography

Melanoma: more than ‘just skin cancer’

In this blog post, we’re bringing you a cancer experience story written by Caroline, a member of our community who was diagnosed with a rare form of melanoma at the age of 29. She’s keen to raise awareness of skin cancer and share the impact that it has had on her life. As always, please share this blog post and let us know what you think!


I’ve been worried about developing skin cancer since I was 14 years old. I had been stocking up on my favourite fruit-scented toiletries from a certain well-known beauty retailer, and the shop assistant had slipped a leaflet on sun protection into my bag. I’m pale, red-haired, and freckled – and since reading that leaflet, my delicate skin has barely seen the sun. I cover my shoulders in summer, wear sunscreen in winter, and pride myself on staying as white as possible. So how did I get skin cancer?

Mucosal Melanoma

I was diagnosed with mucosal melanoma, a rare form of skin cancer, in May 2017. I was 29 years old. Mucosal melanoma develops on mucosal tissue such as that in the nose, mouth, and sinuses, or in the gastrointestinal tract. In women, it can develop in the vagina, and on the vulva. In men, it may be found in the penis. I’m not going to tell you where my small tumour appeared – but suffice to say, you’re unlikely to see any of my surgical scars!

I spotted a suspicious growth in December 2016, but it took several months – and several

IMG_20170603_132007375

Guest blogger, Caroline

doctor’s visits – before I had a biopsy. It’s hard not to feel angry about weeks of missed diagnoses, but my disease is so rare that I can’t blame the doctors who dismissed my symptoms. However, I knew that something was wrong, and I’m glad I persevered with return visits until I finally had a diagnosis. I learned early on in my cancer journey that there is nothing more important than being your own advocate. Melanoma can spread quickly, and more than one medical professional has told me that if I had not kept returning to clinics, I might not be here now. It’s a sobering thought.

Initially, my treatment plan was the same as the treatment plan for cutaneous melanoma (the one with the moles): I had a surgical biopsy to determine the diagnosis, and then went back into surgery a few weeks later for a wide local excision and a sentinel node biopsy. The wide local excision involved taking a larger section of tissue from the area around the tumour to make sure that there were no more cancerous cells. For the sentinel node biopsy, two lymph nodes in my groin were removed and tested for melanoma cells. Thankfully, there was no melanoma in my lymph nodes – but if there had been, my diagnosis would have been changed from Stage II mucosal melanoma to Stage III, and I would have had advanced cancer.

Unfortunately, my wide local excision found some more melanoma cells in-situ (pre-cancerous cells, which have the potential to develop into cancer) – so a few weeks later, once I’d healed, I was wheeled back into surgery for a third operation. Then, once I’d healed from my third operation, I had a fourth. And then a fifth. Each surgery delivered the same result: a small area of amelanotic melanoma in-situ. ‘Amelanotic’ means that the melanoma isn’t pigmented. In fact, it’s invisible! In the space of eight months, I went from a healthy, active, young woman who had never even set foot in a hospital, to a cancer patient who had been through five surgeries in attempts to rid her body of a now-invisible aggressive cancer. I can scarcely believe it.

Wow, you look so well!

One of the most difficult aspects of my diagnosis has been looking well. Melanoma doesn’t respond well to chemotherapy, and it is not an option for me. When I first ‘came out’ about my cancer, I was asked a lot of questions about chemotherapy. When would I have it? When would I lose my hair? How could I have a serious illness, but look so healthy? And (the worst): did I actually have a serious illness? Despite all my rounds of surgery, and the trauma that comes with any cancer diagnosis, I began to feel as if my specific ‘flavour’ of cancer was being downplayed. If I mentioned melanoma, I felt as if I had to explain that I had always looked after my skin, and actually my diagnosis was not down to any irresponsible behaviour. As an aside: just wear your sunscreen! And no, I have no idea if that mole on your arm is dodgy…

Cancer messes with your head

Although I know deep down that my diagnosis is serious, it took me a long time to stop feeling like a cancer fraud. Not only do I look healthier than ‘the average cancer patient’ (fun fact: there’s no such thing!), but I can’t relate to many support group discussions about chemotherapy and radiotherapy side effects as I had never had that experience. Even if my cancer progresses, chemotherapy will be a last resort.

Through Shine, I’ve been able to meet others who have ‘just had surgery’ and can relate to some of the feelings I’ve described. It’s unlikely that I’ll ever meet someone who has the same diagnosis as me (if you have mucosal melanoma, please make yourself known!), but it is wonderful to be part of a community that acknowledges all the effects that a cancer diagnosis can have. I don’t have to explain or justify myself anymore!

I’ve only lived with cancer for a few months, yet the experience has already taught me a lot about myself. It matters less and less what other people think or believe about my illness. Instead, I focus on how I feel, and my own perceptions of my strengths and limitations. I’m finally giving myself the space to listen to my own needs – and that could be anything from needing to burn off some energy at the gym, to requiring a lazy day of nothing on the sofa.

It is so important to listen to yourself.