Colorectal Cancer

Chris - Interview 40

Age at interview: 46
Age at diagnosis: 45

Brief outline: In June 2010 Chris was diagnosed with rectal cancer. He had surgery, a low anterior resection of his bowel and an ileostomy. Surgery was soon followed by chemotherapy, which he has nearly finished. He hopes to have the ileostomy reversed soon.

Background: Chris is a clinical trial manager. He is married and has three children. Ethnic background/nationality' White British.

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One day in June 2010 Chris was shocked to find that he had passed 5-10 mls of blood from his bottom. He went to A and E at the local hospital and was seen by a doctor who referred him for a colonoscopy. After the colonoscopy Chris was told that he had a rectal tumour (about 9 centimeters up from his anus) which looked like a cancer. Chris then had a CT scan and an MRI scan.
In early September 2010 Chris had surgery, a low anterior resection of his bowel. The surgery was mainly keyhole surgery, which went well. Chris woke to find that he had a temporary ileostomy, as he had expected. This was necessary to allow the internal incisions to heal. Chris was in hospital for about a week and his post-operative recovery went very smoothly. He had a morphine pump and pain was well controlled. At first he found it a bit unnerving changing his ileostomy bag, but after he had done it a couple of times he found it quite easy and not as difficult or as ‘big a deal’ as he had anticipated. Chris had a urinary catheter inserted during surgery. When it was removed he found it impossible to pass urine, so he had another catheter inserted. This happened again, and so eventually he was sent home with the catheter in place, with a bag strapped to his leg, to allow time for bruised tissue to settle down. After three weeks he returned to the hospital where the catheter was removed again. This time he managed to pass urine.  
During the operation the surgeon removed 18 lymph nodes near to the site of the tumour. Six of these nodes were cancerous, which was disappointing, because it indicated that the cancer might have spread. However, CT scans found no evidence that the cancer had spread beyond the bowel which was good news. Chris was then referred to the oncologist.
On 28th October 2010 Chris started chemotherapy. During the first day of each three week cycle he was given an infusion of oxaliplatin. During weeks one and two he took tablets of capcitabine. Chris experienced raised temperatures and on two occasions was admitted to hospital for intravenous antibiotics. He also suffered from diarrhoea, which was exhausting. At times he also experienced other side effects, such as ‘hand-foot syndrome’, which was quite unpleasant. On 1st January 2011 Chris was admitted to hospital for 17 days because of his raised temperature and diarrhoea. He was put on a strict diet to control the diarrhea, which was necessary because he had lost so much weight. The oncologist decided that Chris should start a new regime. He continued with the intravenous oxaliplatin, but discontinued the capecitabine and started infusions of 5-FU. These drugs were delivered through a PICC line (a peripherally inserted central catheter) in Chris’s arm. After receiving the oxaliplatin the 5-FU was pumped into the PICC line over two days during each cycle, from a bag worn round the waist. Chris feels quite well, though is sleeping more than he slept before and has the side effect peripheral neuropathy, which he hopes will disappear once he stops chemotherapy. On several occasions he has had to wait for his platelets and/or neutrophil count to increase to an acceptable level before being able to continue with the next cycle of chemotherapy.

Chris has nearly finished his chemotherapy and hopes to have his ileostomy reversed sometime during the next couple of months. Before surgery he will have an enema to make sure the sections of his bowel have fully joined, and he will also have more scans to make sure that the cancer has not spread that there is no need for more chemotherapy.



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