It was 10th November 2010 just after midnight. I gradually woke up after a marathon 9-hour surgery – the first of what was to be several visits to an operating theatre. The last thing I remembered before going ‘under’ was the voices of the surgical staff. When I woke up, I remember it being dark and I appeared to be constrained and pinned down by the dozen or so tubes going in and out of my weak and battered body. I can still remember the feeling today; it was like I was pinned to the bed and I was completely vulnerable and helpless. However, what I remember most was my wife Chris holding my hand which gave me a great deal of much-needed comfort and security.
The build-up to this day began on 26 July 2010 when I was given the news that I had metastatic Neuroendocrine Tumours and that the prognosis without any treatment wasn’t too good making the decision to have treatment a lot easier. I told my Oncologist to ‘crack on’ with whatever treatment would be required.
However, it wasn’t that easy and as I was yet to find out, Neuroendocrine Cancer isn’t a simple disease. I first had to undergo a plethora of other tests including specialist scans, blood, and urine tests. The specialist scans (crucially) confirmed my tumours were ‘avid’ to something called a ‘somatostatin analogue‘. The scan also confirmed I had more tumours than initially thought. This was key to working out my treatment plan as I now had a grade, stage and I had the right tumour ‘receptors‘ to assist along the way.
When I initially presented in May 2010, I hadn’t realised for some months that I was showing symptoms of one of the Neuroendocrine Tumour syndromes (in my case carcinoid syndrome‘. This was mainly facial flushing but thinking back, there was some diarrhea albeit infrequent. The subsequent specialist blood and urine tests (CgA and 5HIAA respectively) were way out of range confirming both the diagnosis of tumour bulk and tumour activity, respectively. The tumour activity (or function) is one thing that makes NETs different from most cancers and is caused by excessive secretion of specific hormones applicable to the primary location of the tumour. Thus, why I had to be established on a ‘somatostatin analogue’ which is designed to inhibit excessive secretion. I self-injected Octreotide daily for 2 months until the flushing was under control. When certain Neuroendocrine Tumours cause carcinoid syndrome, there is a risk of a phenomenon known as ‘Carcinoid Crisis‘. This is the immediate onset of debilitating and life-threatening symptoms that can be triggered by several events including anaesthesia. As an additional precaution to prevent such complications, I was admitted on the 8th November 2010 to have an ‘Octreotide soak’ (Octreotide on a drip) prior to the surgery on 9th November 2010.
As is normal for such procedures, I had the risks explained to me. There seemed to be a lot of risks on the list and my surgeon, Mr Neil Pearce, carefully explained each one. Death was on the list, but I was happy to hear he had a 100% record on his ‘table’. Trust is an extremely important word when you’re in this situation.
As a snub to cancer, I refused the offer of a wheelchair and chose to walk to the operating theatre at around 2pm. So together with my ‘drip fed’ Octreotide trolley and wearing my surgical stockings and gown (carefully fastened at the rear!), I wandered down to the operating theatre with my escorting nurse. The anaesthetist injected the anaesthesia and commenced his countdown. It worked!
The 9-hour operation was designed to debulk what was described as “extensive intra-abdominal neuroendocrine disease”. The operation comprised the removal of 3 feet of the small intestine at the terminal ileum plus a right hemicolectomy, a mesenteric root dissection taking out the nodes on the superior mesenteric artery and a mesenteric vein reconstruction. With the assistance of a vascular surgeon, my NET surgeon also dissected out a dense fibrotic retro-peritoneal reaction that had encircled my aorta and cava below the level of the superior mesenteric artery. Phew! Thank goodness I was asleep! Read the remainder of my therapy story here.
When I woke up just after midnight on 10th Nov 2010, what I remember most was my wife Chris holding my hand which gave me a great deal of much-needed comfort and security.
One day per year doesn’t cut it for me, so on the basis you can never have enough awareness windows, for me, EVERY DAY IS WORLD NEUROENDOCRINE CANCER DAY and via my own social media channels, I’m making sure everyone knows!
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