August was a busy month. Finished the last of the radiotherapy and then spent a week in Dorset. I was prepared to treat it as a week for convalescence but ended up doing a normal week of walking, eating and drinking. We had a cottage at the foot of Bindon Hill, which is the subject for a chapter in W. Warde Fowler’s book “Summer Studies of Birds and Books” (1895). It starts:

I OFTEN doubt whether there can be such another hill as Bindon in these islands; I at least have never found it. In foreign lands there are famous hills, and health-giving hills — Alesia, Epipolai, or the Acropolis ; but I feel sure that they cannot offer such store of delights, for mind and body too, as Bindon does.

It’s a long spine of a chalk hill, stretching like a rampart from Lulworth Cove to Mupe Bay. Although it’s an area of outstanding natural beauty, it’s part of an MOD firing range for tanks and artillery. You’re only allowed on there at weekends when they are not shooting. Because it has been so untouched (they don’t shoot at the actual hill!) it’s full of birds, bees, and butterflies. And, of course, the ghosts of a Roman legion.

Apart from the health-giving properties of the hill, certain further restorative measures were gleaned from the Cider festival in progress at the village pub. A mere 45 ciders and perries to choose from…

Unfortunately, back at home the ambrosia wore off later in the month and I had a lung infection. Radiation pneumonitis, probably. It triggered all the check list items on my little red cancer card (it fits in your wallet) but I was too sick to actually read the thing to know this. I did go into hospital just after for a check and they gleefully put me back on the Fragmin. Now, back to daily injections for ” at least six months”. Serves me right for going near them.

Despite that, I went back again afterwards for one of my regular consultations. It was one of those pointless ones where there is really nothing to discuss – no scan results, etc. I tried to use it as an opportunity to get more of a long-term view. But I was assigned a relatively young doctor who’d never seen me before and I only ended up with the “every person is different” speech.

I do have another CT scan scheduled for 17th September with the results feedback meeting on 22nd. I will try again to get some sort of a prognosis from them. Although this year has been dominated (again) by chemotherapy, cetuximab and radiotherapy, this is really just the tip of the iceberg. The rest of the iceberg is what’s likely to be the pattern of life for the next few years?

If the 2.2cm tumour has got even smaller as a result of the radiotherapy, then would they consider a more aggressive treatment plan? They said the tumour was too large for radiofrequency ablation and so I had traditional external radiotherapy. What size does it have to be?Lump_actualSize

If the tumour has stayed the same size, my guess is that we’ll go into a holding pattern with scans every 3 months. I would hope that we’ll catch any future growth early so that the treatment doesn’t need to include chemo.

If it has started to grow in size again, we’re dealing with an aggressive customer. I don’t know if they’ll want to repeat the whole procedure and at what stage will they consider a pneumonectomy i.e. total removal of the left lung.

If you allow it, the interaction with the Oncologists stays focused only on the immediate medical actions. They see many people like me, and the next goal is to get them to open up a bit more with that knowledge. I’m not asking for a crystal ball, but just some idea based on normative data as to what typically happens to people like me with inoperable colorectal metastatic lung cancer.