A week past my CT scan, the hospital summoned me for a biopsy, with the objective to snatch a piece of my liver’s tumour for lab dissection. The goal was to unravel its secrets, which in turn would provide the clinicians with a roadmap to propose suitable treatment. Mind you, we weren’t setting our sails for the shores of a cure here, but rather a horizon that promises a few more sunsets, a little more life, and a tad better quality of existence. The doc had already acquainted me with the grim numbers. The median survival statistic grimly stated twelve to fifteen months, with a tiny 5% lasting five or more years post-diagnosis.
Treatment courses converge on a couple of paths when dealing with an advanced form of ocular melanoma in the liver. First, there’s resection: a medical heist to remove a hefty slice of your liver, preferably the one hosting the unwelcome guests – the tumours. The liver, miraculously, possesses the ability to regenerate and swell back to near its original dimensions, albeit with a different form. But as long as you’re not overly concerned with the aesthetic of your viscera, that’s a non-issue.
Second, we have Embolisation therapies: methodologies that inject substances to hamper or halt the liver’s blood flow, thus starving the malignant cells to death. This spectrum includes transarterial chemoembolisation (TACE), which is like a home delivery of chemotherapy drugs straight to the liver.
The most popular weapon in the arsenal currently is immunotherapy. The principle is to stir up the body’s immune system into a rebellion against the cancer. It’s akin to recruiting your body’s innate warriors to battle the alien invaders but with a cheat code, instantly providing them with the best armour and weapons.
All these methods carry their baggage of unpleasant side effects. Gratefully, my specific strain of cancer doesn’t require chemotherapy or radiotherapy – I doubt Stoke has sufficient antiemetics to convince me to endure the daily hurling ordeal.
My next appointment didn’t require me to master the carpark labyrinth. My slot was at the break of dawn, so Helen was at home, preparing a hearty English breakfast for our guests. Helen’s Dad played chauffeur for the day and dropped me off near the main entrance. A couple of days prior, I had managed to strain my back in the shower, which resulted in my walk resembling that of a man with a sizable pineapple lodged up his back passage.
Seeing my painful gait, onlookers may have speculated about my potential surgery. Proctectomy or Hemorrhoidectomy might top their guesses, but a liver biopsy? Highly unlikely.
Guided by the maze of signs, I arrived at the Reception – which was eerily silent, dark, and deserted. Paranoia began to whisper in my ear if I had gotten the date or time wrong. I carried on in search of the day ward I was allocated. Somewhere in the dim corridors, I found a ‘nurse’ who simply asked for my name, checked it against a list, and guided me to bed number 6. Six again. Was this a cryptic message from the hospital?
The procedure required me to be nil by mouth – three words I despise. I don’t do nil by mouth. I do constant grazing, starting with a generous bowl of homemade muesli and tea for first breakfast, followed by a round of toast with marmalade and another cup of tea for second breakfast.
By the time I was seated by my allocated bed, I had already skipped these crucial meals, which had my stomach growling in protest. I was starting to get hangry.
Come 11 am, coffee and biscuit time, my lack of consumption had me both thirsty and hangry. A new nurse arrived to set up a canular. I suggested the other arm, considering my left one felt like a dartboard. Another prick (sorry, sharp scratch), and more vials of my blood drained. “Oh, you’re a bit of a bleeder”, he said as blood oozed from the open canular. I wondered if he had expected confetti to pop out instead.
Roundabout noon, a full five hours post my arrival and sixteen hours since my last meal, I was asked to slip into the infamous hospital gowns of shame.
I was wheeled into yet another operation room, where a jittery young doctor briefed me about the ten lesions detected on my liver from the previous week’s MRI. Ten? Why was I just hearing about this now?
She began her procedure, navigating the freezing ultrasound probe against my ribs, attempting to locate the lesions before extracting a biopsy. After several glances at her screen and growing concern on her face, she announced she needed to fetch her consultant.
My fears began to multiply in her absence. Could there be another ‘growth’? Was I in for another round of “I’m afraid we’ve got bad news”?
If there’s one thing I’ve always known for sure, it’s that the hospital doc life isn’t for me. Don’t get me wrong, it’s not the ‘nightmare of actually remembering every bone in the human body’ or ‘deciphering squiggly lines on a screen’ part that turns me off, but the uncanny resemblance to a soap opera does it. You know, those TV dramas where high-brow consultants treat fresh-from-the-womb junior docs like they couldn’t tell a scalpel from a spoon.
The anxious young doc entered, trailed by the consultant. Picture a peacock but with less charm. He was oozing with the kind of overconfidence only seen in gym bunnies and politicians. Casually ordering her around, giving a tut-tut here and there like a disappointed Victorian nanny, he commandeered the ultrasound probe, pressing into my ribs with all the delicacy of a toddler operating a crane.
“There, that’s one,” the young doc points out, trying to sound confident.
The consultant looked up, a sneer slow-cooking on his face. “You’re welcome to biopsy that if you like, but don’t put my name on it.” His tone was full of that delightful condescension we all know and love.
After another minute of his high-and-mighty ultrasound inspection and less-than-gentle navel jabbing, he turns to me. His professional kindness emerged from its slumber as if a switch had been flicked. My lesions were apparently too petite for his liking, making a biopsy equivalent to playing a high-stakes game of ‘pin the tail on the donkey’. He wasn’t prepared to put me through the risk or discomfort for such a low expectation of a useful outcome.
I squinted at Dr Jekyll-Mr Hyde and asked what the next step was.
“We could play the waiting game until they grow big enough for a decent go, but let’s see what the MDT thinks. They’ll give you a ring soon,” he says with all the commitment of a politician on the campaign trail.
I returned to the ward, greeted by a brown paper bag with my name on it. Inside was the glorious sight of some egg mayo sandwiches, a solitary bag of crisps, and a drink that promised to end my Sahara-desert-like thirst. The sandwiches looked about as exciting as an accountant’s spreadsheet, but my status had been officially upgraded from ‘nil by mouth’ to ‘all systems go’, so I did the only sensible thing – I scoffed the lot.
I started to walk out of the ward with the same painful, pineapple-induced gait I’d walked in with. A small part of me wanted to make a wisecrack to one of the blokes still laid out on his bed. Something like, “Mate, you wouldn’t believe the size of my piles,” just for kicks. But, in the end, I thought better of it.