Month: November 2015

12. Back to the Future – part trois!

Back to the Future Part Trois

So, these Movie hints should be telling you something. But, what?

Dear son, Richard, duly arrived and off we went to the pub – for lunch. Well, Elaine and Richard went off to lunch, I kept them company, toying with my usual – a bowl of thin soup and oh, yes of course, a sprinkling of Weetabix (gotta keep up with my protocol) over the surface, randomly dropped by a Waiter wearing a pair of those big, jam-jar bottom glasses that prove you can’t really see, but do fool customers into believing otherwise!

[That was what I drafted yesterday, but see, we suddenly had a snow fall of 15 cm deep at about 11:30am.  We valliantly tried to get from Ceres to Cupar (3 miles and 11 minutes) to no avail.  We had to abandon the car in Meldrum’s Hotel in the village, having nearly crashed into parked vehicles!  Best laid plans, eh? –  “Of Mice and Men“, (John Steinbeck)]

Of Mice and Men

So, in honour of two of my favourite comedians whom Elaine and I together with her parents, managed to see “live” at the AlhambraTheatre (before refurbishment – much cosier!) in Bradford, West Yorkshire in the 1980s.  “And so, please give a hand to the short fat hairy one  ….  “

Customer: “Waiter, waiter, there’s a fly in my soup!

Waiter:Where Sir?

Customer:There, there of course, can’t you see it?”

Waiter: “Shh, quiet Sir, please?”

Customer:What do you mean, be quiet?

Waiter:The other customers may overhear, and they’ll all want one.”

   …. ba-bum!! (Morecambe and Wise, 1970s)

Morcambe and Wise

And, now for something completely different – not! (Monty Python’s Flying Circus).

And Now for Something Completely Different

We are going to get technical again, and I’d like to share a little more about the drug experience (no, not that one from the 1970s when Timothy Leary and others were experimenting with real, pure, and novel to them, Lucy in the Sky with Diamonds (LSD)!. No, I mean the EOX – my chosen ‘Chemo combo’ (well, selected for me) by the wonderful Dr P, at Ninewells, Dundee. You remember Blog 1 (“You think you’ve got problems”), don’t ya?

LSD – a great track on the Beatles album, “Sgt Peppers Lonely Hearts Club Band.

SGT Pepper

Now speaking of music, did I tell you I like it? What do you think?  Well, also speaking of experience (drugs or any other kind) there is no better than listening to the Jimi Hendrix Experience – especially playing on their very first UK album. Consider this: I bought my vinyl copy of this album in 1966! I had only 3 other (vinyl) records in my possession at the time. Get off my Cloud (The Rolling Stones) – a single 45rpm disk; With the Beatles (1963) and A Hard Days Night (1964) both by The Beatles) on MONO Vynyl LPs (33⅓ rpm).

Are you experienced

Jimi Hendrix (the best guitarist – ever, in my humble view!)

Get off my cloud

“Get off my cloud”, The Rolling Stones.  (Not the original sleeve, which I recall was a pale orange stripey paper thing. Unfortunately, I sold all my 45 rpm singles years ago – big mistake!)

With the Beatles

“With the Beatles”. Although earlier (1963) than a Hard Day’s Night (1964), I bought this second.  Mum and Dad bought “A Hard Day’s Night“,  for me for Christmas; I was 12, I think)

A Hard Days Night

Music and Film (and books) – my favourite things!. But hey, isn’t this supposed to be a technical piece? Ok, back to it, but …

This turned into far too long a piece to cover thoroughly in one go so I have decided to split it and the final part will appear later as, “Back to the Future – part quatre!”.

Chemotherapy drugs destroy cancers by killing cells that make up the abnormally growing tissue mass (ie they are cytotoxic) of a tumour. They disrupt the growth of cancer cells after being given to the patient via one of 4 routes: as an injection; through a drip into the arm (I had that for E and O of my EOX!); through a pump as a slow continuous infusion, or as tablets. (I have them too for X).

The drugs circulate in the bloodstream around the body, targeting the cancer cells (malignant usually; though, benign tumour cells can be targets too), but can also affect other cells that rapidly growing such as the bone marrow, hair follicles, gastro-intestinal tract (which results in some of the observed side effects – anaemia, bleeding, infections, hair loss, diarrhoea and/or constipation (or both in my case – damn it!). There’s going to be a lot more about this later – “Fifty Shades of Brown” – comes to mind, or the opposite end of my body! Watch the next episode here on the BBC!

Depending upon an individual diagnosis chemotherapy may be given before and after surgery; to reduce or control symptoms in advanced cancer (my situation); to slow an advanced cancer down (hopefully my situation too!).

Sometimes, the chemotherapy is given directly into the abdomen when there is evidence that cancer cells have spread onto the inside of the abdominal wall and are making the abdomen swell with fluid (ascites). This is known as intra peritoneal chemotherapy, and though not carried out very often, a small cut is made in the wall of the abdomen, catheterised so that fluid in the abdomen can be drained out, after which chemotherapy infusion utilises the same catheter.

Despite having intra-abdominal malignant cell spread at least to some lymph nodes and elsewhere (pancreas?) I have not been offered this option (note to self – ask why not at next appointment?). I have mentioned other biological and chemotherapeutic treatments and trials elsewhere, so I won’t repeat these here, but the Cancer Research UK Campaign web site is a great source. http://www.cancerresearchuk.org

OK – so, I’m taking a break here.

Back tomorrow folks!

CYA

 

 

 

 

 

 

 

 

 

 

 

 

 

11. And on the 7th Day … he rests!

Cancer Cells

Is this still happening now I’m on Chemotherapy? No rest for those wicked malignant cancer cells!

Me? I’m sleeping in when I return to bed after posting this blog note!

Sorry, read on ….

Well, maybe time for one more visual joke?

 

Kenny Everret2

So as Kenny Everett would say, “this is all done in the best possible taste…

Due to the censors and copyright police, I cannot show you an appropriate scene from this key episode of “Spitting Image”, described below. Nevertheless, enjoy!

Spitting Image

Maggie Thatcher was having a haircut.  

Hairdresser:How would you like your hair done, madam”?

Maggie Thatcher: “Cut it in a way that would be universally popular”.

Hairdresser lops off her head!

My son, Richard, arrives at 12:30pm today, Yippee!

Be back Monday.  CYA.

 

 

 

 


 

 

 

 

 

 

 

 

 

 

 

9. Improving – but grumpier?

Grumpy

Grumpy from Walt Disney’s,

“Snow White and the Seven Dwarfs”.

How can this be? Well, this is not my view, its daughter, Ellen’s (and definitely wife, Elaine’s). Poor thing, she has had to live with yours truly for about a week. She’ll admit that I have had nearly two good days in a row, and therefore, I must be ‘improving’. But right there, that’s it, we part company. I contend I am improving and returning to ‘normal’; she contends the opposite, ie grumpier is ‘normal’, for me anyway. Hey, I’ve encountered this dichotomous stuff before, haven’t I?

So, what’s the evidence for her revelation?

Let’s hope two examples can sort this – it’s Saturday, and I’d like to get away with a short entry in my blog, preferably of a non-technical nature. So here goes, and I know you’ll be rooting for me!

ACT 1 Scene 1 (At the breakfast bar)

Ellen: Dad, what would you like for breakfast?

Moi: Readybrek.

Pause ….

Ellen: Dad, what ‘d you say?

Moi: OK then, Readybrek with some of that special Weetabix whole food type Chemo sprinkled randomly on the top; and by the way, keep your eyes closed when you’re doing it (protocol, you know).

Pause …

Ellen: No, Dad? C’mon, Readybrek … please?!

What’s wrong with this picture? I didn’t see it; she’s my daughter, I know her; we have been together nearly all week; and surely, I must have said please (and probably thank you too) at least once this week?

ACT 5 Scene 3 (Now driving on the M8 and getting snarled in traffic coming off it on to The Great Western Road, and thence to Byres Road for a quick coffee stop in Waitrose (it’s free!).

She’s been surfing the ‘The Fleece-book’ and (Gordon Brown’s) ‘Interwidewebsphere’ on her ‘tablet’ (I thought that was a Yorkshire sweet) for ages, sitting in the back of our car. I’ll acknowledge this thought is courtesy of: Andrew Neill, BBC2, “This Week”, on proper TV, Thursday nights, after David Dimbleby’s “Question time”.

This Week Team

Andrew Neil: chairing “This Week”, with #sadmanonatrain (Michael Portillo – nearly all of the time) and #liz4leader (Liz Kendall – sometimes).

Moi: Are you still working on that document for school, Ellen?

Ellen: Dad, I’m trying to deal with these email enquiries from my other teacher colleagues, they’re urgent (indignant exclamation mark !)

Moi: But, I thought you did those back in ACT 3 Scene 1 (kidding!).

Moi: OK, but that document needs to ready by Sunday afternoon, you realise?

Pause …

Ellen: Daaad !!

Moi: Yes, and if you hadn’t spent an extra hour in the bathroom, we’d be drinking our Waitrose coffee back at your flat by now!

Ellen: Daaaaad !!!!

Moi: What?

Ellen: Don’t you see?  I had to extra-condition my hair and everything!

Now actually, I don’t see. Is this the first hint of a side effect from my new Weetabix treatment? I suspect not. I think what she is saying I don’t get her point of view, and she (obviously) doesn’t get mine.  Fortunately, I remember using a training tool (Johari Window) whilst running Assertiveness Training sessions at the University of St Andrews.  This can help identify what people don’t know about themselves, but others can see easily.  An example, would be me having bad breath, but I might be  the only one that doesn’t know it (or admit it)!

Ultimately, I am forced to conclude I must have a rather large blind spot in my JoHari window (Joseph Luft and Harry Ingham, 1955.).

JoHari Window

Johari Window Diagramme downloaded from http://www.selfawareness.org.uk, Accessed 28 November 2015)

This is a Psychological tool used in contexts where self awareness and personal development can be accessed through judicious exploration of a person’s desire to improve through a combination of receptivity to openness, honesty, giving and receiving feedback, and braveness for opening up to observation and daring to undertake more activities in the first three categories!

[The model works using four area quadrants.
Anything you know about yourself and are willing to share is part of your open area. Individuals can build trust between themselves by disclosing information to others and learning about others from the information they in turn disclose about themselves.
Any aspect that you do not know about yourself, but others within the group have become aware of, is in your blind area. With the help of feedback from others you can become aware of some of your positive and negative traits as perceived by others and overcome some of the personal issues that may be inhibiting your personal or group dynamics within the team.
 There are also aspects about yourself that you are aware of but might not want others to know, this quadrant is known as your hidden area. This leaves just one area and is the area that is unknown to you or anyone else – the unknown area (our subconscious).]

There’s also an implicit assumption that we must also be willing to accept that our sub-conscious (unknown area) can mask our own awareness of how we appear ourselves and others, though often they can see everything (our faults especially) with the perspicacity of a Night Owl. Use of Johari’s window also enables work on improving communications, interpersonal relationships, group dynamics, team-development, and inter group relationships. (Thought: maybe I should give this a go?)

I think Ellen is hinting that I might not score so many out of 10 on a 10 point scale for these things! Of course, she must be right, it’s a female family trait (all the time!).

Perhaps we are both right and maybe even, we are both wrong too? I like this better; “Shades of Gray” again. (Ok, I’ll admit it, I have read all three books. A man can dream, can’t he?)

Moi: OK, Ellen, how else am I grumpy or getting even grumpier?

Ellen: How many weeks of therapy would you like for Christmas?

I’m hoping to negotiate a good deal on a replacement vehicle today, so wish me good luck?

Bye for now.

 

 

 

 

 

 

8. Relief – at 04:00 am!

Turd

I wish!

Another day another dollar! I’m earning my passage today. Darling daughter, Ellen, has been supporting me all week whilst Elaine nears the end of her job at the University St Andrews (one week to go, yippee!). Now today we are returning the favour and re-locating her and all her mobile devices back to Glasgow. Setting off early, so the shower is going to have to cope with three heavy-user demands (Rank Ellen> Colin> Elaine; or something like that). We need to be on our way by 09:00am.

Speaking of passages, I had a bad evening last night – the 5 day thing happened again, but fortunately the earth moved at 20:00h, well actually a mole hill moved, but that is better than a worm-hole (infinitely smaller – literally!). I was in so much pain at one point I took a double dose of laxative. Hope I don’t regret it whilst we head for the M8.

Now, where are we, technically that is? Oh yes, diarrhoea, I suspect, but hope against. This is shit, let’s start again – technically!

I have a stomach cancer called a poorly differentiated adenocarcinoma. What does that mean? Fortunately there’s a system for better understanding what phrases like that really mean, and they can be helpful in determining treatment.

Pay attention, this is going to get easier and easier!

During embryonic, foetal, neonatal and later life most cells (cytology) in our bodies are growing and produce tissues (histology) such as the lining of our bladders, eyes, and of course our guts (epithelium-lined mucosa), and in my case a key bit – the stomach or gastric portion of the alimentary canal (intestine).

Other cells produce muscle layers (which may be smooth, striped or striated, or found only in the heart as cardiac type (also striated, by the way, but branched too); others produce connective tissues including fat, lymph, blood, bone marrow and so on; still others, develop nerve cells or neurones.

Some tissues and organs like the liver, kidney, spleen and lung mainly comprise one major type of tissue whereas others, such as the lining of fat around our internal organs, our omentum for example, may be very diffuse and have several types of tissue such as connective tissues, fat, smooth muscle, as well neurones and blood vessels. The latter are themselves very complex, having three or four layers depending upon wall thickness (from the inside to out: endothelium – special epithelium, smooth muscle, loose or fibrous connective tissue, and may contain blood vessels as well as nerve fibres and neurones too, sitting in the most outer layer, the serosa, again depending upon wall thickness.

Other cells (when looked at down a light microscope) however, can look very grand, special, (and even plump – if we are not being fattist) and distinguished from surrounding tissues, often with special names. The parenchymal cells of the liver are good examples; as are the epithelial cells lining the inner stomach – the square or tall, columnar epithelial layer. These contrast very well with the typically flat or squamous epithelial layers we have in the linings of hollow internal organs such as the bladder, vagina, lungs etc; or on the external parts of our bodies such as our head, hands and souls of our feet, (Great British Rock band of the 1970s, by the way. Try out “Head, Hands and Feet” on Island pink label Vinyl, 1971 Yummy!).

Head, Hans, Feet1

Head, Hands and Feet in concert in 1971 at TOGWT – find out!

All of these cell types take up stains to differing degrees when preparing tissues for examination under a microscope, and they produce beautiful, gorgeous coloured patterns. En passant, this helps histologists and pathologists (and histopathologists – mustn’t forget them!) identify when there may be too much or too little of some tissue component present – compared to what might normally(!) be expected – based on centuries of anatomy, and experience, of course.

So what, I hear you say? Well, this is key to describing cancers, but you need some more information first! In the embryo, most cells outwardly (if we have a light microscope to view them) look pretty much the same and might be said to be unspecialised, undistinguished or poorly differentiated. They reproduce themselves very fast by diving in two, grow bigger again, repeat then repeat – a signal-controlled process. Once a critical mass of cells is reached tissue formation takes place and specialisation or differentiation starts to happen, and thus we form all of our specialised tissues, organs and systems that make up the body.

If this signal process goes wrong, for example in cancer, cells that might normally (there’s that word again) differentiate don’t do so, and instead grow in an uncontrolled way, eventually forming a fairly ugly, undistinguished thing we call a “lump”.  Get that buggar (!) off me; have a ‘lumpectomy’ straight away (to be safe), if you find one (unless it’s a cyst, of course). Even then, you might have one removed – to be sure!

You need one more thing to complete the picture – sorry! So that (histo-)pathologists can have a whole branch of medicine’s nomenclature to themselves when cells and tissues start to become abnormal they give the type of tissues a new, but related name. So, abnormal epithelial tissues are named Carcinoma, muscle or connective tissue tumours become Sarcoma, as two large categories of cancers. A Lipoma (I have one on left shoulder) is a fatty lump!

The more distinguished a cancer turns out to be from a particular location in the body the even fancier a name it can have, such as microglioma or astrocytoma (specialised neurone tumours); or Leukaemia, Lymphoma (specialised connective tissue tumours of blood and lymph glands, respectively) etc. Do you know there’s a tumour called a Teratoma? It sprouts skin, hair and even teeth, sometimes, inside an enclosed sac, often very large.  If such a sac is located in or near female ovaries the ‘bump’ produced can be confused with pregnancy!  Much more information can be found at the Cancer Research Campaign web site (http://www.cancerresearchuk.org, Accessed 27 November 2015).

So there we have it. I have a poorly differentiated adenocarcinoma growing from around the middle of my gastric (stomach) inner mucosal lining. And sod’s law, wouldn’t you know, it has grown backwards through the mucosa, penetrated the smooth muscle of the stomach wall, its surrounding connective tissues of the serosa and into my abdomen. Fortunately, it has only spread to a few (well had – we don’t know what the new CT scan picture would reveal now) surrounding lymph nodes.  Maybe I’ll talk a little more about well-differentiated cancers later?  Watch this space   …..

When anyone asks you, “Now what’s Colin got again?”, you can tell ’em (in scientific discourse).  But don’t forget to tell them, he might not have had one at all if had he heeded earlier warning signs of a belly-ache!  So endeth today’s lesson!

I’m off to the shower before damned daughter gets up.

 

See ya’s all again tomorrow!

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

7. Yesterday – a good day!

Well, as Albert Einstein used to say – everything is relative!

Einstein
Albert in one of his mad-bad moments

Is it me, or do we all go through these phases? Once I thought that the Universe was simply there or maybe it was figment of my human imagination, so it wasn’t. Either way, it’s there or it’s not (black or white; on – off, zero – one etc). Now, as I find I begin to understand Stephen Hawking’s books a little better, actually life just ain’t that simple!

Hawking Universe in a nut shell
One of my favourite Hawking books

Do you know that there may be Multi-verses not one Uni-verse? Now before I break into a poem, I’d reiterate I have changed my mind a lot, and learnt that the Uni-/Muliti verse is also to be like everything else – Shades of Gray (not that one, obviously!).

Shades of Gray
Ahum, have you read it?

I buy that now. I wish Elaine did when we get into our usual rows: you know the kind of thing, “I said this”.  No.  “You said that”. No, “I said etc, with the usual ping-pong of contradictions followed closely by, well, “You must be deaf, cause I didn’t say any of that!!”. Why do I say these things (Jonathan Ross)? Because, as life becomes more complicated, nuanced and well, all those marvellous grays, it also becomes more difficult but truly wonderful, of course.

Now here is an example of the sort of dilemma that ‘gray’ paints. My wonderful sister-in-law relative, Jacqueline, pointed out that my Rugby Blog entry yesterday didn’t contain much for the ‘ladies’, and I whiffed a hint of my chauvinism. Could she have a little more storyline plus a picture of Dan Carter, please?  What do I do?

Yes, and I could get some brownie points from her!  No, and I lose some that I don’t even have yet (I’m neither a debtor nor a saver). But, if I include this request will everyone else start piling in with their favourite player or eye-candy (did I say that?) requests. No win!

Now, I know where my bread is buttered so, here in black and white (and pink all over) is yours truly, Dan Carter.

Rugby Addendum – for you, Jacqueline

Moving on. Yesterday was indeed a good day- relatively, of course! So, how?  First, I managed not only Readybrek with warm milk for breakfast but had an additional shot of Weetabix, my new clinical trial nutritional supplement (you do remember Blog entry 5, don’t ya?). I sprinkled the crumbled biscuit over the porridge a couple of times, with my eyes closed – so it is definitely meeting the protocol conditions for a randomised double-blind study (Medical Research Council (MRC), “Guidelines for Good Clinical Practice in Clinical Trials.” (1998). I’ll brief you further if I notice marked improvements in my eating, and more importantly, excreting habits!

[And, is this good enough? Well yes, until we have something better, or are able to stop being smug in thinking we already have the answer.  Or at least Fiona Albridge (2015) thinks so since listening to “Realising Impact: Making a difference through adult learning” by speaker, Tim Harford (from BBC Radio 4’s “More or Less” and author of “The Undercover Economist”) presented at the European Agenda for Adult Learning Conference, 11 Sep 2015. Her article, “Are randomised control trials into learning the answer?”, reported on the National Institute of Adult Continuing Education( NIACE) web site (http://www.niace.org.uk/.  Accessed 26 November 2015).]

This is important stuff. We cancer patients suffer from constipation and diarrhoea, sickness and nausea, fullness and emptiness, pain and ecstasy (after the morphine, anyway); highs and lows; misery and joy. Hey, am I wrong here, but isn’t this a little dichotomous? Can’t be right, can it? The world is wonderfully gray, surely?

Second, let me tell you, when you have experienced the gripping pains of constipation for 5 days straight (last Friday) then getting to Wednesday (4 days straight), but still no number two visitor, that is relative ecstasy! Getting worried however this morning. I still have to pass muster and it’s getting closer to 5 days again!

Did I tell you I liked music? Yes, just about every genre, though my rank preferences are Blues> Rock> Jazz> > Country Rock> Country > Pop > Classical. I appreciate this is an arbitrary classification.  Since I was listening, with great pleasure, to Joe Jackson play, “It’s different for girls” (I guess it is?), last night, where does he fit in my line up?

Joe Jackson1
Joe in the 1980s

Anyway, the funniest thing I encountered in the 1970s was the satirical, “Spitting Image” puppet show. You know the one, very famous for a one liner. Margaret Thatcher takes the cabinet out to dinner and the waitress asks for her order. “Steak: raw, please”, she replies. “What about the vegetables?” says the waitress? Oh, give them the same as me, she retorts!

Spitting image_Vegetables
Spittting Image portrayal of Maggie Thatcher and her cabinet colleagues out to dinner

Also, linking this to music. I have been a big fan of both Dire Straits and Chris Rea since the mid-late 70s and onwards.

Dire_Straits_1978
Dire Straits 1978
Chris_Rea
Chris Rea 2005-ish

A “Spitting Image” spoof of the new band “DireRea” was a fantastic interlude during one of the episodes. So, tomorrow let’s hope I can talk a little more freely about diarrhoea!

By the way, if you have never heard Chris Rea playing the stuff he likes, blues, then take a listen to the 11 CD and 1 DVD box set, “Blue Guitars”. This traces the history of the blues from its roots in Africa to America via the slave trade; from the Southern states of the USA to its chillier Northern ones, thence to the UK (John Mayall, Eric Clapton, Jeff Beck, Jimmy Page, Peter Green, Mick Taylor, The Stones, Beatles etc) and back again to America, but also taking in Celtic and Mediterranean influences along the way.  An amazing piece of music. Chris wrote all the songs (137 whittled down from about 350), penned during his own life-threatening illness.

Chris Rea Blue Guitars
Blue Guitars (2005)

So, that’s it for today folks, I’m off for a walk and post a letter. Tomorrow might get a little technical again, but hey a man’s gotta do what a man’s gotta do.

Bye, ‘til then.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

6. An Interlude …..

After all that technical cancer stuff I think you need a break, I certainly do. So, what’ll it be?  I know, Rugby!

Part 1  The World cup is over, Ritchie and his boys kicked-ass, beautifully and legally, of course. Commiserations to Australia.

Ritchie's boys

However, they (Aussies) were a tad lucky to have that coward Joubert refereeing when they beat Scotland, perhaps unfairly, but we’ll never know. Can someone tell my wife why, if we was wrong in his decision to award a penalty (scored smartly by the way) that Scotland shouldn’t have been awarded the match post-play? (I’d like to know too!)

Having lived in both New Zealand (Auckland) and Australia (Melbourne) I think I have the flavour of their rivalries. A bit like Scotland (NZ) versus England (OZ). Though we spent longer in OZ I’ll admit my fondness for NZ, in parts, a place, like my own Patria, the North East of England (I may even be a wannabe Scot), where I grew up in my own childhood days of the 1950s.

I was recruited from the University of St Andrews to Unitec, NZ, Auckland in 2008 as their Dean (VP) of Teaching and Learning and never looked back. They knew me well, an ex-Captain of my own Grammar School’s Rugby First XV. On one of the five days of the recruitment and selection process, I got to watch the Auckland Blues firsts versus reserves teams, practice and then play on one of Unitec’s own training pitches – their home! Was I in seventh heaven, or what? How could I turn down the job offer after that?

I bet you’re wondering who he actually supports. Well I actually support great, free-flowing rugby, that’s all. So, in point of fact I don’t often mind who wins if there’s a great match.  Nevertheless, here’s my top 10 team my pecking order (with a National pride tinge):

Jonny
Jonny taking a dump – at goal!
  1. England (Always – I dreamed of being that damned number 10, fly-half, Jonny Wilkinson kid, in my own youth!)
  2. Scotland (We moved here and still reside in Fife)
  3. Wales (For my great friend, Anthony, who is Welsh but sounds like a posher Englishman than me)
  4. Ireland (So unlucky in this last world cup with injury and suspensions at just the wrong time)
  5. New Zealand (Need I comment?)
  6. Australia (Well, most of their really brilliant athletes play either Rugby League or that other thing called ‘footy’, or Aussie Rules, curiously still played with a rugby shaped ball. So, I feel sorry for them.)
  7. Argentina (What a revelation this world cup?)
  8. Canada (For my best friend, Brad, even though he doesn’t play, doesn’t watch many matches of any sort, but is truly patriotic!)
  9. South Africa (I can’t actually quite forgive the apartheid years)
  10. France (Who likes them? Well again actually, I do. I met some great French fans during the 2011 world cup in NZ; and they were also on the wrong end of that man, Craig Joubert’s poor decision making in the All Blacks v France final.)

Part 2  So, to the future.   England sacked their Director of Rugby, Stuart Lancaster, rightly in my view. His team selection was fraught even before the opening ceremony and the great win over Fiji that followed. What followed was a debacle. He was scared not to pick Burgess (an ex Bradford Bulls Rugby Leaguer, Sydney Rabbittoes Rugby Leaguer too, and then over to Bath to learn Rugby union at top level in less than a year). It was never on.

That and other strange selection changes in the Wales game sealed the deal – out you go sunshine! I’m glad. Not because we went out of the world cup ignominiously (which we did), but because it leaves open the possibility of someone (Japan’s now favourite son, Eddie Jones, it turns out) with an eye for flair, hard work and a passion to beat the shit out of the All Blacks next time up.

Eddie Jones
Eddie Jones – Ex_aussie, Ex-Japan and now incumbant England Coach

I’ll just name you two of possibly three or four back lines steady Eddie could pick. The first is my favourite:

  • Will Youngs (9), George Ford (10), Jonny May (11), Luther Burrell (12), Jonathan Joseph (13), Anthony Watson (14), Mike Brown (15)
  • Danny Care (9), Danny Ciprianni (10), Jack Nowell (11), Henry Slade (12), Kyle Eastman (13), Semesa Rokoduguni (14), Ben Thoden (15)
Ford_Farrell
The Dilemma: Kicking or Running?  Owen Farrell versus George Ford

Looks mouth-watering doesn’t it, especially if the ex-Aussie, ex-Japan coach gets the forward pack playing like Japan’s Samurai warriors: tackling anything, hooking (yes, hooking the ball at scrum-time, almost unheard of for the last three years) and playing a fast free-flowing game, scoring tries by the bucket-load?

On a sad note, we also saw the passing of Jonah Lomu an ex-All Black extraordinaire; ex-Auckland Blue; and universally agreed, the gentlest yet most powerful wing three-quarter to have ever played the game – like a gentleman, too. The good die young often, don’t they?

Jonah Lomu
Jonah in action in his prime!

 

Well on a happier exit I like Jethro Tull’s motto, “Too Old to Rock ‘n’ Roll: Too Young to Die”.

Jethro Tull

That’ll do me!  ‘Til tomorrow folks, CYA.

 

5. Back to the Future – Part Deux

Back to the Future Part Deux

Now, where was I? Yes, my stomach cancer.

As revealed through multiple medical and scientific screening tests (CT scan, Gastroscopy and tissue biopsy histopathogy) followed by consideration of the data by a multidisciplinary panel of experts I can now declare that I am the proud owner of a gastric, poorly differentiated, adenocarcinoma (Stage IV – don’t omit that bit). This is really important because that is what makes it inoperable – it has spread into my abdomen and is not confined within the stomach wall – unfortunately for me.

cancer-cells-growing-through-normal-tissue

I used to teach some of this stuff – brings back fond memories of my Bradford University days in the School of Biomedical Sciences (1977-1996).

So, as far as us inoperable types are concerned chemotherapy is pretty much the only option. Inoperable, eh? Well, actually I can ride a bike, drive a car, have flown a small plane, and oh yes, been sick on a boat, ferry and even atop my Cuban-heeled boots from the 1970s, so I can operate some things, so there!

As mentioned previously, a recent discovery that some people (about 10%) have a very specific gene (HER2) confers an advantage to them. They may have longer periods of dormancy of their gastric cancer following treatment with their Chemo. In other words, it allows a Chemo regime that contains Herceptin. This is a monoclonal antibody (MAB) that binds to cells that have the HER2 protein expressed on their surface, after which the cells become more sensitive to the killing (cytotoxicity) of the chemicals in the drug cocktail. In this case the cocktail has two components: the MAB called trastuzumab (or Herceptin) given together with Chemo, but only for patients in a clinical trial to determine if having higher doses of Herceptin alongside chemotherapy will help more people than the standard dose currently used.

There are also other trials ongoing, but hey, I’m not getting one of those potential benefits, so who is kidding who here, am I bovvered, right now anyway?  I am actually, but I thought I’d try to look cool using that famous Tony Blair Red Nose Day  word!

Another trial is looking at another MAB called onartuzumab with chemotherapy for advanced HER2 negative stomach cancer (that’s me, I’m one of them!). This is more like it, maybe I’ll survive long enough for there to be some published outcomes of targeting a receptor on cancer cells called Met. The people in this trial have cancer cells with large numbers of Met receptors. “The researchers want to see if onartuzumab and chemotherapy is better than chemotherapy alone, and to learn more about side effects.

Oh my, isn’t science and medicine complicated, but wonderful? Finally, (for me anyway – me brain is hurting nearly as much as me belly!), the REAL3 trial examined how well a MAB called panitumumab (Vectibix), a drug which acts like a growth factor blocker, worked together with my own very Chemo combo: standard EOX chemotherapy (epirubicin, oxaliplatin and capecitabine) on advanced stomach cancer. Unfortunately, the study didn’t find any benefit from having pantitumumab (Vectibix).

I have Weetabix every morning these days, perhaps I should start my own trial?   Back to the drawing board, eh?  Me too!!  CYA tomorrow; LOL.  Now is that cool enough? Nearly – like a ‘cold cap’, eh?

PS You can find (really detailed) information about biological therapy trials for stomach cancer if this little lot is not enough for you, via the Cancer Research Campaign website (http://www.cancerresearchuk.org, Accessed 25 November, 2015) on their clinical trials database.

 

 

 

 

 

 

4. So, Back to the Future …

“It’s back to the future” (said Marty). Knowing where you began is pretty much always a good way to look forward.

Back to the Future
http://www.backtothefuture.com/ (Downloaded 24 November 2015)

So, how did I get this cancer? Well as I already said, it is a stomach or gastric cancer. This one of more than 200 types of cancer (http://www.cancerresearchuk.org,  Accessed 24 November 2015), is actually on the decline in the UK (“Stomach cancer cases almost halve over the last 30 years”, 2009).

Stomach diagram

Considering the recent research (International Agency for Research on Cancer (IARC), Accesssed 24 November 2015), associating increased consumption of processed meats and red meat (Bacon, sausage, beef/hamburgers and beef etc) maybe this is a surprise to you; it was to me.

Processed meats
Maybe we should have a little less of these?

But then, stomach cancer rates are falling.! It all seems a little contradictory to me!

One reason for this actual decline may be the use of antibiotics in the young. It’s possible that antibiotic use in toddlerhood and childhood is also reducing the levels of a key bacterium in the stomach, Helicobacter pylori, known to be associated with an increased risk of gastric cancer. (Ford, AC, et. al., (2015).  “Helicobacter pylori eradication for the prevention of gastric neoplasia”, Wiley Online Library, Accessed 24, November, 2015).  I had that, I had that; I did!!  And, I was treated for it!  More later …..

Isn’t hindsight a wonderful thing? 20-20, as they say. Glancing back now to the start of 2015, I can see perfectly clearly what has been happening to me, cumulatively, for nearly nine months.

Christmas and New Year are great – rest, family and friends getting together. What more is there? Well, there’s the overeating? (Yes, but what have the Romans ever done for us?) Well, there’s the sherry for Santa and carrots for his reindeer? (Yes, but what have the Romans ever done for us?) Well, yes then there’s the ginormous Christmas dinner, preceded by Sherry for real people, white wine, red wine, probably a beer or two, Christmas pudding followed by mince pies, topped off with brandy, rum or whisky (depending upon your tipple) or all three of course – and then after only three hours, the same again in albeit marginally smaller portions. (Yes, but what have the Romans ever done for us?) Well, they bumped off Christ more than 2000 years ago and yet we still celebrate, to excess. (Yes, but what have the Romans ever done for us?).

Romans
Image: http://violet2.banksideprimary.org/2013/10/08/romans-in-britain-by-saarah-and-sabiah/ (Downloaded 24, November 2015)

That was it. I had developed a belly-ache that persisted for nearly two weeks after Christmas. Perhaps this wasn’t my usual over-indulgence, maybe there was something wrong with me? My typical alpha- male characteristics helped me ignore this and other warning signs, I suspect. But there you are, I’m sure now this was an indication that my gastric cancer was there, or about to be, or at least could be?

Let this also be warning to all of us, early diagnosis is crucial in the prevention and potential cure for cancer.  The National Awareness and Early Diagnosis Initiative (NAEDI), (http://www.cancerresearchuk.org/health-professional/early-diagnosis-activities/national-awareness-and-early-diagnosis-initiative-naedi.  Accessed 24, November 2015).The government advert showing a growing tumour in the middle of a foot path, being avoided by pedestrians, pram-pusher etc is a great metaphor for what can happen to most of us cancer patients.

 

Lump Advert 5

We ignore things perhaps? We fear the actual confirmed diagnosis, perhaps? We are too busy to visit a GP, perhaps? Who knows?  I have digressed a little here, I was going to tell you about my actual cancer type, so I’ll pause, take a deep breath and move on again,  tomorrow …..

By the way, to all of you who have now discovered my blog, I have read some heart-warming feelings of support and affection, thanks.

3. Teamwork – couldn’t live without it

Hi, me again.

So, for anyone curious about how chemotherapy is given by medical staff read on – it’s a multi-disciplinary team effort, let me tell you, and the staff I have met have been absolutely fabulous.  Here goes …..

I trust I have included everyone but I was attended by so many folk please forgive me if I have omitted anyone or confused them.  On arrival I was assigned to K but also quickly met F who pointed me to my corner of the ward, which was empty but quickly filled with more patients and bustle, more nurses, doctors, assistants, tea people, patients’ loved ones, all welcomed with big grins and kindness.

When K arrived she led me to a senior nurse, E, who then ‘walked me’ through what was going to happen, explaining possible reactions, short and long term side effects, how these would be treated and a final instruction to just keep asking (for anything: info, help, drinks food – cannabis – no, kidding!).  I may later, however!

After that K prepped me for cannulation – in first go – not like the previous Friday when I went for my blood transfusion of packed red cells.  Now that was a disaster.  Several nurses both had several goes  at getting a decent vein entry – to no avail.  I have those slippery-sucker veins (alludes to ‘Pretty Woman’), that look easy, but move when approached by a needle.

Pretty Woman
Courtesy:  ia.media-imdb/images Pretty Woman Poster (1990)

They both felt bad as I began to look like the bull at the beginning of a bull fight getting the Picador treatment, but I was happy enough after eventual success.  And what’s a few minor scratches when you are about to be poisoned for several weeks?  Anyway, I digress, as there was no problem today,  Whoop, whoop as my daughter Ellen would say!

I then met with Dr P, one of the medical oncologists, who answered even more of mine and Elaine’s questions.  All good.  Then, I had another chat with yet another member of the team to tell me about the switches to some of my medications.  New anti-inflammatory, new anti-nausea, new anti-pain (as well as the Chemo).  Off to the Pharmacy!

Finally, the Epirubicin starts to flowdown my cannula and into my arm.  I know this cause it’s red.  I’ll pee red for about several hours later in the afternoon proving I have ‘had it’, and that my kidneys are functioning.  I then switch to the Oxaliplatin.  The unfortunate thing is that because of the hypersensitivity to cold this drug causes I have to negotiate not choosing to wear a ‘cold cap’ to protect and minimise hair loss (or hang around for lots more hours getting warmed through between drug swap-overs).  Not me, I’m afraid.  I’ll have the number 5 buzz cut later if I do get hair loss.

So, I’m underway.  I get a semi-predicted visit from two of our friends, Alison and Martin who had arraged to meet Elaine for a coffeee mid-morning – nice.  I had more blood taken before I left to monitor the progress of my previous blood transfusion, and at last, we were on our way home.

Wallace and Gromit
Courtesy: Aardman/PA Wire

A ‘grand day out’, as Gromit (Wallace and Gromit’) would say. K and F were marvellous all day – and still swabbing the place down as we left – Friday afternoon – 5:00pm – Angels (1997), “Life Thru a Lens”...Robbie Williams

Robbie Williams Angels
Robbie Williams singing “Angels”.

https://www.youtube.com/

Angels Robbie Williams

 

“Life Thru a Lens”, Robbie Williams. (1997)