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Interview 11

Age at interview: 68
Brief Outline: He was invited to be screened for bowel cancer in 2005, when aged 67, but for various reasons he decided not to take part.
Background: A white English man, retired managing director, married with 4 children.

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About five years ago he noticed some blood in his stools. He consulted his GP, who referred him to a local hospital, where he had a colonoscopy. This investigation did not reveal anything seriously wrong, but he found it embarrassing and it made him feel quite 'down' and 'depressed,' at least for a short while. Recently a good friend of his was diagnosed with bowel cancer. After several operations his friend sadly passed away. These experiences have made him reluctant to take part in a screening programme for bowel cancer.

 
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He wondered about making screening compulsory.

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Do you want to say any more about screening?

Only that sometimes you might reflect that a lot of people, perhaps like me with bowel cancer [screening], tend to turn away or shy away from the implications or ramifications of it. You wonder sometimes whether it might be worthwhile making screening almost compulsory, in fact perhaps offer screening and impose a fine if you don't go for the test, a bit like the Australians do with the general elections if you don't vote you pay a penalty. Now I'm sure that that could get argued about fairly sort of strenuously but there's a thought, there's a thought, it must have a degree of mileage and I'm sure somebody has thought it through.

If you were told you had to go and be screened how you would you feel?

Like pretty well everybody else. I was told I had to do National Service so I did it and if somebody said get screened or you're fined '100 guess what, as a pensioner I'd get screened wouldn't I?

I don't know, how would that help? I haven't even thought it through, it's a thought that only occurred to me while I was talking to you.

 
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He found colonoscopy embarrassing, undignified and depressing. This was one reason why he did not...

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Yes I'm not totally sure of the year but I reckon about five years ago I first noticed blood in my stools. First of all I thought, well perhaps it's beetroot I've been eating, but then it persisted for a short while. So I went and saw my own doctor and he examined me with a rubber glove and his finger and he said 'I don't think there's too much of a problem but nevertheless I'll refer you.' And I was referred to the hospital within a very short space of time, where I went through the joyous indignity of the colonoscopy. It was not the most accommodating of experiences, I said to my wife afterwards, 'I went in there a very fit and healthy 60, 62 year old and I came out a broken man'. I really found it quite difficult. I have to say the people there, the doctors, the nurses everybody else in the department were absolutely flawless in the way that they helped (').

The colonoscopy is not particularly painful but I did find it acutely embarrassing, especially when one of the nursing assistants looked at me and said, 'Oh I know you,' which I thought [laughs] well this is the one time I just don't want to know anybody. But nevertheless the process was complete within I would think about 20 minutes or so.

Were you offered a sedative at all?

No, no I wasn't. I was asked whenever the camera was travelling whether I was feeling any pain, and he did say at the time, 'There is nothing that we can see that is in any way a cause for concern'.

Would you describe it as uncomfortable or painful?

Uncomfortable rather than painful. After that it was just a question of getting back into my civilian clothes after the surgical clothes and leaving the hospital and actually being, not humiliated that's the wrong word, but I felt very down after the experience, I really felt that it wasn't one that I really wanted to go through again unless it was absolutely necessary. But a few years later I had fairly sort of massive haemorrhoids so I did have to go through the experience again only not to the same sort of extent. But really that was the sum total of my experience as far as the colonoscopy was concerned.

And afterwards you said you came out feeling quite 'down'.

Mm.

Can you elaborate on that a bit?

Well I was a fit 60 year old who was doing a lot of running and still playing rugby on occasions and suddenly I was a wizened little man, (') I felt really depressed by the whole event.

How long did that feeling go on for?

Oh not long, not long, I soon bounced back, may be 24 hours. But my wife will probably tell you, I rang her and said, 'I feel,' as I said humiliated is not the right word, but '.(pause) I think inevitably when you're a 60 year old plus male and I'd been very fortunate I'd never had any time in hospital before in all my life, it's a fairly sort of salutary experience. And it was, for me. 

Were you given adequate preparation and information about what was going to happen beforehand?

Not particularly. I mean the mechanics of the process were explained to me but I don't think you grasp, I think you have to remember that I, I grew up in an age where the body was almost sacrosanct, you know it was at the time when it was considered inappropriate ever to be seen naked in public, or even semi naked. Whether that made a difference I don't, I really don't know but that's the way I felt and that probably has led onto my reaction to the offering of further
 
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Having seen a friend die of bowel cancer, and a brother die of a different cancer, he did not...

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Well [laughs] my wife told me I was a bloody fool anyway for not doing it [the screening test] but we haven't discussed it depth. And certainly we've had friends who've had the tragedy of having a husband having passed away through having bowel cancer and one might have thought that given that, as an association, I would do something about it. The other thing of course to say is that because I saw my friend go through all the trauma and all of the operations associated with discovering that he had bowel cancer, and he was a very brave man, I somehow felt that there seemed to me a degree of inevitability about discovering it. Now I know that people do have operations that are successful but my friend's case was one where I think he had three or four operations and the ultimate, having fought very hard, very brave he was, he passed away. And I think sometimes you tend to turn your face to the wall to be truthful, tend to switch off and perhaps not take proper sensible intellectual consideration on these things and that's what I think that I've done.

So from what you've said does that suggest that you're not very optimistic about treatment for bowel cancer?

Yeah, I suppose that's true.

Is that what you meant?

Yeah it's, it's an, it's unfair because it's just based on one person, so it's not, it's not a fair statement I suppose about treatment from bowel cancer generally. I know that there are remarkable successes with the early treatment of bowel cancer but my friend did suffer tremendously through a series of operations that he had for his cancer. And I, I found it, I'm very proud of him, he was great, but as I said I think sometimes you, you tend to switch off and think well I'll have another pint and worry about it tomorrow, or two.

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