Tom – Interview 29
Diagnosed with breast cancer in his right breast in 2007. He had a radical mastectomy and ancillary node clearance, followed by preventive chemotherapy, radiotherapy, Herceptin and tamoxifen. In consultation with his oncologist, he discontinued taking tamoxifen because of extreme sleepiness and lethargy. He is now taking Arimidex.
In retrospect, Tom had been feeling drained and generally unwell for about a year prior to noticing a lump behind his right nipple. He immediately suspected that it might be breast cancer and so he telephoned that day for an appointment with his family doctor. He saw a part-time GP who tried to suggest a course of antibiotics, but Tom insisted on an urgent referral, to which she eventually agreed. A mammogram, ultrasound and biopsy confirmed that he had breast cancer. Initially the shock of his diagnosis brought on a violent, panic response which affected his breathing for two weeks or so.
Surgery was arranged to take place just twelve days following diagnosis. A separate room was found for him on a breast ward, otherwise populated by female patients. He had his mastectomy early one morning, and he was pleasantly surprised to be well enough to go for a short walk when his wife visited him later that afternoon. He was discharged from the hospital the following day, although he still had a drain in his chest for another two weeks. He found the drain – a long piece of pipe inserted in his chest cavity attached to a bag to collect fluid – increasingly uncomfortable. Occasionally the drain leaked, and on one occasion he had to call out district nurses late at night to replace the dressing that held the pipe in place.
The cancer had spread to around half of the lymph nodes which had been removed, so Tom was referred to another hospital – a specialist cancer centre – for treatment to prevent cancer recurrence. There was a delay of around a month associated with the transition to the cancer centre. His oncologist here was very happy to talk him through the detailed scientific background to treatment options (in contrast to the breast surgeon he had seen), and he was recommended to have chemotherapy, radiotherapy and longer-term preventive medication, which he was pleased to accept.
The chemotherapy treatment started around a week later. This was tough and debilitating treatment, making him very tired and cold, affecting his appetite for food, and starting a stomach upset that has stayed with him, to some extent, for several years. He was prescribed additional medication in an attempt to offset the serious side-effects of chemotherapy. It was necessary to strike a balance between these additional drugs, and this balancing-act was successful in managing queasiness on all but one of six treatments with chemotherapy, but on that single occasion he vomited extensively during the days immediately following the treatment. A particularly unpleasant and painful side effect of the chemotherapy was the loss of skin from his bottom of his feet. Towards the end of the course of treatment, he developed a queasiness immediately after having the chemotherapy injected, whilst still in the hospital, which he suspected might be partly psychosomatic in origin. This hospital was quite progressive in its approach, and he was offered complementary therapies to have alongside his chemotherapy. He found reflexology to be very effective in preventing this psychosomatic; queasiness. He was offered a cold cap; to wear on his head during the chemotherapy injections in an attempt to minimise hair loss caused by the treatment. The cold cap was very uncomfortable, but it was successful in preserving much of his hair, so he persevered with wearing it. The efforts which his hairdresser made to make the best of his remaining hair lifted his spirits during the treatment. He worked throughout the treatment, and was fortunate to be able to adapt his work schedule to cope with the tiredness, and to minimise contact with people when his immunity was at its lowest. Overall, he found the most distressing aspect of chemotherapy was seeing how upsetting it was for his wife to see him going through the discomfort.
Three weeks of almost daily radiotherapy treatment started a few days after the end of the chemotherapy. The suite where his radiotherapy was administered was much brighter and the atmosphere more upbeat than the chemotherapy ward. Although the treatment itself took just a few minutes, being positioned precisely for the X-ray beam was more time-consuming. He found the sometimes extended delays whilst waiting for treatment – usually caused by some of the X-ray machines being out of order- frustrating.
Treatment with Herceptin began ten days after the end of the radiotherapy. The Herceptin was injected in a day ward every three weeks over a period of around twelve months. He didn’t experience any very pronounced side-effects, although it became increasingly difficult and distressing to find a suitable vein to administer the treatment.
Tom started taking tamoxifen in the form of daily tablets at the same time as the Herceptin treatment began. After around eighteen months he discontinued the tamoxifen in favour of Arimidex. He did so, in consultation with his oncologist, because the tamoxifen seemed to be contributing to a profound sleepiness and lethargy that he was experiencing. Whilst on Arimidex he has experienced some degree of pain in his joints.
Throughout the treatment, Tom has been fortunate in receiving very strong and understanding support from his wife, and from his work colleagues. He was also delighted to receive exemplary technical and emotional support from a specialist breast cancer nurse at the cancer centre, who has played a leading role in pioneering such forms of patient support.