Ann was diagnosed with pancreatic cancer in May 2007. She had a Whipple’s operation and then chemotherapy. Ann recovered and was incredibly well for two years. Then symptoms returned and a scan showed the cancer had come back with secondary tumours in her lungs.
Ann had breast cancer in 1995. After treatment, she recovered and led a busy life. In May 2007, she noticed changes to her digestion. Her poo was more fatty than usual and hard to flush down the toilet. She also noticed a strange metallic taste in her mouth. She went to see her GP, who sent her to see a gastroenterologist (a specialist in the digestive system). At first, Ann thought that she might have bowel cancer.
Ann had various tests, including a blood test, colonoscopy, endoscopy, ultrasound scan and a ERCP (Endoscopic Retrograde Cholangio Pancreatography). Ann was devastated when the consultant told her she had pancreatic cancer.
A surgeon recommended that Ann have a Whipple’s operation. Ann dreaded this operation but didn’t think there was any other option. A date for the operation was set for two weeks later, so Ann went away on holiday, walking in Corsica, which she enjoyed.
Ann returned from her holiday for the operation, which took 5-6 hours. The pathologist found a small tumour that was 2cm. Some of the lymphatic glands close to the pancreas were also affected by cancer.
After surgery, Ann felt terrible and at times wanted to die because she felt so ill. She felt sick for some time but couldn’t take anti-sickness pills (antiemetics) because of the side effects. She had a nasogastric tube, a drip and a catheter.
Ann had an epidural (an injection in your back to relieve pain) for three or four days, which controlled the pain very well. She also had a morphine pump, (for after the epidural), but she only used it once.
Ann felt that the surgeon was excellent but thought that medical and nursing care could have been better after the operation. She felt that she needed a doctor who could be an advocate; and who was interested in her case. She found that the showers and toilets were dirty at times. However, she felt protected; in hospital and didn’t want to go home at that stage after surgery.
Ann got an infection in her abdomen (tummy), which gave her a fever. Doctors drained the abscess and gave her antibiotics. Gradually she started to drink and then eat again in small quantities. She had lost two stone in weight.
Ann stayed in hospital for three and a half weeks, and then went home. Five weeks after the operation she managed to eat clear soup and some other foods, such as ice cream. Ann felt very tired for weeks. She went out of the house for the first time about five weeks after the operation. Her stomach felt bloated and tender for a while, and she had headaches.
Two months after the surgery, Ann went to France for a holiday. She felt well enough to swim and felt good, though she still felt very tired at times. She ate small meals frequently. She had to poo several times a day and verged on diarrhoea.
When Ann returned to England, she felt under pressure to start chemotherapy. She felt pressure from herself, and from family and friends, even if this wasn’t talked about. She decided that she would try to have at least some of the 18 courses of chemotherapy that the doctors recommended.
In October 2007 Ann had a CT scan and more blood tests and she started chemotherapy treatment (gemcitabine). Ann managed to do six of the 18 courses, over about three months, but had to stop the treatment because she couldn’t handle the side effects.
The side effects of the chemotherapy included sickness, nausea, tiredness and depression. Ann took Nabilone (a Cannabinoid extract) for the sickness. This made her feel woozy; and she had to stay in bed, but this was better than feeling sick. Each time she had the chemotherapy she felt ill for about three days.
After stopping chemotherapy, Ann felt very well for two years. She went back to work part-time. In 2009, Ann suddenly started to get digestive symptoms again. She found she was waking at 3.30am to poo. She had discomfort in her tummy, just under her ribs. She also felt distended and bloated, and had some pain down her leg. Ann had a CT scan and discovered that the cancer had come back, not only round the area of the pancreas, but in her lungs too. Soon afterwards, Ann also had some pain in her chest.
Ann felt desperately sad to find that she had a recurrence of the cancer. It was very difficult telling the children and she found it hard to deal with other people’s reactions.
Since then Ann has needed strong painkillers, including morphine, and hopes that her doctors will be able control her pain. Ann has never wanted alternative; treatments for cancer.
She has made a living will; and does not want resuscitation if she suddenly collapses and there is no chance that she will recover. She also thinks that people in the UK should have the right to an assisted death if that is what they want.
Ann has prepared for her death. She has looked at her Will, sorted out her drawers, thrown away rubbish and put all her photos into albums. She would like to die at home if she can get enough nursing care and support, to maintain some sort of dignity;.
We spoke to Ann in 2007 and 2009.