David Birch – Colorectal Cancer

“Following a few tough years and the devastating loss of my father to cancer in 2020, I could feel my own health deteriorating but had put it down to perhaps stress-related IBS. I found myself feeling more tired than usual and needing the loo more frequently, but there were no other symptoms to raise any serious alarm bells, so I let it slip. It was only after being encouraged by my family to see the doctor that I made an appointment in the December and dutifully went along, thinking it was something of a waste of time. My doctor didn’t seem overly concerned but suggested I go for a blood test as a precaution. When the results came back, I was told I had an iron deficiency and that I would need an infusion. My doctor also suggested I go in for a colonoscopy. Suddenly, those alarm bells rang loud and clear. A colonoscopy was scheduled for the January after Christmas.

The procedure was a morning appointment, so the evening before, I went through the unpleasant task of ‘bowel preparation’. The doctors ran through the usual questions, and a nurse directed me to a private changing room where I was given a gown to wear and fitted with a cannula. During the procedure, I remember drifting in and out of consciousness, occasionally overhearing the discussion between the team of doctors about what they were seeing. It was towards the end of the procedure that the tone of the conversation changed, and I knew something wasn’t quite right. Once the film crew had wrapped, they took me to a holding area while the anaesthetic wore off and asked if my wife could come and join me. It was then that I knew the prognosis was not going to be good. I changed out of my gown while they called my wife in. Once she arrived, the doctors took us both into a small quiet room and sat us down. They explained that the colonoscopy had revealed a tumour and that it was almost certainly cancer.

Cancer.

That name again.

They went on to explain the next steps and that I would need a CT and MRI scan to verify the extent of the tumour and any potential spread. Thankfully, I didn’t have to wait too long for the scans, which confirmed that I did indeed have bowel cancer. The scans also showed that the cancer had been more considerable than previously thought – the disease had spread to the liver. Albeit a relatively small node, this made the cancer a stage 4 diagnosis. Due to the proximity of the tumour to a major blood vessel, they also explained that, depending on the results of the chemotherapy, they would need to use IORT (intraoperative radiation therapy) during surgery to reduce the tumour further and minimise the possibility of damaging the artery. If the IORT was unable to achieve this, then the surgery may not have been possible.

Over the coming weeks, the doctors arranged for a video call with an oncologist to discuss my chemotherapy treatment and put me in touch with an online support group for people diagnosed with bowel cancer. They also explained that I would need a stoma and that it would likely be – or at least advisably be – irreversible. There was also a possibility that I may need both an ileostomy and a colostomy. Amongst the other side effects discussed was the likelihood that I would not be able to have children due to the damage caused to the muscle tissue and nerve endings. I explained that my wife and I couldn’t have children because of the effects of radiotherapy during my first cancer treatment. Yes, you read that right – this is, in fact, my second battle with cancer. I was diagnosed with a Wilms tumour at the age of 4.

Due to COVID restrictions, my initial chemotherapy treatment was at the Spire Southampton Hospital, where I had my own private area during the two-hour administration of Oxaliplatin. It was during those first sessions that I first met Marie and Hannah, who became my primary care team. And care they really did. Checking in when they had time and always being there on the end of the phone when I needed support. Even now, I occasionally reach out and catch up with them, including several of the Planets charity support groups. I underwent four rounds of chemotherapy over a three-month period prior to surgery. While physically tough, the chemotherapy itself was far less invasive than I had anticipated. The aforementioned two-hour session on an intravenous, followed by two weeks of tablets twice a day, and then a week off before starting over again. It was certainly easier to manage than the treatment I underwent as a child. No hair loss or vomiting this time around, just pins and needles in both feet and hands and an inability to touch anything cold without it feeling like a lightning bolt surging up my arm.

Further CT and MRI scans showed that I had responded well to the chemotherapy and signs were as good as they could be for a planned surgery in the July. While I knew I would need bowel preparation before the surgery, I had hoped they might allow me one last meal. But alas. I was famished and knew that my next meal would likely be at least three weeks from now (it was actually more like four).

The morning of the 29th came, and the nurses arrived to gown me up. Obviously, thanks to the incredible support and care from the teams of doctors, surgeons and nurses at Southampton General – not to mention the PLANETS charity for the IORT radiation therapy machine, without which my surgery may not have been possible – surgery went as planned, and I am here to tell this particular tale. Coming around from my surgery, my first thought was, ‘I’m alive. ’ Still delirious from the anaesthetic, a nurse informed me that the surgery had gone well. From there, they moved me into an ICU. A few days later, I was moved into a shared ward and was able to take my first tentative steps.

I was making good progress, and even the surgeons, doctors and nurses were impressed by my general recovery. It was just a waiting game for my stomach and bowel to adjust to the changes. My stomach was still producing a lot of fluid, which meant I had to put up with an insufferable nasogastric drain that constantly made me want to wretch.

Once the stoma had kicked in, I would be able to have the drain removed, and I could finally have something of substance to consume beyond just water. This was perhaps my lowest time of all during my treatment. Knowing that the surgery had been successful, the cancer had been removed, and I was getting better by the day, yet unable to eat or go home until the stoma had started working. Finally, almost 4 weeks after surgery, my stoma was in action. The relief was incredible. From there, I was able to have the drain removed and start proper fluids. My first cup of apple juice tasted amazing, but when I was finally able to have some soup, I could honestly have cried it was that good. In quick succession, more drugs and fluids were taken away, and a few days later, I was able to go home.

​​The feeling was one of both relief and a certain amount of trepidation. I no longer had the support of the nurses and hospital care. It was down to me now. To get my weight and fitness levels back up.

Of course, a consequence of the surgery, however, has meant I am left with a permanent stoma. Whilst a relatively small price to pay to spend more years walking the earth, there is no denying that this has been one of the hardest things to come to terms with. Affectionately called Geoff, he has a slightly racist attitude towards foreign food, talks a lot of crap and likes to wear Pouis Vuitton. A name I coined for my ostomy pouches. Having a stoma is something I am continuing to adapt to and deal with as I find a ‘new normal’ with eating habits and daily routines.

​​Over the last year or so, I have started to focus more on myself and the things I can control. So much of life is out of our hands, but finding a way forward through small wins helps put things on an even keel. Creating more good days than bad, saying ‘yes’ more and giving myself a good reason to say ‘no’ to invitations and new experiences.”