The Treatment

My deteriorating eyesight forced me to give up driving twenty years ago. This has made me dependent on my wife and, to a lesser extent, my daughter, should I ever need to leave Pearly Beach, and that is why I could not travel back and forth for cancer treatment on my own.

The treatment started on Monday, 31 October, 2022. We left pearly Beach at 1.45pm, allowing sufficient time for delays through the road works between Gansbaai and Stanford in order to be at the Centre by 3pm. After visiting the spotless grey and black tiled facilities with their gleaming white receptacles, we found Pathcare just round the corner. There were no other patients and it did not take long for a nurse to draw a small quantity of blood from my arm and stick a pledget over the puncture site.

At Radiology, I had barely seated myself on the sumptuous black leather couch when Melané and Rochelle arrived and greeted us in a friendly fashion and we descended to the bunker. They showed us the control room from where they monitored the procedure and then took us into the radiation area and explained how I would lie on the table with my head immobilised in the plastic mask and be remotely moved into position beneath the equipment. This, they said, was a linear accelerator programmed prior to each session to deliver high-energy X-rays that conform to the specific size, shape and location of a tumour. In this way, the LINAC could target and destroy cancerous cells in a precise area of a patient’s body with minimal exposure to the surrounding healthy tissue.

Before lying on the table, I was asked to remove my shirt so that the mask fitted snugly over my shoulders. On seeing the scrawny condition of my torso, Melané registered something bordering on horror, and she urged me to eat more protein and start taking food supplements. I later realised that her concern was informed by the knowledge that I would soon be losing weight. I climbed onto the table, was strapped into the mask and they retreated to the safety of the control room. I lay listening to the hum of machinery and wondering whether I was going to have a panic attack.

I heard some whirring and clicking and assumed the radiation head was rotating above me and taking up position to target the tumour. The table jolted, there was more whirring and clicking, and after a few minutes a loud buzz as the actual zapping began. It lasted some ten to fifteen seconds, ceased, and then was repeated another three times with intervals of about two minutes. I heard the head move back to its original position, and then the sound of the door opening and footsteps approaching. The therapists were either side of me releasing the mask from its anchor points and asking me if I was okay. The table was moved out and lowered, and I was able to sit up and get to my feet. The process had lasted no more than fifteen minutes.

I ended up having a total of 32 radiation sessions over a period of almost seven weeks. In that time, Melané, Roshelle and Karien were extremely supportive and seemed to genuinely care about how I was responding to the treatment as it progressed. The fourth member of the team was Michelle, the receptionist, and she proved to be friendly, efficient and helpful, even to the extent of trying to sort out a software issue on my phone.

The following day, Tuesday, we were back at the Centre for my 9.30 am appointment with Doctor D. He announced that my blood test was normal.  This was to be expected at this stage, but as treatment progressed it was important to monitor my condition and ensure that my white blood cell count did not fall too low as the chemotherapy took effect. The programme he had worked out entailed six or seven weekly chemo sessions, and 32 doses of daily (apart from weekends) radiation. Again, he briefly mentioned possible side-effects before taking us through to the chemo lounge to meet Aggie.

Apart from Carol, the tea lady and Sunelle and Martie., the pharmacists, there were three nurses. For some unfathomable reason, I came to think of them as the sisters of mercy. They were Aggie, Tania and India.

I was shown to one of the twelve black leather La-Z-Boy recliners and asked to place my left arm on a pillow for it to be covered with a warm towel. After allowing five to ten minutes for my veins to dilate, India removed the towel and went about inserting a canula and connecting me to a litre bag of prehydration fluid hanging from a mobile drip stand. Attached to the drip stand was a monitor that began beeping a warning when there was a hitch, or the bag was about to run dry.

Prehydration took about an hour and a half, and before the next phase could commence, I was to prove myself ready by passing at least 300ml of urine. The chemotherapy drug was administered from two 400ml bags, one after the other, and took a further hour and a half. The drug that I was given was Cisplatin, which attacks rapidly dividing cells like cancer and, in combination with radiotherapy was designed to destroy the malignancy that was intent on killing me as soon as it could.

As Doctor D had warned me, Cisplatin came with unpleasant side-effects, and to counter them I was given a cocktail of pills to be swallowed before and after meals. Omeprazole was an antacid, and for nausea there was Aprepitant, which was also meant to stimulate the appetite, Prednisone, Granicip and Contromet. They proved effective in that I never felt outright nauseous, and I never threw up in spite of a growing aversion to almost all food and drink.

Tea or coffee was on offer and was always accompanied by a ginger biscuit, ginger being a nausea antidote. However, by the fifth week even this confectionary had become unpalatable.

These three-hour chemo sessions were not too tedious because patients came and went and provided a degree of interest and entertainment. I regularly got to chat to one man in particular. About my age, he was also receiving radiation as well as chemo. Cancer was eating up the fingers of his bandaged right hand. He tried to show me what the wound looked like on his phone but, unable to see any detail I had to use my imagination to appreciate the gory spectacle. Intelligent and outwardly cheerful and positive, he had an irreverent sense of humour that reminded me of my father, and I was grateful for his company.

And there were the nurses, of course. When there were half a dozen patients or more, they worked under extreme pressure, setting up and disconnecting drips, and responding to the frequent beeping of monitors. Nevertheless, they were always cheerful and unflustered, and even managed to chat and banter with their more extrovert charges. The atmosphere was never gloomy, despite the seriousness of the incurable illness each patient was contending with. I asked India if she found the work distressing, and she said she enjoyed interacting with her patients and getting to know the individual, even if it was only for the duration of their treatment. The distressing part was when news came that they had lost someone before the end of their course.

Observing the nurses and the radiation therapists at work, my indignation and anger on encountering injustice was rekindled. How is it, I asked myself, that a society can support a system that rewards self-interest, materialism and greed far more generously than altruism and dedication to alleviating suffering? There has to be something fundamentally wrong with such a status quo but, I told myself, there is nothing much I can do about it, and must confine my feelings to gratitude and admiration for all of those working in the health care profession.

Next: The Side Effect

Other posts chronicling my encounter with cancer:

The Lead Cylinder and the Plastic Urine Sieve

One Thing Leads to Another

An Aggressive Uptake of Glucose

The Man in the Plastic Mask

To view my longer work as an author, you can find me on Smashwords here.