Strategies

It’s Sunday morning and I feel quite good after a relatively undisturbed night’s sleep.

My main symptom of the treatment this time has been dizzy spells, fatigue and a little nausea and the meds have dealt with those pretty well. There’s still damned constipation but even that may be on the move, if you’ll pardon the expression.

I have been giving some thoughts to my priorities and I shared them with Ann yesterday. Don’t get me wrong; I have made no decisions as I don’t have the facts on which rational decisions can be based but I think I am moving towards a basis for those decisions.

My main priority is to maximise my long-term survival chances and if I can avoid surgery without putting survival at risk then I will probably do so. However both Ann and I need some certainty in our lives, a line drawn under events and a chance to start rebuilding to a new normality whatever that may be for us. That need would suggest going for surgery earlier rather than later as surgery does draw that line.

But what are the facts?

I was told that undergoing chemotherapy would improve my five-year survival chances from 50% to 55%. I suspect that is the official figure but I also suspect that that figure covers a multitude of different treatments, doctors and hospitals from world-class ones like the Christie to Nether Alderly’s cottage hospital. Dr. W, who is supervising my treatment so far says that in his experience chemo is so successful that in a third of cases surgery is no longer necessary and radiation treatment can finish the job. That is highly encouraging and there seems to be no down side to undergoing the treatment except that it really knocks you about physically and mentally.

However I have also read that in 40% of cases treated as described above bladder cancer returns and then the only recourse is surgery. Once more I wonder if that general figure really reflects the results obtained locally and that is a question I will need to ask. A 40% chance of reoccurrence is pretty high and for the first few years at least our anxiety levels are going to remain high from test to test hence the option of going for surgery anyway and drawing a line.

Does delaying surgery in this way actually reduce the success rate of the surgery? Another question for the future.

But now I’ll just get through today and then tomorrow avoiding planning too much and letting my body set the agenda.

The family should be here this afternoon and I want a sleep before they arrive so I have the energy to enjoy their visit. They are off to a caravan in the Lakes tomorrow and the forecast is for rain up there. Mind you, one can hardly be surprised that it rains in Windermere in August. After all, this is England.