This is why screening is important.
This. All of this. Everything I'm going through and everything I've written here. This is why screening is important.
Prior to December 17, 2018 I had no idea that there was a tumour growing in my rectum. I was asked by my GP to undergo a very non-invasive but inelegant test - pooping on a stick - out of an abundance of caution. The only reason for doing a FIT on me was that I had already completed more than fifty trips around the sun, and after that many miles my hardware needs to be checked. That test came back right at the threshold for reporting a positive result.
I could have ignored it. My GP even told me that if I didn't want to be referred for further screening we could just repeat the test in two years. What would have happened if I had waited two years, I wonder...
Two years earlier, my FIT result was half the value it was last year. Neither result were impressive. And ironically, my results are apparently more related to whether I am having a flare of my previously undiagnosed diverticular disease than they were about my cancer. But still, I endured a potential loss of dignity and pooped on a stick and then lay on my right side so a gastroenterologist I work with could slide nearly two metres of scope into my colon.
Yeah... that was a hit to my dignity as well. But what price would I put on my dignity?
If I had put my dignity first and stamped my feet and blustered about how I wasn't going to do anything as uncouth as let someone examine my poop, I never would have had the colonoscopy. And if I hadn't had the colonoscopy, I wouldn't have found out about the tumour in my rectum. It would have sat there, biding its time and growing without inhibition until I did notice something unusual. Maybe I would have persistent pain when moving my bowels. Maybe there would be streaks of blood in my stool. Maybe I would become obstructed by the tumour and not be able to move my bowels at all. Maybe I would lose weight - not a bad thing at first, but as the weight continued to slide off without any real attempt to lose it on my part, I would eventually figure out something was wrong.
Then I would act, right?
Well... maybe. Don't underestimate anyone's capacity to lie to themselves - least of all me.
If I was squeamish about pooping on a stick, how likely would I be to take a look at the poop in the toilet bowl when I move my bowels? "Not very" seems the most likely answer. Streaks of blood or even small gushes of blood could be ignored or explained away with other bodily processes like hemorrhoids. And denial can be such a sweet, sweet state of affairs once you start.
But denial can also be deadly.
I took the threshold positive result for my FIT seriously. I took my colonoscopy seriously. I didn't panic when my gastroenterologist found the benign-looking polyp that turned out to be adenocarcinoma. But I took that seriously as well. I took it seriously when I met with my surgeon and went through the options, and took it seriously when I had a CT and MRI to see what else might lurk inside me. I took my surgery seriously and I am taking my recovery seriously.
I take my life seriously. And so should you.
Pardon the crude language and groan-worthy pun, but who gives a shit what someone does with your poop if it will save your life? Having a digital rectal exam or a mammogram or a pap smear are at the very least uncomfortable. Let's be perfectly honest here, they are also at least a little humiliating. I get why people might not want to have them.
But they could save your life. And that's serious.
Put your taboos aside. Check your concepts of couth at the door. Get over yourself and do what it takes to save your life.
I did, and I don't regret a second of it.
I wrote this rant back in March of this year, before I knew that I had a metastatic lymph node and before I was referred for chemoradiation. A lot has happened since then - a whole lot!! - and as I consider the somewhat negative tone of my past few posts and the burden of illness that I now have I re-read what I had written then through the lens of a single question.
Is what I wrote still relevant?
At that point I didn't know that my cancer was not limited to my rectum which was essentially already gone. At that point I felt pretty darned good. I was recovered enough from my surgery that I could start working out at the gym again, and the only change in my life was that I was a bit deconditioned after surgery and my bowel habits had changed. At the time, I thought that was pretty major, although I knew even then that it was not as major as I had feared it would be. I didn't feel sick then. I figured that I was on the road to recovery and that by mid-summer I could consider going back to work. It's now pushing on towards the last part of summer and I am at least four months away from even considering going back to work. And I feel sick now, pretty much every day.
Is what I wrote still relevant?
It was easy to be optimistic in the spring. I thought I had already undergone the biggest challenge I faced and that all that lay ahead of me was recovery. I couldn't know how my mouth would feel raw and sore, how painful bowel movements would become, how light breezes could set off electric shocks across my skin that are at the very least disconcerting. The thought of being neutropenic was laughable; my immune system was strong and fully functional and could swat away interlopers with ease. I never considered that I would have a new sunburn on my butt from one of the radiation beams that was directed into my pelvis. I never thought I would have to consider the risk to others of mundane pedestrian things like my urine in a toilet or tears wiped on a towel in a common washroom.
One other side effect that I am having since I started chemotherapy is that I produce a lot more saliva than usual. Kind of gross, but there it is. When I'm awake I swallow it, just like we all do. When I'm asleep... well, you can probably guess from your own experience that I don't always do that. I woke up at one point last night with my cheek in a noticeably damp spot on my pillow and realized that there was probably an unhealthy amount of chemotherapy-laced saliva now in my pillow.
Yeah... I never thought I'd have that thought back in March, either.
Is what I wrote still relevant?
Yes. It is. Moreso now than it was then, if I'm honest. But why?
It's relevant because I don't want anyone to go through what I'm going through. It's relevant because screening programs are the best way of catching cancers like mine when they are stage 1 or 2 and considered curable rather than when they are stage 3 or 4 when the chances of survival drop to acceptable (Stage 3) to poor (stage 4). Colorectal cancer is diagnosed in about 27,000 Canadians every year (2017 statistics) - about 75 each and every day - and affects men slightly more often than women although it is pretty undiscriminating about how it invades. It is the second most commonly diagnosed cancer in Canada (after non-melanoma skin cancers) and is the second leading cause of death from cancer in men and third leading in women. Nearly ten thousand Canadians die from colorectal cancer each year - fully one-third of those diagnosed. And without screening programs, these numbers would be much, much worse because stage 1 and 2 colorectal cancer are virtually undetectable. It's not until they are stage 3 or 4 - where other tumours outside the colon start to form and where the tumour bulk is so great that the person can actually feel it inside them or notice changes in their bowel habit because of it - that treatment would be sought. Take a look at the 5 year survival statistics for colorectal cancer by stage and I think you'll agree that the outcomes are WAY better when these cancers are caught early.
So... yes. What I wrote is still relevant. And while it may be more than a little bit of reiteration, I think it's appropriate to remind everyone why it's important to get over your taboos and undergo every single screening test that is appropriate for you.
Chances are that you will be lucky - either your results will come back negative or you will have easily-treatable stage 1 or 2 cancer. But if you don't get tested, you can't possibly know whether you are cancer-free. Don't take that chance.
You are far too important for that.
Prior to December 17, 2018 I had no idea that there was a tumour growing in my rectum. I was asked by my GP to undergo a very non-invasive but inelegant test - pooping on a stick - out of an abundance of caution. The only reason for doing a FIT on me was that I had already completed more than fifty trips around the sun, and after that many miles my hardware needs to be checked. That test came back right at the threshold for reporting a positive result.
I could have ignored it. My GP even told me that if I didn't want to be referred for further screening we could just repeat the test in two years. What would have happened if I had waited two years, I wonder...
Two years earlier, my FIT result was half the value it was last year. Neither result were impressive. And ironically, my results are apparently more related to whether I am having a flare of my previously undiagnosed diverticular disease than they were about my cancer. But still, I endured a potential loss of dignity and pooped on a stick and then lay on my right side so a gastroenterologist I work with could slide nearly two metres of scope into my colon.
Yeah... that was a hit to my dignity as well. But what price would I put on my dignity?
If I had put my dignity first and stamped my feet and blustered about how I wasn't going to do anything as uncouth as let someone examine my poop, I never would have had the colonoscopy. And if I hadn't had the colonoscopy, I wouldn't have found out about the tumour in my rectum. It would have sat there, biding its time and growing without inhibition until I did notice something unusual. Maybe I would have persistent pain when moving my bowels. Maybe there would be streaks of blood in my stool. Maybe I would become obstructed by the tumour and not be able to move my bowels at all. Maybe I would lose weight - not a bad thing at first, but as the weight continued to slide off without any real attempt to lose it on my part, I would eventually figure out something was wrong.
Then I would act, right?
Well... maybe. Don't underestimate anyone's capacity to lie to themselves - least of all me.
If I was squeamish about pooping on a stick, how likely would I be to take a look at the poop in the toilet bowl when I move my bowels? "Not very" seems the most likely answer. Streaks of blood or even small gushes of blood could be ignored or explained away with other bodily processes like hemorrhoids. And denial can be such a sweet, sweet state of affairs once you start.
But denial can also be deadly.
I took the threshold positive result for my FIT seriously. I took my colonoscopy seriously. I didn't panic when my gastroenterologist found the benign-looking polyp that turned out to be adenocarcinoma. But I took that seriously as well. I took it seriously when I met with my surgeon and went through the options, and took it seriously when I had a CT and MRI to see what else might lurk inside me. I took my surgery seriously and I am taking my recovery seriously.
I take my life seriously. And so should you.
Pardon the crude language and groan-worthy pun, but who gives a shit what someone does with your poop if it will save your life? Having a digital rectal exam or a mammogram or a pap smear are at the very least uncomfortable. Let's be perfectly honest here, they are also at least a little humiliating. I get why people might not want to have them.
But they could save your life. And that's serious.
Put your taboos aside. Check your concepts of couth at the door. Get over yourself and do what it takes to save your life.
I did, and I don't regret a second of it.
*****
I wrote this rant back in March of this year, before I knew that I had a metastatic lymph node and before I was referred for chemoradiation. A lot has happened since then - a whole lot!! - and as I consider the somewhat negative tone of my past few posts and the burden of illness that I now have I re-read what I had written then through the lens of a single question.
Is what I wrote still relevant?
At that point I didn't know that my cancer was not limited to my rectum which was essentially already gone. At that point I felt pretty darned good. I was recovered enough from my surgery that I could start working out at the gym again, and the only change in my life was that I was a bit deconditioned after surgery and my bowel habits had changed. At the time, I thought that was pretty major, although I knew even then that it was not as major as I had feared it would be. I didn't feel sick then. I figured that I was on the road to recovery and that by mid-summer I could consider going back to work. It's now pushing on towards the last part of summer and I am at least four months away from even considering going back to work. And I feel sick now, pretty much every day.
Is what I wrote still relevant?
It was easy to be optimistic in the spring. I thought I had already undergone the biggest challenge I faced and that all that lay ahead of me was recovery. I couldn't know how my mouth would feel raw and sore, how painful bowel movements would become, how light breezes could set off electric shocks across my skin that are at the very least disconcerting. The thought of being neutropenic was laughable; my immune system was strong and fully functional and could swat away interlopers with ease. I never considered that I would have a new sunburn on my butt from one of the radiation beams that was directed into my pelvis. I never thought I would have to consider the risk to others of mundane pedestrian things like my urine in a toilet or tears wiped on a towel in a common washroom.
One other side effect that I am having since I started chemotherapy is that I produce a lot more saliva than usual. Kind of gross, but there it is. When I'm awake I swallow it, just like we all do. When I'm asleep... well, you can probably guess from your own experience that I don't always do that. I woke up at one point last night with my cheek in a noticeably damp spot on my pillow and realized that there was probably an unhealthy amount of chemotherapy-laced saliva now in my pillow.
Yeah... I never thought I'd have that thought back in March, either.
Is what I wrote still relevant?
Yes. It is. Moreso now than it was then, if I'm honest. But why?
It's relevant because I don't want anyone to go through what I'm going through. It's relevant because screening programs are the best way of catching cancers like mine when they are stage 1 or 2 and considered curable rather than when they are stage 3 or 4 when the chances of survival drop to acceptable (Stage 3) to poor (stage 4). Colorectal cancer is diagnosed in about 27,000 Canadians every year (2017 statistics) - about 75 each and every day - and affects men slightly more often than women although it is pretty undiscriminating about how it invades. It is the second most commonly diagnosed cancer in Canada (after non-melanoma skin cancers) and is the second leading cause of death from cancer in men and third leading in women. Nearly ten thousand Canadians die from colorectal cancer each year - fully one-third of those diagnosed. And without screening programs, these numbers would be much, much worse because stage 1 and 2 colorectal cancer are virtually undetectable. It's not until they are stage 3 or 4 - where other tumours outside the colon start to form and where the tumour bulk is so great that the person can actually feel it inside them or notice changes in their bowel habit because of it - that treatment would be sought. Take a look at the 5 year survival statistics for colorectal cancer by stage and I think you'll agree that the outcomes are WAY better when these cancers are caught early.
So... yes. What I wrote is still relevant. And while it may be more than a little bit of reiteration, I think it's appropriate to remind everyone why it's important to get over your taboos and undergo every single screening test that is appropriate for you.
Chances are that you will be lucky - either your results will come back negative or you will have easily-treatable stage 1 or 2 cancer. But if you don't get tested, you can't possibly know whether you are cancer-free. Don't take that chance.
You are far too important for that.
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