Cancer 2002
===========

I had treatment for tonsillar cancer during May--Nov 2002. I have been
pretty well recovered since about mid 2003, and my health is no longer a
big issue. I wrote the stuff below as the treatment was taking place to
keep friends and colleagues informed, and as kind of therapy. I don't want
to delete it (other sufferers have found it useful), and I'm too busy to
edit it, so I am just leaving it as is.

Medical update
==============

I have been having treatment for cancer in Cambridge since May 2002. It
now seems most likely that I will survive, and the timetable for the final
course of radiotherapy is now fixed; this page explains the situation. I
should start by thanking all the people who have sent me good wishes.

I had a sore throat and swollen left tonsil from mid-Mar 2002, and visited
the GP (general practictioner = English for family doctor) several times
in Apr and May, suspecting a malignant growth. He referred me to
Addenbrooke's towards the end of May, and I had a tonsilectomy 3 days
later, on Tue 28th May. The tonsil contained the primary cancer, but by
the time of the first operation it had already spread to the lymphatic
nodes on the left of the neck. Jun was the most anxious time for me,
since the malignancy was confirmed, and in the absence of any further
information, I worried that the condition was terminal. On Thu 20th Jun I
had a CT scan (computed tomography), providing an accurate 3-dimensional
map of the cancer. On Wed 26th Jun 2002 I had a consultation with the
specialists, who gave me a very good chance of recovery (70--80\%).

I was called into the hospital again for a major operation on Thu 8th Aug,
which seems to have been very successful (or miraculously so). I came out
of hospital on Wed 14th Aug, with a scar and various aches and stiffness
in the neck. I have lost some of the surface nerves in the left neck and
shoulder, but no motor functions. The operation, called a modified radical
neck dissection, involved cutting into the neck, and cleaning out diseased
tissue all the way from the jaw bone to the collar bone. I was in the
operating theatre from 9:30 am to about 2:00 pm. The surgeon seems pretty
satisfied that he removed all macroscopic traces of the cancer. Altogether
the operation and its aftermath went as well as could be hoped.

The next stage is a course of radiotherapy, involving 6 doses of radiation
per week for 6 weeks, and is fixed up for Thu 19th Sep--Tue 29th Oct. The
radiotherapy apparently has some side-effects, including tiredness,
temporary drying-up of the saliva glands, loss of taste, and consequent
lack of appetite and eating problems. Alcohol is forbidden. I will have to
stay in Cambridge, taking medical leave from Warwick for at least 5 weeks,
and possibly the whole of Term 1.

Miles, Fri 30th Aug 2002

The radiotherapy has now started. It's roughly one 5 minute session every
day for 6 weeks. They will zap me from 3 different directions to have the
best chance of killing the bad guys and not causing too many innocent
civilian casualties. I'm currently feeling very well, but the treatment is
designed to make me feel pretty bad over the next 6 weeks, and to allow me
to recover. Fri 20th Sep 2002

With 8/34 sessions done, the radiotherapy routine is well established. They
clamp my head into a tight-fitting transparent mask, to give the
radiographers a fixed coordinate system, and a place to mark targetting
guides. Each session takes 5--8 minutes. The side-effects are noticeable:
I have a mouth full of glue, and I want to sleep for about 15 hours a day,
but nothing especially bad. Sat 28th Sep 2002

17/34, halfway through the course. The side-effects of the treatment have
started to make themselves apparent: I have sores at the top and back of
my mouth that make it hard to speak and to swallow; and I've just started
moulting hair and skin from a little area on the left-hand side of my
face. Apart from that I'm pretty well. There's only 3 weeks zapping to go,
and I hope that I will recover speedily after that. I'm still busy with my
work, and interfering by e-mail with people at Warwick and in my European
network. Wed 9th Oct 2002

The last 2 weeks of the course was hell -- I had all kinds of damage around
my mouth and throat, and couldn't swallow any food or drink. At the end,
obviously starved and dehydrated, I was admitted to the hospital as an
in-patient, to be dripped liquid and given food via a pipe to the stomach.
After one week in hospital, I am now back home, able to look after myself
and feeling much better. The mouth and throat should start repairing
themselves soon. Tue 5th Nov 2002

I had my first regular check-up with the consultant at Addenbrooke's
on Wed 4th Dec. He says that I am recovering normally, and that there
is no indication that the cancer will recur. He says that they have
done 40 patients with similar condition over the last 10 years, and
have only lost 2, both of whom were worse off than me to start with.

The recovery from the radiotherapy is still slow, painful, and so far
only partial. But it seems that the ordeal is coming to a conclusion.
Thu 5th Dec 2002

I'm feeling altogether better now. The pain swallowing has almost gone,
and I can eat a whole repertoire of different things, but not bread or
large quantities of rice. I can drink beer, but so far not wine (it 
stings the throat). I was in Spain for 2 weeks in Dec, where I gave my
lectures (2 hours at a time, with constant sips of water). I had various
good and not-so-good experiences in the Madrid restaurants. I'm back to
normal working at Univ. of Warwick, although I fall asleep during the day
even more than usual. I'm planning a 10 day trip to Japan at the start of
Mar, followed by another month in Spain.

The worst affected part of the beard on the left side currently grows at
about 25\% efficiency, and is a kind of visible barometer -- it more or
less matches the damaged saliva gland on that side; the radiotherapist says
that they will take about 2 years to get back to normal, but with steady
improvement in the meantime. Mon 3rd Feb 2003

I'm now very well. The long term prognosis is less than 5\% chance of
recurrence of the cancer. I still have some problems with "fried mouth"
(the scars of radiation burns to the top and back of the mouth, together
with lack of normal saliva), but nothing like as bad as three months ago.
I lost more than 20 kgs between Oct 2002 and Mar 2003, but I'm now eating
fairly normally, and have put about 5 kgs of it back on. I have a
long-term problem with the left shoulder, where the surgery cut the
spinal accessory nerve to the trapezius muscle; this is a well-known
consequence of accidental or surgical damage to the neck, and is exactly
as explained to me before the main operation. It manifests itself as
discomfort and stiffness of the shoulder, for which I am supposed to do
physiotherapy exercises. Wed 11th Jun 2003