The Unwelcome Guest

After having your breakfast, in my case coffee along with muesli topped with blueberries and yoghurt, what’s the question you’d least like to be asked? Well I suppose there are many possibilities but ‘Do you need an enema?’ has to be right up there. But that’s Rafiq for you, a no-nonsense radiographer at St Thomas’ Hospital, who doesn’t mince his words. He requires a Preen with no excrement in his bowels and that’s what he’s going to get.

It’s 830am and I’m at St Thomas’ Hospital, accompanied by Mrs Preen, and ready for my first blast of radiotherapy. For the treatment to be effective an empty bowel and a full bladder is required as this gets the prostate gland into the right position and apparently helps reduce side-effects.

Cancer doesn’t lend itself to whimsy, but I’ve been thinking about the Unwelcome Guest who’s been getting a good kicking from the hormone therapy treatment I’ve been enduring for almost a year. Now the little bastard is about to get an agricultural blast of the finest NHS Tomotherapy. ‘What fresh hell is this?’ I imagine the Guest thinking, hopefully giving him all the encouragement he needs to check out.

But enough of such whimsicality this is a serious day. You can sort of tell it’s serious because there is free chocolate everywhere. The cash strapped NHS doesn’t generally hand out treats to its patients, so I assume the deluge of Cadbury’s comes from some kindly charity.

Breaking news: no enema is required so I’m taken to sit with a bunch of old boys who are also waiting to be treated. I’m given 350ml’s of water to drink to swell my prostate to an appropriate size.

Forty-five minutes later Rafiq appears and leads me through to a changing room where I don a hospital gown. Helen and Hanna, also part of the radiography team, then show me into the treatment room where I’m confronted by the Doughnut of Doom or the Tomotherapy device as it’s more commonly known.

If you’ve read Radio Days (2) you will know I underwent a trial run, which involved me getting inked with three tattoos to enable the team to line me up correctly on the table. This process involves lasers focussing on the tattoo crosses and ensures the radio-beams are fired at the Guest and don’t damage too much healthy tissue.

Preen placement is achieved quickly with Helen telling me that first they scan my prostate to check my bowels are sufficiently void and my bladder sufficiently bloated and then, if all is well, the treatment begins.

So I’m lying there in the heart of the doughnut, I guess I’m the jam, keeping as still as I can with my hands folded across my chest. Thankfully bowels and bladder are in peak condition, so the treatment goes ahead with the whole process taking no more than 12 minutes.

The room is quite cold, presumably to keep both the machine and patient cool and unlike the MRI scanner, this one is mercifully quiet. There is a kind of high frequency rushing sound combined with a gentle knocking that reminded me of a wheelie suitcase being dragged across an uneven pavement.

The treatment causes no pain, but some side-effects may follow, with tiredness being the most likely. I’m out the door by 9.45.

This was ray-day one and I’m now to undergo a further 38 of these treatments every weekday until 7^th November. I’m quite interested to see how I progress and whether side-effects do manifest themselves. You’ll be hearing from me.