Back on 8th November I returned to the Christie for my biopsy. Step one was an ultrasound scan to map out the approach, which requires a straight line to the tumour without any danger of impacting major blood vessels, nerves or organs. The radiologist took a good look and couldn’t see a good path, so he called in a more experienced member of the team who confirmed that the only feasible approach was in through my lungs and liver and carried significant risk. So no biopsy was done. The following day the drug trial nurse practitioner phoned me to discuss the situation. We agreed that I would attend clinic on Tuesday to talk it through with a consultant.
Jan and I went back in as planned, first for a routine CT scan that had already been arranged and then off to the clinic. We talked it through with the consultant who explained the risks of the biopsy, which included puncturing the lung allowing air out into the chest cavity. This could have serious consequences would lead to being hospitalised for several weeks. The chance of this occurring was close to 50%. If the procedure did go wrong I would at best spend several precious weeks in hospital and come back out weaker and less fit than am I now, impacting the standard chemo treatments.
Comparing the risks with a net benefit of between 6% and 8% made it an easy decision to make, forget the trials and get on with the chemo, something both the consultant and drug trial nurse practitioner agreed was the right one from their viewpoints. An appointment for my first chemo session was arranged then and there for Tuesday 26th November, followed by another session a week later and a review on the Thursday the week after that, the beginning of three week cycles repeating indefinitely. The good news is that after the first sessions I may be able to have my chemo in Macclesfield hospital, something that wouldn’t have been possible if I’d been in a trial.
Overall I don’t feel too bad about this, when I was first told they couldn’t do the biopsy as planned it was a bit of a blow but doing the sums to show the likely benefits did make me realise I hadn’t lost out on much. There are times in life when the choice is to go with the expert recommendation or do your homework to come to your own conclusions, but if you opt for the latter you have to be rigorous about it as it’s all too easy to believe the facts are as you want them to be. I count myself a sceptic, which means I question things I want to be or think are likely to be true more than I do evidence that goes against my preconceptions. People who deny climate change is a serious problem because they like driving cars and flying on holiday please take note.
Incidentally, the picture is of me in Prospect Park, Reading in 1962.