BACKGROUND

In November 2010 I was diagnosed with secondary cancer in the liver. No definite primary has been found, and although doctors think it is most likely to have originated in the bile duct, based on the biopsy tissue, it remains the fairly rare presentation of cancer of unknown primary (CUP). Surgery wasn't an option, as too much of the liver was involved, so I wound things up at work by the end of November, was signed off on sick leave, and started on palliative chemotherapy at the beginning of December 2010. 


I'm under the care of the Royal Marsden Hospital in South Kensington, London (conveniently close to where I live), and I've had 9 cycles of chemo (Gemcitabine and Cisplatin). Each cycle consisted of treatment 1 day a week, with 2 weeks on and 1 week off. Each session was a long day, arriving first thing in the morning and often not getting home till 6 or 7 pm, but I usually managed to go to one of the many nearby cafes for lunch - I got to know the area well! 


Overall I tolerated the chemo very well, feeling tired at times but manageably so. I lost my sense of taste for the first couple of months, which took all pleasure out of eating, but thankfully regained it with the help of acupuncture, and I still hugely appreciate being able to savour food and drink - it makes such a difference to morale! I also experienced a lot of thinning of my hair from April to July, which I hated (strands fell out continually, especially when I washed it), but compared to the other side-effects I could have had (nausea, ulcers, nervous system damage or kidney failure) I got off extremely lightly.


As you may not be surprised to hear, I've also pursued alternative therapies to help me stay as healthy as possible. I have weekly acupuncture, see a cranial osteopath, take homeopathic remedies, go to a healer, and have changed my diet (cutting out dairy and sugar). For the emotional side of things, I saw a counsellor for a couple of months, and had a few sessions with a hypnotherapist, both of which have helped me not to get too overwhelmed by worries and fears, and to adjust to the uncertainty. I use self-hypnosis and visualisation every day - it's been interesting and rewarding to go back to some of the skills I routinely used in my work with clients before I trained in clinical psychology. On the whole I've been surprised and pleased at how positive I feel most of the time, and I'm learning to let go of trying to plan things too much and just take it a step at a time. Although it's impossible to know for sure, I'm certain that all of these helped me come through the chemo relatively smoothly, as I'm told that most people on this combination have a much harder time than I did. 


However during my 9th cycle, in June 2011, I found it harder going, and was admitted to the Marsden for a week in early July with severe abdominal pain and inflammation, fever, and very low blood counts. I was given a blood transfusion and intravenous antibiotics in case it was a infection, but since no bacteria were found it could well have been caused by accumulating toxicity from the chemo. Being in hospital was pretty grim (I definitely prefer being an employee of the NHS to being a patient!) and it knocked my confidence and morale in a big way. 


The chemo was more successful than the doctors had expected, shrinking some of the tumours, but since the Marsden's only plan was to keep going with chemo as long as I could bear it, I did a lot of research into integrative approaches to cancer care, and found that Germany appears to be at the forefront of innovative treatment combined with complementary therapies. I went on a recce trip to southeastern and central Germany in late June, with my friend Jacqie, visiting 2 clinics and having consultations with the head doctor at each, and from that decided to go to Dr Herzog's clinic for treatment (www.fachklinikdrherzog.de).