So it’s time to talk about it. Enough weeks have passed that I can distance myself from the experience enough to be able to tell the tale objectively and honestly. After 28 doses of external pelvic radiotherapy, and 5 rounds of chemotherapy, the time had finally come. The treatment I had been dreading even more than chemo was only a few days away: Bracytherapy. The Bracy. In my imagination I had characterised it as a huge and monstrous beast, like the Kraken - a horrific and aggressive mysterious creature, which lurked in the depths and preyed on unwitting souls - like me.
But before it all gets messy, let’s do a quick vocab check, for those of you who aren’t intimately acquainted with gynaecological cancer treatments - lucky you, frankly. Anyway, cervical cancer is tricky, as anything beyond the very earliest stage can’t usually be fixed by the “whip it out” approach of a hysterectomy (if that wasn't bad enough). So the treatment for any stage after that is usually Chemoradiation, which is a combination of: (my translations in green)
Chemotherapy uses drugs, given intravenously, to destroy cancer cells. The drugs travel in the bloodstream around the body and help stop cancer cells growing.
Trans: Horrific ungodly ass-kicking drugs are fed into your veins, which make you feel the sickest you have ever felt in your life. They also make you lose control of your bodily functions and are basically a huge dose of poison. Side effects are a total shit storm. Ensure your bathroom floor is warm, comfortable and wipe-clean before starting chemo, as you will be spending a lot of time lying on it, curled up in a ball.
External Radiotherapy destroys cervical cancer cells using high energy x-rays.
Trans: You lie on a trolley every day for weeks, in a big empty room while a huge white machine whirrs and clicks its way round you, delivering beams of radiation at the cancer. It doesn't hurt at the time but the fun comes later. Depending on where your tumour is, it will also affect the tissues and organs nearby. Pelvic radiotherapy will usually hit the bladder and bowel, causing damage to both. Often, this recovers in time, but in a significant number of cases, some residual damage is permanent and life-changing. Think holes in your bowel, stents, permanent diarrhoea, incontinence and more.
Internal Radiotherapy - Brachytherapy gives radiation directly to the cervix and the area close by. One or more hollow tubes, called applicators, are put into the vagina. The radiotherapy is given through these tubes. Applicators are passed up through the cervix into the womb. Padding is placed inside the vagina to help protect the rectum and prevent the applicators moving. A catheter is put into the bladder to drain urine.
Trans: Hell. On Earth. Say goodbye to your last shred of dignity and enter a horror story of the most personally invasive treatment yet. This is what I have coming up. This is how it panned out.
I’d seen my oncologist a few days before and she had told me that my tumour had halved in size after the chemo and external radiotherapy (which goes on working for weeks afterwards) so that was a great response. We whooped silently because, well, britishness, and she went on to talk me through brachytherapy from a medical point of view. The applicators, padding and catheter would be inserted (up your fanny) under general anaesthetic on the first morning of my 2 day in-patient hospital stay. I’d have an MRI after that (I really hate those things) and the first bracy session would be later that day.