The bombshell of the diagnosis is actually less of a surprise to me than some other people who find out later on. As both parents, two cousins (before age 50), two uncles, a school friend and two clients have died from the condition, plus a familiarity with life insurance proposal forms “have any of your parents, brothers or sisters had a serious illness etc….” I am not so shocked. There has been a little voice in the back of my mind saying that maybe…. it might be cancer. The people that I knew with cancer all bore their condition with courage and dignity right up until the last, so now it is my turn.

In a way, the news is a relief and the medical process gears up. I have a long chat with the medical team at UCH who specialise in cancer of the head and neck. For the fourth time in as many weeks, my larynx is viewed with a laryngoscope. The doctor tells me that the growth looks like a strawberry on one of the vocal cords and is about as long as a fingernail.

As the cancer has been caught early, chemo will not be necessary – a huge relief even though it is less traumatic now than a few years ago. I have never forgotten the late Roy Castle describing his chemo as having paintstripper injected into his veins. The options are surgery which will be a quick fix or a period of radio therapy – RT. I prefer the option of RT which is usually given for between 5 and 7 weeks and my regime will involve 33 weekday sessions lasting 6 and half weeks. My daughters accompany me on the various visits to different members of the medical team, a dietician, a voice therapist and a Macmillan nurse.

The theory behind the RT treatment is that that healthy cells will recover from being exposed to radiation whereas cancerous cells will not. A dosage in “Greys” is calculated and this is administered over the sessions with doses on each side. One does not feel anything while the radiation is being administered but the effects build up. The reason for spreading the treatment over a number of sessions is to catch the cells at different points in the growth cycle and prevent the growth of future generations of cancer cells.

The short and long term effects are all explained to me, which include: loss/change of voice, change of taste, ageing of the skin and loss of some beard on my neck. The main one will be fatigue which will be slow at first but cumulative and will continue building for up to two weeks after the treatment has finished, so I elect to to have the RT sessions in the afternoon so I can work in the mornings and rest afterwards. I sign a form to say that I have received and understood all this information – rather like compliance in financial services.

A key part of the preparations for the treatment is a visit to have a facemask made. This made with a green thermoplastic mesh which is warmed up in hot water and then draped over my face to make a close-fitting mask. The mask will keep me still, ensure that the same place is zapped each time (to within 3 millimeters) and any targetting or calibration marks can be made on the mask rather than on me. All the same, my explanatory notes state that a blue tattoo spot will be made on my chest to aid targetting the RT beams. I have never liked tattoos, but since I am going to have one, I ponder having it made into something artistic – a bullseye target maybe? As it happens, I am spared this and I am still tattooless. The first mask turns out to be too loose, so after an hour another one is done. The green mesh has 5 huge bulldog clips attached and the outfit certainly keeps me fixed. The worst thing is that the mesh gets caught in my eyelashes and while not painful, it is really irritating – rather like having grit in your eye. Tissue over the eyes cures this.

I am shown a computer-generated slice of my upper chest showing the angle at which the beams will come in from each side. The beam pattern looks like a flat “X” and avoids radiating the spine. My windpipe appears as a shadow and a red cross marks the target on one of my vocal cords.

The dietician tells me that I should not lose weight during the treatment so I can worry about losing my paunch later and I visit the voice-therapist where I am told that the voice therapy will start after the treatment has finished.

The last session before it all starts is a dummy run. The treatment room down in the Basement of the new UCH building is space age stuff with the scanner taking up the whole of one wall. It is about 7 feet high and reminds me of a giant food mixer but with the whirly bits and bowl removed. The machine can rotate through 180 degrees from the horizontal through the vertical and back down again. There are 5 scanners at UCH with 4 being used continuously keeping the 5th as a spare or for private work. The images are stored in a computer so they can be accessed quickly but at the final quality check, these images do not match up so the calibration and dummy run are done again. This delays my treatment for a week and means that my treatment will now finish on Friday 13th July – someone, somewhere has a sense of humour.

Bank Holiday over, one of my daughters comes with me for the first 3 three sessions which are longer as images are taken before the radiation is given. Each day the mask is put on and I am clipped down to the moveable table. Fortunately, I do not suffer from claustrophobia but 20 minutes more or less stapled to a table gives me an inkling of what it might feel like. Ironically I am the only one who cannot see what is going on with the mask keeping my eyelids shut although I can hear a buzzing when I am being radiated which lasts about 20 seconds on each side. As predicted, there are no side effects initially and after the first three, the sessions are shorter so I give my daughters the week off.

Each Thursday, I meet the doctor and dietician. I had gone back to wet shaving as I found electric shaving slow and untidy but am told firmly to use my new electric razor to avoid skin problems later on. In the corridors, I notice other patients with red necks walking slowly up and down the corridors.
By the end of the second week I cannot drink hot liquids and then notice some discomfort in swallowing. My neck and upper shoulders now have a 4 inch red strip across them as if sprayed by some graffiti artist warming up. I am given some skin cream and told to put this on my neck twice and then four times a day. At the end of week 3, I really notice the swallowing and am given stronger painkillers in the form of pills and goo which I am supposed to keep in my mouth for as long as possible and then swallow. For a few days ironically, a few people say my voice sounds stronger.

I have an inspiring meeting with Thomas Power, Chairman of the on-line social networking group www.ecademy.com who encourages me to write up my experiences in a blog. One of the responders to my blog is Susan St Maur who has had cancer twice and started her own blog with a little humour thrown in http://www.cancercomicstrip.blogspot.com/ One of Thomas’s exercises is to get me to make a list of 10 things I would like to do before I die. I have no intention of doing this, but this thought provoking exercise ties in with the lady’s blog i.e. cancer is really the ultimate wake up call. I make the list and am surprised by some of the items……
By the end of week four, I am losing my voice and long chats are no fun. My neck soaks the cream up like blotting paper and I have 4 inch square target over my Adams Apple. But the skin is now raw rather than just being red. It also feels tight as If I have just had plastic surgery to remove a double chin. Sadly, I have to tell Peter at Dolphin Swimming Club that I will not be teaching any more this term. I really miss my pupils, but then I doubt that the chemicals in the swimming pool will do my skin much good.
Now on my way back from town, I make a point of getting off the tube at Highgate and walking through Highgate Wood where there is a little café with good food – a great place to chill. One day there is a guy showing a small snake to a lady who seems fascinated by it. It is draped over her forearm and she is stroking its head which is about an inch wide. I do not recognise it as a British species so I ask what kind it is – he tells me it is a baby boa constrictor. I wonder what he is going to do with it when it gets big?

The positive side shows itself again on Fathers’ Day with the love and support of my 3 daughters and their partners, and I have the best steak I have ever eaten.

In the second week of December 2006 my voice went husky sounding to me like a whisper which made networking in crowded locations a bit difficult. I had only lost my voice once before when I basically worked myself into the ground, getting up early, working till after 10 p.m. and lugging a heavy laptop and huge case around. I took 6 weeks off and it came back.

I visit Thailand in the third week of December for 3 and half weeks and feel very inclined to spend future Christmases there http://www.georgeemsden.co.uk/?p=78 A week back at work and I am still feeling run down and one day on the way to the bus stop, something tells me to go back to bed. Another two weeks off. I cut down networking to nil but the voice stays the same. Penny Power of ecademy kindly suggests voice therapy and Rhidian Jones recommends me to his GP in Wimpole Street who has done wonders for him. Eventually I go back to my GP as the prescribed antibiotics have had no effect. I have had no temperatures, aches or coughs like many other people have in winter so I am sent to the Royal ENT hospital near King’s Cross and told to say that mine is an urgent case so I will not have to wait long.

The lady doctor examines my throat pressing my tongue down with a spatula, and says that she is going to examine my voice box. She gives me a local anaesthetic via a nasal spray and says something to a nurse. After a couple of minutes, I notice that the nurse is working with something that looks like a hand torch with an 18 inch black worm stuck on the end of it and she keeps staring at me. The penny finally drops that she is warming up or maybe cleaning the laryngoscope. The doctor returns with the worm-thing and asks me if I have a preference for which nostril this thing should be stuck into? For some reason, I say the left one.
It just takes a few minutes and is not as bad as I thought it would be – “one of your vocal cords is swollen” she says.

Two days later, I get a letter giving me an appointment on 5th April so unusually for an IFA, I am not in the office on that often frantic day. The final phone call before this is hysterical as apart from the usual questions, do you take any medication etc I am asked if I have any implants! I am really tempted to answer what sort? but decide to be serious for once and tell them, no.

I am told one teeny-weeny sample of tissue will be taken and that they will have a better look as I will be under general anaesthetic. After changing into a blue hospital smock, I am on the trolley and a needle is put into my wrist. It will feel a bit cold, the anaesthetist says. “Now we will give you some oxygen” and the facemask is put over my face. For a few seconds, I breathe funny smelling oxygen and that is the last I remember until I wake up. My daughter is there and I am given a cup of tea and a sandwich. My mouth is very dry from the anaesthetic and even with a sip of tea, swallowing is difficult and I spit some of the sandwich out. The sore throat soon disappears and I am able to join my 3 daughters and their partners for my birthday dinner in the evening.

I am scheduled to return to the Royal ENT two weeks later – no change in the voice. I eventually see the doctor who has my file on his desk and a funny drawing on it. A nurse comes in and leans against the wall. I am told in a matter-of-fact tone that yes it is cancer - to be specific a squamous cell carcinoma which means that the cancerous cells are in the mucous. Three tissue samples were taken and two show some cells to be invasive. The funny drawing turns out to be a hand-drawing of my larynx showing a growth on one of the vocal cords. As both my parents have had the big C, plus some other members of my family, this news does not come as such a huge shock as it might have been for other people. I do not break down with the news and the nurse leaves.

I am now handed over to UCH which fortunately has just been rebuilt with brand new scanners and stuff to take images of and zap the cancer with radiation. I have CT computer tomography a kind of smart X-ray which gives better images of soft tissue and am told that as the cancer has been caught at an early stage, chemo is not necessary and only RT or radiotherapy should be needed. I am offered a surgery option which would only entail a one day stay in hospital, but since removed tissue cannot recover, I opt for RT.

The ultrasound visit is great fun with three lymph nodes (glands to non-medical types) being sampled with needles to check that the cancer has not spread. Having a needle stuck in my neck and waggled about to get a sample for the glass slide, is the only painful part of the process so far but does not last long. Within 24 hours I get a call that the samples are clear so they will not have to have a look at any of the other 300 lymph nodes in my head and neck – we have 1,500 of them apparently.

The effect of the news on family friends and colleagues after the initial shock is very positive – squabbles have been put aside in some cases. Lovely to see people working with each rather than fighting each other. Also the larynx is an area with little blood supply so there is less chance of it spreading than other areas. If you think about it, there are worse places where one could have the big C. The support of family friends and colleagues is very heart-warming and compared to some of the other people I see at the hospital every day, I am having an easy time of it.

Thank you to all of you who have and are supporting me. I will describe the treatment and its effects in a later blog.