Hearing those dreaded words "You have cancer" and how I reacted

It was National Cancer Week in Ireland recently and there were many events in various places around the country to raise awareness of the disease.

This year I had a special reason for paying attention. Just a few months ago I became one of the unlucky ones.

Or to look at it another way, I should say I became one of the lucky ones because my cancer was picked up at an early stage by the new National BowelScreen Program run by the Health Service Executive in Ireland (the HSE). The experience taught me a lesson I'd like to share with long-time readers of this column, particularly readers entering their golden years.

The moment I learned the bad news was a complete shock. It happened like this:

"You have cancer," the doctor in the Mater Hospital in Dublin told me. "You have cancer. You have cancer."

In fact he said it only once, but the world had suddenly gone silent and his words echoed and re-echoed in my head. A trap door had opened beneath me and I could feel myself falling through it. I seemed to go deaf for a few seconds, so, even though he was still talking to me, I wasn't hearing anything.

That was eight months ago. But I need to begin this story at the beginning.

A few weeks before last Christmas a letter arrived at my home with a leaflet telling me about the new National BowelScreen Program and inviting me to take part. This was not something I had requested.

I'm in my sixties, and men and women in that age bracket in Ireland now get the letter automatically under this new HSE initiative which began in May 2014. The aim is to test everyone in Ireland between the ages of 60 and 69 for bowel cancer, and the program is on track to be completed by the end of this year.

I glanced through the information leaflet quickly and then I did what most men do: I decided to deal with it later. I added the letter to the pile of old post on my desk and within a few days I had forgotten all about it.

I had too much going on. The weeks before Christmas are the busiest time of the year for books and I was literary editor of the Irish Independent. I had more pressing things to think about.

Besides, although I'm in my sixties I felt as fit as a fiddle. I was not overweight, I was eating a healthy diet and I was exercising every day.

Everyone said I looked younger than my years. Cancer? That was something that happened to other people.

A few weeks after Christmas I got a reminder letter. Probably because I then had time on my hands, I read the leaflet again about how you could do the simple home test, and I rang the number requesting the screening pack.

When the package arrived it contained a small plastic tube, a lollipop stick, instructions on what to do and a postage prepaid return pack. It's not complicated. You use the stick to scrape a stool after you have been to the bathroom, put the stick in the little plastic bottle, seal it, pop it in the return package and post it back.

The next day it was mission accomplished. Nothing to worry about, I thought, feeling virtuous.

The leaflet had explained that what the test looks for is traces of blood invisible to the naked eye, which can be an indicator of cancer. It reassuringly added that less than five percent of people who do the test are positive. There was nothing to worry about, I told myself again.

But a couple of weeks later I got a phone call. The voice at the other end told me my test was positive and I needed to have a colonoscopy.

Although now slightly nervous, I was still confident that everything would be alright. After all, the information leaflet had said that even if you are positive, there is usually another explanation, like hemorrhoids.

Less than five percent of the five percent who are positive and are called in for a colonoscopy turn out to have a cancer problem. Five percent of five percent? How could I be that unlucky?

The hospital nominated for my colonoscopy was the Mater, not far from where I live. On the day I was semi-sedated for the procedure which I was told would take about 20 minutes.

Afterwards, while I had tea and toast in the recovery area, the doctor told me that the colonoscopy had taken over an hour and that he had found and removed several small polyps from the lining of my bowel. He said that one polyp was slightly bigger and he was sending a sample for analysis.

A week later, I got another call asking me to come back in to see him to discuss the results. And that's when I learned I had cancer.

Very gently, the doctor said that the analysis had shown there were cancerous cells in the larger polyp. In my innocence, I still clung to hope and when I found my voice again I argued back.

"But when you did the colonoscopy you removed the polyps, so they're gone," I said. "That means the cancerous cells are gone too."

"No," he said. “You have cancer."

The root of the cancerous polyp was still embedded in my bowel wall and the cancer cells could also have spread to nearby areas. I would need a bowel section to remove that part of the bowel.

The good news was that it was Stage 1 cancer, he said. It had been caught early and the likelihood of a full recovery was high.

He immediately sent me downstairs for a CAT scan to see if there were any growths in the area surrounding the bowel. The scan was clear so it looked as though the problem was only in the bowel itself.

Leaving the hospital that day I was in shock. We always think these things happen to someone else. When it's you, it's devastating.

A week later I met one of the Mater's colorectal surgeons, who looked young enough to be my son, which was mildly disconcerting. But he said he had done nearly 300 of these operations.

Looking at the pictures from the colonoscopy, he also said that it was very likely that the surgery would fix me and I would not need any chemotherapy or radiotherapy afterwards.

My bowel section was done in the Mater and I was there for a week afterwards recovering. The operation removed a 15 inch section of bowel – this seems astonishing, but I'm told we have lots of it – and my bowel was then joined up again.

It was uncomfortable rather than painful when I woke up after the operation. I had a catheter in me to remove waste, which made sleeping difficult. I also had a morphine pump which I could squeeze to control pain.

"But I don't need it, I don't have any pain and I don't do heavy drugs," I told the nurse.

"That's the morphine working," she said, clearly thinking she was dealing with a half-wit. "Press it as often as you need. It won't let you overdose!"

The bowel has an amazing ability to restore itself quickly and within three days I was eating normally and using the bathroom again, albeit with some difficulty. The catheter had been removed and towards the end of the week, after getting more lab results, my surgeon confirmed I would not need chemo or radiotherapy. I would be going home in two days.

That would be that for most Stage 1 bowel cancer patients. But in my case, there was another issue. The bowel surgeon said that during the operation he had noticed I had a slight thickening of the bladder wall and this needed to be examined.

He referred me to a urological surgeon, who also was young enough to be my son (but I was getting used to that). I rested at home for a couple of weeks to get over the bowel operation and then went back to hospital for a bladder scope. This revealed two small polyps in the bladder, one of which looked problematic.

Further analysis showed that it had Stage 1 cancer cells and so I needed a bladder section operation to remove the surrounding bladder area. This was done, also in the Mater, a couple of weeks later.

There were more tubes in me when I woke up and again it was uncomfortable. But the good news was that once more I was told I would not need any chemo or radiotherapy, and a week after the operation I was home again.

I still had a catheter in through my stomach and a stent between my bladder and kidney, but these were removed two weeks later in day visits. And that was it. After two separate weeks in hospital and five visits for tests or day procedures, I was finished.

When I got home that day I went for a long, slow walk on the beach near where I live in the village of Howth on the North Side of Dublin. It was raining but I didn't care. The air never smelled sweeter. The world never looked more beautiful.

After a difficult two months (this all happened in March and April) I was through it. There are regular follow-up checks to be done, of course, but as far as both consultant surgeons are concerned I am cured. I'm one of the lucky ones.

Bowel cancer is the second most common newly diagnosed cancer and cause of cancer death in Ireland (roughly 2,500 new cases reported each year here and 1,000 related deaths). Many of these deaths will be avoided with this new program through early detection followed by appropriate treatment. The program is all free, regardless of income.

Remember, I had no visible signs that anything was wrong. Were it not for the National BowelScreen Program I would have remained undetected, perhaps for years, until I began to show visible signs of blood in the bathroom or developed tumors.

By then I might have been Stage 3. Or even Stage 4, when there is a much lower chance of survival.

There are no guarantees with cancer, of course. But it looks like I am clear of it. I think it's fair to say that the National BowelScreen Program in Ireland probably saved my life.

I don't know if there is a similar program in the U.S. If there is, and you are in your 60s, be sure you avail of it. If there isn't, pay to have a colonoscopy done. It could save your life too.