In 1979, when I was just 35 years old, I started experiencing abnormal vaginal bleeding and lower back pain. When a Pap test came back normal, the gynecologist I saw said not to worry about anything, that I was fine. But I wasn’t fine. My symptoms quickly escalated, and I sought the opinion of another gynecologist. He gave me a physical examination and said that I had a large tumor on my cervix. He was sure it was malignant and that I needed to be admitted to the hospital the next morning for additional tests. A pathology examination of the cervical tissue from a dilation-and-curettage procedure confirmed cervical cancer. The news sent me reeling.
I was told that the cancer had not metastasized, but that the tumor was so big it was inoperable and that I would need external-beam radiation therapy, followed by high-dose brachytherapy, to dissolve the mass. I don’t remember exactly how many radiation treatments I had, but I know that it went on for 3 months and left me exhausted and also so nauseated that I had to stop the car along the side of the road on my way to work.
Although those early side effects gave me hints of the digestive troubles that would plague me 2 decades later, for the most part I was able to manage the therapy well. It was the mental anguish of having such a deadly cancer that caused me greater initial problems. I was so paralyzed with fear and depression and so certain I was going to die, I refused to buy Christmas presents, even though Christmas is my favorite holiday, or even shop for a new dress. Why buy a new dress if I’m not going to be around to wear it?
Escalating Health Problems
My husband Don was so supportive. He would hold my hand and tell me that we would beat this cancer, and together we fought it. After 5 years with no cancer recurrence, my oncologist declared me cured, and for much of the next 20 years I felt well. But in 2004, I started having episodes of vomiting that were so violent I would bring up green bile. Three years later, the vomiting became more frequent and was often accompanied by severe abdominal pain caused by intestinal blockages. This resulted in hospital stays to have my stomach pumped and receive intravenous nutrients and fluids.
Since then, the problems have gotten worse. In 2008, I had a bowel resection that kept me hospitalized for 6 weeks yet has not completely healed. My general health has deteriorated. Because every diet I tried failed to remedy my extreme digestive pain and bouts of vomiting, a medication port was implanted so I could get total parenteral nutrition (TPN). Although the TPN was discontinued a few months ago, eating and absorbing solid food is still a challenge for me.
Now, in addition to increasing abdominal pain, I have severe rectal bleeding and peripheral neuropathy in my feet, all of which have diminished my quality of life. Because digesting food and eliminating waste have become so excruciating, even the simple act of going out to dinner with friends is unthinkable.
Improving Survivors’ Quality of Life
My doctors tell me that all these health issues are the result of late effects from the radiation therapy I received more than 3 decades ago, and the damage can’t be reversed. I’m grateful that the treatment saved my life and has prevented the cancer from coming back. However, half my life has been spent battling the effects of the radiation I received in 1979, and I wish I had been warned about the potential long-term risks so I would have understood what was happening to me. I know advances have been made in the treatment of cervical cancer since I was diagnosed and that therapies—including radiation therapy—are now much more targeted, greatly reducing long-term complications, and that’s good news.
What my 34-year-long health odyssey has taught me is the importance of having a good doctor/patient relationship—one in which patients are treated as individuals, not as statistics, and are given as much information as possible about the potential consequences of specific treatments.
While the side effects from my treatment are permanent, my greatest hope is that the combination of more targeted therapies and more open communication between doctors and patients will result in greater long-term quality of life for the millions of cancer survivors living today. ■
Carol Goodrich lives in Naples, Florida.
