Cancer: coping with a loved one's illness and subsequent death

They say that money brings out the worst in people. It's probably also true that other peoples' illnesses do the opposite and tend to bring out the best in human nature. At least this was my experience when my wife was diagnosed, underwent treatment, and (eighteen months later) subsequently died of colon cancer.

The cancer was diagnosed following a bowel cancer screening test, mailed out as part of the National Bowel Cancer Screening Program, though some earlier signs had been ignored. My wife was notified of a positive result and subsequently had a colonoscopy, which confirmed the bad news. Surgery was urgently scheduled.

Fortunately we had private health cover, and following a procedure lasting many hours, the cancerous areas of her colon were removed. The surgeon was confident that he had removed all the cancer, and also undertook tests to evaluate the risk that the cancer had spread. Unfortunately, the tests indicated a need for follow up chemotherapy.

Two of the worst consequences of her illness were the need for a colostomy bag, and the effects of the chemotherapy. For me, much of my life was on hold during the illness because I was not prepared to leave her on her own, in case anything happened. Equally, it was best for her to be accompanied to appointments and treatments.

My wife needed a colostomy bag temporarily (about nine months), while her colon was healing from the surgery. This involved unpleasant routines, and certain foods needed to be avoided. Unpleasant matters included that the surgical opening from the abdomen could become tender. Also regular changing/emptying of the bag was required, and this process (especially attachment of the colostomy appliance) was somewhat intrusive and uncomfortable for the patient, who generally performed these tasks herself.

The chemotherapy was a cyclical event every two weeks. Typically the worst effects seemed to come a few days after administration, with the patient returning close to normal late in the second week, only for the cycle to repeat. The main side-effect seemed to be a general loss of energy. My wife also experienced some persistent loss of feeling in her hands and feet. She was stoic in the face of all her treatments and discomforts, and was a very good patient, who rarely complained. A positive effect of chemo was that it caused the symptoms of her arthritis to temporarily disappear.

Following the course of chemotherapy, there was hope of remission. Further scans some weeks later unfortunately showed that, while the original cancer was gone, it had spread to her liver and one lung. It was decided to treat these cancers with radiotherapy, but this turned out to be ineffective against such an aggressive cancer.

More chemotherapy was prescribed. Before undertaking this, my wife's colon was reconnected so she could do away with the colostomy bag. This was not a "return to normal", as it apparently takes a long time in such circumstances for body motions to return to anything resembling normality. We were, however, (after some recovery from this) able to enjoy a two-week holiday in far north Queensland before the chemo treatment began again. Toileting. however, needed to be carefully planned for.

After a couple of renewed chemo treatments with seemingly stronger drugs and worse side-effects, it was decided that my wife's body could not take any more, and chemo was stopped.

We could not fault the medical professionals providing treatment. All were diligent, competent, compassionate, and did their best. The specialists were informative but interestingly did not provide a survival prognosis unless specifically asked. Initially the cancer was deemed to be Stage One with a fifty per cent chance of survival beyond five years. After the cancer had spread, it was regarded as Stage Three. Without further chemo, survival of only three to six months was likely, we were told. With further chemo, there was a 25 per cent chance of survival beyond two years.

In the end my wife succumbed to her cancer about three months after the chemo was stopped.

Despite the warnings (and explicit advice from our GP about how to speedily obtain a death certificate) my wife only partly planned for the inevitable. We had updated our wills early in her illness but details like telling family members about phone, internet, and other passwords had been overlooked.