• unexplained fatigue
• difficulty swallowing and unexplained nausea
• severe headaches and odd neurological symptoms (such as weakness or numbness)
• unexplained abdominal swelling
• vaginal bleeding between periods and any vaginal bleeding after the menopause.
Of course, all of these symptoms can also result from much less serious conditions than cancer and, more often than not, a doctor will be able to reassure you that nothing is seriously wrong. However, it is important to wait until all of the appropriate diagnostic tests have been done. Too often, GPs give reassurance on the basis of a clinical examination in their surgery, only to be proved wrong at a later date. GPs expect patients to come back if symptoms persist, so it is important to trust yourself and keep going back if you think something is not right. Although most people are sent for tests immediately, far too many visit their GP over and over again before they are sent for the appropriate X-rays, blood tests or other investigations. They can then discover in the end that their intuition was right – that something is seriously wrong and that a cancer that could have been treated easily as a primary has now spread to other parts of the body. So, please be alert to whatever messages your body is giving you.
If you are really concerned that a GP is not responding to you appropriately, get a second opinion from another GP or even arrange to have investigations done privately or through an integrated medicine doctor.
Ask yourself what support you need to get through the diagnostic process.
Visiting your GP
Once you have overcome your fears and are able to actively seek a diagnosis, make an appointment with your GP. If you wish to, take a friend or partner with you. Clearly explain your symptoms and your concerns about having cancer or a recurrence of cancer. This is important so that the GP takes your situation seriously and so that, if you do not have cancer, you can be properly reassured.
Receiving good news
Once the tests have been done, it is often possible for doctors to give you reassurances that all is well. This is particularly common for those who have had a primary cancer and who understandably then suspect every headache or twinge of being a recurrence. What is important here is your peace of mind, and the doctors should help you to get the reassurance you need until you feel better and settled again.
But even if the news is good, you may perhaps wish to treat the incident as a ‘wake-up call’, and embark upon a Health Creation Programme as an insurance policy to avoid your ever having a scare like this again.
Receiving bad news
Regrettably, 270,000 people per year in the UK do receive a diagnosis of primary cancer, and an equal number have a diagnosis of secondary spreading. A cancer diagnosis is something we all dread. If you are sitting in the horrible hot seat at this moment and have just got the news, be reassured that a great deal of help is at hand!
Despite the high rates of cancer in the developed countries (four in every 10 of us will develop a cancer during our lifetime), most of us live our lives feeling immortal, believing that these things only happen to other people. The news of a life-threatening diagnosis can be like a bomb going off in the centre of our lives, completely shattering our security and our sense of the life we expected to have.
Nevertheless, there are people reading this who can say, ‘No, I actually expected my diagnosis of cancer. I knew that my life and health were seriously out of kilter and that it was only really a matter of time before I got seriously ill.’
Most probably, if you are reading this book, you have already been through the initial impact of receiving a diagnosis of cancer. However, if you are waiting for test results, it is important that you are protected at that moment of greatest vulnerability. Try to take someone with you, and ask for the privacy and time you need with the doctor to enable yourself to take on board fully the information you are being given.
Getting support while waiting for test results
If you are waiting for test results, what support do you need to help you through this tense time?
• A talk with my GP
• A talk with my practice nurse, health visitor, social worker or practice counsellor
• A talk with the consultant or hospital support team
• A talk with a private counsellor
• A talk with a spiritual guide
• Being able to confide in a friend or family member
• Being able to tell colleagues at work and arrange to be excused from normal duties
• Being able to take time off to go into ‘retreat’.
If you have you been waiting more than a week for test results, it is reasonable to seek help to find out what has happened to your results. You could try telephoning your GP, the practice nurse or your consultant’s secretary. Ask them to chase your results for you. Make it absolutely clear that you wish to receive your results over the telephone or face to face from one of your medical team.
The moment of truth
The time will come for you to get your test results. If you are expecting bad news, it may be helpful to find out before your appointment with the consultant what kind of assistance is available from a member of the support team (if there is one) or a specialist nurse at the hospital. This is particularly relevant if you live alone, have no close partner or confidante and nobody around to look after you and see you through your vulnerable period after you get home. You may also wish to find out what support is available from the GP’s surgery, the local community nurses or hospices, counsellors, skilled volunteers, support groups, chaplains, spiritual helpers or psychologists. Quite often, resources are to hand which busy doctors and nurses forget to tell you about. So, it is advisable to do some homework in advance if you are at all worried.
Finding Out What Support Is Available at the Hospital
This information is available from the clinical staff (nurses and clerks) where you go to see the consultant, from the cancer or unit information centres (if they have these), and from those in charge of the surgical wards, and chemo-/radiotherapy treatment units.
Getting Support When You Receive Your Results
Ask yourself whether you prefer to be alone to get your test results or with a supporter. If you do take a supporter, who will you ask to accompany you?
If you prefer to go alone or have no choice, who can be at the end of a phone to support you or stay with you overnight if the news is bad? Is this arrangement confirmed? You can celebrate with them, too, if the news is good.
If you want someone to be with you after the appointment, let him know the time of your appointment and arrange where you can meet when you are finished. Ideally, arrange to have him pick you up if you need support.
Establishing the best relationship with your doctors – whether that is your GP, surgeon, oncologist or radiotherapist – will be very important for your ongoing security and peace of mind. You may be lucky and find an enlightened doctor who will help you obtain the best integrated medicine, but you may find yourself in a position