We went to see the oncologist at the comprehensive cancer center at St John of God Hospital in Subiaco on Monday afternoon (December 21). He reiterated that chemo was the best way forward, and invited me to take part in a randomised clinical trial. Half the people in the trial get the accepted chemotherapy as the first line of attack while the others get chemo plus SIRT, a form of radiotherapy. Of course I agreed - I wanted the big guns.
Another appointment was made for Tuesday after I had had a blood test and another CT scan. I have described what happened on the other blog. The CT scan showed that in addition to the liver metastases I also have tumours in my lungs as well as some pulmonary embolisms. Not good news.
Wednesday we had a third appointment, this time at Royal Perth Hospital. This was for establishing participation in the clinical trial. The oncologist decided that I will need a daily injection of Clexane for "ever" because of the clots in my lungs and the fact that I have Leiden Factor V in my blood which predisposes me to thromboses. We were given a demonstration of how to administer the injection, a big packet of skin wipes, a Sharps storage bin for the syringes - and a prescription to be filled at our local pharmacy.
I was sent away for another blood test and got a call on my mobile while waiting for it. The computer had done its randomising and I had missed out on the SIRT part - just chemo for me. I was to have 12 cycles, each a fortnight apart. The first one was to be the following Tuesday, December the 29th, with the pump being removed on New Year's Eve.
It all happened so quickly. From diagnosis to confirmation of the diagnosis to the start of treatment was only two weeks. I am not sure whether it would all have happened with the same speed if we had been solely dependent on the public hospital system, but private health insurance meant we had immediate access to hospital treatment without a waiting period. We have been members of the Hospital Benefit Fund of WA since we were married 44 years ago. It is now obvious the premiums were a worthwhile investment. Another major financial assistance is Medicare (Australian Government health insurance) which covers a major portion of the costs incurred outside the hospital, such as the oncologist's fees. Our third benefit is the PBS (Pharmaceutical Benefits Scheme) which in our case, because we are self funded retirees on a limited income, restricts the costs of prescriptions to $5.40 per script or, once we have had 100 scripts filled, no cost at all. I think we will be reaching the safety net for this pretty quickly this year.
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I can't comment on the Australian public health provision, but in the UK it is excellent, at least when it comes to emergency and acute care. I was initially diagnosed with oesophageal cancer on 14 December, the staging was complete on 23 December (boo!) and I had the first part of my treatment on 6 January, the fitting of a stent. My chemotherapy itself started on 12 January. I know things would have happened quicker if Christmas and the New Year hadn't intervened. I have nothing but praise for my doctors and other medical practioners in the UK National Health Service.
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