WEBVTT
1
00:00:04.080 –> 00:00:10.540
You’re listening to the Cornwall Cancer Cafe podcast with me Matthew and me Emma. Thanks to
2
00:00:10.540 –> 00:00:17.220
the National Lottery Community Fund for supporting this podcast. So this week we are, well first of
3
00:00:17.220 –> 00:00:25.000
all before we do anything I think it’s important that we make one of our announcements isn’t it?
4
00:00:25.000 –> 00:00:31.000
It’s an announcement about our expertise because actually I don’t have any expertise.
5
00:00:31.000 –> 00:00:37.780
I don’t have any medical ones no so. Okay let’s clarify that yeah I do have
6
00:00:37.780 –> 00:00:43.300
expertises but nothing to do with medical or psychological. Yeah same same definitely yeah
7
00:00:43.300 –> 00:00:48.340
so we don’t have we’re not qualified doctors nurses we don’t have any medical qualifications
8
00:00:48.340 –> 00:00:54.040
whatsoever we are just working on our experience of living with cancer.
9
00:00:54.040 –> 00:01:01.420
It’s important to also say that we do like to bring you people who do have that
10
00:01:01.420 –> 00:01:09.880
education that training that experience of working with patients and all the qualifications
11
00:01:09.880 –> 00:01:18.540
and we are back with a very good one it is Dr David Tucker this week and he’s such a lovely
12
00:01:18.540 –> 00:01:23.200
guy isn’t he? He’s so lovely and he’s so generous with his time as well so we’re very
13
00:01:23.200 –> 00:01:31.780
grateful to him. Okay so we had some people talking about well we should we should be
14
00:01:31.780 –> 00:01:38.140
doing interviews about remission and side effects and things like that so for this one
15
00:01:38.140 –> 00:01:43.240
we’ve been talking to David Tucker about you know what is remission what does it mean?
16
00:01:43.840 –> 00:01:51.040
Also we get onto secondary cancers talking about those because that sort of leads on from
17
00:01:51.540 –> 00:01:59.080
what is remission as well and also we move on to side effects which are very important to
18
00:01:59.080 –> 00:02:07.280
discuss so let’s get into this conversation with Dr David Tucker. So what I would say is that first
19
00:02:07.280 –> 00:02:13.840
first caveat is I’m a lymphoma and leukemia doctor so I can’t speak directly for some
20
00:02:14.480 –> 00:02:22.760
cancers that I don’t treat but remission generally means that we can no longer
21
00:02:24.200 –> 00:02:32.580
detect the disease the cancer at a certain level now you there are different types of
22
00:02:32.580 –> 00:02:37.720
remission and there are different levels of remission so remission essentially means the
23
00:02:37.720 –> 00:02:44.700
is controlled and no longer detectable that’s complete remission so that’s when we can’t see
24
00:02:44.700 –> 00:02:52.200
it anymore either on a scan or down the microscope if it’s a bone marrow or a leukemia
25
00:02:52.200 –> 00:02:58.360
type. I’ve seen complete metabolic remission that’s an extra word in there that I struggled
26
00:02:58.360 –> 00:03:05.680
with to understand. So complete metabolic remission is a deeper form of complete remission
27
00:03:05.680 –> 00:03:12.820
when we use what’s called a functional imaging so that’s when we use imaging which looks at
28
00:03:12.820 –> 00:03:21.040
tissue and body tissue and whether or not it is active on a scan and if it’s not active it’s
29
00:03:21.040 –> 00:03:25.780
called a complete metabolic remission. One way of looking at remission is a little bit like
30
00:03:25.780 –> 00:03:33.800
zooming in further and further down a telescope so maybe you can see from outer space what the
31
00:03:33.800 –> 00:03:39.360
looks like but you can’t see everything on it on it as you zoom in further and further
32
00:03:39.360 –> 00:03:45.740
you get to see the real detail and if you can it’s a bit like that with cancer
33
00:03:46.520 –> 00:03:52.700
you can do a very simple scan for example like a CT scan a plain CT scan and not find any
34
00:03:52.700 –> 00:03:59.080
evidence of cancer that will be a complete radiological remission as your imaging gets
35
00:03:59.080 –> 00:04:05.820
more detailed that resolution improves and you can see less more and more cells and if you can see
36
00:04:05.820 –> 00:04:12.040
no cells that have got cancer then it becomes a complete metabolic remission and then on top of
37
00:04:12.040 –> 00:04:18.160
that when you’re analyzing the cells down a microscope or through an analyzer you can tell
38
00:04:18.160 –> 00:04:24.280
at a genetic level or at it at a DNA level whether there’s any detectable residual disease
39
00:04:24.280 –> 00:04:31.400
that’s a whole other level of resolution so the word remission is it has nuance so it depends a
40
00:04:31.400 –> 00:04:37.500
little bit on what you’re talking about and at what level of analysis you’re doing but basically
41
00:04:37.500 –> 00:04:42.720
it means we’ve got control of the disease and we can’t see the disease at that particular
42
00:04:42.720 –> 00:04:49.420
level so complete metabolic remission is to do with PET scans and then there are other forms
43
00:04:49.420 –> 00:04:55.220
of remission but you can have partial remission which is where we’ve got control we can still
44
00:04:55.220 –> 00:05:01.240
see some evidence but it’s responded really well and sometimes that’s as good as you get
45
00:05:01.240 –> 00:05:08.760
with some forms of cancer you don’t fully get it to complete remission or you can have
46
00:05:08.760 –> 00:05:13.480
absolute you know no detectable disease and that’s obviously what we strive for but it’s
47
00:05:13.480 –> 00:05:18.900
not always possible in some forms of cancer so we have to bear that in mind and sometimes
48
00:05:18.900 –> 00:05:25.820
it’s not the goal so remission is a really tricky and complex word and it really depends on
49
00:05:26.560 –> 00:05:33.100
what you’re looking at we don’t tend not to use the word cure in cancer because we
50
00:05:34.160 –> 00:05:40.840
sometimes cancer can come back years and years later or as a matter of four months or very
51
00:05:40.840 –> 00:05:48.260
quickly yeah so 11 months yeah so sometimes people say well you know how long do I have
52
00:05:48.260 –> 00:05:53.460
to be in remission before you’re going to say that I’m cured and that’s where cancer
53
00:05:53.460 –> 00:05:59.640
doctors are often quite reluctant to say that word there’s this cancer-free this concept of
54
00:05:59.640 –> 00:06:07.440
oh you know I haven’t had cancer for five years I’m cancer-free yeah and that’s refers
55
00:06:07.440 –> 00:06:14.480
to when we do clinical trials you the five-year rule tends to come from the clinical
56
00:06:15.160 –> 00:06:22.900
trials tend to stop their follow-up at five years and so we often will sometimes follow
57
00:06:22.900 –> 00:06:27.160
patients up for a number of years and then after a number of years if it hasn’t come back
58
00:06:27.440 –> 00:06:32.900
we’ll say you’re in a good remission the chances are it’s not going to come back
59
00:06:32.900 –> 00:06:40.080
it might always I mean I’ve seen cancer come back 18 years after we discharged somebody but
60
00:06:40.080 –> 00:06:46.640
you can say with some degree of certainty that you’re in a good remission and you’re yes you’re
61
00:06:46.640 –> 00:06:54.240
cancer-free but we always encourage patients to even when we discharge them to have that
62
00:06:54.240 –> 00:06:58.520
support where they can get back in touch with us if something changes because sometimes things
63
00:06:58.520 –> 00:07:04.980
do of course there’s always the worry in the patient’s head and you hear about it of
64
00:07:04.980 –> 00:07:14.560
secondary cancers yeah so you know secondary cancers are a complication not just of having
65
00:07:14.560 –> 00:07:21.440
treatment but actually having some forms of cancer increases the risk of having another cancer
66
00:07:21.440 –> 00:07:26.540
so some leukemias and lymphomas they reduce the immune system a bit and your immune system
67
00:07:26.540 –> 00:07:36.360
is key in watching for cancer so secondary cancers just having a primary hematological
68
00:07:36.360 –> 00:07:43.020
for example can increase your risk of secondary cancers so we would always encourage patients to
69
00:07:43.580 –> 00:07:50.200
use all of the sort of sun creams and watch out for skin things get them seen get them
70
00:07:51.000 –> 00:07:58.240
because they can be a secondary thing and some of the treatments we use they are really good
71
00:07:58.240 –> 00:08:04.160
at getting rid of that initial cancer but they are often they often do cause some damage to
72
00:08:04.700 –> 00:08:11.900
dna and i suppose from the scans you know pet scans with bits of old nuclear submarine
73
00:08:11.900 –> 00:08:12.700
yeah
74
00:08:14.280 –> 00:08:22.340
you know so pet scanning does that was a joke sorry it was a joke but they do have radiation
75
00:08:22.340 –> 00:08:29.620
with with with scans the the link between it causing cancer is not actually that well
76
00:08:29.620 –> 00:08:34.820
established because it’s often confounded by the fact that the patients have other treatments
77
00:08:34.820 –> 00:08:40.760
and what cause you know so we don’t tend to make a direct link but we are conscious of
78
00:08:40.760 –> 00:08:48.040
fact that scans certainly x-ray based scans do have some radiation in them we try to spare
79
00:08:48.040 –> 00:08:53.880
patients scans that are not necessary that’s one of the reasons we don’t do much surveillance
80
00:08:53.880 –> 00:09:01.000
scanning with our low-grade lymphomas for example not not for everything but yeah we
81
00:09:01.000 –> 00:09:06.620
secondary malignancies is a is a late what we call a late effect and it can occur
82
00:09:07.140 –> 00:09:13.160
together with other things like infertility and and other late effects that that patients might
83
00:09:13.160 –> 00:09:25.140
want to know about and talk about yeah so you’ve sort of moved on to the the next bit
84
00:09:25.140 –> 00:09:30.200
that i was going to ask about which is the side effect so it’s the side effects of having
85
00:09:30.200 –> 00:09:36.580
the cancer but also the side effects of the treatment and the side effects don’t just happen
86
00:09:36.580 –> 00:09:40.740
whilst you’re having the treatment they can carry on after your treatments finished and
87
00:09:40.740 –> 00:09:47.560
also change obviously that’s quite difficult to deal with as a patient but i suppose you
88
00:09:47.560 –> 00:09:53.800
you probably are used to seeing this sort of thing and can maybe help the patient by
89
00:09:54.500 –> 00:09:58.940
saying this is normal we would expect this but the patient’s still got to deal with it
90
00:09:59.620 –> 00:10:04.560
no that’s true i mean when we talk about side effects with treatment we usually talk about
91
00:10:05.620 –> 00:10:11.820
early sort of medium term and then long term side effects so the early side effects they vary
92
00:10:11.820 –> 00:10:16.020
very much between treatments but those are sorts of things that you would want to discuss with
93
00:10:16.020 –> 00:10:22.780
your consultant or your nurse specialist the medium term ones again they can be different and
94
00:10:22.780 –> 00:10:28.660
then you’re right the long-term ones can be different for each patient sometimes and
95
00:10:28.660 –> 00:10:33.020
sometimes we have to accept an element of there’s going to be some side effects but we
96
00:10:33.020 –> 00:10:38.940
need to we need to go with it because we need to get control of what can be a really aggressive
97
00:10:38.940 –> 00:10:48.380
disease other times we say well actually maybe if there are things like frailty and other organ
98
00:10:48.380 –> 00:10:53.480
problems or other diagnosis which means that we can’t deliver the most intensive treatment
99
00:10:53.480 –> 00:10:59.660
because we know that the side effects would be too much for the body and so we have to tailor
100
00:10:59.660 –> 00:11:06.440
our treatments accordingly i know that you do a lot of checks beforehand to make sure that the
101
00:11:06.440 –> 00:11:12.140
patient can take the treatment you know such as checking on the heart and the lungs and the
102
00:11:12.140 –> 00:11:19.060
kidneys and all of those things so there are certain drugs that we know have risks to
103
00:11:19.060 –> 00:11:25.200
certain organs and so we have protocols where if we’re giving a certain drug which we know
104
00:11:25.200 –> 00:11:31.200
might have a heart complication we would want to check the heart function beforehand kidneys
105
00:11:31.200 –> 00:11:35.820
likewise some of the troublesome things that people often report are things like peripheral
106
00:11:35.820 –> 00:11:43.600
neuropathy so nerve pain after treatment that’s that can be quite common it often gets better
107
00:11:43.600 –> 00:11:49.420
but sometimes it doesn’t i mean i had a lot of neuropathy in my fingers i could barely play
108
00:11:49.420 –> 00:11:54.620
guitar i can’t really play guitar anyway can i and i couldn’t feel the guitar and i was
109
00:11:54.620 –> 00:11:59.720
worried about the fingernails breaking as well things like that so that was one end of it and
110
00:11:59.720 –> 00:12:06.340
then you had i had the um the neuropathy in the feet and um where the hands have got better
111
00:12:06.340 –> 00:12:12.040
the balls of the feet i still feel that neuropathy yeah and that’s very common and that’s to do
112
00:12:12.040 –> 00:12:17.360
with the length of the nerves uh to a degree so the longer the the nerve along with the
113
00:12:17.360 –> 00:12:23.040
wire um the more um likely you are to get some nerve um damage if you’ve got certain
114
00:12:23.040 –> 00:12:28.040
drugs that can cause that nerves get better really slowly they grow back at the same pace
115
00:12:28.040 –> 00:12:34.260
that a tree grows roughly so um they they can be damaged and it can be and it can be really
116
00:12:34.260 –> 00:12:40.160
troublesome and we’re getting better at reducing that with our newer drugs but um it can be a
117
00:12:40.160 –> 00:12:48.120
real um pain for want of a better word well and uh for the ladies i suppose not so much
118
00:12:48.120 –> 00:12:54.600
is a problem for the men i don’t think but losing the hair uh is another big thing because
119
00:12:55.340 –> 00:13:02.640
um some men look good balls you know um well and you’ve must have met some people along the
120
00:13:02.640 –> 00:13:08.680
way who’ve had these yeah i have um so it i my treatment didn’t affect me like that
121
00:13:08.680 –> 00:13:13.680
um but i’ve been to lots of groups and i went to a group called look look good feel better
122
00:13:13.680 –> 00:13:17.680
and there were some ladies in there that were wearing head scarves and they’d lost all of
123
00:13:17.680 –> 00:13:21.980
their hair so they’d lost their eyebrows and their eyelashes and that can be really
124
00:13:21.980 –> 00:13:27.760
challenging as a lady but the all of the ladies that i’ve met along the way have almost sort of
125
00:13:27.760 –> 00:13:32.800
like taking it as a right what can i do differently and they’ve chosen to wear bright
126
00:13:32.800 –> 00:13:37.960
head scarves or they’ve gone and got a really nice wig i mean it’s it’s absolutely
127
00:13:37.960 –> 00:13:43.420
devastating that they’ve lost their hair but i haven’t met anybody who’s gone who’s been
128
00:13:43.910 –> 00:13:49.080
about it um two of the ladies i’ve spoken to have talked about how their hair has grown back
129
00:13:49.080 –> 00:13:54.380
differently to how it was before and one lady was very upset that her hair was dead straight
130
00:13:54.380 –> 00:14:01.140
before and now it’s not and she said this doesn’t feel like my hair anymore um but hey
131
00:14:01.140 –> 00:14:05.160
she’s she’s had treatment so there’s that side of it because um that was one of the
132
00:14:05.160 –> 00:14:09.880
things i was i was going to talk about was um the the sort of permanent change to your
133
00:14:09.880 –> 00:14:14.940
physical how you were before and how you are after and we often talk about before cancer and
134
00:14:14.940 –> 00:14:19.640
after cancer and how you’re a different person once once you’ve had that cancer diagnosis you
135
00:14:20.220 –> 00:14:25.100
but you’re a different person from that point onwards yeah yeah i think you’re absolutely
136
00:14:25.100 –> 00:14:31.760
right and uh hair loss and and your your hair is is part of your identity and particularly
137
00:14:31.760 –> 00:14:37.260
for some you know people um it’s really important and um we and some of the things
138
00:14:37.260 –> 00:14:41.720
we think well it’s not that bad you know it’s just you know yeah but that can be a lot to
139
00:14:41.720 –> 00:14:47.940
somebody and um and your physical appearance is obviously important so um we we sometimes need to
140
00:14:47.940 –> 00:14:53.120
remember that i think um when we’re talking about um side effects the other thing i suppose
141
00:14:53.120 –> 00:14:58.420
is um we haven’t touched on but fertility and menopause i was just about to ask this
142
00:14:58.420 –> 00:15:02.720
because i mean this is something which i find very difficult after the amount of treatment
143
00:15:02.720 –> 00:15:09.580
i’ve had that before i was you know as far as i was concerned a fully functional man
144
00:15:10.330 –> 00:15:17.200
but now i libido is dead absolutely dead and it makes me feel like a different completely
145
00:15:17.200 –> 00:15:22.500
different person the way i relate with the world yeah and we often underestimate that i
146
00:15:22.500 –> 00:15:27.990
think as as doctors but we need to be make make sure that we remain aware of it there
147
00:15:27.990 –> 00:15:35.270
things that you gp that gps can help with on that front but um early menopause um is also
148
00:15:35.270 –> 00:15:40.830
a big issue with some drug combinations not with everything and fertility isn’t always
149
00:15:40.830 –> 00:15:46.330
um affected by treatment so that’s a conversation to have um i have been
150
00:15:47.210 –> 00:15:53.750
once a patient came in to see me um in his he was in his 50s and i think he had a
151
00:15:53.750 –> 00:16:01.130
younger wife and he was furious he said one of your um predecessors told me that i would be
152
00:16:01.130 –> 00:16:11.190
infertile and now my wife’s pregnant and sorry sorry i shouldn’t laugh a survey in sweden i
153
00:16:11.190 –> 00:16:18.550
think it was we showed that um patients who’d had hodgkin lymphoma in their 20s they had
154
00:16:18.550 –> 00:16:24.450
more children in their 30s than their matched counterparts so whether they had made different
155
00:16:24.450 –> 00:16:29.350
life choices having been through cancer and had their priorities changed but we do have to be
156
00:16:29.350 –> 00:16:35.210
careful not everything is is associated with infertility but it’s something for us to think
157
00:16:35.210 –> 00:16:41.050
about and and menopause and as a cancer doctor i’m not a good um person to talk about
158
00:16:41.050 –> 00:16:45.190
menopause and things like that so i would refer that to my gp colleagues but it’s
159
00:16:45.190 –> 00:16:53.930
that we should know about yeah i had to have a catheter which i called clarence clear water
160
00:16:53.930 –> 00:17:01.770
you sit and think how am i going to cope after surgery when i was diagnosed i really
161
00:17:01.770 –> 00:17:06.810
just didn’t have anywhere to go with my feelings i think it’s about giving them support
162
00:17:06.810 –> 00:17:15.230
and knowing that whatever their situation is there is always someone there visit our website
163
00:17:15.230 –> 00:17:26.670
www.cancercafepodcast.org chemo brain brain fog yeah no that comes up a lot um patients not
164
00:17:26.670 –> 00:17:32.230
um being able to remember remember things i don’t know that i’ve got a very um sensible or
165
00:17:32.230 –> 00:17:36.970
rational explanation for it i don’t think anyone has it’s so everyone seems to have
166
00:17:36.970 –> 00:17:42.110
different opinions yeah uh we don’t yeah we don’t have um because it’s it’s so difficult
167
00:17:42.110 –> 00:17:49.570
an organ to study but um it’s definitely a thing yeah we we do we do see it and we do hear about
168
00:17:49.570 –> 00:17:56.550
it um something to discuss um but um i don’t know that i’m going to be able to i don’t have
169
00:17:56.550 –> 00:18:01.070
a fix for that one i’m afraid i wonder whether it’s linked to the trauma of everything as well
170
00:18:01.070 –> 00:18:05.570
the way the body and the brain’s trying to deal with hearing the word cancer and then
171
00:18:05.570 –> 00:18:09.290
going through the treatment you know it’s trauma there’s a lot of chemicals going through
172
00:18:09.290 –> 00:18:14.270
the body as well there are and we don’t we we know a lot about those chemicals from the
173
00:18:14.270 –> 00:18:20.610
from the trials so but we’re always encouraged to report things um that might be um weird
174
00:18:20.610 –> 00:18:25.430
and wonderful side effects so um i would always encourage patients to to report
175
00:18:25.430 –> 00:18:33.210
to report back on the onto us i mean during treat pre-treatment during treatment fatigue is
176
00:18:33.210 –> 00:18:40.310
a big issue but then after treatment it’s surprising how long the tiredness element
177
00:18:40.310 –> 00:18:47.570
goes on for yeah and that’s uh again underestimated and um i often tell patients
178
00:18:47.570 –> 00:18:51.910
that going through treatment fairly intensive treatment is like having major surgery or a
179
00:18:51.910 –> 00:18:58.490
major trauma in your life and it can take years to recover and as you pointed out
180
00:18:58.490 –> 00:19:04.010
it never sometimes never you never return to what you were before um you’ve you go through
181
00:19:04.010 –> 00:19:11.270
a step change in who you are having survived if you’re fortunate enough to go through and
182
00:19:11.270 –> 00:19:18.770
survive cancer so it’s not um the fatigue is a major um thing that we we have to we have
183
00:19:18.770 –> 00:19:24.830
to remember and um managing expectations some people say well when will i be able to go back
184
00:19:24.830 –> 00:19:29.830
and when will i feel back to normal um and that can be really difficult actually because
185
00:19:29.830 –> 00:19:35.790
it’s very much patient by patient but the fatigue is a real issue i can understand that
186
00:19:35.790 –> 00:19:40.930
let’s talk about anxiety now and we we have you know mentioned that we’re going to talk
187
00:19:40.930 –> 00:19:48.610
about scan anxiety as well uh so anxiety is a major issue isn’t it it is and i think
188
00:19:48.610 –> 00:19:53.990
you don’t always realize that you are dealing with anxiety and i think you probably
189
00:19:53.990 –> 00:19:58.610
look back and you think my goodness i was anxious through all of that i mean i found
190
00:19:58.610 –> 00:20:03.330
myself walking around and my my shoulders are up around my ears and i have to think drop your
191
00:20:03.330 –> 00:20:07.770
shoulders down and when i do that i then realize that i’ve been mulling over something and
192
00:20:07.770 –> 00:20:12.210
that you know the anxiety is there and it’s not necessarily it’s scan but it’s just you
193
00:20:12.210 –> 00:20:16.090
just mull over you know what you’ve been what you’ve been through what’s coming up next
194
00:20:16.090 –> 00:20:21.450
week oh i forgot what i was doing yesterday there’s just so you just don’t stop i think
195
00:20:21.450 –> 00:20:28.470
at this point i think it’s worth reminding people to signpost uh to services at macmillan at the
196
00:20:28.470 –> 00:20:34.250
cove they have psychological team there to help you and is it something that the consultant
197
00:20:34.250 –> 00:20:40.530
can refer yeah i mean we we have um direct referral into the cove and to our psychology
198
00:20:40.530 –> 00:20:45.850
support services so we would encourage patients and if not us then the clinical nurse specialist
199
00:20:45.850 –> 00:20:50.690
can refer you so um definitely take that up we’re not that good at dealing with
200
00:20:50.690 –> 00:20:56.310
those long-term anxieties we just don’t have the you know they may not have the skill set and
201
00:20:56.310 –> 00:21:02.870
also it is it’s it’s impossible not to be anxious i think you know you’ve got had a
202
00:21:02.870 –> 00:21:08.930
diagnosis a very difficult diagnosis i can’t say you know everything’s going to be fine
203
00:21:08.930 –> 00:21:13.850
all the time it’s just impossible so there is a level of anxiety that we have to learn to
204
00:21:13.850 –> 00:21:18.950
cope with learn to live with um and your what you’re talking about these support these
205
00:21:18.950 –> 00:21:25.190
measures are really important in that um i think um yeah that would be something i would say right
206
00:21:25.190 –> 00:21:29.550
let’s go through some more i was just going to mention the scans i attained because that was
207
00:21:29.550 –> 00:21:34.550
something that i think uh we were going to ask you about so as a patient you have a scan and
208
00:21:34.550 –> 00:21:38.890
then you’re waiting waiting waiting as a consultant you’re working in the background
209
00:21:38.890 –> 00:21:42.810
with the team do you want to talk us through that yeah you’re absolutely right so there’s
210
00:21:42.810 –> 00:21:50.570
a delay between tests and results um or either at diagnosis when you have those initial biopsies
211
00:21:50.570 –> 00:21:57.570
or your scans or um after you know you finish treatment and it’s not that nothing’s happening
212
00:21:57.570 –> 00:22:02.950
during that time but they have to for example biopsies have to be processed in the lab and
213
00:22:02.950 –> 00:22:08.070
then they have to be read by a histologist and that can take um a few days to a couple of
214
00:22:08.070 –> 00:22:14.890
and sometimes the results are not um completely conclusive so there’s things happening in the
215
00:22:14.890 –> 00:22:20.290
background the report has to be made by for a scan so there’s often a delay of uh of some
216
00:22:20.290 –> 00:22:26.950
time that can be really difficult and we we appreciate that um try to um make sure that
217
00:22:26.950 –> 00:22:31.710
you schedule your appointments um you know the week or or so after you’ve had that so that
218
00:22:32.210 –> 00:22:39.070
that in time for you for you for your thing but the scans iot is a real thing um we try
219
00:22:39.070 –> 00:22:43.210
not to scan too much when patients are in complete remission it depends a bit on the
220
00:22:43.210 –> 00:22:49.310
type of type of cancer and some cancers need surveillance scanning but for lymphoma for
221
00:22:49.310 –> 00:22:55.150
example um surveillance scanning is not something that we do um because in the uk
222
00:22:55.150 –> 00:23:01.010
because it’s not been shown to add anything to just clinical reporting how are you um how
223
00:23:01.010 –> 00:23:09.190
you feel um and being examined in in in clinic but anxiety scans iot is a real is a real issue
224
00:23:09.190 –> 00:23:12.930
we try to minimize it but it’s not because things aren’t happening in the background
225
00:23:12.930 –> 00:23:18.390
okay let’s uh go through a few more because we’ve we’re running out of time we’re getting
226
00:23:18.390 –> 00:23:26.350
so much going through so many things okay so uh we’re looking now at appetite and nausea
227
00:23:26.350 –> 00:23:33.650
i remember recovering from stem cell transplant being on low and wards during uh watching oh yes
228
00:23:33.650 –> 00:23:42.370
i was i was watching elton john uh at glastonbury in the hotel hospital room and uh you were in
229
00:23:42.370 –> 00:23:47.210
the hotel room yeah in my head it was a hotel room in the hospital room i was watching and
230
00:23:47.210 –> 00:23:53.430
i think during every song on elton john’s list i vomited and that was nothing to do
231
00:23:53.430 –> 00:24:00.130
elton john i’m sure it wasn’t but you know nausea appetite for a big thing yeah so nausea
232
00:24:00.130 –> 00:24:06.610
is a i mean is a common side effect of the medications that we put people on there is a
233
00:24:06.610 –> 00:24:12.990
sort of a biological reason for that the body does not like having poisons put into it and
234
00:24:12.990 –> 00:24:19.850
it the kind of primitive reflex is to vomit because um you know when we were you know
235
00:24:19.850 –> 00:24:26.590
scavenging on planes and things if we ate something that was bad um it it included toxins
236
00:24:26.590 –> 00:24:32.050
and that would make the body vomit it up so we’re putting poison sometimes poisonous things in
237
00:24:32.050 –> 00:24:36.750
you know that we’re to treat the patient and that can cause the patient to feel sick
238
00:24:36.750 –> 00:24:41.830
sorry emma you’re looking at me strangely oh yeah i was just thinking oh they poisoned you
239
00:24:42.330 –> 00:24:47.310
well i mean i know that’s a frivolous thing to say but these drugs they do have
240
00:24:47.310 –> 00:24:54.090
effects and nausea is a is a key one we’ve got better at dealing with nausea it used to be a
241
00:24:54.090 –> 00:24:59.090
real problem with almost everything we gave and there are drugs that you give as well
242
00:24:59.090 –> 00:25:04.570
and so now there are really good anti-sickness drugs which are sometimes called anti-emetics
243
00:25:04.570 –> 00:25:11.990
which can deal with a lot of nausea but we sometimes can’t escape particularly when what you
244
00:25:11.990 –> 00:25:16.010
went through with that with a transplant which is one of the most intensive things
245
00:25:16.010 –> 00:25:22.550
we can do you don’t need to tell me that um that that is um that is often a nausea
246
00:25:22.550 –> 00:25:29.030
inducing thing um i mean in hospital we can give syringe drivers for nausea and pumps and things
247
00:25:29.030 –> 00:25:34.810
out of hospital there’s tablets and and things but um and and then and there’s the the
248
00:25:34.810 –> 00:25:39.710
appetite thing people’s taste changes you know oh i don’t like chocolate at the moment
249
00:25:39.710 –> 00:25:43.690
things like that yeah you’re absolutely right so i don’t know if that’s something that
250
00:25:43.690 –> 00:25:48.850
you’ve both experienced but the taste is uh no okay no i’ve been absolutely fine
251
00:25:49.930 –> 00:25:57.790
no changes oh i still enjoy chocolate and it does vary um and one of the things that sometimes we
252
00:25:57.790 –> 00:26:03.770
um again um if if particularly in women if they’ve had morning sickness um during
253
00:26:03.770 –> 00:26:08.110
pregnancies they’re often more nausea they often have more nausea when they have
254
00:26:08.110 –> 00:26:12.370
chemotherapy for some reason we don’t for which we don’t understand understand some
255
00:26:12.370 –> 00:26:17.290
people tend seem to be able to eat their way through their treatment and not have an issue
256
00:26:17.290 –> 00:26:22.050
other people could go completely off their food thank you very much david that’s a pleasure
257
00:26:22.050 –> 00:26:38.730
thank you share this podcast on your social media so others may benefit so another great
258
00:26:38.730 –> 00:26:46.630
chat with dr david tucker there in his office and we weren’t there in a consultant’s room
259
00:26:47.510 –> 00:26:52.690
dealing with ourselves which was actually quite nice it was very refreshing wasn’t it actually
260
00:26:52.690 –> 00:26:58.090
going to the hospital not to have a medical appointment but to talk to someone with so
261
00:26:58.090 –> 00:27:16.610
much knowledge and um the the um emotional intelligence that goes with it i mean what an
262
00:27:17.110 –> 00:27:24.090
of people who go through whether it’s oncology hematology any of those units
263
00:27:24.090 –> 00:27:29.630
yeah i mean i don’t i don’t think we recorded the bit with him when i asked him what excites
264
00:27:29.630 –> 00:27:38.290
him um but he was talking about how um the oh well he gets really excited about research
265
00:27:38.290 –> 00:27:46.590
doesn’t yeah research and and when cancer moves forward another step but he sort of he’s on the
266
00:27:46.590 –> 00:27:51.470
already researched it and he goes to all the webinars and he reads all of the documentation
267
00:27:51.470 –> 00:27:58.210
to go with it so that’s what really excites him and that just makes him the best person
268
00:27:58.210 –> 00:28:04.550
to do the job that he’s doing well good news we have another recording date booked with him
269
00:28:04.550 –> 00:28:10.550
and that is exactly what we’re going to be talking about in one of the upcoming podcasts
270
00:28:11.170 –> 00:28:17.270
i asked him what would you like to talk about and lo and behold he sent a list
271
00:28:18.050 –> 00:28:22.670
he was very well prepared actually when we went to speak to him wasn’t he oh yes he he had
272
00:28:22.670 –> 00:28:27.670
everything mapped out and i thought i was well prepared and making a list but his was even
273
00:28:27.670 –> 00:28:33.730
more in depth it was and it was all bullet pointed it was excellent he was so keen
274
00:28:33.730 –> 00:28:41.210
to do such a great job for us and then to offer to do more for us i mean it’s amazing because
275
00:28:41.210 –> 00:28:47.630
um as as someone going through cancer i think if you hear from um a consultant who’s actually
276
00:28:47.630 –> 00:28:54.550
explaining where they’re coming from what makes them tick um how it how it is from their end um
277
00:28:54.550 –> 00:28:59.190
i think he’s going to explain about what happens in the background um it’s all useful
278
00:28:59.190 –> 00:29:03.830
information that as a cancer patient you’re just in your head going through your journey
279
00:29:03.830 –> 00:29:08.910
but of course outside of your outside of your journey there is there’s so many other things
280
00:29:08.910 –> 00:29:14.790
happening and i think it sometimes helps to know what those other things are well we better
281
00:29:14.790 –> 00:29:19.490
leave that for then and we’re coming to the end of this podcast and we haven’t given anyone
282
00:29:19.490 –> 00:29:27.490
a hug yet oh no well here we go so from us we’re going to send you a big hug because
283
00:29:27.490 –> 00:29:34.890
when you give a hug you get a hug well thank you so much that was wonderfully done am i i am
284
00:29:34.890 –> 00:29:39.010
going to do that song using one of those one day and you’re going to hate me for it
285
00:29:40.530 –> 00:29:46.810
so we will be with you again next week just look after yourselves yep take care bye
286
00:29:50.830 –> 00:29:56.810
here to support you the Cornwall Cancer Cafe podcast thanks to the National Lottery
287
00:29:56.810 –> 00:29:59.430
Community Fund for supporting this podcast