It’s been a strange and rather awful three weeks. For various family reasons I couldn’t write about this till now, but the fact is that when we went back to the Kyrenia Medical Centre on the day before my birthday, after our round of health checks, they found abnormal growth in my uterus lining, raising the possibilty of endometrial cancer. The specialist said that it might be the effects of my HRT but that the risk of cancer was too high to ignore and that a biopsy was required.
It didn’t sink in at first to be honest. We left the hospital brushing it off, but over the next 48 hours I thought about it deeply, whilst reading and researching online. And what I read indeed backed up the fear that it could well be cancer – endometrial cancer is a big killer of women, especially in my age group. We have grown accustomed to thinking that all cervical cancer is caused by the HPV virus. It isn’t. A significant proportion is caused by growths in the endometrium – the lining of the womb. Especially if that lining is not shed in a monthly period.
The fear, no… beyond fear…. terror – began to grow. The overwhelming emotion of not being ready to pop off just yet – so many things left to do…… On the 21st November, I contacted my GP – using their online form as requested, this being the only way to make an appointment – explaining this serious situation. Their automatic response logging my message promised a reply within 72 hours. I waited over a week and then received an appointment with a nurse on the 19th December. Great….Thankfully, we had already decided not to wait on the NHS.
We decided on a second opinion out here, and I rang the Dr Suat Gunsel Hospital on Monday 21st to make an appointment to see one of their gynaecological specialists. This is a joint teaching hospital between Near East University and the state and is only 2 years old – we went there during the pandemic for our tests so we were familiar with it. It’s an amazing campus and the facilities are first class. It’s just to the east of Girne in Karakum. There is a much larger Near East hospital on the northern outskirts of Lefkosa too. Anyway, I was routed to an English speaking receptionist and an appointment was made for me to see an English speaking consultant that very morning at 11am.
Bob drove me in and I met the specialist, a very nice woman who indeed spoke excellent English. She reviewed the ultrasound picture from the Kyrenia Medical Centre and took my medical history. She then performed her own ultrasound using a different type of scanner that scanned from an “internal position”. It was linked wirelessly to a screen I could see as well as the one she used for monitoring. At the end of that examination she confirmed the abnormality. She said that it could well be my medication but that it was too big a risk to take and that she recommended a d&c for biopsy. It would be done under general anaesthetic.
We decided not to hesitate further and agreed to go ahead. I was immediately started on a round of pre-op tests: blood work, urine sample, chest x ray, blood pressure, ecg and pcr test. I had a meeting with the anaesthetist who would conduct the general anaesthetic. All the results were rushed through that afternoon, recorded digitally on the hospital network and supplied to me in a folder. My operation was schedued for 9am on Wednesday, 23 November, and I would go home that day. I was told to come in for 7am and not to eat or drink anything after midnight the night before. We had to agree the costs in advance. This was a bit daunting but we’d already decided that we were prepared to use savings to pay. We were delighted however to be given a bill of £250 to cover all the pre tests, the consultation, the anaethetist and all the costs of the operation and subsequent biopsy test. It was hugely reassuring to be dealt with so promptly. It felt like progress even if it was progress towards an unknown result.
We drove away in somewhat of a daze. Coming face to face with a possibly serious diagnosis like this certainly sharpens the mind. We tried not to focus on it, but we veered between optimism and pessimistic anxiety. I imagined breaking bad news to our daughters… what would I say? It didn’t bear thinking about…. All the scenarios of a possible cancer diagnosis….. thank heavens we only had a really short time to wait. I cannot imagine how torturous and agonising having to wait weeks for consultations and diagnosis would be. This was bad enough. I tried to comfort myself that there had been no worrying symptoms, that I certainly hadn’t lost any weight but it didn’t really work. I remembered that my father and my paternal grandfather had both died at 68. I’d always believed I would take after my mother and live on into my 90s….. but maybe this was going to be proved wrong. Bob and I didn’t talk about it too much. It was just too awful to contemplate. In some ways it was worse for him than me…. Of course he was a rock of support and comfort.
On Wednesday morning we drove into the hospital for 7am and we were taken to our day room. Wow! We were allocated the most enormous ensuite hospital room overlooking the sea with state of the art facilities – a great surgical bed, comfortable arm chairs, spotlessly clean and fresh all of it. A nurse came in and gave me a brand new hospital gown and surgical stockings. Hilariously, she had to help me get them on, my manicured long nails couldn’t pull them up!!!!! The gown was a fetching shade of dark pink – quite nice to wear. Believe me, this may sound shallow, but at this point, any cheer was very welcome. We sat and waited enjoying the view over the sea which was just as calm and blue as always, unlike our mental torment.
At about 8am 2 nurses came in and took my blood pressure, pulse, temperature, reviewed all the test results and put an iv line into my wrist (ouch) and attached a saline fluid bag. Then at about 845 a nurse and a porter came to wheel me down to the operating theatre. At this point I had to put on a sort of hairnet cap!!!! Not so fetching I daresay… They moved so fast poor Bob had to chase me down the corridor calling out for them to stop so he could kiss me goodbye!
In the operating theatre – very modern and again spotless – I was moved onto the operating table and a team of theatre nurses started attaching me to various monitors – pulse, heart, blood pressure. I just lay back and let them get on with it. I was aware of the anaesthetist sitting behind me. My consultant came in and greeted me and said she would see me later. I was unaware that another fluid had been put into my iv because the next thing I knew, I was in the recovery room. I had no sensation of falling asleep or indeed waking up. It literally felt like the next minute but it was in fact 75 minutes later. The monitoring nurse told me that the operation was over and that it had taken about 5 minutes! Once they were sure I was properly awake and responsive, I was wheeled back to my room and left to rest. Bob was so relieved to see me. He’d gone off for a whacking breakfast and had to come hurrying back when he heard I was on the way up.
They brought us lunch at midday. Mine was a light lunch which I was told to eat slowly, although I wasn’t nauseous at all. And I had been expecting some post operative pain, but there was none. A bit of an uncomfortable feeling. The iv which was still in, ached. At 2pm the doctor came to call and she told me that the operation had been easy and quick and that in her opinion there was nothing to worry about although of course we would have to wait for the biopsy results to be sure. However she felt that there was nothing that she saw to be concerned about at all. We fixed an appointment for exactly a week later and she told me I could go. What a huge relief!!!! We felt as though a great burden had been lifted, even in advance of the biopsy results. She had found nothing concerning and so, we reasoned, even if the endometrial lining was found to have cancer cells, it would mean we had caught it very, very early stage and therefore the prognosis would be very positive.
We returned to the hospital on Wednesday, 30th November for our biopsy results….. huge disappointment awaited. The consultant told me that various doctors needed to review my biopsy results and they had tried unsuccessfully to telephone me the day before. My heart sank. Clearly something was wrong. It was, but not what I imagined. Two of the pathologists had been sent off with covid and would be out all week, delaying a lot of test results. Phew…. in a way…… She said she might have them by Monday 5th, December, mindful that we were due to fly home on the 8th. If not, she would have to email me….. Obviously this was hugely disappointing. We had geared ourselves up for the results on the 30th, and were so keen to either draw a line under the whole experience or, start to make plans… and we were still held in limbo. Bob was more upset than me, very disappointed and depressed. Clearly, he’d been very tense and absolutely crashed to be delayed again from a relief to that tension. I felt a bit more sanguine, mainly because I felt so well, I had a job believing the results could be bad.
Today, we had the call from the hospital at 0830, the results were in and I should come down and see the doctor. We went nervously down and were incredibly relieved and grateful to be given a total all clear. They want to see me for a check up and ultrasound when I am back in April, just to make sure that post operatively everything has returned to normal for a woman of my advanced years, and they want me to stop taking the hrt, which I had done since the middle of November and the first diagnosis. We drove home feeling totally happy for the first time in weeks. An indescribable relief and a confidence that we can move forward with our plans for the coming months.
I’m writing about this because it just confirms in our own minds the value of these screening tests. In my case because I was symptomless at this point, I would never have known of the abnormality because it was only shown by the ultrasound test. Of course, it might never have developed into cancer, but the possibility remains that it might well have. And by then, a hysterectomy would have been the best case scenario followed up by whatever cancer treatment was necessary depending on the stage. It could have been much, much worse. It could easily have spread. You might feel that we went through this for a false alarm but I’d rather do that than find out I had a cancer that had spread too far to be treated. So, we will continue to have the checks annually or bi-annually, when we are here – less than £100 buys you an invaluable early warning system. Even more reassuringly, that early warning can be backed up by prompt state of the art treatment locally or in Turkey. And it is very clear to us that the hospitals here are very far superior to any we have visited at home. If my biopsy had found cancer, we had already decided to stay on and be treated in Cyprus rather than return home to the uncertainty and waiting lists and long delays of the NHS. I would encourage everyone to have regular checkups – blood work, ultrasounds if possible. If you’ve ever smoked, get a ct scan of your lungs regularly, not an x ray. They are available in the UK although not all of them are free under the NHS. A chest x ray is next to useless in spotting lung cancer in time for it to be treatable. If you holiday here, just spend a few hours one morning getting them done. It’s better to know. Don’t let things get too far advanced before they are discovered. Early detection can save your life. I’m very glad we had the checks.