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## Action
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### Audio
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### Description
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htmlText_265AB0FE_7296_E549_41C7_A0B31BDC7A15.html = Use the menus for more context and detail of Paul's Journey.
Randomly selected messages sent & received are shown.
Medical details and swearing may be observed
Randomly selected messages sent & received are shown.
Medical details and swearing may be observed
In combat, repeated blows are aimed at an opponent's torso over the course of a contest. These bodyshots serve to weaken them in preparation for a knockout blow.
Cancer, is a slow, multi-round fight to the death.
It is a scorched earth war of aggressive attrition versus the will to survive.
Yes, I have been badly beaten and I am weakened, but I am alive & without cancer.
Survival is often a matter of timing, the 'good fortune' to develop early but very unpleasant symptoms and the sense to visit the doctor early.
Cancer survival, and not, requires love. It takes 'Big Tent' type wraparound love from your family, your friends and your global village, however disparate. Prayers have been said to many gods, services held in my name, generous fundraising efforts half a world away, flowers delivered and more. The supportive messages you read here represent many more delivered in person or remotely. These are the waves in the tide of love upon which I was carried safely home.
---
Cancer involved loving myself enough to accept help from others, it involved looking at the lives around me, wondering whose diagnosis may have progressed in more challenging ways, it involves both compassion and survivor guilt. People have called me a warrior, but I am neither brave nor unique, just a lucky one-in-two, this time.
My good fortune gave me the responsibility to check myself, to remember that the other path was so very close and runs parallel to this day. I have never felt as humbled or vulnerable as I have during this battle; in presenting my body here as life-scale artifact, this exhibition extends that vulnerability in a relatable, human experience.
When days got difficult, I became grateful that I was able to have those days. The cancer may re-present itself sooner or later. In knowing that, I am more grateful for every day that I am here, and for the love I continue to receive from my Village.
Thank you.
With Love, genuinely.
Thank You
It is not possible to individually thank everyone who has supported me along the way.
In trying, without doubt I would unknowingly leave many out.
I'll not single anyone out for appreciation, you know who you are, but I will say that without doubt my siblings, my family, my friends and my mighty global support community, have carried me here in as good condition as I am today, battle scars notwithstanding.
Thank you.
Thank You
It is not possible to individually thank everyone who has supported me along the way, in trying, without doubt I would unknowingly leave many out.
I have much gratitude an respect for the incredible professionalism and care I received from the NHS staff and the support received from the brilliant Macmillan Nurses.
Whilst I'll not single individuals out for appreciation, you know who you are, I will say that without my siblings, my family, my friends and my mighty global support community, I would not be here in as good condition as I am.
I am here because you carried me home.
Thank you.
Thank You
It is not possible to individually thank everyone who has supported me along the way, in trying, without doubt I would unknowingly leave many out.
I have much gratitude an respect for the incredible professionalism and care I received from the NHS staff and the support received from the brilliant Macmillan Nurses.
Whilst I'll not single individuals out for appreciation, you know who you are, I will say that without my siblings, my family, my friends and my mighty global support community, I would not be here in as good condition as I am.
I am here because you carried me home.
Thank you.
Thank You
It is not possible to individually thank everyone who has supported me along the way, in trying, without doubt I would unknowingly leave many out.
I have much gratitude an respect for the incredible professionalism and care I received from the NHS staff and the support received from the brilliant Macmillan Nurses.
Whilst I'll not single individuals out for appreciation, you know who you are, I will say that without my siblings, my family, my friends and my mighty global support community, I would not be here in as good condition as I am.
I am here because you carried me home.
Thank you.
Thank You
It is not possible to individually thank everyone who has supported me along the way, in trying, without doubt I would unknowingly leave many out.
I have much gratitude an respect for the incredible professionalism and care I received from the NHS staff and the support received from the brilliant Macmillan Nurses.
Whilst I'll not single individuals out for appreciation, you know who you are, I will say that without my siblings, my family, my friends and my mighty global support community, I would not be here in as good condition as I am.
I am here because you carried me home.
Thank you.
Thank You
It is not possible to individually thank everyone who has supported me along the way, in trying, without doubt I would unknowingly leave many out.
I have much gratitude an respect for the incredible professionalism and care I received from the NHS staff and the support received from the brilliant Macmillan Nurses.
Whilst I'll not single individuals out for appreciation, you know who you are, I will say that without my siblings, my family, my friends and my mighty global support community, I would not be here in as good condition as I am.
I am here because you carried me home.
Thank you.
In combat, repeated blows are aimed at an opponent's torso over the course of a contest. These bodyshots serve to weaken them in preparation for a knockout blow.
Cancer, is a slow, multi-round fight to the death.
It is a scorched earth war of aggressive attrition versus the will to survive.
Yes, I have been badly beaten and I am weakened, but I am alive & without cancer.
Survival is often a matter of timing, the 'good fortune' to develop early but very unpleasant symptoms and the sense to visit the doctor early.
Cancer survival, and not, requires love. It takes 'Big Tent' type wraparound love from your family, your friends and your global village, however disparate. Prayers have been said to many gods, services held in my name, generous fundraising efforts half a world away, flowers delivered and more. The supportive messages you read here represent many more delivered in person or remotely. These are the waves in the tide of love upon which I was carried safely home.
---
Cancer involved loving myself enough to accept help from others, it involved looking at the lives around me, wondering whose diagnosis may have progressed in more challenging ways, it involves both compassion and survivor guilt. People have called me a warrior, but I am neither brave nor unique, just a lucky one-in-two, this time.
My good fortune gave me the responsibility to check myself, to remember that the other path was so very close and runs parallel to this day. I have never felt as humbled or vulnerable as I have during this battle; in presenting my body here as life-scale artifact, this exhibition extends that vulnerability in a relatable, human experience.
When days got difficult, I became grateful that I was able to have those days. The cancer may re-present itself sooner or later. In knowing that, I am more grateful for every day that I am here, and for the love I continue to receive from my Village.
Thank you.
With Love, genuinely.
Getting Help in N Ireland
Get information from NHS or Cancer charity websites only.
Getting Help in N Ireland
Get information from NHS or Cancer charity websites only.
Getting Help in N Ireland
Get information from NHS or Cancer charity websites only.
Early Symptoms
Most Stomach Cancer Deaths occur because they are diagnosed when it is too late for treatment.
The initial symptoms of OG (Oesophageal & Gastric [stomach] cancers) are vague and easy to mistake for other less serious conditions.
Who may develop OG cancers?
You're more likely to develop stomach and oesophageal cancers if you:
• are male
• are 55 years of age or older
• smoke
• have a diet low in fibre and high in processed food or red meat
• have a diet that contains a lot of salted and pickled foods
• have a stomach infection caused by Helicobacter pylori (H. pylori) bacteria
Symptoms include:
• Persistent indigestion and heartburn
• Trapped wind and frequent burping
• Feeling very full or bloated after meals
• Persistent stomach pain
Advanced symptoms can include:
• blood in your stools, or black stools
• loss of appetite
• weight loss
When to see your GP
Because the early symptoms of stomach cancer are similar to other conditions, the cancer is often advanced by the time it's diagnosed and is more complex to treat
DO NOT DELAY asking your GP for advice if you think you have the symptoms.
Your GP will ask about your symptoms and examine your tummy. If they think that stomach cancer may be a possibility, they'll refer you to a specialist for further investigation.
Whatever the result, you are best to know as early as possible.
View Official Stomach Cancer NI Stats
Early Symptoms
Most Stomach Cancer Deaths occur because they are diagnosed when it is too late for treatment.
The initial symptoms of OG (Oesophageal & Gastric [stomach] cancers) are vague and easy to mistake for other less serious conditions.
Visit your GP if you exhibit any of the symptoms
Waiting for it to 'clear up' may kill you!
#CatchItEarly
Who may develop OG cancers?
You're more likely to develop stomach and oesophageal cancers if you:
• are male
• are 55 years of age or older
• smoke
• have a diet low in fibre and high in processed food or red meat
• have a diet that contains a lot of salted and pickled foods
• have a stomach infection caused by Helicobacter pylori (H. pylori) bacteria
Symptoms include:
• Persistent indigestion and heartburn
• Trapped wind and frequent burping
• Feeling very full or bloated after meals
• Persistent stomach pain
Advanced symptoms can include:
• blood in your stools, or black stools
• loss of appetite
• weight loss
When to see your GP
Because the early symptoms of stomach cancer are similar to other conditions, the cancer is often advanced by the time it's diagnosed and is more complex to treat
DO NOT DELAY asking your GP for advice if you think you have the symptoms.
Your GP will ask about your symptoms and examine your tummy. If they think that stomach cancer may be a possibility, they'll refer you to a specialist for further investigation.
Whatever the result, you are best to know as early as possible.
Early Symptoms
Most Stomach Cancer Deaths occur because they are diagnosed when it is too late for treatment.
The initial symptoms of OG (Oesophageal & Gastric [stomach] cancers) are vague and easy to mistake for other less serious conditions.
Visit your GP if you exhibit any of the symptoms
Waiting for it to 'clear up' may kill you!
#CatchItEarly
Who may develop OG cancers?
You're more likely to develop stomach and oesophageal cancers if you:
• are male
• are 55 years of age or older
• smoke
• have a diet low in fibre and high in processed food or red meat
• have a diet that contains a lot of salted and pickled foods
• have a stomach infection caused by Helicobacter pylori (H. pylori) bacteria
Symptoms include:
• Persistent indigestion and heartburn
• Trapped wind and frequent burping
• Feeling very full or bloated after meals
• Persistent stomach pain
Advanced symptoms can include:
• blood in your stools, or black stools
• loss of appetite
• weight loss
When to see your GP
Because the early symptoms of stomach cancer are similar to other conditions, the cancer is often advanced by the time it's diagnosed and is more complex to treat
DO NOT DELAY asking your GP for advice if you think you have the symptoms.
Your GP will ask about your symptoms and examine your tummy. If they think that stomach cancer may be a possibility, they'll refer you to a specialist for further investigation.
Whatever the result, you are best to know as early as possible.
Prehab
Get your rehabilitation in first!
Treatment for cancer can be hard on the mind, body and spirit of the patient. It is important that before treatment starts, the patient undertakes steps to put themself in the best position possible.
Prehabilitation or 'prehab' means getting ready for cancer treatment in whatever time you have before it starts.
Diagnosis
Stage 2b - ypT4N0*
Diagnostic Process
Endoscope / Coloscopy
On receipt of the Red Flag Referral from my GP, I was offered an Iron infusion and scheduled for both endoscope and colonoscopy on 21st December 2023. This is a 'camera' investigation 'North and South'
The Doctor discovered a growth during this investigation that he was 'highly suspicious' would be cancerous. Biopsies were taken and confirmed 24 hrs later as adenocarcinoma, the most common form of Oesophago-gastric (Stomach) Cancer.
Insert weird Christmas
CT Scan
One week after, on 28th Dec, I attended a CT scan where the full extent of the tumour could be ascertained.
Insert Weird New Year
Multi-Disciplinary Team
on 2 January I attended a Multi-Disciplinary Team meeting where I met with the Surgical team, Anaesthetist, physiotherapy, dietician, Macmillan and had a Pre Assessment evaluation.
The surgeon confirmed that my tumour was a T4, the largest size. It had penetrated my stomach layers fully from inside to outside. He also confirmed that it appears to be 'well differentiated'. Not obviously spreading.
Staging Laparoscopy
As a result of the MDT meeting, I was assessed as fit to undergo an investigative staging lararoscopy. This Keyhole surgery, accompanied by an endoscope allowed the surgeons to view the tumour from all sides and take biopsies.
Washings'
It further allowed them to insert fluid into my chest cavity and then withdraw it to assess for microscopic cancer cell spread. These 'washings' would determine if my staging was stage IV, indicating a spread which would rule out curative treatment. My results came back negative and surgery was planned.
Staging
Clinicians would not give me a staging** at this point beyond the tumour being T4.
**I have since worked out that my staging at this point was cT4N0 (c= Clinical staging, Tumour = size 4, affected Nodes = 0)
*Post-chemo and surgery my staging was ypT4N0M0 (y =Pre-op Chemo, p = pathology results Tumour size 4, zero nodes affected and no Metastases)
*My cancer stage equates therefore to 2B because there was no spread.
It is impossible to be precise, but the tumour may have been growing silently without symptoms or several years, my good fortune was that it has not spread, despite its size.
80% of cases are diagnosed too late for a curative pathway to be an option.
It is critical to respond quickly to any persistent symptoms in this area.
Bodyshots in Person
Bodyshots is now a real-life exhibition.
Bodyshots was accepted to be shown in QSS Studios Belfast as part of the N Ireland Mental Health Arts Festival.
I am seeking further opportunities to exhibit the work and to start conversations to raise awaress of symptoms
View Exhibition Documentation Images
It Takes A Village...
They say it takes a village to raise a child.
Each individual, whether there professionally or through personal relationship serves to support your mind and spirit as well as your body. This group of people I call my 'Village'.
Whilst the treatment steps can ony be taken by the patient alone, it is important that they are supported along the way and in many ways by as many people as possible.
Support falls into three main categories
• emotional support when a person feels valued and has people nearby whom they can trust;
• instrumental support - People who can provide help in emergencies or to take every-day tasks off your hands; and
• informational support Those who can supply facts and information that can help you e.g. Macmillan, 'Stomachless Living Group' forum.
I know that not everybody has family, friends, neighbours or a wide social circle around them, but it is important for a patient to allow themselves to ask for and accept help.
For many independent people, myself included, asking for and accepting help is something that can be difficult to do. It involves accepting that you don't have control over every element of your days at this time or that you are compromised in your practical ability to do every day things.
Help takes many forms but I cannot emphasise enough how important your mind and spirit become in this process.
30% Weight Loss
Stable Bodyweight 2022 - 80kg
Lowest bodyweight 2024 - 55kg
History & Symptoms:
I had been losing weight over the period 2022-23 without really trying. Changes in my home status to living alone, business concerns and not really prioritising my health and diet were all contributing factors.
In mid 2023 I was working in Japan and the USA where my weight was stable at around 75kg. In one 6 week period I had experienced extreme time zone shifts and changes from my normal diet.
My work touring with Trinity Irish Dance Company on the road as a videographer was also non-stop and pressured. I did not realise at this stage that I had a tumour growing inside, robbing me of blood supply, making me anaemic, exhausted and foggy mentally.
On my return I started to experience intermittent issues in my lower abdomen that became more frequent. I had a loss of appetite for all food or I would eat only a small amount before becoming nauseous.
Eventually I started to feel food 'sticking' in my stomach and could taste undigested food. It was clear that the system was not moving everything through as intended. (I believe this was caused by fecal impaction or very slow moving constipation)
In late September 23, I contacted my GP who took bloods that showed 'folate anemia'. I had 5 weeks of B12 shots and then more blood tests. Those also showed the same anaemic condition and because there was no other sign of blood loss, the Doctor 'red flagged' it as a potential cancer risk at the start of December 23.
2 weeks later I had an infusion and 2 days after that I had endoscopic and gastroscopic investigations. The laxative given cleared 'everything' out of my system and I have had no further discomfort of the type that drove me to the doctor. I believe this 'constipation' saved my life.
After completing the scopes and sitting me up, the doctor advised that potential cancer was identified in my upper intestinal tract. it was 4 days before Christmas. Biopsies were confirmed as cancerous the next day, 22 December on a phone call,
The cancer was confirmed as a T4 tumour by CT scan between christmas and New year. I was assessed by a multi-disciplinary team on 2 January 24 after which I had actual information about my condition. I broke the news as gently as possible to my children that evening.
The next day a staging laparoscopy was undertaken. This was only 12 days after diagnosis, Holiday period notwithstanding.
The laparoscopy and 'washings' would be the indicator if I would be on a pathway to a surgical 'cure', or require palliative care to make me comfortable to the end.
It took 10 of the longest days of my life for those results to arrive. I will never forget the phone call I received. Thankfully surgery became the prime option and whilst it has been an arduous path, here I am today, cancer free at the time of writing.
Surgery, followed by not eating whilst my new 'join' healed, took off even more weight. I was eventually discharged at 60.3 kg. I did lose further weight down to 55kg as I embarked on my new eating regime. I have stabilised now around 57-58kg, no matter how much I try to eat. I am still 20kg down.
The graph below runs from 1 Oct 23 to 30 Sept 24 and is my average weight per month. It was a shock when I first saw it.
Food
An odyssey begins...
These questions occur in pretty much in every conversation when the topic is first talked about.
You have no stomach?
• Correct. I don't.
• My oesophagus connects directly to my small intestine
• I only have capacity for around 1/3 an adult meal.
How / what do you eat?
• I can eat any food but sugar causes 'dumping'
• Eat slowly & chew well.
• 6 small meals per day to achieve 2000 Calories
• Calorific snacks inbetween
• Prioritise protein in calorie heavy foods,
• Limit space-taking carbs & fibre
• Avoid drinking when eating. It causes dumping
Do you feel hungry / full?
• Kind of - l sense a persistent 'void'
• I have no full signal
• over-eating becomes uncomfortable later & can cause dumping.
• I have had to learn by trial & error how much food to eat
Do you have a bag?"
• No, I don't
Mental Attitude
There will be hard days. You need to prepare to dig in.
"over : under : around : through"
This was my 'determined' mantra over the 20+ years as a single dad.
It means that no matter what, I am getting to the 'other side' of a challenge. It served me well then, as now, I am happy to share if it helps you.
--
A cancer diagnosis presents a series of challenges on many levels and ultimately there is no way to skirt or avoid it. The only way to the 'other side' is to go through it.
One of the tools in my arsenal was to actively develop a positive mental attitude. If you speak with me or read through the content in the project, you will hear me express genuine gratitude for the opportunity to have this treatment.
This does not mean that the treatment was easy, or that I wasn't battered and ravaged by the disease. There is no way to avoid the battle. As a person of facts and logic mostly, It was important for me personally to kow as much as possible about mmy disease and about the surgery. I asked the surgeon, oncologist and each professional to give me as much information as possible.
I find that a known thing, a thing that is understood,
is inherently less intimidating.
It means that I remained acutely aware of how close I was to walking the path that would have led to my not surviving. That simple reality check makes me grateful to be upright and breathing every day.
Adding to this factor for me was a film I had made a few years previously with ladies in their 30s-60s who had secondary, 'metastatic' breast cancer, a re-appearance elsewhere in their body, for which there is no cure. It is a Stage 4 cancer and is terminal.
The ladies had mostly followed a path similar to mine, they had receved chemo, surgical 'curative' treatments, had rung the bell and had embarked on the rest of their lives.
Having beaten Cancer once, their stories and situations regarding their re-occurrence were even more heartbreaking and impactful upon me. I cried many empathetic tears for them and ther families. Their situations have stayed with me throughout my own path as a reminder of how fortunate I am, but just for today.
During the 10 day period between staging keyhole surgery and receiving the 'staging' result, it was impossible to not feel myself on either side of this path. The not-knowing time was a traumatic holding of my breath whilst my mind oscillated between hope and fear. In my mind, I faced up to death more squarely in that moment than at any time, even when I was about to undergo life-changing surgery.
I was fortunate to have been told that there was no obvious spread beyond the original tumour. I was elated naturally, the release of tension was indescribable but tempered with a sense of 'there but for the grace of God go I'.
That period of facing death stayed with me throughout treatment and remains to this day, the breast cancer ladies' experience lives in my mind and is never far from recall.
These are my comparators, every day that I am not stage 4 is a good day and I am grateful for the opportunity to have had treatment. An opportunity denied to many, usually through late identification.
The sad reality of most aggressive cancer types is that they tend to come back. I could take this information and live under a cloud, but I choose to use it to intensify the importance of every day I wake up.
As I have progressed through diagnosis, assessment, treatment, surgery and now into recovery, I check my attitude every day. I give thanks for my good fortune to be on 'this' side today, and I weep for those who walk on the other side.
---
I am 1 in 2. I was lucky. Please be lucky
• Only 20% of all who are diagnosed with Gastric (stomach) cancer are alive 5 years later.
• Of those who receive 'curative' treatment:
• 50% are alive 5 years later
• 20% are alive at 10 years and beyond
This exhibition hopes to encourage even one person with symptoms to visit the doctor. The only message in this project is to not ignore symptoms. Men, I'm looking at you.
Most people with Stomach cancer die because they ignore or dismiss symptoms.
Rule cancer out or identify it early. Either way, it is 100% best to know as early as possible.
Physical Impacts
30% body weight loss
• 80kg to 50kg
1cm Loss in height
• Adult Life 170.5 cm
• Now 169.5cm
Loss of taste (Hypogusea)
• I had no taste for 4.5 months out of 9
Loss of fingernails & Toenails (Onycholyosis)
• All fingernails lost and regrown
• All toenails lost, still growing 9 months later
Hair loss
• Strange to feel my smooth face and body
Persistent Neuropathy
• I have 'dead spots' at the tips of my fngers
Physical Changes
When one thinks of losing weight one usually thinks of achieving some kind of attractive look. I have to admit that whilst this overall 2 year process was unfolding, a times I did find that I felt good at a certain weight physically and thought I was in 'decent shape' for a 60 year old (almost).
As weight continues to be lost however and any fat reserves we had built up are exhausted, the weight still has to come off from somewhere. These are factors I really hadn't anticipated.
To my advantage, for 5 decades I have been a drummer, whilst not at all a sporty type, the activity kept me active and was 'mildly aerobic'.
Additionally I have also had a long time aversion to sweet things. Both of these factors mean I accidentally achieved a moderately athletic muscular structure.
What I hadn't considered was the weakening effect on the general fabric of my body, not just muscle degradation but loss of bone density. It was a complete shock to find out that over the course of about 6 months, I had lost around a centimeter in height.
Now, when I look at and examine my body, it saddens me that I can contain my entire upper thigh within the closed ring of my two hands, that the skin on my face has aged 10 years as the 'plumping' fats have been eaten up. It pains me that I bought new 29" jeans, 5" smaller than my old size and they are still too big or that I have 18" of belt that shows all too clearly my weightloss progression.
However, I balance these facts with my gratitude that I had the physical resources to pay the price to get to this side of cancer. Drumming and schlepping heavy drum cases maybe saved my life.
Getting Help in N Ireland
Get information from NHS or Cancer charity websites only.
Getting Help in N Ireland
Get information from NHS or Cancer charity websites only.
Getting Help in N Ireland
Get information from NHS or Cancer charity websites only.
Prehab
Get your rehabilitation in first!
Prehabilitation or 'prehab' means getting ready for cancer treatment in whatever time you have before it starts.
Treatment for cancer can be hard on the mind, body and spirit of the patient. It is important that before treatment starts, the patient undertakes steps to put themself in the best position possible.
The more determined you are and the more muscle & strength you can build, the better the results. You cannot be too fit.
Early Symptoms
Most Stomach Cancer Deaths occur because they are diagnosed when it is too late for treatment.
The initial symptoms of OG (Oesophageal & Gastric [stomach] cancers) are vague and easy to mistake for other less serious conditions.
Visit your GP if you exhibit any of the symptoms
Waiting for it to 'clear up' may kill you!
#CatchItEarly
Who may develop OG cancers?
You're more likely to develop stomach and oesophageal cancers if you:
• are male
• are 55 years of age or older
• smoke
• have a diet low in fibre and high in processed food or red meat
• have a diet that contains a lot of salted and pickled foods
• have a stomach infection caused by Helicobacter pylori (H. pylori) bacteria
Symptoms include:
• Persistent indigestion and heartburn
• Trapped wind and frequent burping
• Feeling very full or bloated after meals
• Persistent stomach pain
Advanced symptoms can include:
• blood in your stools, or black stools
• loss of appetite
• weight loss
When to see your GP
Because the early symptoms of stomach cancer are similar to other conditions, the cancer is often advanced by the time it's diagnosed and is more complex to treat
DO NOT DELAY asking your GP for advice if you think you have the symptoms.
Your GP will ask about your symptoms and examine your tummy. If they think that stomach cancer may be a possibility, they'll refer you to a specialist for further investigation.
Whatever the result, you are best to know as early as possible.
Early Symptoms
Most Stomach Cancer Deaths occur because they are diagnosed when it is too late for treatment.
The initial symptoms of OG (Oesophageal & Gastric [stomach] cancers) are vague and easy to mistake for other less serious conditions.
Visit your GP if you exhibit any of the symptoms
Waiting for it to 'clear up' may kill you!
#CatchItEarly
Who may develop OG cancers?
You're more likely to develop stomach and oesophageal cancers if you:
• are male
• are 55 years of age or older
• smoke
• have a diet low in fibre and high in processed food or red meat
• have a diet that contains a lot of salted and pickled foods
• have a stomach infection caused by Helicobacter pylori (H. pylori) bacteria
Symptoms include:
• Persistent indigestion and heartburn
• Trapped wind and frequent burping
• Feeling very full or bloated after meals
• Persistent stomach pain
Advanced symptoms can include:
• blood in your stools, or black stools
• loss of appetite
• weight loss
When to see your GP
Because the early symptoms of stomach cancer are similar to other conditions, the cancer is often advanced by the time it's diagnosed and is more complex to treat
DO NOT DELAY asking your GP for advice if you think you have the symptoms.
Your GP will ask about your symptoms and examine your tummy. If they think that stomach cancer may be a possibility, they'll refer you to a specialist for further investigation.
Whatever the result, you are best to know as early as possible.
Early Symptoms
Most Stomach Cancer Deaths occur because they are diagnosed when it is too late for treatment.
View Stats
The initial symptoms of OG (Oesophageal & Gastric [stomach] cancers) are vague and easy to mistake for other less serious conditions.
Visit your GP if you exhibit any persistent symptoms
Waiting for it to 'clear up' may kill you!
#CatchItEarly
Who may develop OG cancers?
You're more likely to develop stomach and oesophageal cancers if you:
• are male
• are 55 years of age or older
• smoke
• have a diet low in fibre and high in processed food or red meat
• have a diet that contains a lot of salted and pickled foods
• have a stomach infection caused by Helicobacter pylori (H. pylori) bacteria
Symptoms include:
• Persistent indigestion and heartburn
• Trapped wind and frequent burping
• Feeling very full or bloated after meals
• Persistent stomach pain
Advanced symptoms can include:
• blood in your stools, or black stools
• loss of appetite
• weight loss
When to see your GP
Because the early symptoms of stomach cancer are similar to other conditions, the cancer is often advanced by the time it's diagnosed and is more complex to treat
DO NOT DELAY asking your GP for advice if you think you have the symptoms.
Your GP will ask about your symptoms and examine your tummy. If they think that stomach cancer may be a possibility, they'll refer you to a specialist for further investigation.
Whatever the result, you are best to know as early as possible.
It Takes A Village...
They say it takes a village to raise a child...
Each individual, whether there professionally or through personal relationship serves to support your mind and spirit as well as your body. This group of people I call my 'Village'.
Whilst the treatment steps can ony be taken by the patient alone, it is important that they are supported along the way and in many ways by as many people as possible.
Support falls into three main categories
• emotional support when a person feels valued and has people nearby whom they can trust;
• instrumental support - People who can provide help in emergencies or to take every-day tasks off your hands; and
• informational support Those who can supply facts and information that can help you e.g. Macmillan, 'Stomachless Living Group' forum.
I know that not everybody has family, friends, neighbours or a wide social circle around them, but it is important for a patient to allow themselves to ask for and accept help.
For many independent people, myself included, asking for and accepting help is something that can be difficult to do. It involves accepting that you don't have control over every element of your days at this time or that you are compromised in your practical ability to do every day things.
Help takes many forms but I cannot emphasise enough how important your mind and spirit become in this process.
30% Weight Loss
Stable Bodyweight 2022: 80kg
Lowest bodyweight 2024: 55kg
History & Symptoms:
I had been losing weight over the period 2022-23 without really trying. Changes in my home status to living alone, business concerns and not really prioritising my health and diet were all contributing factors.
In mid 2023 I was working in Japan and the USA where my weight was stable at around 75kg. In one 6 week period I had experienced extreme time zone shifts and changes from my normal diet.
My work touring with Trinity Irish Dance Company on the road as a videographer was also non-stop and pressured. I did not realise at this stage that I had a tumour growing inside, robbing me of blood supply, making me anaemic, exhausted and foggy mentally.
On my return I started to experience intermittent issues in my lower abdomen that became more frequent. I had a loss of appetite for all food or I would eat only a small amount before becoming nauseous.
Eventually I started to feel food 'sticking' in my stomach and could taste undigested food. It was clear that the system was not moving everything through as intended. (I believe this was caused by fecal impaction or very slow moving constipation)
In late September 23, I contacted my GP who took bloods that showed 'folate anemia'. I had 5 weeks of B12 shots and then more blood tests. Those also showed the same anaemic condition and because there was no other sign of blood loss, the Doctor 'red flagged' it as a potential cancer risk at the start of December 23.
2 weeks later I had an infusion and 2 days after that I had endoscopic and gastroscopic investigations. The laxative given cleared 'everything' out of my system and I have had no further discomfort of the type that drove me to the doctor. I believe this 'constipation' saved my life.
After completing the scopes and sitting me up, the doctor advised that potential cancer was identified in my upper intestinal tract. it was 4 days before Christmas. Biopsies were confirmed as cancerous the next day, 22 December on a phone call,
The cancer was confirmed as a T4 tumour by CT scan between christmas and New year. I was assessed by a multi-disciplinary team on 2 January 23 after which I had actual information about my condition. I broke the news as gently as possible to my children that evening.
The next day a staging laparoscopy was undertaken. This was only 12 days after diagnosis, Holiday period notwithstanding.
The laparoscopy and 'washings' would be the indicator if I would be on a pathway to a surgical 'cure', or require palliative care to make me comfortable to the end.
It took 10 of the longest days of my life for those results to arrive. I will never forget the phone call I received. Thankfully surgery became the prime option and whilst it has been an arduous path, here I am today, cancer free at the time of writing.
Surgery then not eating whilst healing of my new 'join' occurred took off more weight and I was eventually discharged at 60.3 kg. I did lose some weight down to 55kg when adjusting to my new eating regime but I have stabilised now around 57-58kg for 6-8 weeks, no matter how much I try to eat.
The graph below runs from 1 Oct 23 to 30 Sept 24 and is my average weight per month. It was a shock when I first saw it.
Food
An odyssey begins...
These questions occur in pretty much in every conversation when the topic is first talked about.
You have no stomach?
• Correct. I don't.
• My oesophagus connects directly to my small intestine
• I only have capacity for around 1/3 an adult meal.
How / what do you eat?
• I can eat any food but sugar causes 'dumping'
• Eat slowly & chew well.
• 6 small meals per day to achieve 2000 Calories
• Calorific snacks inbetween
• Prioritise protein in calorie heavy foods,
• Limit space-taking carbs & fibre
• Avoid drinking when eating. It causes dumping
Do you feel hungry / full?
• Kind of - l sense a persistent 'void'
• I have no full signal
• over-eating becomes uncomfortable later & can cause dumping.
• I have had to learn by trial & error how much food to eat
Do you have a bag?
• No, I don't
Mental Attitude
There will be hard days. You need to prepare to dig in.
"over : under : around : through"
This was my 'determined' mantra over the 20+ years as a single dad.
It means that no matter what, I am getting to the 'other side' of a challenge. It served me well then, as now. I am happy to share if it helps you.
A cancer diagnosis presents a series of challenges and there is no way to skirt or avoid it. The only way to the 'other side' is to go through it.
One of the tools in my arsenal was to actively develop a positive mental attitude. If you speak with me or read through the content in the project, you will hear me express genuine gratitude for the opportunity to have this treatment.
This does not mean that the treatment was easy, or that I wasn't battered and ravaged by the disease. There is no way to avoid the battle. It means that I remained acutely aware of how close I was to walking the path that would have led to my not surviving. That simple reality check makes me grateful to be upright and breathing every day.
Adding to this factor for me was a film I had made a few years previously with ladies in their 30s-60s who had secondary 'metastatic' breast cancer, a re-appearance for which there is no cure because it has spread throughout their bodies. It is commony known as Stage 4 cancer and is terminal.
The ladies had mostly followed a path similar to mine, they had receved chemo, surgical 'curative' treatments, had rung the bell and had embarked on the rest of their lives.
Having beaten Cancer once, their stories and situations regarding their re-occurrence were even more heartbreaking and impactful upon me. I cried many empathetic tears for them and ther families. Their situations have stayed with me throughout my own path as a reminder of how fortunate I am, but just for today.
During the 10 day period between staging keyhole surgery and receiving the 'staging' result, it was impossible to not feel myself on either side of this path. The not-knowing time was a traumatic holding of my breath whilst my mind oscillated between hope and fear. In my mind, I faced up to death more squarely in that moment than at any time, even when I was about to undergo life-changing surgery.
I was fortunate to have been told that there was no obvious spread beyond the original tumour. I was elated naturally, the release of tension was indescribable but tempered with a sense of 'there but for the grace of God go I'.
That period of facing death stayed with me throughout treatment and remains to this day, the breast cancer ladies' experience lives in my mind and is never far from recall.
These are my comparators, every day that I am not stage 4 is a good day and I am grateful for the opportunity to have had treatment. An opportunity denied to many, usually through late identification.
The sad reality of most aggressive cancer types is that they tend to come back. I could take this information and live under a cloud, but I choose to use it to intensify the importance of every day I wake up.
As I have progressed through diagnosis, assessment, treatment, surgery and now into recovery, I check my attitude every day. I give thanks for my good fortune to be on 'this' side today, and I weep for those who walk on the other side.
---
I am 1 in 2. I was lucky. Please be lucky
• Only 20% of all who are diagnosed with Gastric (stomach) cancer are alive 5 years later.
• Of those who receive 'curative' treatment:
• 50% are alive 5 years later
• 20% are alive at 10 years and beyond
This exhibition hopes to encourage even one person with symptoms to visit the doctor. The only message in this project is to not ignore symptoms. Men, I'm looking at you.
Most people with Stomach cancer die because they ignore or dismiss symptoms.
Rule cancer out or identify it early. Either way, it is 100% best to know as early as possible.
Physical Impacts
30% body weight loss
• 80kg to 50kg
1cm Loss in height
• Adult Life 170.5 cm
• Now 169.5cm
Loss of taste (Hypogusea)
• I had no taste for 4.5 months out of 9
Loss of fingernails & Toenails (Onycholysis)
• All fingernails lost and regrown
• All toenails lost, still growing 9 months later
Hair loss
• Strange to feel my smooth face and body
Persistent Neuropathy
• I have 'dead spots' at the tips of my fngers
Physical Changes
When one thinks of losing weight one usually thinks of achieving some kind of attractive look. I have to admit that whilst this overall 2 year process was unfolding, a times I did find that I felt good at a certain weight physically and thought I was in 'decent shape' for a 60 year old (almost).
As weight continues to be lost however and any fat reserves we had built up are exhausted, the weight still has to come off from somewhere. These are factors I really hadn't anticipated.
To my advantage, for 5 decades I have been a drummer, whilst not at all a sporty type, the activity kept me active and was 'mildly aerobic'.
Additionally I have also had a long time aversion to sweet things. Both of these factors mean I accidentally achieved a moderately athletic muscular structure.
What I hadn't considered was the weakening effect on the general fabric of my body, not just muscle degradation but loss of bone density. It was a complete shock to find out that over the course of about 6 months, I had lost around a centimeter in height.
Now, when I look at and examine my body, it saddens me that I can contain my entire upper thigh within the closed ring of my two hands, that the skin on my face has aged 10 years as the 'plumping' fats have been eaten up. It pains me that I bought new 29" jeans, 5" smaller than my old size and they are still too big or that I have 18" of belt that shows all too clearly my weightloss progression.
However, I balance these facts with my gratitude that I had the physical resources to pay the price to get to this side of cancer. Drumming and schlepping heavy drum cases maybe saved my life.
A seahorse has no stomach. It must eat constantly
It has been adopted as a symbol by the 'Stomachless' Community
The Seahorse is the symbol of Belfast City
Where I'm from
The Seahorse is the symbol of Belfast City
Where I'm from
The Seahorse is the symbol of Belfast City
Where I'm from
The male Seahorse bears and raises its young
I was a single dad of 3 kids for 2 decades
Cancer is a terrible disease that takes away people we love.
During the period to which this exhibition refers, two very dear friends both lost their mothers to cancer.
I would like to dedicate this work to the memory of Eileen Werchouski and Philomena O'Hare and to the strength of the families who carry on and make it work.
I would also like to mention poet Gerald Dawe who also passed during the period. We worked together briefly, the Shisen-do book on the table is a reference to his 'Moon-Viewing room'.
I have adopted the Seahorse as a totemic symbol.
A seahorse has no stomach. It must eat constantly
It is a symbol within the 'Stomachless' Community
Cancer is a terrible disease that takes away people we love.
During the period to which this exhibition refers, two very dear friends both lost their mothers to cancer.
I would like to dedicate this work to the memory of Eileen Werchouski and Philomena O'Hare and to the strength of all families who carry on and make it work.
I would also like to mention poet Gerald Dawe who also passed during the period. We worked together briefly, the Shisen-do book on the table is a reference to his poem 'Moon-Viewing room'.
I have adopted the Seahorse as a totemic symbol.
The Seahorse is the symbol of Belfast City
Where I'm from
The male Seahorse bears and raises its young
I was a single dad of 3 kids for 2 decades
Concept, Artistic Direction & 'Body subject': Paul Marshall
Studio B&W Photography, & project collaborator: Jim Maginn 3D Model Lifesaver: David Hanan
Concept & Artistic Direction: Paul Marshall
3D Lifesaver: David Hanan
I have set out in this project to express my overwhelming sense of love and gratitude that I received over the 12 months from not feeling 'right' through diagnosis, surgery and to finishing treatment.
A cancer 'bubble' that with hindsight, in many ways is otherworldly. Albeit absent a stomach and with a new complicated relationship with food.
the many thoughts and emotions that
Diagnosis
Stage 2b - ypT4N0*
Diagnostic Process
Endoscope / Coloscopy
On receipt of the Red Flag Referral from my GP, I was offered an Iron infusion and scheduled for both endoscope and colonoscopy on 21st December 2023. This is a 'camera' investigation 'North and South'
The Doctor discovered a growth during this investigation that he was 'highly suspicious' would be cancerous. Biopsies were taken and confirmed 24 hrs later as adenocarcinoma, the most common form of Oesophago-gastric (Stomach) Cancer.
Insert weird Christmas
CT Scan
One week after, on 28th Dec, I attended a CT scan where the full extent of the tumour could be ascertained.
Insert Weird New Year
Multi-Disciplinary Team
on 2 January I attended a Multi-Disciplinary Team meeting where I met with the Surgical team, Anaesthetist, physiotherapy, dietician, Macmillan and had a Pre Assessment evaluation.
The surgeon confirmed that my tumour was a T4, the largest size. It had penetrated my stomach layers fully from inside to outside. He also confirmed that it appears to be 'well differentiated'. Not obviously spreading.
Staging Laparoscopy
As a result of the MDT meeting, I was assessed as fit to undergo an investigative staging lararoscopy. This Keyhole surgery, accompanied by an endoscope allowed the surgeons to view the tumour from all sides and take biopsies.
'Washings'
It further allowed them to insert fluid into my chest cavity and then withdraw it to assess for microscopic cancer cell spread. These 'washings' would determine if my staging was stage IV, indicating a spread which would rule out curative treatment. My results came back negative and surgery was planned.
Staging
Clinicians would not give me a staging** at this point beyond the tumour being T4.
**I have since worked out that my staging at this point was cT4N0 (c= Clinical staging, Tumour = size 4, affected Nodes = 0)
*Post-chemo and surgery my staging was ypT4N0M0 (y =Pre-op Chemo, p = pathology results Tumour size 4, zero nodes affected and no Metastases)
*My cancer stage equates therefore to 2B because there was no spread.
It is impossible to be precise, but the tumour may have been growing silently without symptoms or several years, my good fortune was that it has not spread, despite its size.
80% of cases are diagnosed too late for a curative pathway to be an option.
It is critical to respond quickly to any persistent symptoms in this area.
Surgery
'Roux en Y'
Radical Gastrectomy & Distal Oesophagectomy
May 2024
Removal of the cancer tumour along with the my stomach and lower end of my oesophagus.
Remaining oesophagus reconnected to my small intestine. The join was 29mm in diameter at the time.
My pancreas and liver were re-plumbed lower down to deliver enzymes and bile into my new digestion arrangement.
View Animation
-----------------------
Laparoscopic Staging Investigation
Jan 2024
I had keyhole surgery to ascertain the physical size and extent of the tumour and to take 'washings' to check for microscopic cancer cells in one's system.
My tumour was a (T)4, the most aggressive on a scale of 1-4, meaning that at its location it had infected the entire layers pf the organ from inside to outside. It was however contained to its own area and had not spread, therefore surgery became the pathway.
My post-surgical staging was T4 N0 (0 nodes affected) M0 (0 Metastases)
It is impossible to be precise but the tumour may have been growing silently without symptoms or several years.
80% of cases are diagnosed too late for a curative pathway to be an option.
It is critical to respond quickly to any persistent symptoms in this area.
There are several types of stomach cancer, which can be categorised based on the location in the stomach where the cancer begins*.
The most common type of stomach cancer was adenocarcinoma.
*links below to Wikipedia definitions
Other types of stomach cancer include:
• Lymphoma: This starts in the lymphatic system, which is a network of vessels and nodes that help circulate blood and fight infection.
• Sarcoma: This develops in the connective tissues or muscles of the stomach.
• Gastrointestinal stromal tumor: This type of tumor arises from the interstitial cells of Cajal, which are specialized cells that control the movement of food through the digestive tract.
• Carcinoid tumor: This type of tumor arises from the neuroendocrine cells in the stomach, which produce hormones that regulate digestion. Official Statistics (NICR)
Click Here for NI Summary Statistics
Prehab is a programme of support and advice that many Trusts use, supported through clinical staff.
Prehab covers :
• Eating and weight
• Physical activity or exercise
• Mental wellbeing
Even one week of Prehab can be very helpful. ANY level of activity pre-treatment will improve your chances of success.
A Simple Prescription:
• 8-10000 steps per day : Target 12mins per km
• Take onboard as many calories of any type as possible
• Sleep / Rest between activity
• Repeat
Changes & Effects
This is a rest of life change to an every day ritual that I have taken for granted for 6 decades.
It takes a while to learn one's new food and eating regime.
------
The stomach has an important role in our ability to take energy on board. It is a storage area, like a fuel tank in the car, that allows us to take enough food onboard to keep us going for several hours. Usually we need around 2000 calories per day. Food is not absorbed in the stomach, that happens in the intestine.
The stomach is our 'kitchen', enzymes, acids etc plus a grinding / mixing motion, break down foods & liquids into a mix called 'chyme' and outputs that at specific intervals over time into the small intestine. When there is no more food we feel hungry.
When I swallow however, my food goes directly into my small intestine. I try to make it as broken down as possible through chewing, however I can't compete with the original organ so there is a degree of malabsorption. Some food in every meal just 'passes through', that effect is evident for now through my inability to put on weight despite eating constantly. I understand that it will improve as everything re-adjusts to the new normal.
The physical amount of food I can manage is greatly limited because I have no 'tank' for storage, just the short distance between swallowing and processing.
The timing and preparation of food entering my intestine therefore is determined by my calorie onboarding schedule and my chewing technique's ability to release those nutrients.
To be honest, the management & preparing of 6 small, calorific meals a day is a real challenge as a single person living alone. A meal for one for me is actually 3 meals and I struggle badly with facing the third attempt at a meal in 2 days.
It's impractical to cook 1/3 size meal many times per day, I do a couple but I find options limited that don't require me to be filling my day around food preparation. Especially when Ireturn to fll time work. I love having house visitors because I get to cook a fresh, protein-rich, butter and calorie heavy, full fat meal at each meal time. My visitors generally enjoy their visits as do I. little islands of food joy.
I hear you say "Dry yer eyes, just reheat leftovers" or "batch cook & Freeze". I do both, but I need more meal variety. A meal for two decanted into 6 x portion-sized freezer containers takes up almost a drawer
It is expensve also because I may be eating 2000-2500 calories per day but only absorbing 1800. It feels like I spend twice as much on food as I used to do.
• As is my way, I step back from perception in the search for perspective. Realistically these are really small frustrations, Yes a change in a life long process & ritual.
• Yes it is inevitable that a steep learning curve was required,
• Yes I'm a long way from a routine and method that works.
• Yes I'm alive and cancer free.
I'm grateful for these challenges because they mean I am still here.
Dumping Syndrome
Dumping syndrome occurs when food, especially sugar, moves too quickly from the stomach to the duodenum—the first part of the small intestine. This condition is also called rapid gastric emptying
Dumping syndrome has two forms, based on when symptoms occur.
Early dumping syndrome occurs 10 to 30 minutes after a meal. It results from rapid movement of fluid into the intestine after a sudden addition of a large amount of food.
The small intestine expands rapidly and causes symptoms due to the shift of fluid into the intestinal area with acute intestinal bloating, diarrhoea and crampy abdominal pain.
Late dumping syndrome occurs 2 to 3 hours after a meal. It results from excessive movement of sugar into the intestine,raising the body's blood glucose level and causes the release of insulin. This causes a rapid drop in blood glucose levels, a condition known hypoglycemia, or low blood sugar. Light headedness, fatigue or head neck & chest sweats are symptoms.
Controlling sugar intake and keeping meal sizes small are daily habits that keep dumping syndrome at bay.
Facts, Stats & Data
The following stats can be difficult reading.
They are not here to scare you but to illustrate the importance of early diagnosis and the potential impact of ignoring persistent symptoms.
Over time numbers are improving because of increased awareness and improvements in medicine
Statistics taken from NI Cancer Registry - data 1993-2022
(see below for links)
- On average in Northern Ireland 188 cases per year were diagnosed (2018-2022)
- 90% were aged 55+ when diagnosed
- 59.2% of staged cases were stage IV
Five-year survival ranged from
- 80.4% diagnosed at Stage I
- 0.7% diagnosed at Stage IV
Following a Stomach Cancer diagnosis:
- 45.9% survive to one year plus
- 21.6% to five years plus
- Five-year survival for stomach cancer patients diagnosed in 2012-2016 was:
- 20.1% among men and
- 24.3% among women.
If you have persistent symptoms, acting early may save your life
Chemotherapy
FLOT
Neo-adjuvant chemotherapy Feb-Apr 2024
4 x 2-weekly infusions
Adjuvant chemotherapy August - September 2024
2* x 2-weekly infusions
F – fluorouracil also known as 5FU - delivered in a 'baby-bottle' pump worn around the neck for 24hrs.
L – leucovorin also known as folinic acid or calcium folinate
O – oxaliplatin (the cause of my neuropathy and fingernail issues)
T – doceTaxel
I was fortunate in that I had a 'complete response' to chemo, the tumour was 100% destroyed by the chemotherapy treatment.
-----------------------
Side Effects Experienced
Fatigue
... on top of existing fatigue from anemia etc.
Nausea
Often in an unpleasant split second co-incidence with diarrhoea. Yes really.
Constipation / Diarrhoea
Flipping between the two.
Mouth Dryness and Ulcers
More of a discomfort than anything else, although the ulcers made spicy food a challenge.
Loss of taste
In a 9 month period I had no sense of taste for 4.5 months. Specifically I was unable to taste anything except sweet which was extreme, and some sour which was normal.
*The effect of this on weight-loss was existential to me and was the reason for me leaving post-surgical adjuvant chemotherapy, 2 sessions early.
Loss of Fingernails & Toenails
I lost all of my fingernals and toenails. The process was slow and painless but frustrating and awkward. It has taken 8 months for fingernails to grow back, my toenails are still working on it.
Surgery
'Roux en Y'
Radical Gastrectomy & Distal Oesophagectomy
May 2024
Removal of the cancer tumour along with the my stomach and lower end of my oesophagus.
Remaining oesophagus reconnected to my small intestine. The join was 29mm in diameter at the time.
My pancreas and liver were re-plumbed lower down to deliver enzymes and bile into my new digestion arrangement.
View Animation
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Laparoscopic Staging Investigation
Jan 2024
I had keyhole surgery to ascertain the physical size and extent of the tumour and to take 'washings' to check for microscopic cancer cells in one's system.
My tumour was a (T)4, the most aggressive on a scale of 1-4, meaning that at its location it had infected the entire layers pf the organ from inside to outside. It was however contained to its own area and had not spread, therefore surgery became the pathway.
My post-surgical staging was T4 N0 (0 nodes affected) M0 (0 Metastases)
It is impossible to be precise but the tumour may have been growing silently without symptoms or several years.
80% of cases are diagnosed too late for a curative pathway to be an option.
It is critical to respond quickly to any persistent symptoms in this area.
There are several types of stomach cancer, which can be categorized based on the location in the stomach where the cancer begins*.
The most common type of stomach cancer was my own diagnosis of adenocarcinoma.
*links below to Wikipedia definitions
Other types of stomach cancer include:
• Lymphoma: This starts in the lymphatic system, which is a network of vessels and nodes that help circulate blood and fight infection.
• Sarcoma: This develops in the connective tissues or muscles of the stomach.
• Gastrointestinal stromal tumor: This type of tumor arises from the interstitial cells of Cajal, which are specialized cells that control the movement of food through the digestive tract.
• Carcinoid tumor: This type of tumor arises from the neuroendocrine cells in the stomach, which produce hormones that regulate digestion. Facts, Stats & Data
The following stats are not positive reading.
They are not here to scare you but to illustrate the importance of early diagnosis and the potential impacts of ignoring persistent symptoms.
Statistics taken from NI Cancer Registry - data 2017-2021
(see below for links)
- On average in Northern Ireland 193 cases per year are diagnosed
- 82% were aged 55+ when diagnosed
- 58% of staged cases were stage 4. Without a curative path
Five-year survival ranged from
- 79.0% diagnosed at Stage I
- 1.1% diagnosed at Stage IV
Following a Stomach Cancer diagnosis:
- 45.8% survive to one year plus
- 21.0% to five years plus
- Five-year survival for stomach cancer patients diagnosed in 2012-2016 was:
- 19.4% among men and
- 24.6% among women.
If you have persistent symptoms, acting early may save your life
Prehab is a programme of support and advice that many Trusts use, supported through clinical staff.
Prehab covers :
• Eating and weight
• Physical activity or exercise
• Mental wellbeing
Even one week of Prehab can be beneficial. ANY level of activity pre-treatment will improve your chances of success.
A Simple Prescription:
• 8-10000 steps per day : Target 12mins per km
• Take onboard as many calories of any type as possible
• Sleep / Rest between activity
• Repeat
Dumping Syndrome
Dumping syndrome occurs when food, especially sugar, moves too quickly from the stomach to the duodenum—the first part of the small intestine. This condition is also called rapid gastric emptying
Dumping syndrome has two forms, based on when symptoms occur.
Early dumping syndrome occurs 10 to 30 minutes after a meal. It results from rapid movement of fluid into the intestine after a sudden addition of a large amount of food.
The small intestine expands rapidly and causes symptoms due to the shift of fluid into the intestinal area with acute intestinal bloating, diarrhoea and crampy abdominal pain.
Late dumping syndrome occurs 2 to 3 hours after a meal. It results from excessive movement of sugar into the intestine,raising the body's blood glucose level and causes the release of insulin. This causes a rapid drop in blood glucose levels, a condition known hypoglycemia, or low blood sugar. Light headedness, fatigue or head neck & chest sweats are symptoms.
Controlling sugar intake and keeping meal sizes small are daily habits that keep dumping syndrome at bay.
Changes & Effects
This is a rest of life change to an every day ritual that I have taken for granted for 6 decades.
It takes a while to learn one's new food and eating regime.
------
The stomach has an important role in our ability to take energy on board. It is a storage area, like a fuel tank in the car, that allows us to take enough food onboard to keep us going for several hours. Usually we need around 2000 calories per day. Food is not absorbed in the stomach, that happens in the intestine.
The stomach is our 'kitchen', enzymes, acids etc plus a grinding / mixing motion, break down foods & liquids into a mix called 'chyme' and outputs that at specific intervals over time into the small intestine. When there is no more food we feel hungry.
When I swallow however, my food goes directly into my small intestine. I try to make it as broken down as possible through chewing, however I can't compete with the original organ so there is a degree of malabsorption. Some food in every meal just 'passes through', that effect is evident for now through my inability to put on weight despite eating constantly. I understand that it will improve as everything re-adjusts to the new normal.
The physical amount of food I can manage is greatly limited because I have no 'tank' for storage, just the short distance between swallowing and processing.
The timing and preparation of food entering my intestine therefore is determined by my calorie onboarding schedule and my chewing technique's ability to release those nutrients.
To be honest, the management & preparing of 6 small, calorific meals a day is a real challenge as a single person living alone. A meal for one for me is actually 3 meals and I struggle badly with facing the third attempt at a meal in 2 days.
It's impractical to cook 1/3 size meal many times per day, I do a couple but I find options limited that don't require me to be filling my day around food preparation. Especially when Ireturn to fll time work. I love having house visitors because I get to cook a fresh, protein-rich, butter and calorie heavy, full fat meal at each meal time. My visitors generally enjoy their visits as do I. little islands of food joy.
I hear you say "Dry yer eyes, just reheat leftovers" or "batch cook & Freeze". I do both, but I need more meal variety. A meal for two decanted into 6 x portion-sized freezer containers takes up almost a drawer
It is expensve also because I may be eating 2000-2500 calories per day but only absorbing 1800. It feels like I spend twice as much on food as I used to do.
• As is my way, I step back from perception in the search for perspective. Realistically these are really small frustrations, Yes a change in a life long process & ritual.
• Yes it is inevitable that a steep learning curve was required,
• Yes I'm a long way from a routine and method that works.
• Yes I'm alive and cancer free.
I'm grateful for these challenges because they mean I am still here.
Chemotherapy
FLOT
Neo-adjuvant chemotherapy Feb-Apr 2024
4 x 2-weekly infusions
Adjuvant chemotherapy August - September 2024
2* x 2-weekly infusions
F – fluorouracil also known as 5FU - delivered in a 'baby-bottle' pump worn around the neck for 24hrs.
L – leucovorin also known as folinic acid or calcium folinate
O – oxaliplatin (the cause of my neuropathy and fingernail issues)
T – doceTaxel
I was fortunate in that I had a 'complete response' to chemo, the tumour was 100% destroyed by the chemotherapy treatment.
-----------------------
Side Effects Experienced
Fatigue
... on top of existing fatigue from anemia etc.
Nausea
Often in an unpleasant split second co-incidence with diarrhoea. Yes really.
Constipation / Diarrhoea
Flipping between the two.
Mouth Dryness and Ulcers
More of a discomfort than anything else, although the ulcers made spicy food a challenge.
Loss of taste
In a 9 month period I had no sense of taste for 4.5 months. Specifically I was unable to taste anything except sweet which was extreme, and some sour which was normal.
*The effect of this on weight-loss was existential to me and was the reason for me leaving post-surgical adjuvant chemotherapy, 2 sessions early.
Loss of Fingernails & Toenails
I lost all of my fingernals and toenails. The process was slow and painless but frustrating and awkward. It has taken 8 months for fingernails to grow back, my toenails are still working on it.
Company Name
www.loremipsum.com
info@loremipsum.com
Tlf.: +11 111 111 111
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