In early 2011, a package arrived in the mail, unsolicited. It was from the government and they were here to help. Really. It was from a free government program to screen for bowel cancer.

Doctors call the test ‘FOBT’: faecal occult blood test — a search for hidden haemoglobin.

Ever ready to harvest the benefit of some of my taxes, I complied. Sampling one’s stools is a somewhat icky business, but if you have changed your kid’s nappy you’ve been there before, though some precautions are necessary to avoid contaminating the samples with urine or any of that blue stuff people like to add to the flush.

The results came back a week or so later. It was positive: something was leaking inside. So, off to the GP I went, test in hand, and was promptly referred to a gastroenterologist, with the reassuring words that what ever it was it had been detected early. 

A week or so later, the gastro-man assured me that there was nothing to worry about. Two polyps had been found, removed and sent for biopsy to confirm his diagnosis. And I should return in two years for a second colonoscopy. All this delivered in a measured tone that one suspects he would use, equally, to announce the birth of a child or the impending end of the world. 

Two years later: nothing. 

But come back in two years to make sure that is the way things might stay.

Twenty-fifteen rolled around and mid-year’s routine plumbing inspection was delayed by overseas travel and general busy-ness, so it wasn’t until October that I was back at the same hospital for a check-up. With that same imperturbable manner, gastro-man said he had found two polyps: one he removed but the other he had sampled and tattooed. For easier later identification he said. It was Saturday October 10.

The biopsy report was back on Wednesday, it was bad news. I was in front of a specialist in laparoscopic surgery, key hole surgery of the abdomen, on Thursday, and on the following Tuesday afternoon, I was wheeled into an operating theatre at a large city hospital. 

Medicine moves fast when it has to.

It was the opening chapter in an almost six year long story, a journey I am pleased that nature compelled me to take. I found you don’t fight cancer: the fight, if there is one, is with yourself.

This laparoscopic surgery is an amazing business. A two or three centimetre incision, crossways, below the navel, and three one centimetre cuts at the three other cardinal points, a team of creepy-peepy cameras and long, thin instruments. Three hours later my bowel was a hands-span shorter and the cancerous polyp gone.

I spent the night in intensive care and the following five days in the surgical ward. Apart from the pharmaceutical regime, the unexpected part of the therapy was elastic stockings to ward-off deep-vein thrombosis (I kept them for future long haul flights), and being directed to walk several kilometres a day, around and around the corridors of the ward, dodging traffic, other patients, nurses, doctors and visiting chaplains.

There were two further stays in that same hospital. A month later, feeling a bit unwell, I checked into the hospital’s emergency department and flashed my ‘should be seen in 30 minutes card’. It was: into a bed, onto a gurney and I was conducted on a tour of the underground labyrinth that knit that inner-city, multi-campus hospital together. A dose of Staphylococcus aureus, ‘golden staph’, common on the skin and in the respiratory tract, had invaded the wound. It is potentially fatal inside the body, so I was on intravenous antibiotics and under observation for the next four days. 

And it seems I may have not treated recovery and avoiding heavy lifting with due seriousness. Weeks later an haematoma broke through on the site of the primary incision staining my shirt front with blood. My GP strapped it to stop the bleeding and sent me back to that same emergency department. But here happened a high point of humour in the whole saga.

The emergency department of any inner-city hospital on any Friday night is scene of barely contained chaos. Road accidents, drug overdoses, knife fights and bashings are all on the go.

So I had to sit there after my ‘should see in 30 minutes’ assessment while more urgent cases were treated. 

About 9pm, a well-dressed woman and her husband, similarly well attired and out of company with outers in the room, sat down next to me. She kept making furtive glances towards me, with particular attention to my blood stained business shirt. Finally, she exclaimed in an accent straight out of Anglosphere Toorak, or a Noel Coward play, ‘Have you been fighting? 

I never found out why they were there as a booth had been found and the tedious business of cleaning and controlling the haematoma was done. Another couple of days in hospital was needed to repair the damage.

But the journey was not half over, more only half begun. Six months of increasingly arduous chemotherapy was to come then five years of half-yearly monitoring.

All this triggered by that simple, but doubtless life saving blood test. All this is six years in the past and my risk profile for reoccurrence is now the same as any male of my age. But the key message in my story is early detection. My bowel cancer was at early stage one. At stage four I would likely be dead within weeks and bowel cancer is the second biggest cause of cancer death here. More than 4,000 Australians die annually. Detection at stage one means your chances of a total recovery is 90 per cent plus.

These early detection kits are sent to all citizens with Medicare cards, every two years from age fifty to seventy-four. But, according to a paper published by the Australian College of General Practice, the take-up rate is barely 40 percent. Sixty per cent of recipients are not just wasting their tax dollar, they are risking their lives.

So when you get a kit in the mail from the National Bowel Cancer Screening program, do use it. Invest a poo sample in your future. Better than buying CSL at the Initial Public Offer.

Vincent O’Donnell

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