After the Treatment Ends

Once again, it has been a while since I last wrote anything here on Vocal. This time, it’s definitely not my fault, but the fault of my broken wrist. For a while, I haven’t even been able to butter my bread, let alone type.

The good news is that after an operation to insert a little metal plate in my wrist to keep the broken bone in place, my wrist is healing, and I can type again!

But this post is not about my broken wrist, but about cancer and its side effects, one in particular.

I know, such a cheerful topic! But while it might not be cheerful, it can help someone who, unfortunately, has to face “the cancer journey”.

I was diagnosed with womb cancer seven years ago and had to have a hysterectomy to remove the cancer. For those who don’t know and to save you trouble Googling it, a hysterectomy is an operation to remove the womb. By the way, I didn’t know what a hysterectomy was until I had to have one. It was just one of the many things I learnt through the process.

So almost exactly seven years ago, I had a hysterectomy and, for good measure, they also removed my cervix, ovaries, and fallopian tubes to prevent the cancer from spreading. Also, to prevent it from spreading, I had to have chemotherapy and radiotherapy.

Little did I think at the time - and had I thought about it, I would still have chosen the treatment, of course - how the hysterectomy, chemo, and radio would affect me in the long term.

And here is where we get back to my broken wrist. When I went to the A & E on one lovely Sunday that didn’t end so lovely, the doctor said I had brittle bones. She also said that if I had normal bones for my age, I probably wouldn’t have broken my wrist when I fell and landed on it. And she is probably right. You could say that my bones belong to someone much older than me.

There are several - all cancer treatment-related - reasons for that:

• Surgical menopause: Having a full hysterectomy meant that my body stopped producing estrogen immediately. This leads to rapid bone loss, which is usually higher than in a natural menopause.
• Chemotherapy: Some chemo drugs directly reduce bone density. Also, if one still has ovaries in place, I obviously didn’t, but for those who have, the drugs can damage ovaries and induce early menopause.
• Steroids: These little pills (that I hated so much), which are used to manage nausea during chemo, can interfere with your body’s ability to absorb calcium, causing - surprise, surprise - increased bone loss.

So there we have it in a nutshell, the reasons why I have brittle bones.

The thing is that I am so grateful to be alive (one of my doctors, Dr Gloom, I called him, said I had a one-in-ten chance of making it) that I will take brittle bones any day.

But I wish my doctors had emphasised it earlier. As wonderful as my doctors were (yes, even Dr Gloom, who was an amazing surgeon), there was a lack of advice for life after. I understand that, because after all, they were focused on getting rid of the cancer. Which, thankfully, they did very successfully.

But once it became clear that I was going to stay in the land of the living, it would have been helpful to have an appointment solely focusing on the "what next", where all the potential and definite long-term effects would have been explained together with how to prevent what can be prevented.

Because brittle bones after hysterectomy and chemo can be prevented.

To be honest, I always thought my bones were fine because I drink gallons of milk. But it’s not just about the calcium intake. It’s also about vitamin D and how well the calcium is absorbed. And more, which I will not go into because I’m not a medical expert.

The bottom line, if you or someone you know is diagnosed with cancer, speak to your doctor about how to prevent long-term side effects such as osteoporosis. Because, while it might not feel like it at the time of diagnosis and treatment, for more people than ever, there is life after cancer.

And I would just like to finish with something my doctor at the A &E said: “It could have been worse, you could have broken a hip!”