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Treatment and Update Summary
  • 87/8 - Original treatment for endometrial cancer consisting of some chemotherapy and about 40 sessions of radiotherapy to the pelvis, both front and back.
  • 95 - Codeine Phosphate to help "rapid transit".
  • ~99 - Dextromoramide, a powerful opioid analgesic for pain relief during blockage attacks.
  • 2001 - Referral to a gastroenterologist with a special interest in damage from radiotherapy. Tried antibiotics as bugs in gut can be factor.
  • Feb 02 - Started trial of Pentoxifylline (PTX) + alpha-tocopherol (vit-E).
  • July 02 - Hospitalised with series of pain and vomiting (blockage) attacks. Treated conservatively with IV hydration, morphine and gastric nasal tube.
  • Feb 03 - Reported improvement to gastroenterologist since PTX + vit-E.
    Blood tests during above visit revealed deficiency of vitamin B12, common in bowel injuries. Regular intramuscular injections have normalised levels effectively. These will continue for life.
  • Aug 03 - Fewer attacks since February visit! Recommended PTX + vit-E continues.
  • Feb 04 - Continue with PTX + vit-E.
  • Sept 04 - General improvement sustained. Long term effects of Vit-E at high doses unknown so stopped vit-E, continue PTX.
  • Feb 05 - No overall change so stopping vit-E had no effect. The PTX + vit-E appears to have reduced the impact of attacks.
  • Oct 05 - Dextromoramide now unavailable. Subligual Temgesic tried to no effect.
  • Dec 05 - Continue PTX.
  • Dec 05 - A skin lesion, thought to be Bowens disease, has been developing on Jan's back just outside the irradiated area. Her oncologist thought now best to have it removed and examined so referred to plastic surgeons.
  • 23 Dec 05 - 8 Jan 06 - series of attacks ending in hospital admission for re hydration.
  • April 06 - Skin lesion removed without need of difficult operation. Was actually a basal cell carcinoma.
  • Dec 06 - Gastroenterologist visit - reported overall deterioration. More attacks, more with vomiting. Continue PTX.
  • June 07 - Gastroenterologist visit - who noted Janice had been relatively free from attacks following antibiotics for a severe asthma attack. Thought worthwhile trying antibiotics for 5 days every month as prophylactic. These upset her so abandoned. He also suggested Fentanyl in lollipop lozenge form (Actiq) for pain. Not effective.
  • Oct 07 - Original Oncologist Janice sees every year. Found iron low and recommended supplements. Saw GP who thought likely to do with limited dietary intake and absorption due to damage. Ferrous Sulphate prescribed.
  • Dec 07 - Gastroenterologist visit - reported 22 attacks in just over year. He had been informed about iron levels.
  • Jan 08 - Saw Oncologist due to back pain. X-rays and CT scan all OK. Ferritin (iron) levels only rose slightly into normal range. GP prescribed Tramadol for pain before seeing Oncologist.
  • June 08 - Attended the first meeting for patients with Pelvic Radiation Disease at the Royal Marsden Hospital in London.
  • July 08 - Saw Gastroenterologist. 12 attacks in 7 months. No anaemia even though Ferritin levels still low.
  • Aug 08 - Saw dietician who put Janice on some multivitamin tablets. These upset her so abandoned.
  • Sept 08 - Saw Oncologist again. Back pain and right leg weakness investigated but OK on X-ray and MRI, neither explained. Referred to rheumatologist.
  • Jan 09 - Pain/vomiting attack late Dec 08, repeated three times throughout Jan 09. Well enough between to see Gastroentrologist and Dietician. Told of report from Dr Delanian who used Clodronate with PTX and Vit-E. Dietician prescribed juice style vitamin drinks called Ensure Plus Juce.
  • Feb/March/April 09 - Saw rheumatologist who saw earlier MRI. Leg weakness confirmed on examination and nerve conduction tests. Physiotherapy helping with improving strength.
  • Oct 09 - 12 pain (blockage) attacks. Saw Gastroenterologist & Dietician. Continue with PTX and vitamin drinks. As pain very severe during attacks advice from pain team recommended Effantora (buccal Fentalyl). This reasonably effective for a short period.
  • Nov 09 - Saw Oncologist and was assured all was generally well, current problems notwithstanding.

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