I am seeing Dr J, the oncologist this Friday, 14th July and these are the questions we are thinking of asking.

1. Question about any certainty with respect to extent of the cancer. Mr S has informed me that the CT scan I had at Halifax at the beginning of June showed cancer in the liver and the para-aortal node. Two doctors were fairly certain that the deep biopsy I had on 16th June 2006 would reveal signs of cancer returning to the colo-rectal region. It didn’t. This raises the question about whether we can be certain that there is cancer in the nodes. I’ve read that a definite diagnosis of lymph node cancer can only be made from a biopsy. The diagnosis of lymph node cancer in my case has been made on the basis of MRI/CT scans. Given that my recent colonoscopy seemed to indicate a return of cancer of the bowel which a deep biopsy disproved, might the scans need to be backed up with a biopsy to prove lymph node cancer? (My acupuncturist – while advising me to follow advice from the hospital consultants – has said that as far as she is concerned, she finds no evidence of cancer in the way other cancer patients show it. – deleted)

2. Cure or remission. What is the likelihood that the chemotherapy offered will cure or push the lymph node cancer into remission?

3. What is my life expectancy likely to be with and without chemotherapy?

4. Chemo in Hebden Bridge? Given that one of the NHS’ “Core Principles” is: “The NHS will shape its services around the needs and preferences of individual patients, their families and their carers,” is it possible that if I decide to have chemotherapy I might be able to receive it either at home or at the Hebden Bridge Health Centre?

5. Postponing the chemo to try other ways: I am seriously debating whether to have chemotherapy. How much is the cancer likely to progress within 3 months if I decide to try other means to treat it? (Including, for example, a further visit to the Bristol Cancer Centre). Would it be possible to have MRI/CT scans in 3 months time to monitor the situation?

6. Treatment elsewhere. Along with my partner, and some of my friends and family, I am well used to the rigours of academic inquiry. Using our critical faculties and trying to avoid clouding our judgement with wishful thinking, we have of course been looking at the work of other medical centres. Is there anything you can tell us about possible, pioneering work elsewhere, eg, the Leonardis Clinic in Germany.

7. Bowel inflammation – ever since my bowel operations in January-February 2005, I have had a regular, extremely painful and uncomfortable bouts of severe acidic defecation. It was seeing the inflammation from this that spurred Mr S into organising a scan and colonoscopy. I still have had no explanation for this, or suggestions for treatment.

Comments and thoughts most welcome.