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Anal Cancer: The Point of No Return

Part 4 in the Blog Series "Anal Cancer: A Gay Man's Nightmare"

November 8, 2013

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The tissue around the colostomy entrance has also swollen up, a bit like a hernia, so that will probably need to be surgically fixed too but the wound at the back is almost healed up and very little fluid escapes these days. The swollen ankles and feet are almost back to normal and one or two worries about diarrhoea, urinary tract infections and other almost unavoidable discomforts, are causing him less worries than they might have done a month or two ago. It has been a traumatic year, added to three traumatic years before that but his strength of character is seeing him through and he's cautiously looking more optimistically towards the future and what he might do. As yet, it's too early to really plan ahead but the signs are looking good.

I should point out the vital role his partner Martin played at that point. When John arrived at his temporary home in Martin's parents' house (their own house has four flights of stairs -- that was impossible at that point), the in-laws were away and Martin had to take over John's care. This sounds like a sort of given but it was far from that.

Nobody has cancer alone. Their families, partners and friends go through the process too. They don't suffer in the same way physically but they do go through their own traumas and sleepless nights and that can be a fraught and difficult process. The patient may be angry or emotional at what's happened to them. They may also have been fiercely independent, pre-cancer people and relying on others may come very difficult to them. They may have held the reins in the household; done the shopping, cooked, been handymen or women and generally been proud of fulfilling that role in the relationship. All of the above applied to John and Martin. They were used to fulfilling their relationship tasks in their own way. They'd never imagined that this sort of dependency situation would arise but it did and it was a problem.

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Martin had of course lived through the previous cancers too and had some experience in having to assume responsibilities he wasn't used to but this anal cancer was a whole new ball game. He was naturally terrified that he was going to lose his partner and that in itself causes breakdowns and frictions in a lot of relationships. Some people just can't cope with it. Martin surprised himself I think, in how he rose to the challenge. When he realised he had to care for John in a real physical sense, for however short a period, it hit him like a sledge hammer. Remember, this meant changing dressings for a really ugly wound, bathing and cleaning where necessary, cooking, cleaning, shopping, running errands and generally running the house. A nurse did come round fairly regularly to do certain things but mostly it was left to Martin to take over. That he did exactly that is a tribute to his maturity. John sent me a mail at the end of June:

Martin has got all his priorities sorted out now. Today began well and I really can't or won't complain. He's thrown himself into looking after the wound and we don't need the nurse to do that anymore. I'm so glad he isn't "freaked out" by the whole thing and is just concerned for my welfare.

Of course they had their "off" days (especially John) when one or the other was feeling low, or depressed or just plain tired and that is to be expected but I know John was both relieved and surprised that Martin did such a great job.

He's had such a lot to put up with from me the last few months and I never could have expected him to react so well. I'm grateful, it's made life so much easier.

All-in all, although you would never wish one cancer, never mind three, on anyone, it seems to have made their relationship even stronger than it was before. If ever the saying "strength through adversity" was true, it has certainly applied to John and Martin.

This article is not so much about cancer and gay men, or even anal cancer; much more information on those specific problems can be found by following the links. It's meant to show readers what it means for real people to go through these things. By using my oldest friend as an example, I hope it has put some meat on the bones of dry medical facts and made people aware that cancer is a life-changing event.

For people living with HIV and LGBT people in general, it may be wise to read up a little on how anal cancer can be avoided if it stems from HPV and other sexually related causes. It's certainly a growing problem amongst the LGBT community as a whole and the HIV and male community in particular. Men and women are living longer with HIV and many cancers are more likely to appear the older you get. Knowledge is power and being aware of what anal cancer can involve may just help you avoid it.

In the meantime, John and Martin are doing well. Slowly but surely, they're coming to terms with living with the fallout of this cancer. There are no guarantees in life but there are options and they've taught me that you have to make the best of the cards you're dealt -- what's the point otherwise!

Much more, important information can be found here:

Send Dave an email.

Read Dave's blog HIV, Neuropathy and More: Avoiding Becoming a Nervous Wreck.

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Reader Comments:

Comment by: Gerd (Dortmund, Germany) Thu., Dec. 19, 2013 at 2:32 pm EST
I didn't really want to read this, or the other three parts but I'd lost a friend to cancer recently and I just couldn't leave it alone. I'm so glad I read it in the end because it became a sort of catharsis for all the stopped up feelings I'd had when my friend died. I really hope other people who don't have cancer will read it and take the hints that they should do everything they can to avoid it happening to them. Especially gay people who already have HPV need to get checked up as soon as possible. You've done a great job here telling other people's real stories. It beats the hell out of reading it up in a text book. Thank you.
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Comment by: Sarah Dees (St. Petersburg, Florida) Mon., Nov. 11, 2013 at 7:54 pm EST
Excellent articles by Dave Richardson.
These articles are important because anal cancer patients have to be able to overcome the stigma of humiliation to reach out and get the help they need, whether they are male or female, gay or straight. I was lucky enough to make it and I have been cancer free since 2007. I admit it, I still tell people I had colorectal cancer, not rectal or anal cancer, because it's so hard to say that. And cancer is not over, even if you are supposedly well, or cancer free. It is never over. The side effects of treatment, the financial devastation I've gone through, the sexual side effects that happened that now make it impossible for me to be a normal woman any more. We are always told we have to get used to our "new normal" although nothing is ever really normal any more.

I feel for Dave's friends. What a hard and lonely road to travel. I wanted other people to understand what I was going through. I think these articles did a great job of sharing that experience. The part about how you are treated by medical people is so true. I know they have to be clinical, but certain doctors really do forget to treat you like a person and the humiliating, mortifying things you have to go through can be just awful. Yes, you have to adjust to it. Any sense of modesty about your body is the first thing they throw out the window.
 
I was ashamed and embarrassed during my treatment, so I was not able to reach out for help that would have made things better for me. I didn't get support. I hid out and remained isolated. Over time, my attitude has changed. I have done a lot of advocacy for cancer causes.
I will be sharing a version of these articles (with permission) in my feature in an online magazine.
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Replies to this comment:
Comment by: Dave R (Amsterdam) Wed., Nov. 13, 2013 at 3:29 am EST
Thank you so much for your comment Sarah and for reminding us that the loss of self, especially sexual self, is one of the most underestimated side effects of cancer and its treatments. I would encourage people to visit your site at http://www.examiner.com/cancer-advocacy-in-tampa-bay/sarah-dees and see the great work that you do for people living with cancer.


Comment by: Williams Moi (uganda) Sat., Nov. 9, 2013 at 2:47 am EST
i have today visited your blog during and HIV training in ADISABABA ETHIOPIA
THANKS
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Comment by: Jennifer Coltrane (Miami, Florida) Fri., Nov. 8, 2013 at 3:00 pm EST
I've just read this last part of the cancer story and had to go back and read the first three parts again to remind myself what a horrible time this must have been for this guy and his partner. I don't normally cry at stories like this but was moved to tears anyway. I lost a friend to cancer some years ago and this brought back how helpless you feel when you watch someone go through it. I'm not gay but I have HIV and I just hope lots of young men read this and decide to pay more attention to the health of their anus. If it's avoidable, men should do everything they can to avoid anal cancer but I don't suppose they'll take much notice anyway. Hopefully someone will make them read this story and make them think a bit more about what they do.
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