June 27, 2011

Short-term bum

I learnt something in high-school biology that has shaped all my subsequent thinking about the human body. It was this: the body can be thought of, quite simply, as a series of bags and tunnels.

The biggest of the tunnels runs right through your body, it starts at your mouth and ends at your bot-bot.

When things go wrong with this tunnel new openings are sometimes needed. Just like roadworks taking place in a city, major thoroughfares in the body can be blocked, bypassed, detoured or closed down for service.

My upcoming surgery goes by the acronym ULAR, but I prefer the term Ooh-la

The Ooh-la will remove parts of the colon and rectum affected by the tumour and then re-attach healthy bits (colon, it seems, is quite stretchy and can be pulled down to meet what will be left of my rectum).

As any good surgeon or plumber will tell you – where you have cracks and joins, you have leaks. To help the new join between my colon and rectum heal as quickly as possible after surgery, the whole area will need a break from the stress of handling poo.

Early exit coming up
Diversion + Ostomy = Diverting ostomy

In addition to the Ooh-la then, I need an ileostomy. The 'ostomy' means that some of my insides will actually end up outside. The 'ile' comes from the name of the inside bit that will end up outside, the ileum.

The ileum is small intestine and connects to the large intestine. During my surgery, the ileum will be (1) pulled through a tailor-made hole in my abdomen, (2) partially cut (like a fat sausage) and then (3) sewn to my skin. Ta-da, new place for poo to come out!

Ben, meet Abdo-Bum

The ileum + hole in abdomen + place for poo to come out is called a stoma. You can also have stomas that are made from colon (colostomy) or that allow urine to leave your body (urostomy).

The idea is to keep Abdo-Bum for 4 to 12 weeks, just long enough to let my newly joined colon-rectum heal and handle poo. Then this hole thing will be reversed.

Final fact

I will still get to use my original bum while Abdo-Bum is around because the colon will be collecting cells and producing mucous that will need to leave my body.

An ileostomy in five steps

June 24, 2011

From Oz with love

Dr Oz has had two polyps removed from his colon in the space of a year, one of them precancerous. He recently wrote about it in TIME magazine. I mean, this is Dr Oz - former cardiac surgeon and health and fitness nut!

He makes the outstanding point that bowel cancer can appear in healthy people too (ie. Oz and me).

You do not need to be a 190 kilo balloon who exclusively eats fries and steak shakes to contract this cancer.

Don't be scared, just be mindful.

Photograph by Marco Grob for TIME

June 23, 2011


I have been comfortable with poo ever since I realised that playing with it was a big part of a zoologist's life.

Giant panda poo
You can tell a lot from animal poo. Scientists use poo to work out where an animal has been, what time it was there, what it recently ate, if it is ready to mate, has mated, or is pregnant, if it is stressed, if it's a male or female, how old it is, and how related it is to the animal next door.

For some animals you see their poo more than you see them. I once met a PhD student in China studying giant pandas who had only seen one giant panda in three years of looking, and even then he had had to use a secret video camera at night, and only ended up with a picture of its leg.

Luckily giant pandas produce a lot of poo and are known to excrete up to 120 green balls of shredded bamboo every day. To describe the shape, size, colour and moisture content of the enormous amount of poo produced by giant pandas, and all the other species that make poo, classification systems are needed. We are no different.

Classifying our poo

The Bristol Stool Chart is the medical equivalent of zoological guides for identifying non-human animal poo.

The different Types look different because they have spent differing amounts of time in the colon. The colon's main job is to absorb water and some minerals from poo, so the wetter and less formed the poo the less time it has spent in the colon.

During chemoradiotherapy I sometimes went from Type 2 to 5 to 1, in a single day.

Now this chart is of particular relevance to me because very soon I am going to have my colon drastically shortened, and even more interestingly, I am going to have a procedure done that means what is left of my colon will be temporarily bypassed, completely.

Remember what I said about runnier poo spending less time in the colon? Imagine what poo that has spent no time in the colon looks like.

Got the image? My work here is done.

Tricks like this can only be performed by poo after travelling through the colon

June 16, 2011

I'm an endangered species

From an early age I respected animals and felt a need to protect them. I took conservation subjects at university, I stopped eating animals, I stopped buying leather. I went to work for the government department charged with protecting Australia's wildlife. Then I went to help the Chinese look after some of their endangered species.

And then I became an endangered species

Now I get to apply all the conservation knowledge I learnt to myself. Radiation therapy is like using pesticides to control noxious plants in the immediate area. Chemotherapy is like sending in rangers to look for hidden poachers. Cutting the tumour away is like building a fence and removing predators. Herbs and supplements are like nourishment for damaged ecosystems.

Classifying threat levels

The Red List is the predominant classification system used to work out how threatened animals are. It was developed and is kept up-to-date by the IUCN (International Union for Conservation of Nature).

There are a bunch of classification levels, from Critically Endangered (think pig-tailed langur) to Least Concern (think red kangaroo). The system considers how many animals remain on Earth, current threats, and whether the population is decreasing or increasing.

Once an animal has been identified as being of conservation concern, people begin trying to save it. The one rule in conservation planning is that you need a number of different protection strategies, because ecosystems are complicated and no animal or plant lives in isolation.

My conservation plan

I was listed on the Red List on 7 January 2011. My plan is no different from those designed to save species, except mine is selfishly devoted to saving just one critter: me.

A major thing I learnt from my scientific training is that no two ecosystems are the same. Something that works in one area may not work in another. One cancer treatment that worked for your Uncle Tom, may not work for me.

Cancer is a systemic disease that is likely to have different causes in different people. My conservation strategies include addressing the anatomical, psychological, spiritual, nutritional, immunological and physiological aspects of my cancer.

All good plans should set a time frame for action. My goal is to be re-listed from Critically Endangered to Least Concern by January 7 2012 (exactly one year after my diagnosis).

This sign appeared on my bedroom door shortly after listing.

June 14, 2011

Think cancer

I have cancer and sometimes this seems to be the only thing I can think about. I know people often say sometimes they can only think about one particular thing, but cancer is one of the biggest particular things you can ever have to think about. When I think about cancer I think about losing organs, shitting in bags, pissing down pipes, of giant scars and risk factors. I think of side effects and medicines and alternative medicines. I think of dying, living and somewhere in between.

At the time of writing this I am thinking about cancer a lot. I think I am thinking about it so much because of other stressful things going on in my life: I got a parking fine, a borrowed car was almost towed, I spent an hour in the welfare office, I yelled at Sana, I was told I looked like crap by my Chinese doctor, house hunting and then moving, eating right, drinking right, meditating right, exercising right, family members fighting.

Sometimes I feel as though I am facing all these things on my own. And then I remember that I am never really on my own because Cancer is with me every step of the way.

I have cancer, not a paper cut

I recently read an opinion piece in the New York Times about some of the things people who aren't sick say to people who are.

You should read the article, but here is a summary of what the author disliked and why.

1. "What can I do to help?" This puts the burden back on the person with cancer to come up with something.

2. "My thoughts are prayers are with you." Overused.

3. "Did you try the mango colonic I recommended?" Something that saved your Uncle Tom won't work on me.

4. "Everything will be okay." You're not a doctor or fortune teller.

5. "How are we today?" I'm an adult, speak to me like one.

6. "You look great." Leave the idea of how we think we look to us.

I had mixed feelings about this article. I also shudder when people say 1 and 2. I haven't experienced 5. And I don't have a problem with 3 and 6 because I like hearing things people have tried, and because I worked out from an early age that I was easy on the eye.

Then there is Number Four

Number Four is an interesting one. I feel there is a real role for this kind of blind optimism - it balances the statistics and raw truths you hear from specialists. It restores that sense of "Yeah, maybe everything can be alright in the end". Hearing this phrase can pull you out of a funk, put a bounce in your step or bring a smile to your face.

I began incorporating positive affirmations into my daily life almost immediately after my diagnosis. Little signs in my house can be found exclaiming 'Each day I am stronger' and 'I heal quickly and without complications'. I treat Number Four as a sort of unsolicited positive affirmation.

It wasn't always that way

At the beginning I would burn on the inside when people said Number Four, especially if earlier they had had to check with me what type of cancer I had (You've got stomach cancer right?). I saw red when hit with what I felt were completely unfounded and unintelligent assessments of my complicated cancer.

I would smile, but inside yell: I have C-A-N-C-E-R, not a paper cut!

I now understand that when people say Number Four they don't actually know, but they are hoping - and that is a damn nice thing to hear. They want you to be okay. They want you to be alright. They want you around in 12 months time.

While I am not personally comfortable saying Number Four to people who have cancer, I do like it when people say it to me. So keep it up.

Just ask someone what they like people to say and say it.

June 8, 2011

Taoism, training and cancer

While my feet have been busy walking up and down Taoist mountains in central China, Brock's feet have been busy pounding treadmills at his local gym.

June 1, 2011

I'm trendy

According to the newspaper The West Australian I'm part of a trend and may not be that special after all.

"More young Australians than ever are battling bowel cancer, new data has found.
Recent rising international figures prompted The Australian Institute of Health and Welfare to investigate local bowel cancer rates.
The figures, released on Wednesday, found incidences of bowel cancer among all age groups had increased.
But colorectal surgeon Professor Graham Newstead said the number of people under 35 with the disease was "extraordinarily high"."

The article goes on to make an excellent point

"In the younger people, they are not only getting a huge increase in the incidence, but they're dying," Prof Newstead told AAP.
Over the research period, bowel cancer deaths claiming young women aged between 20 and 34 had doubled.
In their male counterparts, fatalities had risen by almost 25 per cent.
"They're dying because they present late and they present late because, if you're 30 years of age, you've got a bit of bleeding your GP is likely to say: `Probably haemorrhoids, don't worry about it'," Prof Newstead said."

The article then goes to make a totally crap point
"Prof Newstead couldn't explain why bowel cancer was on the rise, but said it could be linked to the modern diet "filled with hormones and this and that". 

That's sloppy science communication and does nothing to inform the reader. Are they talking about animal hormones? Plant hormones? My hormones?! What is This and what is That? Actually I think I saw That on a menu once but didn't order it because it was yellow.

I've personally never come across any information suggesting a link between hormones (mine, yours or those from plants and animal species) and colorectal cancer, plus, I have been mostly vegetarian for 6 years.

Is this That?

Sigmoid Sling

There's only one thing I like more than a party, and that is being the center of attention at a party.

I decided to throw a "Help me kick Ass Cancer" party at a local bar in the hutongs of Beijing. The owners of the bar are artists of alcohol and so I set them a challenge: combine as many cancer fighting ingredients as possible and then add alcohol. I suggested something based around pomegranate juice as some studies indicate it may have anti-cancer properties, especially for colorectal cancer.

The Sigmoid Sling

According to Wikipedia: "The Sigmoid Sling is a type of Sling cocktail made from anti-angiogenesis and anti-inflammatory ingredients such as pomegranate juice, apple juice, ginger and cucumber mixed with alcohol. This popular drink was named by Ian Black and first memorialized in 2011 by "high-profile cancer sufferer" Ben Bravery. This "colon-cancer fighting" drink typically is served in a Collins glass over ice."

The bigger picture

I figured a lot of people would come because I was playing the C card, and because I was offering free Sigmoid Slings, so I decided to turn the event into a fundraising opportunity.

My Canadian caller, Brock, has never met me but is going to run 10 km in my name and in his underwear to raise money and awareness for colorectal cancer.

To encourage people to donate I made a paper mâché bum and dressed it in a pair of my underwear. The collection bum worked very well and we were able to raise over 5500 Chinese Yuan, or 850 Canadian Dollars!

The drink lives on

The owners of Mao Mao Chongs, where I held the party, have decided to put the Sigmoid Sling on their menu and donate all profits from this drink to cancer research! Stephen and Stephanie, you guys are fantastic.