“Be strong and courageous. Do not be afraid or terrified because of them, for the Lord your God goes with you; he will never leave you nor forsake you.” (Deuteronomy 31:6)
So, on 16th October 2016, at around 10am, I booked into Umhlanga Hospital for my first nuclear treatment. I was shown to a private room and usual checks were made blood tests, BP etc. before a Sister inserted two intravenous catheter lines, one on each arm above the wrist.
To protect the kidneys from too much radiation, a total of four bags of amino acids are first inserted intravenously, and also anti-nausea medication. The nuclear material is flown down from Johannesburg on the day of the treatment and arrives at the hospital around 1pm. This is Lutetium 177 (Lu-177) dotatate and when injected into the bloodstream, (usually over a 30-minute period), it binds to protein receptors called somatostatin receptors, located on NET cells, and delivers high doses of radiation to the tumour. Because it’s a systemic treatment, PRRT targets NETs with somatostatin receptors anywhere in the body. Unlike a treatment such as chemotherapy, which is systemic therapy and has an impact on the entire body, Lu-177 dotatate is a highly directed therapy. For this reason, it has few side effects.
Following the treatment, I was sent to have a series of scans to look at uptake of the radioactive material. These scans were repeated the following day, morning and evening and also on the morning of the third day. I was discharged from hospital around lunchtime on the third day. I was given the following protocol to observe:
Always flush the toilet twice after use for one week after the treatment
Refrain from all contact with young children and pregnant women for 3 days
Restrict close contact with other adults for 3 days
Avoid sharing a bed with another person for 3 days
Apart from some fatigue, I experienced little discomfort from the process.
I continued with the remaining three treatments in January, April and July 2017 which went much the same as the first, although towards the end, and particularly after the fourth treatment, I was really fatigued (I remember that the simple exercise of hanging washing on the line reduced me to lying on the couch from exhaustion).
At the end of the programme, on the 31st August 2017, I again had a Gallium 68 Nuclear scan this time in Durban, to determine the impact of the PRRT treatment; in summary the results showed that there had been complete response in the transverse process of C2, left lower lobe lung nodule, and left mesenteric lymph node anterior to D3 of duodenum. There had also been partial response in the left adrenal gland and pre-aortic lymph node.
This was good news indeed.
What was not comfortable news however was that by this time, it was evident that the hernia repair operation had failed, as a result of the mesh infection, and that my abdominal hernia had reappeared. I was not happy to continue of this basis, and decided to revisit Prof. Botha to see whether he could repair the hernia once and for all, and at the same time look to see if he could surgically remove any of the remaining tumours.
My appointment with Prof Botha was scheduled for Wednesday 25th October 2017, so Colleen and I drove up to Johannesburg on the Monday and Pauline and Mike were king enough to let us stay with them at their home in Chartwell, until the Saturday when we returned to Kloof.
My experience with Neuroendocrine Cancer 