Having been reassured by everyone that I might just need 'a bit of radiotherapy' we went along to see the ENT consultant on 6th Feb. After checking my throat was healing well (which it was) the registrar brought in the oncology consultant. After two room changes (not enough rooms, apparently) we ended up in a treatment room, where the oncology consultant proceeded to scare us to death with stories of side effects, tooth extraction, complications, etc. He was very nice, very supporting and brutally 'worst case' honest about what would happen next. For us, the shock (and I actually went into shock a little and had to lay down) was the contrast between the casual assessment given previously and the dire predictions we were now hearing. No change to the prognosis, still good, so at least long term I was still likely to be OK, but only after a 6 week combined chemo/radiotherapy course. I had even been told previously that there would definitely not be any chemo, so all in all a very shocking half an hour for us. Subsequently we have realized that we were being given the very worst case in every respect, as he ticked off the risks he had to outline to us.
What was a bit upsetting was the need to have a PEG feeding tube installed - this is a small tube inserted through the abdomen directly into the stomach, which allows direct feeding of people who are unable to eat or drink. Addenbrookes install these for anyone undergoing radiotherapy on the throat, as hardly anyone manages to eat properly throughout the treatment, and maintaining my weight will be very important not just from a general health point of view, but also to ensure that the treatment remains correctly calibrated. Whilst I know it is the right thing to do, and rationally I know I'll be fine once it's in and I get used to it, the thought of it makes me pretty apprehensive.
Once we'd calmed down we were sent to the dental department to have my teeth assessed. Apparently any dodgy teeth have to be removed due to the risk of dental complications (which can then cause the jaw bone to die and shed through the skin!). Sadly we just missed the x-ray department before they went to lunch, so we had to wait an hour for them to get back, then quite a lot longer for our notes to arrive and our slot to come along. The first step was the x-ray, for which I stood with my head on a little ledge whilst a small x-ray machine rotated around me. I then went to wait some more, and was eventually called through to talk to a very nice consultant who told me I had excellent dentition and hence had no work to be done. He prescribed me with a lifetime supply of extra-strong toothpaste and told me to use it in perpetuity. What a relief, one fewer thing to deal with :)
We went home, and awaited the next appointment. We had been told I would have an immobility mask made, a CT scan done and the treatment schedule provided over the coming few weeks, along with the dreaded PEG insertion, after which treatment would start and run for 6 weeks, after which I would take anything from a few weeks to a few months to recover somewhat.
So home we went, emotionally drained and somewhat apprehensive, but still happy that the prognosis remained good so it would all be worth it.
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