HCCA Health Care Consumers Association

Garpets Goodies

Recently, having finished my treatment at TCH (otherwise known as The Canberra Hospital) I somehow managed to find some literature about an organisation called the HCCA.Being a health care consumer I have to say that I found the idea that there was an organisation which would actually represent people like me most interesting. In my inimitable fashion I made some 'discreet local inquiries' and found out that this organisation has its offices in Pearce and that some of the people who I have 'met' or at least communicated with during the period that I have been ill were not only members, but important members.

As there was a committee that was looking at management information pertaining to the LINAC (linear accellerators) and in need of a consumer representative I thought I would make further inquiries to see whether what I had to offer might meet some of the needs.

As you would expect from any community organisation I was immediately told that there was a process by means of which I could apply and that this would be considered in due course by the relevant committees that undertook such work. I was also advised that there was a series of training days that I would be required to attend and presumably pass in order to be even considered suitable for being a consumer representative.

I was impressed.

I undertook to apply for membership, pay my membership fees and lodge an application to become a member of this committee looking at LINAC related matters.

So far I have had the pleasure of meeting with three of the main movers and shakers in this organistion and some of the staff who have been more than cordial and welcoming.

In return for their generosity in putting up with someone who still is unable to talk I have also joined their discussion group on Yahoo and tried as hard as I could to be of some assistance with their web site and with looking at their computer related services.

I hope to be able to be even more useful over time. Meanwhile I have placed a number of issues on to the discussion group and have taken the liberty of posting a few files on to the site so that Oesophageal Cancer actually is given a heads up opportunity among all of the more well known cancers in the community.

Among other things I have suggested that perhaps a support group for people suffering from this form of cancer could be useful and have urged people who are members of the list to let me know if there was any interest in starting such a group.

It's early days so I am not too disappointed by the fact that so far I have not had a response to this matter.

I have however had some very positive responses to some suggestions I have made about paid parking at the hospital.

If there are others out there who are readers of my blog that want to know more about the HCCA either because they themselves are comsumers of health services in the ACT or are carers for someone who is a consumer, then I would be happy to assist them to make a call to the HCCA and consider becming a member. It seems to me that the more people in the ACT who join an organisation like this the more powerful its voice can become in providing feedback from a consumer perspective to the ACT government and to the management of the various health providers in this community.

If you want to know more just drop me a line or better yet look up:
http://www.hcca.org.au/

29th August

Pete's Points It's all very well to attend a speech therapist or pathologist as they are known over here but unless there is a very clear idea of exactly what is going on in the throat it is very difficult to prescribe treatment.

At my meeting with my therapist today we agreed that the best thing to do would be to have an ENT specialist look at what is going on in my throat and then on the basis of the information obtained look at options, risks and benefits.

There is a guess that has been made about why I suddenly managed to recover my voice for day and a half and this seems to involve some inflammation of tissues next to the immobile vocal chord that maneuvered it into a different position so that the vocal chord that was able to move was closer to it and so able to create normal sounds. As the inflammation ceased so the chords once again moved apart and voila no more clear speech again.

One of the possibilities that has been discussed with me might involve the injection of material next to the immobile chord such that it moves back into the parallel position again. While this would in all likelihood restore the voice it would have a major downside which is that when I was exerting myself with heavy exercise for example I would in all likelihood not be able to obtain sufficient oxygen and so would struggle for breath.

An interesting conundrum - so I want to breathe or would I prefer to talk. For someone who in the past has been accused of being able to talk underwater this is a whole new ball game.

There is no point in jumping the gun so let's just wait and see what the ENT specialist has to say on the subject. I have managed to get an appointment on September 5th which is really excellent going considering how full the schedules of these specialists are. So I expect that there will be an initial consultation followed by some more exhaustive examination and then consideration of options that arise from that.

I will of course keep people in touch with what is happening.

In the interim I have finally picked up a copy of my blood test and it seems that I am able to enter into the company of people again (albeit quietly) so for those who have wanted to have a coffee or "do lunch" now is the time to let me know when you are available and I will look at my extremely busy social calendar ;-) and make a time to meet.

Give me a call or alternately drop me an email.

While all of this is going on I can of course refer people to the HCCA web site and to the HCCA group on Yahoo where there is some activity about Cancer related issues happening. Not least of these concerns the pay parking at the various hospitals around here and of course another call to form a support group for people with Oesophageal Cancer and their carers.

Improved Prognosis of Resected Esophageal Cancer.

From Pub Med

Stein HJ, Siewert JR.
Chirurgische Klinik und Poliklinik, Klinikum Rechts der Isar, Technische Universitat,
Ismaningerstrasse 22, D-81675, Munchen, Germany.

Because of the perceived high risk of esophagectomy and the assumed poor long-term
results, the role of surgical resection as the mainstay of treatment for localized esophageal
cancer is currently being challenged. Early tumors are increasingly approached by
endoscopic mucosectomy or mucosal ablation techniques, whereas combined
radiochemotherapy without surgery has become the treatment of choice for locally advanced
tumors at many institutions. Several recent reports and our experience, however, indicate
that surgical resection of esophageal cancer has become a safe procedure and long-term
survival rates after surgical resection have improved markedly during the past two decades.
A number of factors have been associated with the marked reduction in postoperative
mortality and improved long-term survival after surgical resection. They include changes in
the epidemiology with an increased rate of adenocarcinoma mostly located distally, patient
selection for surgery, improvements in surgical technique and perioperative management,
and the use of neoadjuvant treatment protocols. The treatment strategy and extent of the
surgical procedure can now be tailored based on histologic tumor type, tumor location,
tumor stage, and the general condition of the patient. With an individualized approach,
surgical resection of esophageal cancer can predictably offer cure. Surgical resection thus
remains the major pillar in the successful treatment of esophageal cancer.

Do Canberrans need education and support?

Pete's Points

Oesophageal Cancer - Do Canberrans need education and support?

Twenty years ago almost all oesophageal cancers were "squamous cell carcinomas" arising in the upper third of oesophagus or gullet. The risk of squamous cell carcinoma is almost entirely explained by tobacco and alcohol consumption.

In the late 1980s it became apparent that many developed countries were experiencing an increase in "adenocarcinoma" of the oesophagus. These cancers arise in the lower third of the oesophagus, that is, near the stomach, and are not related to smoking or alcohol. Instead, they are related to obesity and gastro-oesophageal reflux (acids coming up the gullet).

Adenocarcinoma of the oesophagus is not a common cancer, but its sharp rate of increase, related to the increasing levels of obesity in our community may mean that this cancer becomes an ever more important and prevalent one in the next few years.

Oesophageal cancer is renowned for poor survival. Less than 20% of patients are alive five years after diagnosis.

In Canberra, we are fortunate to have some gastroenterologists, surgeons and oncologists who are very familiar with this disease and are expert in its treatment.

What we do not have, is a support group for the patients and for their carers.

Should there be one to help spread the message about this disease and its impacts and provide support for those people who are afflicted?

The sharp increase suggests that we should. Because of the small numbers of people afflicted, this group should then join up with support groups in Victoria and NSW and share information for the mutual benefit of all.

An article of interest perhaps

Acid Reflux to Esophageal Cancer Mechanism, Revealed

By Gloria Gamat | Related entries in on esophageal cancer

According to a new study published in the Journal of Biological Chemistry, a particular enzyme called NOX5-S is significantly higher in cancer cells that have been exposed to acid, leading to the overproduction of hydrogen peroxide: a possible explanation for how acid reflux may lead to cancer of the esophagus.

Quackwatch

It may be of interest to my readers to have a look at Quackwatch

The Mission Statement of this site is provided for information.

Mission Statement

Stephen Barrett, M.D.

Quackwatch, Inc., which was a member of Consumer Federation of America from 1973 through 2003, is a nonprofit corporation whose purpose is to combat health-related frauds, myths, fads, fallacies, and misconduct. Its primary focus is on quackery-related information that is difficult or impossible to get elsewhere. Founded by Dr. Stephen Barrett in 1969 as the Lehigh Valley Committee Against Health Fraud, it was incorporated in 1970. In 1997, it assumed its current name and began developing a worldwide network of volunteers and expert advisors. Our activities include:

• Investigating questionable claims
• Answering inquiries about products and services
• Advising quackery victims
• Distributing reliable publications
• Debuking pseudoscientific claims
• Reporting and illegal marketing
• Assisting or generating consumer-protection lawsuits
• Improving the quality of health information on the Internet
• Attacking misleading advertising on the Internet

Just a quick note

Managed to get the blood results over the phone. I seem to need either leafy green vegetables or red meat or an iron tablet. It appears that my haemoglobin is low. Still none of the other results I am told are at serious variation from the norm so it appears that I can finally focus fully on the vocal issues and once again be in a position to have a coffee with people. However I do issue a warning about this on my other BLOG, Pete's Place

It appears that we may have to beware the fun(gi) in coffee!

25th August

Pete's Points
Went to see the doctor yesterday and had one of those days that you really want to forget about after you had it.

Let's start at the beginning.

First there is the wonderful opportunity to enjoy circling one or more of the parking areas waiting for a spot on a rainy day and cursing as the time passes and the opportunity to find something close to the Radiation Oncology Unit so you can walk there in the pouring rain and NOT be late for your appointment becomes almost like a search for the holy grail.

Then when you get a spot eventually the "pay and display" opportunities mean that as you start to feed in your coins you discover that by the time you have paid for the time which you assume your appointment will take AND added a safety margin, you have in your hand what amounts to an all day parking ticket!

That is annoying enough!

Then when you get in to see the doctor, the poor thing is almost run off her feet and running late. Patients like me sit in the waiting room feeling comfortable knowing they have secured their parking spots while others seem to squirm in their seats as each minute passes knowing that they have not.

Finally when I got to see my doctor she asked how I was faring. I described my circumstances as best I could indicating that the treatment for the radiation burns that had been suggested - namely some zinc and castor oil cream had actually produced a negative reaction in my case and seemed responsible for causing an open wound rather than solve the problem. I was advised that at least one other patient had enjoyed a similar experience. My solution - namely cleaning the area and then applying an antiseptic powder with the result that the wound is healing in the normal manner brought a smile to her lips. Following an examination I was told that the area looked to be recovering well. I then advised about the issue with the nasal bleeding and was afforded the opportunity to have a scope shoved up my nostrils and eventually down into the throat and past the larynx. Even with a local anaesthetic spray that numbs the various areas and tastes bloody awful I can assure you that having that little tube shoved into those spaces is less than comfortable!

Suffice it say that she noted that I was red raw and that I needed to use something to start a healing process inside the are. A pseudo ephedrine spray as a vaso constrictor was suggested, or if that was unavailable a pill but taken at half dose. She also noted that my larynx was apparently pushed to one side as a result of the operation perhaps. I asked that this be reported to the speech pathologist so that she would have more work than expected.

Having finished with this examination and suggestions for treatment I let and only afterwards remembered that I really did want to find out the results of the blood test. Ah well a phone call will do today!

Meanwhile I went back to the parking lot and found more people circling still looking for spaces - so I gave my spot and my parking ticket with plenty of time left on it to the next poor sod who was tearing his hair out as he was late for his appointment.

Then off to the pharmacy where I was able to obtain the pills only and finally a real saline nasal spray.

Together these should resolve the sinus problem.

The lack of voice remains - next week will start to solve that mystery.

I hope the blood tests were OK - will find out and advise when I get the news.

23 August - Some surprises

I am actually flabbergasted about recent events.

I had a really bad night the other night.

To start off with, my sinuses were clogged up again and I had to fight to breathe. Used the suggestion from my doctor about spraying some saline up the nasal passages to clear the blockage and found that useful if somewhat time consuming. I have noted that dried blood seems to be the cause of the blockage. I put this down to the fact that the heating in the house dries the air and so gives me a condition that I reported on in an earlier bulletin.

Since this situation is literally keeping me up nights I have tried to turn the heating down and then finally off. To no avail - the condition persists.

So I will be mentioning this at the next doctors visit and we will see whether a referral to an ENT specialist is indicated and whether this will reveal something more.

I also experienced one of those now rare attacks of reflux that resulted in my having to cough somewhat violently for some time to clear some obstruction. When you can not breathe and have reflux to boot I can assure you that getting those airways clear is a matter of life and death - or at least feels like it.

Having finally managed to clear the various passages I found to my incredible surprise that I could once again talk normally!

What? Yeah, normally. No straining, no blocked sinuses, real vocalisation. I tried out the range of this amazing discovery and found I could without effort actually manage at least one or two full octaves of pure sound.

Amazing!

What is even more surprising is that the condition persisted for around 12 hours before once again disappearing.

Now I have NO idea what happened or why, but for obvious reasons I want it back.

I will be asking both my doctors and the speech therapist what the hell is going on. I am just hopeful that they tell me the good news that they now know how to get my voice back. I am of course fearful that they have find a reason for the blocked sinuses and that the reason is not good news!

Still there is no point in hiding - I have to know what is going on so that I can deal with whatever the outcome.

15 th August

Pete's Points
Attended the last of the treatment regime yesterday. I have to say that yesterday was not a good day. I felt totally out of sorts, tired and really like someone at the end of my tether.

That said, I found the staff at the hospital filled with bonhomie and helpfulness.

The radiology staff were very encouraging and even asked if I wanted to keep the mask they had been using to help direct the treatment. I have to say I declined.

If I ever want to be reminded of anything it is certainly NOT having to go into a room in which there is a linear accelerator, lie down on a narrow cot, be strapped into a tight mask and then wait slowly for the massive machine to move to its predesignated locations and beam x rays into my system!

Please do not misunderstand. There is nothing unpleasant in the treatment or indeed in the whole process per se. It is merely that having anything around that reminds one of the uncertain level of mortality with which one clings to life is not something to dwell on.

The nursing staff were even more helpful. They have now provided me with creams and bandages that can now be used since there is no further treatment envisaged, to try and alleviate the burning of the tissues that has arisen as a result of the treatment. They tell me that it will, in all likelihood get worse before it gets better and that it takes around two weeks for the skin to come back to 'normal'.

As for the white blood cells, they sort of shook their heads in amazement when I told them that there had been no follow up appointments with the chemo therapy oncologist and shook their heads even more when I told them that the follow up with the radio therapy oncologist was set for December. They intervened nicely and suggested that perhaps I should let them make an appointment for me to see her in say two weeks and by the way also get a blood test to see how those pesky drugs had impacted my immune system.

So I now have to look forward to another few weeks of waiting around until I can have the blood test and then the appointment. From there I guess I will hear the news about what next.

Meanwhile there are some other 'joys' that I have to share.

The "good news".

Thanks to the treatments the skin is likely to be highly sensitive to solar radiation for the next 12 WEEKS! In other words, forget about finally being able to get out in the sun and pretend that I am a cold blooded lizard. No soaking up the warm rays for another three months. This will of course bring us into November when it is likely that it will be too hot to go out in the sun anyway!

AAARGH!

Exercise - well there is no bad news about this at least. The pundits all suggest that after I manage to get rid of the cytotoxic waste products from the 5FU (within 48 hours for most of it) I should resume going for my walks again taking it easy to start off with and then building up to back where I was before - possibly more. As the warmer weather starts to appear I may be able to actually manage a larger walk around the big lake near home and since I am now retired this could mean joys like walking around the lake followed up with a quick coffee and snacks at the new outdoor cafes that are being built in time for the spring and summer trade.

If this comes off then I suspect I will probably have a few envious former work colleagues who may wish to join me for the coffee and cake. I suspect that most will NOT want to undertake the walk. They seem to get enough exercise walking from their computer terminals to the next ubiquitous 'meeting'.

Mind you there are a number of colleagues who were exercising and actually taking off weight before I went into treatment - hopefully encouraged by my situation not to let something similar to happen to them. I wonder if I will recognise their new svelte figures when we meet?

The voice - or lack of it! As the impact of the treatments are taking a greater hold I am finding that even the small progress I have made with being able to make sounds is slipping again. Still this may yet come good in the longer term. For those people who could not get me to shut up in my former years this will come as good news. Finally they will be able to get a word in when THEY want to and there will be nothing I can do about it.

People have simply NO idea how much motivation this provides for me to regain the use of my voice!

I have an appointment with the Speech Pathologist again in a few weeks and I have to say that she will be disappointed in me as at present I feel as sick as a dog and not really in the mood to practice my vocal tricks.

That seems to be that for the time being. I suspect that since there is no news the volume of reports will decrease unless something exciting happens.

14 August 2006 - the last day of treatment,

Pete's Points
It is not often that cancer is a cause of celebration.

Today marks another turning point in my 'adventures' with this disease. I am about to go into the hospital for the last round of treatment - both chemo and radio therapy, hopefully for the last time.

Amazingly, no one has bothered to tell me what happens from here on in. I assume that I go home and simply await the finalisation of the treatment effects and gradually recover back to where I was before the latest attack of the 'beast' took place.

It is amazing to me that there is an assumption in the medical world that the patient will understand, by osmosis perhaps, exactly what will happen now. I mean it's all very well to assume that since you are alive there is at least a remote chance that this state of affairs will continue for at least a little while. It is all very well to assume that the radiation scars will start to heal over time, that the nausea from the chemo therapy regime will dissipate in around 48 hours and that the impact of the chemicals on the body will, over the next 6 months finally be reduced to the extent that they no longer matter.

What does this MEAN? What actually happens as these radiation scars heal? What will be left? What will I look like both from the outside and more importantly from the inside?

At present I know that I have this area around the parts that are being treated that have changed colour and texture and now looks like a giant strawberry birthmark on the neck. I suppose that in different circumstances I would be able to compete with Michael Gorbachov and his birthmark. His 'feature' is not due to any radiation from Chernobyl while mine is definitely due to the impact of x rays on my neck over thirty treatments. What will be the result of the operation to remove the lymph nodes and surrounding tissue in the neck and under the collar bone and the subsequent treatment by these x rays? What will remain there? Assuming that the tissue that is left and will regenerate is likely to be very different from what was there in the first place what if any impact will this have on my life?

Already we know that as a result of the condition and the subsequent operation and treatment there is a major problem with my vocal chords and my ability to speak. We also know that there is some hope that some of this impact can be corrected with speech therapy and if that fails with other treatment. What no one tells you or perhaps CAN tell you is what the likely outcome will be and over what time frame.

Does anyone out there have some 'plan' which they can give to the patient? A sort of road map that sets out the sorts of things that they might be able to expect or at least look out for in the journey ahead?

No idea - certainly something to ask about!

One of the things that concerns me is whether or not there is some proposed regime for checking to see if there are further metastases and if so, to catch them before they grow again to a size that can seriously endanger life.

The last time that I attended a PET scan it did not show the tumour as it should have. It showed some arthritic tissues and suggested that perhaps one of the other things that I need to consider is what the heck to do about this (provided I live long enough of course) but it did not show the tumour.

Now THAT is a worry. If a PET scan does not show a large tumour then can it be used to find any new occurrence or outbreak of the cancer? Once again this is really unclear and something that needs to be raised with the doctors. Obviously by the time that a person feels that something is wrong the chances are that the problem has gone from microscopic to something a damned sight larger and hence less controllable.

So what I want to know is what are the means for screening for a recurrence this time? Will it be blood tests that are used regularly? Will it be something else? Is there nothing that can be done and we just sit back and wait for the next occurrence and then ????.

Being proactive is all very well, but there is a need to be proactive with some tools that may actually enable something useful to happen.

In other words, I suppose that today will be a day when I get to ask some of my dreary questions and then deal with the look in the eyes and faces of the staff who are the recipients of these questions and their responses.

It is a very happy day in one respect to have reached the end of the 30 treatments. On the other hand it is also a frightening time because I have no idea what is likely to happen from here on in and so far no one has actually drawn a map that at least gives you some idea of the lay of the land.

Let's see what happens and I will report back on the outcomes that may be achievable!

How unlucky can you get?

Pete's Points
And if anyone has any clue about how 'lucky' I feel in being blessed with several bouts of oesophageal cancer then all they have to do is to interrogate the cubes I have referred to in my earlier post and find the following data for my age group.

Number of new cases and age-specific rates for selected cancers by year of registration, sex and 5 year-age groups

All Registrable Cancers (except NMSC) ---------------- C00 Lip C01-C14 Head and neck C15 Oesophagus C16 Stomach C17 Small intestine C18-C21 Colorectal C22 Liver C23-C24 Gallbladder C25 Pancreas C30-C31 Nasal cavity C32 Larynx C33-C34 Trachea, bronchus and lung C37-C38 Other thoracic organs C40-C41 Bone and articular cartilage C43 Skin?melanoma C45 Mesothelioma C46 Kaposi's sarcoma C47-C49 Connective and other soft tissue C50 Breast C51-C52 Vulva and vagina C53 Cervix uteri C54-C55 Corpus uteri C56-C57 Ovary and other female genital o... C58 Placenta C60, C63 Penis and other male genital or... C61 Prostate C62 Testis C64-C66, C68 Kidney, ureter and urethra C67 Bladder C69 Eye C70-C72 Brain and other central nervous ... C73 Thyroid gland C74-C75 Other endocrine glands C76-C80, C26, C39 Unknown primary site C81-C85, C96 All lymphomas C88 Immunoproliferative neoplasms C90 Multiple myeloma C91-C95 Leukaemias ---------------- Nest Columns All Years ---------------- 1983 1984 1985 1986 1987 1988 1989 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 ---------------- Nest Rows All Sexes ---------------- Male Female ---------------- Nest Rows Nest Columns All Age Groups ---------------- 0-4 5-9 10-14 15-19 20-24 25-29 30-34 35-39 40-44 45-49 50-54 55-59 60-64 65-69 70-74 75-79 80-84 85+ ---------------- Nest Rows Nest Columns All States ---------------- Nest Rows Nest Columns

MEASURES ---------------- Number Age-specific Rate ---------------- Hide Calculated Categories as values as % of row total as % of row subtotals as % of column total as % of column subtotals as % of grand total 1983 1984 1985 1986 1987 1988 1989 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 All Years C15 Oesophagus 46 41 45 39 53 60 50 48 55 50 44 67 44 47 57 50 58 67 63 984

All Years ---------------- C15 Oesophagus Male 55-59 All States MEASURES ---------------- [+] C15 Oesophagus [+] Male [+] 55-59 [+] All States [+] MEASURES ---------------- [Hide Total] [Insert Calculation...] [Hide/Show...]

All Registrable Cancers (except NMSC) ---------------- C00 Lip C01-C14 Head and neck C15 Oesophagus C16 Stomach C17 Small intestine C18-C21 Colorectal C22 Liver C23-C24 Gallbladder C25 Pancreas C30-C31 Nasal cavity C32 Larynx C33-C34 Trachea, bronchus and lung C37-C38 Other thoracic organs C40-C41 Bone and articular cartilage C43 Skin?melanoma C45 Mesothelioma C46 Kaposi's sarcoma C47-C49 Connective and other soft tissue C50 Breast C51-C52 Vulva and vagina C53 Cervix uteri C54-C55 Corpus uteri C56-C57 Ovary and other female genital o... C58 Placenta C60, C63 Penis and other male genital or... C61 Prostate C62 Testis C64-C66, C68 Kidney, ureter and urethra C67 Bladder C69 Eye C70-C72 Brain and other central nervous ... C73 Thyroid gland C74-C75 Other endocrine glands C76-C80, C26, C39 Unknown primary site C81-C85, C96 All lymphomas C88 Immunoproliferative neoplasms C90 Multiple myeloma C91-C95 Leukaemias ---------------- All Years Male 55-59 All States MEASURES ---------------- [+] All Years [+] Male [+] 55-59 [+] All States [+] MEASURES ---------------- [Hide Total] [Hide/Show...]

There were certainly not many in my age group by 2001 but note the volume of increase in raw numbers and then as percentages since 1983. As I say in my opening lines this is a fast growing group of people, unfortunately I seem to be one of them!

News on August 12th

Garpet's Gossip

My recent treatment regime involves having to get to the hospital at 8 am to receive my chemo therapy and then wait around for four hours from the end of this treatment until I can receive the radiation therapy.

Naturally to hang about in hospital for this time is difficult in the extreme. After all what would there be to do?

• Go and sit in the library and read a good book?
• Wait in the cafeteria with those noxious chemicals running through the body and hoping that the smell of the food will not induce a bout of nausea?
• Find a nice waiting room and try and read a good book or watch the idiot box where the main shows in the morning are breakfast television apparently aimed at those who stay at home either to undertake domestic duties or enjoy the joys of retirment.
  

There are shows that are regualr serials on one free to air channel, shows that feature one of two personalities that undertake interviews, show cooking tips and of course encourage the marketing of various forms of tools that will assist those who remain at home. There are of course those wonderful adverts designed it seems to remind us all that we are mortal and that taking out life insurance for a price per week that is the equivalent of a cup of coffee these days is a great investment. This is then of course accompained by those adverts that tell us that as we get older there is a good chance that we will die and asks whether we have prepared for this event or are likely to leave our loved ones in the lurch having to pay for those really expenside funeral costs. The advgerts then of course provide its viewers with the opportunity to prepay their funeral costs and save the family the grief of haivng to find thousands of dollars at the time in their lives when they have just lst their loved one - namely YOU the person watching the show.

So the best thing to do is to call upon your lovely carer to come and pick you up and take you home. There you can be useful and prepare a nice mid-day meal and then have your carer come home for a lovely cooked meal before invoking another favour - namely that she take you back to the hospital for the radio therapy treatment.

Since in my case this involves only three days out of her busy working life I was not afraid to try it and I have to say it is working out well!

I get to feel useful and she gets a nice home cooked meal and a little time out from the stress and rush of the office.

As the food is cooking I can take it easy and do some research on the web about my favourite topic at present - namely oesophageal cancer. Well it's not really a favourite topic, but what they hey the more you know the less you have to worry about. Then again reading the data I am thinking seriously about revisiting my views on this.

For those of you who have an interest in Oesophageal Cancer you may be interested in the information that is available at http://www.aihw.gov.au/cancer/datacubes/index.cfm

The data which is provided lists various forms of cancer and the Oesophageal Cancer rates are provided at:
http://www.aihw.gov.au/cognos/cgi-bin/ppdscgi.exe?DC=Q&E=/Cancer/cancerageratesv7

For people not familiar with 'cubes' of data and their abililty to interact with the data by using the little icons on the bottom of the page to get various tables and graphs from the raw materials provided on line I would be happy to assist if called upon.

This is a fabulous if frightening resource for all Australians. I give you an example only of the sort of data that is available for information. Since the data is completely interactive it does require some knowledge of how to use "cubes" (this is something that those familiar with Cognos Powerplay Products will be able to do with ease.

Number of new cases and age-specific rates for selected cancers by year of registration, sex and 5 year-age groups

All Registrable Cancers (except NMSC) ---------------- C00 Lip C01-C14 Head and neck C15 Oesophagus C16 Stomach C17 Small intestine C18-C21 Colorectal C22 Liver C23-C24 Gallbladder C25 Pancreas C30-C31 Nasal cavity C32 Larynx C33-C34 Trachea, bronchus and lung C37-C38 Other thoracic organs C40-C41 Bone and articular cartilage C43 Skin?melanoma C45 Mesothelioma C46 Kaposi's sarcoma C47-C49 Connective and other soft tissue C50 Breast C51-C52 Vulva and vagina C53 Cervix uteri C54-C55 Corpus uteri C56-C57 Ovary and other female genital o... C58 Placenta C60, C63 Penis and other male genital or... C61 Prostate C62 Testis C64-C66, C68 Kidney, ureter and urethra C67 Bladder C69 Eye C70-C72 Brain and other central nervous ... C73 Thyroid gland C74-C75 Other endocrine glands C76-C80, C26, C39 Unknown primary site C81-C85, C96 All lymphomas C88 Immunoproliferative neoplasms C90 Multiple myeloma C91-C95 Leukaemias ---------------- Nest Columns All Years ---------------- 1983 1984 1985 1986 1987 1988 1989 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 ---------------- Nest Rows All Sexes ---------------- Male Female ---------------- Nest Rows Nest Columns All Age Groups ---------------- 0-4 5-9 10-14 15-19 20-24 25-29 30-34 35-39 40-44 45-49 50-54 55-59 60-64 65-69 70-74 75-79 80-84 85+ ---------------- Nest Rows Nest Columns All States ---------------- Nest Rows Nest Columns

MEASURES ---------------- Number Age-specific Rate ---------------- Hide Calculated Categories as values as % of row total as % of row subtotals as % of column total as % of column subtotals as % of grand total 1983 1984 1985 1986 1987 1988 1989 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 All Years C15 Oesophagus 592 657 651 635 758 842 735 802 848 859 918 959 946 983 970 1,005 1,084 1,070 1,078 16,392

All Years ---------------- C15 Oesophagus All Sexes All Age Groups All States MEASURES ---------------- [+] C15 Oesophagus [+] All Sexes [+] All Age Groups [+] All States [+] MEASURES ---------------- [Hide Total] [Insert Calculation...] [Hide/Show...]

All Registrable Cancers (except NMSC) ---------------- C00 Lip C01-C14 Head and neck C15 Oesophagus C16 Stomach C17 Small intestine C18-C21 Colorectal C22 Liver C23-C24 Gallbladder C25 Pancreas C30-C31 Nasal cavity C32 Larynx C33-C34 Trachea, bronchus and lung C37-C38 Other thoracic organs C40-C41 Bone and articular cartilage C43 Skin?melanoma C45 Mesothelioma C46 Kaposi's sarcoma C47-C49 Connective and other soft tissue C50 Breast C51-C52 Vulva and vagina C53 Cervix uteri C54-C55 Corpus uteri C56-C57 Ovary and other female genital o... C58 Placenta C60, C63 Penis and other male genital or... C61 Prostate C62 Testis C64-C66, C68 Kidney, ureter and urethra C67 Bladder C69 Eye C70-C72 Brain and other central nervous ... C73 Thyroid gland C74-C75 Other endocrine glands C76-C80, C26, C39 Unknown primary site C81-C85, C96 All lymphomas C88 Immunoproliferative neoplasms C90 Multiple myeloma C91-C95 Leukaemias ---------------- All Years All Sexes All Age Groups All States MEASURES ---------------- [+] All Years [+] All Sexes [+] All Age Groups [+] All States [+] MEASURES ---------------- [Hide Total] [Hide/Show...]