developed widespread liver metastases and was told earlier in the day at an 

outpatient appointment that the cancer is no longer responding to her current 

treatment. The consultant and nurse specialist have outlined the different 

treatment options available and Julie has a return appointment the following 

week to talk through her decision. Later that evening, Julie is thinking back to 

all the times when she has heard bad news since she developed cancer. To get 

things clear in her head she notes them down on a piece of paper, as follows: 

 

 1) Going to see the GP when I had symptoms and being told I would get an 

urgent appointment in two weeks to see the specialist. I knew then it was 

potentially serious and it could be cancer.

 2) Being told by the hospital doctor that the tests showed it was cancer and 

I needed surgery.

 3) When the nurse specialist explained to me what the surgery would 

involve, especially finding out about the stoma.

 4) Attending the preoperative assessment clinic and hearing about the 

details of the operation and hospital stay, especially the anaesthetic and the 

risk of developing blood clots.

 5) Being admitted to the ward and finding out that visiting hours were 

restricted so my daughter could be with me for only a few hours a day. 

 6) Being marked for the stoma site – this really brought home what I was 

having done. 

 7) Seeing my stoma for the first time and being taught how to keep it clean 

and put on the bags. 

 8) Finding out I would need to have chemotherapy at the cancer centre.

 9) Having the treatment explained to me by the doctor and then the nurse 

at the cancer centre – the months and months of treatment, the scary side 

effects, all of the things I had to look out for and remember to do. 

 10) Being informed that I had neutropenic sepsis and had to stay in hospital 

for intravenous antibiotics. 

 11) Hearing that I needed to go for more scans when I told the doctor about 

the new pain in my side.

 12) My nurse specialist explaining to me why the scans were being done and 

what they might show. 

 13) Learning that I had liver metastases and that the chemotherapy I am on 

at the moment is not working.

 14) Listening to the different treatment options earlier on today – how on 

earth am I going to decide what to do