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He had cancer of the colon with liver metastases and lived a further 20 years - how is that possible

By Harriet Denz Penhey

Republish: EasyPublish™ Published: 12Aug2009 Word count: 756 Viewed: 297 time(s) Get Free Content For Your Site

Old Bill was a real character. He had been diagnosed with cancer of the colon and liver metastases, given a maximum life expectancy of eight weeks and yet he lived life to the full for a further 20 years. This is very, very unusual, so what made the difference?

Bill, or Old Bill, as the elderly man was affectionately known in his local community, was interviewed as part of research into unexpected recoveries in what was usually considered terminal illnesses. The paper was published in 2008 in the Qualitative Health Research journal.

Old Bill had been an outback farmer living and working down a long back road in the middle of nowhere with only his wife and animals for company. Like many older men when he started to get troubles in his lower tummy he ignored it as long as he could. After many months things suddenly became acute. He was unable to go to the toilet any more and he had an emergency trip to the big city hospital.

He needed surgery to deal with his blockage. Then to the horror of the operating surgeon and nurses they discovered not only cancer of the colon but it had metastasized into extensive cancer of his liver. Regretfully they "tidied him up a little," and transferred him home to his local community hospital to be near his family for his last few weeks. Everyone in the local hospital, including Bill, knew he had been given a maximum life expectancy of two to eight weeks. He was not expected to leave the community hospital.

However others' expectations were not about to bother Old Bill. As soon as his wound had healed sufficiently Old Bill set about tidying up his life. He immediately leased out his farm, because he didn't see any reason to go on working for his last few months of his life and he and his wife moved into the local tourist town to enjoy the time they had left. For Bill this meant that he spent as much time as he could in the local hotel.

This wasn't any ordinary hotel, but one in the main street of the little tourist town they had moved to; one with the low ceilings and smoke entrenched fittings that had been there since the times of the gold rush. Old Bill became a story teller and he used to spend hours each day drinking alcohol paid for by tourists passing through and spinning yarns about the early days and what it was like as the local "strong man" and bullock driver before trucks used to take the wool to the markets.

Old Bill outlasted his wife who died of breast cancer a few years after they shifted into town. He nursed her for as long as he could before she had to go to hospital for her last few weeks. Bill's medical practitioner who cared for him was totally bemused as to how and why Bill could survive so long when his prognosis was so poor and yet so many, like his wife could die quickly when they theoretically could have survived much longer.

This was the same question which drove the research in the first place. Medicine has always known that some people do much worse than expected and some people do much better than would be expected. Usually when people do much better than expected doctors talk about spontaneous remission or the placebo effect, but this doesn't actually explain anything, other than give unexpected recovery a name.

Health psychology has provided some answers, but not enough to provide useful information for patients who are faced with a serious diagnosis or for their medical carers who might like to provide psycho-social support.

The Qualitative Health Research paper showed that Bill and others like him who had survived unexpectedly all had very similar ways of living their lives. It didn't matter what age they were, or their educational background or whether they were male or female they all had the same quality of resiliency.

Those who survived terminal illness all learned how to be resilient during the time they were ill. Most did this intuitively, although several in the study set out to learn how to do it. Surviving liver metastases for 20 years is very rare, but the fact that one person can do it means that there is a physical pathway for it to occur. Where there is a physical pathway there is legitimate hope for others who find themselves in the same situation.

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