[intro music]
>> SPEAKER 1 - CHARLOTTE, THERAPEUTIC RADIOGRAPHER:
Hi my name is Charlotte and I'm one of the Therapeutic Radiographers
who will be looking after you when you come for your Papillon treatment.
[music]
[text on screen - What is Papillon treatment?]
Papillon is a type of internal radiotherapy
where we send x-rays down a tube to target the tumour cells.
At Clatterbridge we use it to treat rectal cancer.
[music]
[text on screen - Preparing for your Papillon appointment...]
On the day of your appointment please have a light breakfast or a light lunch
and continue to take the medications you would normally take,
unless we've specifically asked you to stop taking something.
Please bring a full list of the medications you would normally have
and on the day of the appointment,
we might need to give you some pain relief
so please bring someone with you to the appointment
so you don't need to drive home.
[music]
[text on screen - About your Papillon appointment...]
When you first arrive the doctor will take you into a consultation room
to go through the process, get your consent and answer any questions that you might have.
[music]
[text on screen - When you come for your Papillon appointment, sign in at the main reception and then take the lift up to Level 1.]
>> SPEAKER 2 - PROFESSOR SUN MYINT, CONSULTANT CLINICAL ONCOLOGIST:
Nigel, thanks for coming over.
So you're here to have this contact radiotherapy treatment
which is also called Papillon.
What this treatment does is improve the control of the tumour,
reducing the chance of the cancer breaking out again.
[text on screen - Treatment appointments are one or two weeks apart. You will have two sessions if you are post-surgery and three sessions if you are not. And we can give a fourth fraction boost if necessary.]
and I said here possible cure, cure is something you know after a period
and that period is about two years from now.
But this treatment will improve your chance of cure.
There are some side effects, early and late.
Early side effects, you get a bit of mucus coming down and a bit windy,
but they will pass away.
Some people get a bit of discomfort, but most people can tolerate it well.
The main late side effects are bleeding,
which occurs in about 30 to 40% of patients - not everybody gets that - is a streak of blood that's mixed with stools,
when you pass motion, maybe once a month,
maybe every other month or every other week.
And that usually settles down after about 6 months to a year.
But people who are taking blood thinning tablets
and have persistent bleeding can get some treatment for that.
One in 10 people need that,
but I don't think that will be necessary in your case.
You must understand that this is not a standard of care in this country
for young fit patients like you,
but having said all of that, if there is a residual tumour at the end of your treatment
or sometimes the tumour goes away and then comes back later
then you would need to have surgery
and that is what I would strongly recommend because you're young and fit
and your chance of cure is quite high.
The chance of the cancer coming back in our experience
with your stage of tumour is about 20%.
I'm 80% certain that we can eradicate the tumour but only time will tell
and the time is about two years from now.
If you do need surgery that will be during that time when tumour grows back.
Is that all right?
>> SPEAKER 3 - PATIENT:
I understand.
>> SPEAKER 2 - PROFESSOR SUN MYINT, CONSULTANT CLINICAL ONCOLOGIST:
Okay, so we have to share data with other countries
like France, Denmark and Sweden.
It's not your name or data but it's just a number
because they want to know how many we treat how many we cure
and we need your permission for that.
>> SPEAKER 3 - PATIENT:
Of course.
>> SPEAKER 2 - PROFESSOR SUN MYINT, CONSULTANT CLINICAL ONCOLOGIST:
Okay, so I'm going to sign here.
Are there any questions you want to ask me?
>> SPEAKER 3 - PATIENT:
No, I don't think so.
>> SPEAKER 2 - PROFESSOR SUN MYINT, CONSULTANT CLINICAL ONCOLOGIST:
Okay, I want you to sign on this side.
Print your surname, put the date there and your signature first.
>> SPEAKER 1 - CHARLOTTE, THERAPEUTIC RADIOGRAPHER:
After you've finished the consent form
the radiographers will go through a questionnaire regarding any other health conditions
and they will do a set of observations.
Following this we will give you a gown, some shorts and some theatre socks to put on
before we give you the bowel prep which is two micro enemas
to empty out the bottom section of your rectum.
>> SPEAKER 4 - SARAH, THERAPEUTIC RADIOGRAPHER:
Here's some lovely fetching shorts
and at the back is a tiny little window
so if you just make sure that this is on your bottom
>> SPEAKER 3 - PATIENT:
Okay.
[music]
>> SPEAKER 1 - CHARLOTTE, THERAPEUTIC RADIOGRAPHER:
Once you've had your enema
and you've emptied your bowels
we'll take you through into the treatment room
and we'll get you lying on the bed on your back
with your feet up in the air in stirrups.
This is the most common way that we treat patients for Papillon treatment,
however sometimes due to tumour position
we need you laying on your front on your knees instead.
Once you're in the correct position
we'll insert a muscle relaxant cream and gels
to help the process be more comfortable for you.
The doctor will then insert a scope to identify the tumour
and decide whether you're suitable for Papillon treatment.
If you are suitable we'll insert a treatment tube
for the x-ray radiation to be delivered through.
This bit can be more uncomfortable
and we can give you more pain relief in the room if you require it.
Once the treatment tube is in the correct position
we will go behind the screen to turn the machine on.
The radiation will target the tumour to break down the tumour cells.
The machine is only on for one to two minutes
and you won't feel a thing whilst the radiation is delivered.
We look forward to seeing you at your first Papillon appointment
and we're here to answer any questions that you might have throughout the day.
[text on screen: For more information on Papillon, visit our Papillon website page: https://www.clatterbridgecc.nhs.uk/patients-and-visitors/our-services/papillon-treatment]
[outro music]