One of Bren’s main fears was the pain he would be in, in the end, stages of his cancer — for good reason. There were no scans in the last months, so we didn’t have an official tumour count, but each new tumour made itself known to him. He felt them ‘light up’.

A 7cm primary tumour was removed from his right femour early in his treatment. By July 2017, he knew he also had tumours of different sizes in his left femour, clavicle, jaw, spine, ribs, and lungs. Some had been there from the beginning, and most were new. By July, the tumour on Bren’s jaw had ulcerated and broken the skin.

Pain management was our main concern and became our full-time job.

Below is a typical day’s Meds charted on 22/07/17.

7am
Oesteo Panadol 2 tablets (high dose paracetamol)
Anti Nausea 1 Tablet
OxyNorm 20mg (opioid analgesics)
Pazopanib 2 tablets (multi-targeted receptor tyrosine kinase inhibitor that blocks tumour growth) had stopped blocking tumour growth but may have been slowing it down marginally; at the very least, it was still aiding pain relief.

11am
OxyNorm 20mg (opioid analgesics)
OxyCondone (OxyConti) 2 x 20mg (opioid)
Targin 2 x 40/20 mg (contain two different medicines called oxycodone hydrochloride (opioid) and naloxone hydrochloride anhydrous – (protects against effects of the opioid on the gut)

2pm
Oesteo Panadol x2 tablets (high dose paracetamol)
Anti Nausea x1 tablet
OxyNorm 20 mg (opioid analgesics)
Multi-Vitamin 1 tablet

9pm
OxyCondone 80mg (opioid)
OxyCondone 20mg (opioid)
OxyCondone 20mg (opioid)
Targin 80/40mg (contain two different medicines called oxycodone hydrochloride (opioid) and naloxone hydrochloride anhydrous – protects against effects of the opioid on the gut)

Endone (opioid) — breakthrough pain relief when required if the daily pain management program wasn’t stretching between doses. By this stage, it was required a lot, especially when preparing to use the bathroom/shower, leaving the house/travelling, and preparing for visitors.

Actiq Lollipop (Fentanyl – opioid) breakthrough pain relief: occasionally – used if Bren had to lay flat for scans or similar situations, and when the pain was not being managed by a daily pain management program in the end stages of his disease, where the daily allowance of endone had been exceeded.

He never complained!