The term “incidental” usually implies something unimportant or insignificant. However, my perspective on this word has changed. When my cardiac specialist, Dr. Rakesh Sharma, informed me that a CT scan had revealed an “incidental finding” on my spleen, it seemed harmless. He believed it could be a benign cyst and assured me that it was nothing to worry about. As a precaution, he wanted to pass the results on to a gastroenterologist for further investigation.
Little did I know, this was just the beginning of a long journey that started with a seemingly harmless cough in late March and eventually led me to a cancer ward in June for several intense months of chemotherapy. I have been diagnosed with non-Hodgkin lymphoma, a type of blood cancer that affects the immune system. This form of cancer affects approximately 14,000 individuals in the UK each year. The path that has brought me to this point has been challenging, but also filled with unexpected moments of luck. Fortunately, as a staff journalist with private health insurance cover through Healix, I have been able to undergo various tests, scans, and specialist appointments without significant delays, although I have had to dip into my personal resources due to out-patient excesses in the policy.
If reports of up to 100,000 cancer patients waiting to see a specialist on the NHS are accurate, I can’t help but wonder how my experience would have been different. On a positive note, a friend of mine who is undergoing NHS oncology treatment has spoken highly of the swift and dedicated care he has received at the Royal Marsden Hospital in West London. I am incredibly grateful to all the medical professionals who have guided me and refused to dismiss my concerns just because the cause of my symptoms wasn’t immediately apparent.
My journey began with our office GP, Dr. Richard Harris-Jones, who, even though my cough had improved by early April, felt it was worth referring me to a respiratory specialist at the Royal Brompton. At the time, I didn’t feel overly worried. In fact, at times, the increasing number of tests ordered by physicians made me question if it was all just a scheme to generate more income for private sector medicine. However, as a financial writer, my cynicism was beginning to cloud my judgment, and little did I know that I was standing at the precipice of a cancer diagnosis.
It also became clear to me that while hands-on specialist treatment and intuition still play important roles for doctors, the use of health-tech has largely replaced the stethoscope, reflex hammer, and physical examination. Diagnosis now heavily relies on the interpretation of computerized data and advanced scanning, genetic testing, and blood testing.
My first stop on the journey to the oncology ward was with respiratory consultant Dr. Peter George at the Cromwell Hospital on March 27. He listened to my chest, assessed my symptoms, and ordered a series of tests, including X-rays, lung and liver function tests, and blood tests to check my immune system cells. The positive outcome was that there wasn’t anything significantly wrong with my respiratory system (despite being 73 years old, my lung function exceeded expectations). Dr. George prescribed omeprazole for acid reflux, which had worsened this year. He also gave me an inhaler to help with an allergic, mildly asthmatic cough that my wife, who has had asthma her whole life, had already diagnosed.
Dr. George also found a heart murmur, which came as a surprise. He referred me to his cardiologist colleague, Dr. Rakesh Sharma, at the Royal Brompton for further evaluation. This led to additional scans and a coronary angiogram, which involved X-rays taken from multiple angles. The radiologist who performed the angiogram noticed something significant—an “incidental” finding of an “apparent 9cm low attenuation structure” on my spleen. Dr. Sharma was concerned and forwarded all the data and images to his colleague, gastroenterologist Dr. Kinesh Patel.
During our meeting, Dr. Patel asked about any symptoms I had been experiencing. Night sweats? Yes, I had been having a few. Acid reflux? Yes. Irregular bowel movements? Not as regular as usual. However, none of these symptoms were particularly bothersome. They were just minor annoyances, and I didn’t attribute any significant importance to them. After reviewing the images and information at hand, Dr. Patel gently suggested that the findings were indicative of non-Hodgkin lymphoma, a type of cancer that begins in the lymphatic system—a vital component of the immune system. He needed more information to confirm this diagnosis, which led to further blood tests and a second CT scan focusing on the spleen, pancreas, and surrounding organs.
From that point on, events unfolded rapidly.
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