Gaby Von Blerk – Stopping the shame

Gaby Von Blerk openly speaks about her difficult journey of facing squamous cell carcinoma of the anus.

Gaby Von Blerk (60) lives in Umhlanga Rocks, Kwa-Zulu Natal. She is divorced and has a daughter, Greta.

Squamous cell carcinoma of the anus  

It was thanks to the words of Gaby’s friend, Eric, who endured a long battle with cancer that prompted Gaby to see a doctor and in turn be diagnosed with squamous cell carcinoma of the anus in July 2016. 

“Just before Eric passed away, he implored to me, ‘If you notice anything unusual on your body, please have it seen to. So, when I was in the shower and noticed the thickening of the skin of my external anal sphincter was a little harder than the other side, I immediately remembered what Eric told me and made an appointment with my GP,” Gaby recalls.

“My GP wasn’t happy with what he saw and did a biopsy. The results came back positive for squamous cell carcinoma. My first thought was shock. How can this happen to me? Then, what would I tell my daughter? The fear I had was for her, not myself. I believe what will be, will be.”

“After much debate with my GP and people undergoing cancer treatment, I was confused as to which way to procced. At this stage I had become fearful and decided to have chemotherapy and radiation. My daughter, Greta, was in matric and I needed her to know I was going to be okay.”

Constant bleeding

“I was sent to a surgeon who removed what he could without damaging the sphincter muscle too much. I learnt first-hand that even private hospitals were understaffed (this was their excuse). My 18-year-old daughter had to come in after school each day to do wound care on me. Despite my profuse bleeding, I was discharged, only to nearly bleed out at home the next day. My dog, Baloo, started barking at the site of the blood trickling out of my bed. This alerted my daughter who immediately carried me to the car and back to the hospital.” Once at the hospital, Gaby was given an injection to stop the bleeding.

Treatment

“Thereafter the recommended combined chemotherapy and radiation began. The first few weeks were fine then the potent drugs took control of me. It was the hardest experience ever. I don’t think I will ever do that journey again. For two years, I felt 30 years older.”

Gaby had one mitomycin chemotherapy infusion on the day radiation started. Mitomycin is a well-known radiosensitiser (an agent that makes tumour cells more sensitive to radiation therapy). Her radiation consisted of 28 sessions and she was then put on oral chemotherapy tablets, capecitabine.

She shares her experience of sitting in the chemo room: “All these patients at different stages sitting on the comfortable lazy boy having their chemo for the day. I was saddened by how many young girls were at the final stages of treatment and how cruel this cancer had been to them.”

“The oral tablets were so large and hard to swallow. I gained such hatred towards them, so much so that I collected the boxes they came in and then burnt them all in a pile at the end of my treatment. Crazy, but true!” she explains. 

“Radiation was easy to start with as all I did was lie in this amazing machine that circled me and it was over in a few minutes. However, then the accumulation took effect and this is what totally debilitates you. I lost all my strength and was extremely tired. 

I couldn’t walk more that two steps. My last few treatments I had to be driven and carried to treatment,” she says.

Pain and embarrassment

Unfortunately, Gaby suffered severe moist desquamation (skin thins and begins to weep) from the radiation and was hospitalised for a week where she was put on antibiotics and analgesia. She was prescribed lignocaine jelly to apply. “I eventually got someone to bring me a cannabis ointment which kept the skin moist but healed at the same time,” she says.

Gaby goes on to say, “It was rather embarrassing having my entire ‘under carriage’ totally burnt and bleeding. I couldn’t put water anywhere near the area. A catheter was inserted eventually as having to urinate through an open bleeding wound was terribly painful. There were many times I wanted to die and be rid of the pain and destruction to my body. But, somehow you just have to go on.”

With regards to the stigma, the 60-year-old agrees with Desperate Housewives actress amd anal cancer survivor, Marcia Cross’ viewpoint of ending the shame that comes with anal cancer. Gaby says, “Cancer has no morals nor shame. Our private parts have been called just that, private parts, and it’s not easy to bare all to each and every medical person attending to you. My GP understood my concern and assured me that the anus is just another body part and one of many openings. They are all the same to medical fraternity. It’s our mind that lets us feel shame in showing our private parts. You soon get used to revealing all, all you want is healing.”

Finances and support

“My daughter, Greta, was my pillar of strength throughout the process. I thank her and her father, Paul. Thankfully, my medical aid covered everything. I have GAP cover but didn’t need to use it.”

Today Gaby is doing well, and is happy to share her experience to help other cancer patients.