BBC.地平线.2022.认识癌症（2022）

把体液从人体的各个部位抽走
that are drawing fluid away from all parts of your body,
然后向上输送到你的心脏
and then bringing it upwards towards your heart.
这些管道里
Now, along those tubes,
有一些叫做淋巴结的小东西
you have these little things called nodes.
他们给我手术的时候
When they were doing my surgery,
因为担心淋巴结里有癌细胞
because they were concerned about cancer being in
就把它们都清除了
the lymph nodes, they chopped them all out.
所以现在 体液
And so now the fluid just, essentially,
漏出来 聚集在我的腿上
leaks out and collects in my leg.
我魔鬼般性感的连袜裤
My devilishly sexy tights!
它们是压力袜 所以
They’re compression garments, so, um,
有助于阻止体液聚集
they just help stop all of the fluid building up, basically.
底下真的很紧
So, they’re really tight down the bottom,
拉上来以后会松一点
and then they’re slightly less tight as you go further up.
但关键是它们能抑制肿胀
But the idea is that they just keep the swelling down.
所以我每天每时每刻都要穿着它
So, you have to wear them all day, every day.
-你真的一直穿着 -是啊 在沙滩上也穿
– You really do? – Yeah, even on the beach.
穿着它对触碰非常敏感
It just feels very sensitive to the touch.
穿着感觉很饱满 有点紧绷
It just feels very full and sort of tight.
不会痛
It’s not painful.
不是那种极度的痛苦
It’s not, like, excruciating agony.
就是很不舒服
It’s just really uncomfortable.
淋巴水肿的问题是
The problem with lymphedema
你不知道它发展有多快
is that you have no idea how quickly it’s going to progress.
有可能是几个礼拜
It could be that it happens
也有可能是几个月
over the course of a few weeks or months.
真的有这么快
I mean, it really can be that quick.
来吧
Come on.
对此我非常沮丧 因为你知道
I have got really upset about it because, you know,
你无法长时间站立
you can’t be upright for sustained periods of time.
有一天晚上我就想
There was one evening I was like,
好 我要和女儿一起做烘焙
“Right, I’m going to do some baking with my daughter,”
结果我站了一会儿
and ended up standing up for a while.
然后最后
And then finally, like,
我坐下来 抬起脚一看
sat down and put my feet up and like,
我的腿真的肿得像个气球
literally, my leg, it was like a balloon.
真是难以置信 这腿
It was, like, incredible. This thing
就好像在你手下不停地膨胀
just, like, basically expanding, like, under your hands.
我想象不出自己将来那个模样 你知道吗
I just don’t have that view of myself in the future. You know?
我不认为我到了五十多岁时
Like, I don’t see myself as, like, in my 50s
会有一个巨大的肿腿
with, like, one giant leg,
连一百米也走不了
like, unable to walk 100 metres,
甚至无法工作
or like, unable to work, even.
当我们面对着
When we are facing something that feels like
非常可怕的敌人时 比如癌症
it’s a really terrible enemy, like cancer,
我们就会有一种倾向
we have this bias towards
试图先摆脱那最主要的忧虑
just trying to get rid of the overarching concern,
再担忧之后的副作用
and worry about side-effects later.
也许我们太愿意不惜一切代价来做治疗
Maybe we are too willing to just do treatment at any cost
因为这感觉我们是在做点什么
just because it feels like we’re doing something.
据估计 英国有四十万人患有淋巴水肿
It’s estimated up to 400,000 people in the UK have lymphedema.
在进行根治性子♥宫♥切除术后
After a radical hysterectomy,
患此病的几率是百分之二十五
there’s a one-in-four chance of getting it.
四分之一
国民医疗服务体系对淋巴水肿提供有限治疗
There’s limited treatment for lymphedema available on the NHS,
我要去会见一位私人淋巴水肿外科医生
so I’m going to see a private lymphedema surgeon,
他叫亚历克斯·拉姆斯登
Alex Ramsden.
亚历克斯·拉姆斯登先生N淋巴水肿外科医生
医生给我做了根治性子♥宫♥切除术
They did the radical hysterectomy.
-好的 -取出了所有子♥宫♥ 还有一些
– OK. – And they took out everything, and then a bit more.
对 你说所有 所以你做了子♥宫♥切除术
Right. When you say everything, so there was a hysterectomy?
-是的 还有结节 是… -淋巴结
– Yeah, and the nodes. And it was… – The lymph nodes.
这相当重要
So that’s really important.
他们取出了普通淋巴结
So, they took out the common lymph nodes,
-取出了内髂动脉 -是
– they took out the interior iliac. – Yep.
-外髂动脉 -对的
– The exterior iliac. – Right.
他们还取出了… 闭孔肌
And they also took out the… obturator?
闭孔肌 我正要说”闭孔肌”
Obturator, I was just going to say obturator.
这是不是太多了
Is that quite a lot?
是的 我不是妇科医生
Yes. So I’m not a gynaecologist.
-当然 -好吗
– Of course. – OK?
但他们对这种肿瘤经常采取激进的方式
But they are often very aggressive with this sort of tumour,
他们还经常切除很多淋巴结
and they often take out a lot of nodes,
在你做手术之前 很难知道
and it’s very difficult to know, before you start,
它们是恶性还是良性的
whether they’re going to be positive or negative.
正如你将遇到的 淋巴水肿的一个问题是
One of the problems with lymphedema, as you will come across,
充分了解它的人并不多
is not many people know much about it.
人们常提”癌症”这个词 大家听到的
People mention the word cancer and everybody hears,
“癌症 癌症 癌症 癌症 癌症”
“Cancer, cancer, cancer, cancer, cancer.”
病人接受大量治疗
Patients have this massive treatment,
他们投入所有的时间和精力
and they have all this investment of time and care
很多努力 这很好
and effort, and that’s great.
但然后你却要面对
But then you’re left with something
病情加重的危险
that is only going to get worse.
你的余生都要与此病共度
You’ve got it for the rest of your life.
-“给你长筒袜” -“给你长筒袜”
– “Here’s a stocking.” – “Here’s a stocking.”
大家都说 “太糟心了”
And everyone goes, “That’s really rubbish,”
所以人们对淋巴水肿感到很不安
so it’s a very common thing that people get very upset
并且有时候比得癌症还痛苦
and more traumatised by the lymphedema
这是很常见的
than they do by the cancer sometimes.
我很抱歉
I’m really sorry.
听到有人说明这一点 很难受
It’s just quite hard to hear someone articulate it.
好的
OK.
我们已经很快谈到重点了
So, we’ve kind of got to the nub of it quite quickly.
我不知道是否还有一个选择
I don’t really know if there was a choice,
而现在面临的是这种
and now there’s this, like,
似乎是无期徒刑一样的
lifelong sort of sentence, as it were,
能让人真正感到虚弱的
of, like, what could be a genuinely, like, debilitating,
可以改变一生的状况
life-changing condition.
可能原来就没有什么选择
There might not have been options.
-你可能本来就必须这样做 -是的
– You might have had to do it. – Yep.
会有一点刺痛 我提前向你道歉
It will be a little bit stingy, and I apologise in advance.
亚历克斯在向我的淋巴血管中注射染色剂
Alex is injecting dye into my lymph vessels
并用一台红外摄影机来确定
and using an infra-red camera to determine
我的淋巴水肿的程度
the extent of my lymphedema.
这就是想要逃离你这条腿的体液
This is the fluid that’s trying to get out of your leg.
-它不能通过你的骨盆 -是的
– It can’t go through your pelvis. – Yeah.
所以它正流向你的腹壁
So it’s now going onto your tummy wall.
这就是你的腹壁在肿胀的原因
That’s why you’re getting fullness of your tummy wall.
就是这个部位在变得
So, this is the bit that gets really,
-非常肿胀 -对的
– like, thick, basically. – Right.
天啊 好像是一整个星系
God, it’s, like, a whole galaxy!
右腿状况很好
The right leg is really good,
一直到你所描述的大腿上部
all the way up to where you describe, which is the upper thigh,
在那里你开始出现真皮内淋巴逆流
when you’re starting to get those dermal back flow patterns
并流到你的腹壁 那就是淋巴水肿
overflown to your abdominal wall, and that is lymphedema,
但你现在处于最早期的淋巴水肿
but it’s the very earliest stage of lymphedema that you have.
好的
OK.
因为你处于很早期
Because you’re really early,
你现在要做的就是阻止情况变坏
what you’re trying to do is stop it getting worse.
-如果病情一直维持这样 那就没事 -对
– If it stays like this forever, that’s fine. – Right.
接下来的二十年可能会维持这样
It might stay the same for the next 20 years.
我不知道
I don’t know.
最可能的情况是 病情会加重
Most likely, it’s going to get worse.
我所要求的是不是有点多了 我不知道
Am I asking for a bit too much? I don’t know,
或许是吧 或许我有一点贪婪
maybe I am, maybe I’m being a bit greedy.
我处在一种境地 有人必须要
It’s like, I was in a position where someone had
切除一些东西来救我的命 对吧 我知道这个
to take stuff out to save my life, right? I know that.
我只是… 也许我有点贪婪了
I just… Maybe I am being a bit greedy to be, like,
“别留下一个终生慢性病
“Is it too much to ask that
这要求是不是有点太多了”
“I wasn’t left with a lifelong chronic condition?”