The Oncologist Part Two

Kidderminster TC

 

This is where I saw the Oncologist yesterday. It’s where I spent hours (around 70 in total) rigged up to a pump receiving chemicals that come with large biohazard symbols all over them.  Getting close-up and personal with something covered in that particular symbol is great for building risk tolerance, almost akin to lighting matches at the petrol pump or playing Russian roulette.  Cancer is very much like Russian roulette – a potentially lethal game of chance – and although I know the those hazardous chemicals are designed to change the odds, seeing something marked biohazard enter a vein can never be anything other than disconcerting.

I dutifully completed my Persephone trial questionnaire reporting overall improvements in general health, no change in joint pain, continued loss of earnings compared to the pre-cancer days and relatively normal cognitive functioning, so long as I’m not tired.  My height was checked: this always makes me laugh because at my age there is no chance of further vertical growth and only a slight chance of noticeable shrinkage.  My weight was checked: this never makes me laugh because in spite of very regular exercise, healthy eating, plenty of water and a near zero alcohol diet there is still plenty of potential for horizontal growth and only a remote chance of microscopic shrinkage.  Stick thin are words that are unlikely to enter my vocabulary any time soon.

The Oncologist came out of his office to find me, which was unusual because he’s normally too busy to move. After the usual questions we proceeded to the examination which includes tapping over the liver, various prodding of the neck and chest and visual inspection.  All seems well so we proceeded to a conversation about ongoing joint issues – both knees, both ankles and right-hand fingers.  For a long time I have suspected these are all treatment related irrecoverable side-effects. Yesterday the Oncologist confirmed my diagnosis and acknowledged my underlying suspicion that any further improvement is unlikely to occur.  I had prepared for this eventuality; the joint situation is annoying, frustrating and often painful but at least it isn’t cancer. Having its permanence officially confirmed was too good an opportunity to miss so I asked the Oncologist in my most serious tone how I could possibly be expected to climb Kilimanjaro and then run a naked marathon next Spring.  This had the desired effect of making him laugh and put Sally the trials nurse into an uncontrollable fit of the giggles.

Once we all returned to cancer clinic stoicism I asked about the outstanding preventive surgery, described my family history as prolific, aka develop one get five free, and as we all die before age 50 it’s positively infuriating because none of us get to see the paltry pensions we worked like slaves not to have. It may be gallows humour but for my unfortunate predecessors  it’s also true. This made the Oncologist laugh, Sally hadn’t fully recovered from the naked marathon and two laughs in one appointment is quite an achievement. After confirming I’d given it plenty of consideration, know exactly what more surgery entails and have no fear (psychological or physical) about it, the Oncologist and Sally agreed they are both of the mind that it’s a very good idea and unlikely to fall into the over-treatment category in my case. A consultation with the oncoplastic surgeon will be arranged shortly…

All in all the visit was successful. No sign of anything untoward – check. Confirmation that treatment, not age, is responsible for various joint mayhem – check. Validation of my position on the outstanding surgery – check. Making the Oncologist laugh – check, twice 🙂 .

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The Oncologist

Tomorrow I’m heading back to see the oncologist.  A quick recap: he is studious, often serious and I was told some people find him rather terse. He also came highly recommended on the basis I could cope with a scientist who holds a passion for his subject, has considerable clinical trials expertise and presents the facts in a sans-sugar-coating, say-it-as-it-is kind of way.  It’s true he wouldn’t be everyone’s cup of tea because small talk and social pleasantries aren’t his thing. I knew I could live without those but the same could not be said for a well-constructed third generation treatment regimen designed to tackle very aggressive HER2+ breast cancer.

When I was in active treatment I made it my mission to find some way to make the oncologist laugh every time I saw him.  Despite the various cancer shenanigans and associated torments I managed to retain at least a smidgen of my naturally playful, sometimes mischievous (in a harmless kind of way) spirit. So tomorrow I’ll be in his office finding another way to make the man who averts death smile and laugh because let’s face it, 12 hours a day 5 days a week managing various forms of cancer is hardly fun, even if your success rate falls in the upper quartile.

I haven’t been back to the hospital for some time now and if it weren’t for the follow-ups I’d avoid going back there at all costs.  It’s the place where my life switched from relatively stable to completely FUBAR in a matter of moments. It’s the place I associate with a tranche of memories I’d happily erase if permanent amnesia happened to be available in tablet form. It’s a place where the staff are brilliant, my treatment was excellent and as far as I know all traces of the mutant cells terrorising my body were eradicated. Unfortunately it will always be the place where cancer and me were forced to become far too familiar with one another. That acquaintance lasted much longer and caused far more damage than any of us is led to believe so I might just have to strangle the next person who says breast cancer is an easy cancer, the best kind of cancer or anything that remotely infers treatment and recovery is a walk in the park. Oops… I lost my playful spirit for a moment there.

Thankfully my oncologist chose to be an oncologist instead of an actuary, a computer programmer or an astrophysicist. For that I will be eternally grateful. For cancer I will not.

Find what you love

And let it kill you….

This is a Charles Bukowski quote. I like it because it makes sense. Why would any of us want to be killed by something we don’t like?

I tried cancer or rather it tried me, I didn’t welcome it into my life. To date a combination of trusting instincts, taking action quickly and an oncoplastic surgeon and oncologist who both adopt a ‘take no prisoners’ approach helped ensure it had limited chances to move elsewhere. Places where it might later take the opportunity to curtail my life.

Though the treatments have been best in class I am not complacent. Suspicion is an inevitable trait when you inhabit a body that’s let you down. Striking a balance between healthy concern and paranoia is key. Anomalies, functional changes and aches and pains make me suspicious even though I know some of them predate cancer. There’s no way of knowing when the first cell went haywire and research suggests it takes 5 years for a tumour to become palpable. 5 years is quite a long time for unchecked cellular chaos to prevail.

Many cancer patients live with ongoing suspicion and significant worries about what the future might hold. I’m happy with healthy suspicion because deep down none of us really knows what lies ahead. Whether we’ve been touched by cancer or not, life is unpredictable and we could just as easily be killed in traffic accidents or freak storms. Finding something we love and letting that kill us sounds an altogether better option and even if it happens to be cancer in the end, time spent on the things we love is the most beautiful, exhilarating and fulfilling time available to any of us.

Making space for the things we love is almost like starting life anew, with a few more wrinkles and white hairs than the first time around in my case! This year for the first time in far too many years I’ve given time to the things I love, not just the things I’m obliged to do. There’s a sketch book full of drawings and paintings that I have no doubt at all will outlive me. Maybe one day they’ll be treasured by some future grandchildren 🙂 Creating something from pencil or paint and paper offers an opportunity to escape from everyday tasks into somewhere tranquil and serene. Isn’t that the way heaven is meant to be? If so then death through art sounds much more appealing than cancer!

Idle doodlings :-)

Art is my recharge mechanism especially during the long winter months when it’s too wet, cold or dark to get into the garden. When the seasons change being outside with nature is another love that seems altogether more appealing than some of the things that eat up my time.

Although we’re barely into Spring, there’s an old fashioned cottage garden that’s worth every ounce of effort that’s gone into it, a townhouse garden that seems to have relished all the thought underpinning its creation and a new season of vegetables, herbs and fruit beginning to sprout – peas, beans, tomatoes, carrots, parsnips, onions, chives, garlic, parsley, strawberries, loganberries, apples, green gages, rhubarb and plums to name a few. Buying organic produce is expensive, growing it is a worthwhile labour of love even if it is responsible for some of the suspicious aches and pains.

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I have many other loves. The people who are dear to me, my darling cats who remained faithful even when I kept them away during chemo, music, travel, cooking, photography and walking.  From time to time I can even throw decorating, renovating and repairing things into the mix.

At least I know I’ll never die of boredom and I’m hopeful I won’t die of cancer though that one isn’t a given. With luck I’ll simply slip away under the cherry tree one sunny afternoon having completed my best sketch ever at an age where I can happily be called ancient and extraordinarily eccentric 🙂

Until then I’m going to do the things I love and encourage you all to do likewise.

It wasn’t an accident…

 

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Someone I used to work with died last week. We weren’t close and hadn’t kept in touch but it  was still sad and shocking to hear the news. He was young, super fit and healthy just a couple of years back when we worked together. A clean-living triathlete.

When I found out I thought maybe he’d been involved in an accident, some kind of traffic collision. In the city it’s one of the more common causes of premature death. Or maybe one of those completely out-of-the-blue heart conditions, the kind that take people during marathons and football games.  In the moment between hearing the news and hearing what happened, an accident is what I expected to hear.

It wasn’t an accident and what I’m about to say will sound strange. In spite of the trauma, an accident might have been easier.

He was diagnosed with lymphoma in July and spent the past few months in a hospice. Nine months from diagnosis to death. His world and that of his family undone in the space of three seasons; autumn, winter, spring. His wife and young daughter must be devastated and I can’t help thinking it’s really sad. Sad for him and sad for them. They’ll have some gruelling memories to deal with before the good ones find a way back in.

24 hours ago one of our news channels made a big deal of cancer survival rates. The report was positively beaming about 50% of people in England and Wales now living for ten years post-diagnosis. Cancer no longer needs to be seen as a death sentence is what the story said. The same story reported a one in two chance of living (dying) within 10 years of diagnosis as a vast improvement on the 1970’s position. Back then 24% could expect to live for 10 years.

News of a co-workers death from cancer in less than year just one day after this inappropriately upbeat national TV story seems hopelessly ironic. I don’t deny the numbers reflect some progress for the better, but I can’t shake the thought that creeping from 24 to 50% ten-year survival during the course of almost 45 years is extremely slow. Life threateningly slow. The kind of progress that earns a ‘must try harder’ comment on an end of term report.

It wasn’t an accident that we invented the large hadron collider, wi-fi, hybrid cars and protease inhibitors in the last 25 years. We verified the existence of dark matter and down-graded Pluto to a dwarf planet too. But when it comes to cancer we’re supposed to be pleased by a 50% ten-year survival statistic that’s taken 40+ years to achieve? It’s a statistic that means 50% of people, including my ex-colleague, still can’t expect to see their kids grow up, have kids of their own or spend time with their grandchildren.