Another year over…

The winter solstice passed by ten days ago and in the northern hemisphere, slowly but surely, daylight hours are beginning to increase. Tonight we usher in another New Year and in doing so set this one behind us. Another year over. In less than 6 months the summer solstice will mark a return to darker nights and the cycle – birth and death, growth and decay, dark and light – will continue. That is how our planet works.

At two points in my lifetime our family had five generations to celebrate Christmas and New Year, something of a rarity even in days when families were very large and women typically had children in their late teens or early twenties. Today very few of us remain and those who do are scattered over long distances across three continents.  Family is important to me and I would happily forgo all worldly goods for the opportunity to spend an extra year with lost loved ones, though a year would be insufficient because some were lost at a very young age. Young or old I know that parting again from those held dear would be far too difficult, something I would not relish for a second time so memories and photographs must suffice.

My oldest living relatives, my great aunt and great uncle, are 86 and 89 respectively. I was unable to visit during cancer treatment because I was chemo-pale and sickly, doing my best to avoid infections. They had experienced all that 17 years ago, immediately before they lost their only daughter and I couldn’t countenance this elderly couple bearing witness to the ravages of cancer treatment yet again.  A couple of years on and I’m largely recovered, pass for near-normal and have a functioning immune system. The Christmas break offered a good opportunity to visit and I found that Aunt and Uncle wear time well. They remain largely independent though they’ve both faced many personal health challenges in the last few years. They continue to live in the house they moved in to over half a century ago, the first house to be occupied on their street of brand new houses at the time.  Uncle tells me they are the last of ‘the originals’ on the street, they have seen many people come and go and he has lost his oldest friend in the last few months. Great aunt remains a country girl at heart, the Welsh lakes and mountains are never far from her thoughts and I am sure if she could, she would return there.  Though they’ve been married for 63 years I noticed Aunt continues to call Uncle cariad; he calls her cariad in return. Darling or sweetheart in Welsh. We talk of many things, of our lost loved ones and of those who are still here, of modern times and days gone by. Uncle gives M a bottle of beer and they discuss their favourite brews, he has a J2O for me because Aunt has told him I’m doing my best to take care of my health. We pet their dog (who is also very old at c17 but no-one knows his age for sure – he was rescued). We drink tea and remind Aunt and Uncle to keep warm in the cold weather, stay safe indoors.  The visit passes quickly and when its time to go Uncle takes my hand and says “keep looking after yourself, once there were lots of us but now there are few. We don’t want to lose any more.”  So true.

I wonder if there’s a point in our lives when we come to realise time slips through us quickly, more quickly than we might appreciate? If so, does the realisation change the way we view the world and go about our lives? Perhaps our experiences ordain when that point might be and make it dawn earlier for some than others, if at all?  As ever there are so many questions that seem to have so few real answers. 

Another year over and I think perhaps I have reached the point where I appreciate the value of time, how fleeting it is and how far beyond our control it lies. I also realise, and have done for a while, that I am free. Free from worrying about my pension, what other people think, how I look, whether my health will stay stable or my joints will ever improve.  I realise there is no time to waste which means enjoying the time there is, all of it, in whatever shape or form it takes. That is my mission for 2015, nothing more and nothing less.

To everyone who has followed Fecthis, liked and commented, thank you all – your encouragement and support is truly inspiring. To those who are facing cancer afresh or continue to live with it, I send fortitude, love and compassion. For everyone, I send wishes for happiness, well-being and peace in the year ahead. You are all amazing and you all deserve more time than human form allows.

Happy New Year

Happy New Year

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A small star of wonder

There are few miracles in Cancerland. Many of today’s treatments are founded on surgeries, chemo and radio therapies that have been around for decades. The concept of mastectomy has existed for centuries, though thankfully surgical practice has improved significantly in that time. Cancer research is resource intensive, costly and for every positive advance there are many more that fail to deliver useful results.  

As a recovering cancer patient, thinking about all of this is a daunting prospect. So many race for the cure because no-one wants their life cut short by cancer. Yet the cure continues to elude us and every day there are tears and condolences as more of our number depart the human race.  This, all too often, is the stark reality of Cancerland. It makes the psychology of cancer equally as challenging as the disease itself.

Science has not given up though and for those of us affected by this odious illness, from time to time there are breakthroughs, stars of wonder that shine a ray of hope into what might otherwise be a very stark world. Since being diagnosed as HER2+ I’ve hunted down as much information as possible about the ramifications of my particular cancer subtype. I am the kind of person who needs to know what she’s up against and until recently it painted a very challenging picture. More aggressive, more difficult to treat and more prone to early metastasis are not the kind of facts I hoped to discover. Without the advent of Herceptin my consult had said our initial conversation, the “yes you have cancer” one, would have been followed by “and we’ll do as much as we can but the outlook isn’t good.”

Unable to resist the urge to undertake my own research, I quickly discovered that members of the HER2+ community seemed to be dying at an alarming rate, even if their cancer was diagnosed early and they’d undertaken aggressive forms of treatment. In 2012 a long knife skewered my heart. The “yes it’s cancer” part was unpleasant but it wasn’t a complete shock. The HER2+ part was a twist of the knife, unknown territory which soon became a gargantuan challenge. Though my treatment is over my quest for research did not subside and as we approach Christmas 2014, the season of peace and goodwill,  a small star of wonder shines for those who are HER2+.

The survival benefits of Herceptin have been assessed in long term research, the first of its kind because Herceptin is one of a handful of cancer treatments that haven’t been around long enough to know exactly what the outcomes might be. Earlier this month the Journal of Clinical Oncology published a study that found Herceptin improved 10-year survival from 75 percent with chemotherapy alone to 84 percent with combination therapy – chemo plus Herceptin. The results also established continued improvement of disease free survival – the addition of Herceptin has seen 10-year disease free survival rates increase from 62 percent to 74 percent. As someone affected by HER2 these increases in 10 year survival and 10 year disease free survival are encouraging. They begin to shine a ray of hope in a landscape where hope is desperately needed – 74% isn’t good enough in my opinion but it sure as hell beats less than two-thirds.

It saddens me that, for my friends with metastatic breast cancer, everyone who is stage four at diagnosis, anyone who isn’t HER2+ and all those living in the wrong geography or an insufficient income bracket this discovery offers no comfort. It’s a small breakthrough with relevance for 15-20% of those with breast cancer. I’m part of that population yet there are no guarantees it will be of help to me either. Breast cancer is like that, no-one knows which straw they’ve drawn and reoccurrences can happen well beyond the 5 year “all clear” period.

Uncertainty and unpredictability are part of the fabric of Cancerland and somehow we learn to adapt to that, to cope with an outlook that’s permanently cloudy, but even for the most optimistic among us this becomes psychologically wearing. Coping is marginally easier if the cloudy outlook is perforated by at least one small star of wonder every few years – it seems that Herceptin may well be that kind of star.

 I

In about eight hundred days…

imageThe here and now may not be perfect but its an altogether better place than where I was around 800 days ago. Eight hundred sounds like a lot when you add it up in days, but in years it’s less than three. Just a tiny fraction of the longevity most of us hope to achieve in our lifetimes.

Long before my tussle with cancer began I developed a trait that has proven increasingly useful, particularly during the most challenging four hundred of the eight hundred day mountain climb I’ve taken on in the last few years. Though I haven’t consciously cultivated it, and on occasion even considered it problematic, looking back I can see just how helpful it’s been when the world seemed to be coming undone. Some might call it mindfulness or being in the present, others might say its selective amnesia. Whatever it is and however it happens, closing down frightening, painful or just plain bad memories so they no longer invade daily thoughts or conjure negative emotions is something I now consider a blessing. A body marred by the evidence of physical surgery and some serious chemical bombardment doesn’t need to retain a matching set of psychological scars.

As far as I can tell being anchored in the past makes it impossible to live in the present or imagine anything might have the potential to be different in future. Like many others dealing with cancer, my future is far from guaranteed but being permanently bonded to the fear, confusion and isolation that come with a cancer diagnosis isn’t something I want to sustain. Taking the lessons from past experiences is important, constantly reliving them isn’t. Closing the door on negative memories and the emotions that went along with them has helped me remain relatively calm and stable during some very unstable situations.

It’s about two and a half years down the line now and small signs of normality continue to emerge. A visit to the oncologist last week resulted in confirmation that all seems well so from now on we move to annual rather than six-monthly check ups. There are some things that won’t improve or mend – ankles, knees and hearing – but that’s fine, I can get by with them as they are. The same isn’t true of cancer and though I like my oncologist, I like the thought of a year away from him much more. Being able to go out in public without looking like a medical experiment, walking like a very senior citizen (well over 100) or having what appears to be a constant cold are all welcome steps forward too. They’re small steps but that doesn’t matter because they all contribute to renewed invisibility – it’s hard for chemo patients to blend in! – improving agility and a general sense that slowly but surely, health is beginning to return.