Sunday 18 December 2011

A Farewell To Arms


The other day, I logged on to Facebook and read a link that someone had posted about the death of the writer and broadcaster, Christopher Hitchens. It shouldn’t have come as a big surprise. He had been diagnosed with stage four oesophageal cancer over a year ago, just like his father had done before him. Prior to this, he had unashamedly confessed to having spent a large portion of his life filling his vital organs with copious amounts of smoke and liquor. He had always expected this to happen, but perhaps not so soon. Even so, I couldn’t help but feel sad. I never knew him and am sure that had I done, I might well have despised him. As well as talent, wit and intelligence, he also seemed to be a victim of his own ego and arrogance, which often revealed itself in the form of anger and impatience in television broadcasts. But he was, for the last year and a half of his life, a cancer patient like me. And I remember feeling buoyed with hope and admiration when I discovered that despite the grim prognosis, he still seemed to work and write with the same passion and enthusiasm as before. His writing about cancer seemed to give him an aura of immortality. Here was a man who couldn’t possibly die, not when his writing felt so very alive. And while his words had the power to rouse and rankle all that read his work, they also gave us a false assurance that perhaps here was a man who really was in control of his destiny. Because despite the illness, despite the grueling treatments, he could still do the very thing that gave him the most joy in life, he could still write. The irony of this is that as cancer patients, control is the one thing that we most desire but are the least likely to attain. His passing saddens me because as well as thinking of him as ‘another one bites the dust’, I can’t help but feel the same sense of frustration that I felt when I heard of the deaths of Steve Jobs and David Servan-Schreiber. Both were men were made no secret of their illness, both spent the last stages of their lives actively living with cancer, rather than dying from it. They were great role models for those of us who still struggle daily with the sense of a dual identity given to us by this illness.  

I’m not ashamed to admit that my feelings of sadness also come from a source of my own selfishness. Because for every wealthy, robust individual in the public eye who doesn’t make it, the hope for little ole’ me being able to keep the big C away from my door seems to grow smaller and smaller each day. But metastatic breast cancer is a strange beast. There are examples of women who have lasted just a few years after diagnosis, while others seem to just keep on going and going.  But stranger than this, is the emotive power of the ‘C’ word. Despite the fact that cancer is a collection of more than 100 diseases, diseases that are so diverse in both type and biology that they could easily be categorised as completely different illnesses altogether, I am still able to feel intense feelings of empathy for individuals and their families affected by this disease who I’ll never, ever meet. So farewell Christopher, farewell David, farewell Steve. I never knew any of you at all, but your passing and your achievements despite your illness, will always remain in my thoughts. 

Thursday 8 December 2011

Shooting From The Hip...


After almost a week's sojourn in the lovely little Italian city of Lucca, I can wholeheartedly declare that I  have returned a new woman. While my stay sadly did not include gazing at the Tuscan valleys from the comfort of my hill-top villa, as is so often the case with the many British tourists who visit and then subsequently decide to live in this wealthy part of Italy, I still managed to enjoy this city by wandering through the medieval, cobbled streets, doing a great deal of window shopping and stopping off along the way to enjoy a quick espresso. While I was there, I was so busy taking in photography shows and food markets, that I scarcely had time to think about the devastating news that I'd received just the week before. And while the sword of Damocles once again seemed to be wavering precariously closer to my head, I could at least feel smug in the knowledge that even if it was for just one week, for once I had managed to outfox those bastard cancer cells - by booking a trip to a place so gorgeous and thoroughly historic in both architecture and mood, that sometimes, just sometimes, I could fool myself into thinking that I'd stepped back in time and that my new reality really, really wasn't happening to me. 

But I guess all dreams, no matter how real they might seem at the time, have to come to an end. So once again I'm back in the land of scans, referrals and blood tests. I've chosen this time to tell very few people about my recent diagnosis, mainly because I'm not really sure how to. The few friends that I've told have understandably enough, been concerned but hopeful for me. My family, of course feels the same way too. Maybe I'm just a bit worried about being written off. Perhaps deep down I'm hoping that when friends, acquaintances and colleagues see me out and about with my steadily growing hair and my (literally) juiced-up skin - they'll think how great it is that I've recovered - and I'll be taken seriously and welcomed back into the world once more. Perhaps I'm reluctant to be seen as the hopeless case. I'd rather be the survivor who triumphed over tragedy. But of course, things aren't quite so linear. Not where cancer's concerned anyway.

But everyone is keeping positive - positive in the hope that the next drugs will work much better and for a longer period of time. 'If I can't be cured' I told a friend over the phone the other day just after my return from Italy, 'I don't care what they have to do to me, as long as they keep me alive'. And this is I suppose, what they call the 'new normal'. When it becomes normal to say 'I have cancer in my body but I'm still alive' instead of 'I had cancer in my body and I've still survived'. It's amazing how quickly the mind can adapt when it's in crisis. So while I may have lapsed a bit on the no dairy, nearly no refined sugar, no coffee (I'm not even sure why I'm abstaining from this last guilty pleasure as Italy is most definitely not the best place to be when you're trying to abstain from cappuccinos), this week I'm mostly back in Cancerland together with the fresh juices, the turmeric and whatever else I can discover which might help me fight the adversary that I've yet to meet.

You see the difference between having primary or early-stage cancer (basically cancer that hasn't spread) and having metastatic breast cancer is how doctors treat you. Let's use the analogy of a gunfight. When you have primary cancer, the docs go in with guns-a-blazing, throwing the most aggressive treatments at your body in the hope of eradicating it of all disease. They draw, shoot and the opponent falls. And hopefully he doesn't get up. And you're free to get on with your life, however battered and bruised you might feel in the process. But when you're diagnosed with the metastatic version, the opponent becomes more like the psychotic rogue robot, Yul Brynner in the film, Westworld. You shoot, he falls. He gets up. You shoot again, He falls, He gets up. But the next time he looks a bit crazier; a bit more out of control. You might be determined for him to die, but he's just as determined to stay alive. The thing that I love about this film, is that in the end, James Brolin (the good guy) outfoxes him. He holds back on some of the ammo, he figures out a way of second-guessing the robot. He doesn't show all his cards at once. And what I've realised, is that this is exactly how oncologists treat metastatic cancer. Treatment becomes more like a poker game where the skill of the oncologist is not so much about getting rid of your cancer, but making sure that your cancer doesn't get rid of you. And if this means using a combination of drugs, surgery, radiotherapy and even drug holidays to keep you still breathing, then that becomes your treatment. But it certainly isn't a one size fits all. And this is what makes their job so difficult.

So for now, I'll remain in this surreal parallel world, the one that consists of talk of radiation on an area that seems scarily close to the nerves in my legs, the one that talks about taking chemotherapy tablets as if they're paracetamols, the one that gives me lots of statistics, but no real answers and the one that I live in while simultaneously juggling within the world of building blocks and nursery christmas plays and creative ways to get the little one to eat more fruit and veg. And then there's normal life. Or at least the normality that I see other folks living while I move, sometimes unsuccessfully between these two zones. The lives of others (at least the ones that I only see from the outside) seem so simple and straightforward. They go to work, they go home, they have hobbies, they complain about their partners, they complain about being single, they complain about their jobs, they complain about being broke. They live simple lives. And I envy them for this.

But I'm getting used to the fact that this seemingly never-ending round of doctors and scans and treatments is my new normal. Because it's no different to what other women with this disease are facing. And as I enter the 'living with' phase, perhaps instead of hoping that I'll see the light at the end of the tunnel, I should merely wish for a wide, open road. Because if I can stay on this road and move forward without really knowing where I'm going while still being able to enjoy the journey, then perhaps the destination no longer matters.  All that matters is that I stay on this road for as long as I possibly can.