- In this first post I talk openly about my cancer diagnosis and some of the effects this diagnosis has had on my life. It is a personal account that I share in the hope that friends, family and interested strangers might better understand what I have gone through and how I have tried to fight the good fight against the behemoth that is cancer.
Let’s talk about death, baby. Life expectancy in most parts of the world is now higher than it has ever been. Even so, and despite tremendous advances in medical science over the last few hundred years, the chances of you dying at some point in your life still sits at around 100%. Yes, like it or not, you are going to die (although see here). What is uncertain for most of us is how that death will come. Will it be sudden and unexpected, like a surprise encounter with a NATO bomb while you are going about your business? Or will it take the form of a disease that slowly takes your health away from you? One such disease is cancer.
This week marks one year since I was diagnosed with cancer. If you had told me that one day I was going to be diagnosed with cancer I would tell you that is not a bad prediction. According to Cancer Research UK people living in Britain have a lifetime risk of being diagnosed with cancer of around 40%. In other words, 4 out of every 10 people will have the misfortune of encountering cancer first-hand at some stage in their lives. What I never expected, however, was that at the age of 34 and being otherwise very fit and healthy, I would develop a very rare and little understood cancer (anal adenocarcinoma) and that the diagnosis would be delivered over the phone while I was eating a cheese scone at Britain’s best motorway service station. Up until that moment (and on numerous occasions by numerous doctors) I had been told that I was simply suffering from an acute case of haemorrhoids, so I had nothing to worry about. This news changed that.
One of the first challenges for me was to try and make some sense out of this news. When I asked the consultant why I might have developed the cancer, he had no response; other than to say that I did not fit into any of the risk groups (no history of disease or tomfoolery in the region) and so the cause is entirely unknown. The shit had just happened.
But why me? To paraphrase the late Christopher Hitchens who died recently of esophageal cancer, rather than ask “Why me?”, a better question is “Why not?’. Why not indeed! Bad things happen to people all the time. The question then becomes what are you going to do about your situation?
It is reported that seven times Tour de France winner and intelligent rule bender Lance Armstrong said “Cancer is the best thing that ever happened to me”. While it is too early in my cancer journey for me to be able to echo this sentiment, the positivity he emanates is very important. There is clear evidence showing that a positive mental attitude is consistent with better health outcomes. In other words, positive thinking is not only mentally good for you, but physically good for you too.
When I was first diagnosed my attitude was that it was not going to affect my life. I knew that if the medical professionals could fully remove the cancer then I could expect to live a long time. So, I left it in the hands of the surgeons and continued working, thinking of the cancer as little more than a nuisance. Following further tests, however, it became apparent that in order to try and stem the spread of the disease I would need to have an abdominoperineal resection. I am not afraid to admit that this brought a tear or two to my eyes.
This example illustrates the difficulty inherent in keeping a positive mental attitude at such a time. By it’s very nature, a surgical intervention of this type is a pretty traumatic experience and when you have this looming over you it could be easy to let it dominate your thoughts. Sometimes it is close to impossible to be simply, ‘positive’ about everything. What you can do, however, is distract yourself, take charge of your own attitude, and direct your attention elsewhere. By coincidence it was at about the same time that I was invited to try stand-up comedy for the first time through an organisation called Bright Club. I reasoned that my desire to not completely flop in front of a live audience would act as a distraction to all the arrangements for the surgery going on in the background. So, a week before I was due to have my innards rewired, I got up and had a go (see here for video evidence).
As it turned out, my attitude of just ignoring the cancer and assuming that it would go away couldn’t last for very long. The surgery and accompanying pathology reports showed that the cancer had invaded my body more dramatically than first feared. One of the ways that cancer can spread around the body is through the lymphatic system. Once the cancer gets into the lymphatic system it can, from there, make it’s merry way to various major organs. My pathology report showed that of the 22 lymph nodes removed as a pre-emptive strike, cancer was already in 17 of them. Again, a shock. On the positive side, at least these were now out of my body!
In the meantime, I started developing lumps on the skin around my groin. Three independent doctors told me that these were ingrowing hairs and therefore nothing to worry about. They turned out to be wrong. So in my case, the cancer spread from the end of my digestive tract both internally (through the lymph nodes) and externally (onto the surface of my skin). As a result of this spread I have now had two episodes of laser surgery (the cancer is vaporised with a laser), electron therapy (electrons are fired at the cancer in a procedure that is a relative of radiotherapy) and last week I started chemotherapy.
In the meantime I try and keep myself happy and entertained as best as possible. Having dedicated the best part of my life to academia, free time has been a rarity, so it is nice to have a little bit for a change. But how much? Due to the rare nature of my cancer, questions concerning my prognosis are difficult. When you ask your doctor “how much time do I have left?” the answer is based on data concerning what normally happens in such cases. In my case there is no such thing as what normally happens because the disorder is so rare. So all I know is something about the best and worst case scenarios. The best case scenario is that the treatments I am having (all of which have been selected on a ‘best guess’ basis) will stop the steady progression of the cancer. This will mean remission and many years of life. The worst case scenario, and I quote my oncologist, is that “we hope to keep you alive for years rather than months”. It is into this massive void, this uncertainty, into which a positive attitude has to be injected. One piece of good news was that my most recent CT scan showed no evidence of further spread. In the context of everything else, I’ll take that. Cancer is fought in the mind as much as it is in the body. And so, and until further notice, I intend to remain unremittingly, and unapologetically positive.
I have not been doing all of this alone. In this regard I want to thank my loving wife Miriam for helping me get through each day, as well as my family and friends for all their support. I also want to thank all the staff who have helped care for me in various hospital wards and clinics. Finally, in terms of trying to stay positive throughout this experience one of the most helpful organisations has been Maggie’s Cancer Caring Centre. It is brilliant.