My Cancer Blog

Breakfast

2012-01-30T07:54:00.001-08:00

Here’s a sentence I never thought I’d write:

On the way home from the gym I stopped off to buy muesli to have for my breakfast.

And yet, this exactly describes my activities this morning.

Not so very long ago a breakfast wasn’t a breakfast for me unless it was a cooked breakfast – even if it was just a bacon sandwich. And, of course, exercise was anathema to me (but drinking 30 plus pints of ale each week wasn’t). I wouldn’t have been able to spell muesli, let alone dream of eating it. Now, most mornings, it’s washed down with soya milk after a visit to the gym.

I’m not entirely virtuous, you understand. I still enjoy a good fry up and a few beers at the weekend. But I must reluctantly admit to feeling a lot better for my new diet and exercise regime.

Marvellous what a spot of cancer will do to buck your ideas up.

Will I Ever Be Granted Access to the Inner Sanctum?

2012-01-13T03:46:00.000-08:00

I have been a proud member of the Cancer Club for coming up to 10 months now. In that time certain friends of mine have made manful attempts to join me in the club but have had their applications for membership politely but firmly knocked back.

“I’m sorry, sir, but polyps are not cancer. Yes, they have the potential to develop into cancer and, if that happens, please re-apply.”

“I’m sorry, madam, but the lump was removed at an early stage and the backup treatment has been entirely successful. If the trouble does re-occur then please come back to us.”

So, I’ve got myself across the threshold. But, even so, after all this time I still only have junior member privileges. Why? Because they won’t let me have chemotherapy!

Here’s what happened. We piled in to see the specialist on Wednesday, confident that the main topic of conversation would be the schedule to commence chemotherapy. That is what we had been led to believe before Christmas. But, guess what, following the radiotherapy treatment in November and the switch to a different second line hormone treatment my PSA has plummeted from 101 down to 5.15. On top of that I’m feeling particularly fit and healthy – going to the gym again four times a week and what a great walk we had on the moors on Saturday. So, low PSA plus good health equals no chemotherapy!

I tried to talk him into it. I pointed out that if I’m feeling fit and healthy then surely it’s a good time to get the chemotherapy out the way? But the damn fool doctor came back with some ridiculous explanation about how chemo attacks cells that are rapidly dividing and if my cancer cells are relatively dormant then the therapy would have no effect. Damn fool doctors – what do they know?

I’ve a good mind to go back to the NHS. They were quite happy to let my PSA go through the roof. I would have got my chemotherapy there!

How Exercise Can Boost Self Esteem During Cancer Treatment (by David Haas)

2012-01-04T02:06:00.001-08:00

There are countless studies that show how exercise can be physically beneficial during cancer treatments like radiation or chemotherapy. The physical benefits include things like reduced nausea, increased appetite, increased circulation and reduced weight gain for those who suffer from ailments like breast cancer or mesothelioma. While these are all hugely important, what remains equally important are the emotional and mental benefits that exercising during cancer treatments can bring. Many cancer survivors claim that exercise is a way to boost their self-esteem, which can often be low during this challenging time of life. Here are just a few of the reasons why exercise can help to boost self-esteem during cancer treatment and recovery. Of course, before beginning any exercise plan be sure to see your cancer or mesothelioma doctors first.

Body Image: Both men and women can have a negative body image thanks to the horrible disease with ravages their body. A woman might feel less feminine after having a mastectomy, or less attractive after gaining weight to to reduced activity during treatment. To counteract these negative feelings, patients can exercise as a way to improve self-image. Even a small amount of daily exercise in the form of a walk or a yoga class can help to connect the patient with the positive aspects of their body and feel more connected.

Weight Control: Weight is often an issue for those who are dealing with cancer. Some hormonal diseases, especially those among women, can impact the body by causing weight gain. This in turn can lead to other diseases like heart problems, high blood pressure or diabetes. On the other end of the spectrum are the many people who lose weight during treatment like chemotherapy. Those patients who need to lose weight can do so through moderate daily exercise like walking or cycling, while those who need to gain weight can use exercise to increase appetite and build muscle.

Social Aspect: Although many cancer survivors enjoy exercise to allow them time to think and be alone, many others love the social aspect. It can be enjoyable to spend time with friends and family doing something besides discussing the illness or treatment. Consider joining a dance or yoga class to enjoy the benefits of social activity during treatment.

Whether a patient needs to lose weight after treatment, gain weight after surgery, or simply improve their body image, exercise can be a beneficial tool to help boost self esteem.

Guest Blog

2012-01-04T02:01:00.000-08:00

I have been contacted by a David Haas from the United States. He has made some kind comments about my blog and asked if I can aid his campaign to spread awareness of how beneficial cancer support networks and also staying physically fit is to people going through treatments, in remission, and even family members of cancer patients. David, himself, is a cancer patient advocate for the Mesothelioma Cancer Alliance (mesothelioma being an aggressive cancer affecting the membrane lining of the lungs and abdomen).

I am happy to upload in full the article he has sent me on the benefit s of exercise during cancer treatment. As someone who will be facing chemotherapy shortly I have already determined that, during the treatment, life will continue as normally as possible (including my exercise regime which now, once again, includes 3 to 4 visits to the gym each week). I was horrified when I saw how much weight I have gained over the festive period. My wife, I think, was delighted as I suppose it is a normal, healthy reaction to the holiday excesses. I was going to put up a post all about it until I remembered that this is supposed to be my Cancer Blog and not the Diary of Bridget Jones (10,000 calories v. bad; 100 alcohol units v. v. bad!)

I agree with everything that David has written in his article. Well, perhaps less so with the social aspect of exercising – when it comes to the gym I’m more of a head down, iPod earphones in man myself, even, and much to her bewilderment, when I’m with the wife.

David’s article follows.

The Festive Festivities

2011-12-29T09:43:00.000-08:00

I weighed myself the day after Boxing Day. I have gained half a stone. See! See! I told you the weight loss was all down to careful diet and exercise. Now do you believe me? I’m not wasting away with disease – not yet, anyway.

It’s time to up the exercise regime – I’ve only been to the gym once in the past week and a half – and do some serious calorie burning. But with a house full of uneaten Christmas pudding, stollen cake, chocolates, sweets, crisps, nuts and nibbles it is not going to be easy. And the festive season isn’t over yet. There are two good drinking sessions coming up plus New Years Eve to contend with.

I might put the resumption of the diet and exercise regime on hold for a week!

Round Robin

2011-12-18T14:04:00.000-08:00

It’s Christmas card season. I open each card wondering if it will contain a round robin letter. You know the type of thing: “Tarquin did awfully well in his GCSE’s and we had such a lovely time touring the vineyards of Tuscany.”

It makes me wonder how our round robin would read.

“Iain did awfully well in his PSA test and has even managed to improve his score as the year went on. He was given a ten year life expectancy but has worked really hard and managed to bring it down to just three.”

Well, perhaps not.

I recently wrote a letter (an actual letter, not an email or a text!) to a friend who I haven’t seen for a few years which turned into a sort of round robin as I recounted the year’s events. But it made me realise that the year hasn’t all been about cancer. There have been many other things besides.

For example: Four music festivals (Shepley, Bridge Bash, Bromyard, Ramsbottom); two foreign holidays (Brittany, New York); trips away to Lincoln, The Lakes, Wales and other places; lots of football with Accrington Stanley making it to the play-offs; lots of cricket with Ramsbottom winning the Twenty 20 Cup, The Worsley Cup and the Colne Trophy (but failing to retain the title); lots of amateur dramatics with two stints backstage as props and stage manager and now rehearsing the part of Colonel Sir Francis Chesney for the next production (Charley’s Aunt); lots of blog writing. And lots of warmth, love and support from my wife, my family and my friends.

Yes, there has been much more to the year than just cancer and that’s how it’s going to be in the year to come. I’ve still got quite a bit of living left to do.

Merry Christmas and a very happy New Year to all my readers!

Musings on Death (4)

2011-12-15T08:55:00.000-08:00

The thing is, I’ve done most things late in life. I think when I left school I must have subconsciously decided that a year out would never do. It was going to have to be more like 20 years out. So I got my degree at the age of 39.

Not that I was completely idle up until that time. The degree I’m talking about there is my masters in Computer Science. I graduated first time round in Hotel Management at the age of 30 and followed a conventional career path for a few years until I threw it all up for life on the road as freelance relief manager.

But where was I? Ah yes, I got my degree at 39 and was taken on as a graduate trainee – the oldest graduate trainee in the company’s history. I was 42 when I bought my first house, 47 when I got engaged and 48 when I got married. You see, everything late in life.

But the one thing I could do with doing late in life – the one thing everyone wants to do late in life – I can’t manage. (Can you guess what I mean?)

Ironic isn’t it?

Landmark Day

2011-12-08T02:56:00.000-08:00

Yesterday was my first painkiller free day for about two months. Note, I don’t say pain free day but what pain I did feel (and it had built up by the end of the day) was bearable.

The day started with the best session I’ve had in the gym for about two months – treadmill, exercise bike, swimming – because I felt up to it. I then spent the day working – because I have now returned to full time employment.

And the whole day was preceded by a good night’s sleep involving lying on my left side – which a few weeks ago would have been unthinkable because of the pain and discomfort I was experiencing.

What I’m getting at – and it’s early days so I should be a little cautious – is that the radiotherapy appears to have been effective. Effective in that it was designed to relieve the symptoms and the symptoms have been relieved.

The biggest pain I felt yesterday was watching Manchester City pull off a magnificent victory against Bayern Munich only to be denied further progress in the Champions League by the not unexpected victory of Napoli over Villarrael. The pain, however, was slightly alleviated by the “painkiller” of Manchester United’s unexpected loss to Basel which resulted in them also crashing out of the Champions League – only in much more ignoble fashion than City’s exit!

I must try not to feel too smug about that.

Radiotherapy – So Far

2011-11-23T07:05:00.000-08:00

I am led into a large room filled with buzzing machines and flashing lights, all being attended by men in white coats. I’m strapped to the table and a fat man in a tuxedo pulls a lever. A red beam fires from a space age gun suspended from the ceiling. The red beam advances up the table, slicing it in half, and comes dangerously close to my groin area.

“Do you expect me to be cured of my cancer by this?” I ask nervously.

“No, Mr. Bond,” the fat man replies. “I expect you to die.”

And then I wake up.

The reality is I walk down a labyrinth of corridors, through all the NHS radiography suites where the waiting areas are full. Eventually, I arrive at the private radiography suite. Here, the waiting area is empty and I’m shown straight in. I lie on a hard table, just a cushion under my head, and lower my trousers. A piece of blue paper is strategically placed in an effort to preserve my modesty, but it keeps slipping off. A glass plate is positioned above me and lined up with the marks that were made during my measuring up session. The radiographer leaves the room, I hear a high pitched whining noise for a few minutes, the radiographer comes back and tells me that I’m all done.

And that’s it. Three sessions down, two to go. The only ill effect I experience is a vague sense of guilt as I walk back through the crowded NHS waiting areas and see the same faces looking up at me.

The Latest Scans

2011-11-21T04:12:00.000-08:00

I have confounded the medics. My latest scan results are full of surprises. The soft tissue cancers, i.e. the lymph nodes, have shrunk considerably. By more than half in some cases. The bone cancer, however, is a different story. That has spread considerably.

But the situation is not totally desperate. There are, I’m finding out, two types of bone cancer – one bad and one not so bad. To be a little bit more precise, one causes bone destruction (bad), the other causes bone hardening (not so bad). For some reason, not clearly understood, when prostate cancer spreads to the bones it nearly always results in the not so bad cancer.

There is, however, an area of the bad cancer in my lower spine where I have been experiencing pain. So a course of radiotherapy has been decided upon.

Radiotherapy! I’m finally upping my game. Up until now I’ve felt something of a gatecrasher at the cancer party. I mean, I’ve only been on injections and the odd tablet – that’s not proper cancer, is it? But with radiotherapy I reckon I can hold my head up a bit. I’ve arrived!

Of course, what I really aspire to is chemotherapy and to sport the ’slaphead of honour’. But we must be patient. That will come in time (next year).

Meanwhile, radiotherapy beckons. Watch this space for news of my latest adventures.

Advantages Associated with Having Terminal Cancer

2011-11-10T07:26:00.000-08:00

Well, there must be some perks? Here’s a few I’ve thought of so far:

· Increased pub time. Don’t say to the wife, ”Is it alright if I meet the lads for a pint?” Say instead: “I feel I need to spend some precious quality time with my dear friends while I still can. Is that OK?” The answer will be “Yes” every time.

· I could renew my interest in recreational drugs of the smoking type, ie cannabis. If caught all I’ve got to say is that it was the most effective means of pain relief I was able to find for my cancer. And hope the magistrate hasn’t read this blog.

· You can shut boring people up with a choice phrase such as, “Is this going to take long only I haven’t got long to live” or, better, “I’m losing the will to live here!”

· You might, just might, be able to claim the senior citizen rate on a range of goods and services providing you can convince the vendor that, counting back from when you’re going to die, you are technically a senior citizen.

Please note that the comments above are just a poor attempt at humour on my part. My dear wife does not begrudge me one second of time that I wish to spend with my friends. She is, after all, my best friend. And if I do take up cannabis again it REALLY will be because it’s the best means of pain relief I’m able to find. Honest!

The Easy Bit

2011-11-09T03:45:00.000-08:00

Everyone tells me how well I’m coping, how positive I am, blah blah blah. And I suppose I am. But there’s one thing I find hard to cope with and that’s the effect that all this is having on my loved ones – my wife, my family and my friends. I seem to do nothing but pass on bad news these days.

So don’t feel sorry for me; I’ve got the easy bit. All I’ve got to do is die. The hard bit, coping with my death, that’s all left for others to pick up.

The Death Zone

2011-11-09T03:00:00.001-08:00

I am moved by words spoken by the late Lord Gould when he described his final months of life having been diagnosed with advanced cancer of the oesophagus.

“I was in a different place, a death zone, where there was such an intensity and such a power, apparently this is normal, and, even though, obviously, I would rather not be in this position it is the most extraordinary time of my life; certainly the most important time of my life.

When you get to the final stage, the death zone, you are dealing with something that is so intense. I mean I look out the window and I feel the intensity, the intensity of my wife, the intensity of my family, that it is the natural place to be and to leave this now, to leave this extraordinary place now, I would not want to do that. This is the final place, and the right place for me at this time is to be in the final place. “

So, I ask myself, am I in this different place, this death zone? Do I feel the intensity? I pause to reflect.

Hmmm…nah!

Maybe in three years time. Something to look forward to.

Musings on Death (3)

2011-11-09T02:59:00.000-08:00

I know that I’m going to die of cancer and I am prepared for it. Before this happened to me I always found it odd that people with terminal illness can reach a stage of acceptance. But it’s actually not that difficult to come to terms with your own mortality. You only need to remember three things:

1. You were going to die anyway

2. There was never going to be a GOOD time to die

3. All that’s changed now is that you have a slightly better idea of when it’s going to be.

And that’s it. Simples!

Celebrations

2011-11-09T02:58:00.000-08:00

One evening my wife and I are sat quietly in the pub. We both know that the treatment is not working and that the ten year estimate given on my life expectancy is now proving to be somewhat optimistic.

“How long,” Sue asks quietly, “do you think you’ve got.”

I’ve been giving this some thought.

“I just feel,” I say slowly, “that’s it’s going to be around two years.”

Sue nods.

“I’ve been thinking the same too,” she says.

We hold hands and don’t speak for a while.

So, when we next visit my private oncologist I have decided to put a straight question to him regarding my life expectancy. We brace ourselves for the answer. It seems that every bit of medical news we get these days is bad news so, what’s it going to be? One year, six months, three months?

“Well,” the doctor explains, “the average following the failure of hormone treatment is around three years but there are lots of reasons to suppose you are above average, your relative youth and good health for example…”

Three years? Three years plus, by the sounds of it.

On the way home it is Sue who puts forward the suggestion that I’ve desperately been trying to think of ways to tactfully introduce.

“Shall we stop for a drink?” she says.

I readily agree. By chance, we run into a couple of friends and one drink turns into several. They both remark on how well I’m looking. They don’t know it but we are celebrating!

This is what happens in the topsy turvy world of terminal illness. The doctor gives you three years to live and you go out to celebrate!

In Future Let’s Keep Mathematics Out Of It!

2011-10-26T13:23:00.000-07:00

The results of my latest PSA test are due. Now I know, I just know, that my PSA count is going up so, in preparation for the latest reading, I’ve made a few calculations.

On 3^rd August my PSA was 18.1. On 7^th September it had risen to 31.1. That’s a period of 35 days with a rate of increase of 0.37 per day. The latest PSA test was done on 19^th October, 42 days after the previous one. Projecting forward at the same linear rate gives an expected reading of 46.7.

So, anything less than 46.7 would be good. If it’s a little bit more, or in the same ball park, we’re still happy. There now, I’m prepared for the latest result.

So I ring the doctor – and guess what the result is.

101.

101!

Hmm…so that went well, then!

Am I Still In Denial?

2011-10-26T13:19:00.000-07:00

Look, here’s the lowdown. I’ve been watching what I eat and I’ve started taking regular exercise. I’ve even joined a gym. I work out four times a week! So, I’ve lost weight. I’m quite proud to report that I’ve come down a trouser size. And, as I keep telling people, it’s weight loss for the right reasons; I’m not wasting away with disease. My weight has stabilised.

On Saturday night we attended a function at my old social club. This place used to be my regular watering hole but, since moving away, I’ve lost touch with most of the people there. They had, however, all heard about my illness. Consequently, on entering the club, I am confronted with a wall of sympathetic, concerned faces. At first I am quite touched but then, as the evening passes, the real reason for their concern comes out.

The weight loss.

No, I insist, I’ve been watching what I eat and taking regular exercise. I’ve even joined a gym; I work out four times a week.

But the concerned looks don’t disappear. I think I see some pitying glances being exchanged.

It’s true, I persist. It’s weight loss for the right reasons; I’m not wasting away with disease. My weight has stabilised.

The best query of the evening comes from an old friend, my best man’s daughter.

“Is the hair loss,” she asks tentatively, ”due to the treatment?”

Hair loss! Whoa!! I haven’t lost any hair! I haven’t had any treatment that would occasion hair loss. What I have had, that very morning, is a visit to the barber’s and a number two all over.

Now that bit is definitely true!

The Kubler-Ross Model

2011-09-16T02:59:00.000-07:00

First, a history lesson. The Kubler-Ross model was postulated in 1969 by Elisabeth Kubler-Ross and is popularly known as the 5 stages of grief, although they apply equally to any life changing or life threatening situation, eg receiving the diagnosis of a terminal illness. The 5 stages are Denial, Anger, Bargaining, Depression and Acceptance. Elisabeth Kubler-Ross was at pains to stress that not everyone will experience all the stages and not necessarily in the order stated.

So, I ask myself, have I passed through these stages?

Denial

Well, yes, I’ve already written about denial in an earlier blog.

Anger

Don’t recall going in for any anger. For some reason, thinking about this stage brings to mind an incident from over ten years ago when I was on a plane that had to make an emergency landing. Basically, we came in to land with no idea as to whether the undercarriage had properly engaged or not. As we approached the runway I remember thinking, with my head bent down in the brace position, that I couldn’t possibly die today, I was too young (I was 40!). But then I realised that people my age, and younger, die all the time and this really could be the end. In years to come my friends in the pub would remember me as ‘that guy who was killed in the crash at Manchester Airport’. Obviously we landed safely but it was an unsettling realisation.

Perhaps that’s why I’ve never gone in for the ‘Why me?’ nonsense. Because it is nonsense. Why not me?

Bargaining.

The only bargaining I can recall was in relation to the potential side effects of the hormone therapy; breast development and loss of sexual function. “Give me tits,” I remember thinking, “but don’t take my mojo.”

I’m please to say that neither happened. No breast development, notwithstanding the magnificent man boobs of which I was already the proud processor. And in the words of the blues song, “I’ve got my mojo working, baby!”

Depression

This is a tick in the box. I try to stay as upbeat as possible but, sometimes, dying of cancer does get you down. The truth is, at one stage I even considered seeking help for the depression I was feeling.

Acceptance.

Yes, I have come to terms with this and accept that I am going to die of cancer. It might seem strange to a lot of people that this stage can be reached; it’s always seemed strange to me in the past. But you really do reach a point where you can calmly accept what is going to happen to you.

But then it’s easy to accept when you haven’t really got it. Any day now they’ll realise they’ve made a mistake and let me know. You’ll see!

Going Private

2011-09-08T06:56:00.000-07:00

Yes, I’ve sold out my principles and gone private. I tell myself that I’m helping the NHS by relieving the strain that they’re under. People that can go private have a duty to go private, that’s all there is to it.

The real reason is that I’m fed up with the casual indifference that I receive at the hands of the NHS conveyor belt.

And what a different world I’ve entered. I turn up at the usual hospital only, this time, I have a private parking place. No more scouring the side streets looking for a space for me. I bypass the crowded reception area and enter a plush, quiet waiting room complete with complimentary newspapers, tea and biscuits. And the oncologist we get to see has actually studied my papers and is familiar with my case.

Ok, he slips some bad news past us. My PSA is up and it seems I might be looking at chemo sooner rather than later.

But I had a free car parking space and free tea and biscuits!

Sleeping Through the Wakeup Call

2011-08-24T03:10:00.000-07:00

I reported in this blog that the cancer diagnosis had been like a wakeup call to me. It made me realise the many ways in which I am truly a very fortunate person. The great place that I live, the wonderful friends that I have, the job that is not too unsatisfactory and, most of all, my incredible wife, the absolute love of my life.

But now everything seems normal again. Yes, there are holidays, festivals and other outings to look forward to but work goes on and the treatment has become routine. I tell you, if I had a wakeup call four months ago then I’ve fallen asleep again.

Ah, how I yearn for those heady days of first diagnosis. The world turning upside down, the panic, the distress, the tears, the despair, the endless waiting in hospital rooms worried sick as you lurch from one shock to another.

Yes, life was good back then.

Two Things To Do Before I Die

2011-08-17T10:56:00.000-07:00

I told my wife that there were just two things I wanted to do before I died. Naturally, she was interested.

“Love my wife and live my life”, I said. And then I added, “And in that order.”

I think she approved of the ordering.

So that’s it, just two things to do before I die: Love my wife and live my life. Oh, and go to an Alice Cooper concert. But we’re doing that in October. So that’s three things – except the Alice Cooper concert probably comes under the heading of ‘Live My Life’.

Oh well, you get the idea.

The Trials of the STAMPEDE Trial

2011-08-17T10:54:00.001-07:00

So I signed up for this trial called STAMPEDE. STAMPEDE stands for Systematic Therapy in Advancing or Metastatic Prostate cancer: Evaluation of Drug Efficacy. Basically, they try out a range of treatments which are not normally used in the early stages of prostate cancer treatment to see if they are, in any way, effective. You have no choice as to which treatment you will get.

Some of these treatments, and I calculated that the probability of receiving it is 2 in 5 or 40%, involve chemotherapy.

How we agonised about the chemotherapy. Would I really want to go through with it? I’m young (relatively for a prostate cancer sufferer), fit, healthy and still working full time. Why would I want to make myself ill, not to mention bald, if I don’t need to?

On the other hand…

It could actually be beneficial. It might increase my life expectancy. In years to come I might regret not having gone through with it.

But then…

I’ve got other things to do with my life in the immediate term. Holidays, festivals, the interpretation of the role of Colonel Sir Francis Chesney in the Summerseat Players production of Charley’s Aunt. Quality of life is more important than quantity.

Finally…

I reluctantly decided that I was prepared to go through with it – but could it be deferred until after I had trodden the boards? I wasn’t sure.

We arrived at the hospital with great trepidation to receive the news of which treatment I had been ‘randomised’ for. And were casually informed that it was nothing. Nada, zilch, not a bean, nothing!

To put it more scientifically, I am part of the control group. My contribution to the STAMPEDE trial is to receive no additional treatment whatsoever.

Bit of a relief, really.

Happy Birthday to Me!

2011-08-17T10:52:00.001-07:00

It was my birthday on Saturday (52) and it occurred to me that the phrase ‘Many Happy Returns’ would have a particular poignancy this year, ie let’s hope the Happy Returns get into double figures. And then I noticed that none of the birthday cards I received actually contained that phrase.

Is that because it’s an old fashioned phrase that isn’t used anymore? Or did the people sending the cards have the same thoughts?

The Hormone Treatment.

2011-07-04T12:38:00.001-07:00

The hormone treatment is working. My PSA count is down from 84 to 5.2 and expected to fall further.

Here’s how it works. Prostate cancer feeds on testosterone. They give you drugs to stop the production of testosterone. The cancer stops growing and even begins to shrink. Problem is, with no male hormones in your body the female hormones start to assert themselves and I have noticed certain changes.

The other day I was out clothes shopping and I found myself holding a tee shirt against my body as a means of deciding if it would fit or not. And there was the time when I got to the checkout at the supermarket, realised I’d forgotten a single item and rushed off to get it even though there were six people in the queue behind me.

I never used to do that before.

Musings on Death (2)

2011-07-04T12:37:00.004-07:00

One day my wife asks me where I would like to die. We’re quite up front and matter-of-fact about it these days. Hospital, home, hospice, she persists?

For some reason, I’m uneasy about the question and avoid giving an answer. A few days later I realise why. It’s not death that bothers me; it’s bed. Bottom line is, I don’t want to die in bed. I’d much rather be out and about doing something; walking up Holcombe Hill, watching Accrington Stanley, propping up the bar of the Major.

Problem is, those are all heart attack or stroke type deaths. A cancer death tends to be a much more drawn out affair.

I suppose a compromise would be sitting up on the settee watching TV. After all, that is how one on of my great heroes, Charlie Parker, left this world.

Brave

2011-07-04T12:37:00.002-07:00

A friend rings and tells me that he thinks I’m very brave. That doesn’t seem right – I don’t feel particularly brave.

I’ve thought about it and concluded that bravery involves choice. A brave person is someone who chooses to do something that he or she doesn’t have to do – run out into enemy fire, rescue people from a burning building, confess to being gay.

I have no choice. I have to live with cancer and that’s all there is to it. If I seem to be getting on with it it’s because, once the tears and dark moments have passed, that’s all there is to do.

Musings on Death (1)

2011-07-04T12:37:00.000-07:00

I know what you’re thinking. It’s bad enough that he goes on about cancer but does he have to bring death into it? And what’s that number in brackets all about? Is he going to keep going on about death?

Well, given that I’m writing a blog and not attending a polite dinner party then, yes, the chances are that I will keep going on about it. I’ve already thought of at least one other musing on death, hence the parenthesised numeral.

This is the thing – we’re all going to die. Even you. You might prefer not to think about, you might not need to think about it. But it’s true. And having a rough idea as to when it’s going to be isn’t such a bad thing.

I’m not talking about planning your life, although you can do that, of course. I’m talking more about appreciating your life. This experience has been a wakeup call to me. It’s made me realise the many ways in which I am truly a very fortunate person. I enjoy my work, I love where I live, I have many good friends and, most of all, I have a wonderful, loving, caring, supportive wife who is my whole world.

I don't particularly recommend it (the cancer, I mean - having a wonderful, loving, caring, supportive wife is something I highly recommend). If you can get through life without being diagnosed with a terminal illness I would take that option. I'm just saying that there is a positive side. If anyone was to ask me how life has been since the diagnosis I would say, “Better than ever.” And in response to the puzzled frown that would follow I would add, “Because I appreciate it more.”

Here’s a poem I came across today. It’s called ‘Limited’ by Carl Sandburg:

I am riding on a limited express, one of the crack trains of the nation.

Hurtling across the prairie into blue haze and dark air go fifteen all-steel coaches holding a thousand people.

(All the coaches shall be scrap and rust and all the men and women laughing in the diners and sleepers shall pass to ashes.)

I ask a man in the smoker where he is going and he answers: "Omaha."

The Social Nightmare

2011-07-04T12:36:00.001-07:00

I may, in idle moments, have wondered what it be like to contract a terrible disease like cancer. If I did I guess I would have thought about how I would cope with the pain, suffering and fear. I doubt it ever occurred to me that having cancer would be a social nightmare.

The problem is that the casual greeting, “How are you?” is not an enquiry at all into how you are. Quite often that’s the last thing people want to know. OK, so close friends and family all know and complete strangers need not know. But there is a whole raft of acquaintances in between – what do you tell them in response to the “How are you?” greeting? A cheery answer of, “I’ve got cancer, thanks, how are you?” might not be entirely welcome.

Suppose they’ve already heard from someone else about your disease. They might consider that they are high up enough within your social circle to have been told directly themselves, and feel offended when you insist on responding that you’re “fine”.

In one bizarre case I’m convinced that a hypochondriac acquaintance of mine is actually jealous that I’ve got cancer and he hasn’t.

I’ve settled now for telling people how I’m feeling on a day to day basis, which is “fine”. But then close friends look at me with pain and bewilderment. Why am I suddenly excluding them, pushing them out, as it were?

I tell you, having cancer is a social nightmare.

Telling People

2011-07-04T12:35:00.001-07:00

It’s time to tell people. Face to face meetings with my family, a long email sent out to my friends. The reactions I receive are a mixture of shock, sympathy and nothing (some people just don’t know how to handle the news).

I begin to realise something (an old friends who is currently in remission from throat cancer had the same experience) - this is all much easier for me than it is for the people around me. It could be that I’m still in denial. But I think I’m beginning to realise the real reason why.

I’m fortunate enough to have a network of family and loving friends around me. The biggest impact of my death is going to be my absence in their lives. But, meanwhile, I remain centre stage of my own show (it’s just that the curtain is coming down a little sooner than expected).

I am not going to be an absence in my own life.

...but keep It coming!

2011-06-20T05:14:00.001-07:00

Anyone who read the previous blog, please don’t be put off sending me information. It all gets processed eventually.

If you know something, pass it on.

Information Overload...

2011-06-20T05:13:00.001-07:00

8^th April, 2011

People are very kind but they do insist on telling you things. I really need time to assimilate just one piece of information at a time. Principle sources of information, roughly in order, have been my wife, my wife’s friends and my friends.

I’ve been informed about apricot kernels, broccoli, cabbage, dark chocolate, environment, flaxseed, green tea, hydrogenated vegetable fats, imbalance of omega 3 and omega 6, juniper berries, killer white cells, linseed, meditation, nectarines, olive oil, pomegranate juice, qiqong, raspberries, soy, turmeric, unfiltered tap water, visualisation, wine, x-rays, yoga and zen.

Meanwhile, I’m thinking: “Hang on, did they say I have cancer?”

Diagnosis

2011-06-18T00:50:00.001-07:00

1st April, 2011

Mr John Cleary’s clinic at North Manchester General Hospital. Words are being said. The hot spots on the bone scan are cancer. The leg swelling is caused by cancer in the lymph nodes. Ten years is mentioned. I struggle to make sense of what is going on.

“Are you saying,” I ask, “that I have ten years left?”

“In fifteen years time,” says John, “you’ll probably come to see me to tell me that I was wrong. But, yes, ten years is a good average.”

I turn to my wife.

“Well, we’ll just have to make the most of them,” I say.

My wife, my dear darling wife, Sue, the love of my life. I haven’t mentioned her before but she has been with me every single step of the way. All the appointments, scans, biopsy – she was there at my side, seemingly unaware of the incredible support and comfort she gives me. I don’t know where I end and she begins, so much does she complete me. I am so, so lucky to have her in my life. Facing all this without her just doesn’t bear thinking about.

John asks if we want to get a coffee and come back to talk some more. But what more is there to be said? We decide to leave. John shakes my hand. I like John Cleary; he insists on shaking your hand when you arrive and leave, even if he’s just told you that you’re going to die.

Sue and I walk across the car park. It is a grey, drizzly afternoon. The date is 1^st April, 2011. This is no joke.

Denial

2011-06-18T00:49:00.001-07:00

25th March, 2011

Denial takes many forms.

When I went to the doctor I knew there was a problem with my prostate. But it was just an infection, or a swelling, nothing more.

And when the blood test indicated a high PSA count there were lots of reasons that could cause that. I mentally rehearsed the email that I would send my friends when the biopsy results came through. “Sorry, guys, it’s just an infection. I know I held out the prospect of cancer and the epic life and death struggle that would ensue and all I can offer in its place is a course of antibiotics.”

And when the biopsy result was positive I ignored the ‘hot spots’ that had been found on my back and rib. The scan results haven’t come through but those spots can’t possibly be cancer. They’re far too far away from the prostate; there can’t be a connection. I have localised cancer, easily dealt with.

The Biopsy

2011-06-18T00:48:00.001-07:00

11th March, 2011

If you ever have a biopsy performed on your prostate I highly recommend the Entonox, or gas and air. I can’t believe that this is optional and that some men actually decline the option. One, it dulls the pain of what is a very painful experience. Two, it is absolutely, fucking brilliant! Think of the best joint you’ve ever had, times it by two and you’re getting close.

I had a stroke of luck. I had assumed what is, by now, the all too familiar position – trousers down, on my side, knees up to my chest, waiting for the latest violation of my back passage (how fortunate we men are that the prostate is so easily accessible) – when there was an equipment failure. By now the gas nozzle had been thrust into my hand and I was eagerly puffing away. As my head inflated and began bouncing around the ceiling like a helium balloon I became vaguely aware that the doctor was struggling to assemble the spring loaded needle thingy that he was proposing to stick up my arse.

“Very sorry, Mr Marshall, we start soon,” the doctor assured me.

“No problem,” I said, taking another toke, “you take your time.” Or did I say it? Perhaps I just thought it.

I have no idea how much time passed before the procedure began. Minutes, hours, seconds? But the 'me that was me' was a long, long way away from the 'me that was my bum'. Someone, somewhere was having needles inserted into him and bits hacked out of him and someone else was flying through the air. Pain, however, brings people together and as the number of bits being hacked out of the 'me was that my bum' approached double figures the 'me that was me' became only too aware of what was going on.

“Are you sure this is working?” I demanded, shaking my nozzle about. “There’s nothing coming out of it.”

“Don’t worry, Mr Marshall,” reassured the doctor, “I save the air only for bankers.”

My body began to convulse with laughter. The nurse put her hand on my shoulder.

“If you’re laughing,” she said, “it’s working.”

Finally, it was over.

“Just lay there for a few minutes,” said the doctor.

“No problem,” I said (or thought?), ”I’ll just have a bit more of this.”

My lips headed back to the nozzle, the promise of more sweet hedonism to come, but lips and nozzle never did meet.

“Finished now,” said the nurse sweetly, snatching the nozzle away.

Finished! Finished! She took my Entonox away! Oh, man…

Helping the Young Doctor

2011-06-05T04:05:00.000-07:00

2nd March, 2011

I don't remember why I had arranged a doctor's appointment but it wasn't to get the test results as I didn't think that they would be ready for a another few days. But the young doctor thought that was why I was there.

"It's quite high," he mumbles, desperation and panic growing in his voice.

"What is?" I ask, not quite catching on.

"The blood test."

"The blood test?"

"Erm...yes."

"The blood test is quite high?"

"Yes."

"You mean the PSA count is high?"

"Yes."

"Which is an indication that I could have prostate cancer?"

"Yes."

"But the high PSA count could be caused by other things, such as an infection.?"

"Err, yes, that's right."

"If it is cancer what is the prognosis or the treatment?"

"Well, that depends..."

"I suppose it depends on whether it's spread and, if so, how far?"

"Yes."

"So what happens now?"

The young doctor looks relieved. He's on safer ground now.

"I will book you in for a biopsy and scan."

I leave the surgery and head for the supermarket where I find myself exercising incredible patience and experiencing feelings of kindness towards the slow stupid woman in front of me at the checkout who takes an eternity to pack her shopping and insists on engaging the check out person in conversation. I groan inwardly. Don’t tell me I’m going to become one of those wonderful, brave spiritual people just because I’m dying of cancer. I couldn’t bear that.

No, I tell myself. It’s just shock, it’ll wear off.

Expressing my concerns

2011-03-24T10:06:00.000-07:00

18th February, 2011

So I just happened to mention to my doctor that I was peeing a bit slower than usual. The next thing I know he's stuck a finger up my arse, told me I've got an enlarged prostate and booked me in for a blood test.

I wouldn't mind but we were stood at the bus stop at the time. You just have to be so careful what you say to that man.