I am delighted to have reached the end of my current chemotherapy course, and somehow to have reached this milestone feeling better than I did when it started. It is not difficult to bid farewell to sixty nights of pills, all the nausea and fatigue and changes of appetite, and the other side effects like the itchy rash. Still, all that poison seems to have done its job, so was always welcome in my life.
We have deferred celebrating this milestone for the time being. Next week I have a regular MRI and the following week my oncologist will pronounce on its findings and his suggested next steps. I understand that a break from chemo is almost mandated at this point whatever my condition, to allow some time for recovery of platelet and white blood cell counts and a few other metrics. So even if we might possibly be leaving the door slightly ajar for the cancer, it and any other ailment would encounter a stronger immune system to impede its progress.
Still, reaching the milestone with such unexpectedly good health has filled me with awe and wonder and prompted a few tears. I find myself noticing small seasonal events and contemplating how I never thought I would have that good fortune. The change of the clocks and the evening daylight hours, some occasional warm sun, the colours of early flowers and blossom, the transitions through the end of lent and in Holy week, and even the start of a new baseball season have all made me pause and give thanks.
I see the main oncologist, a man we greatly respect, every eight weeks, although that might become more occasional in the next phase. Before each visit I make a list of questions to ask him, and I have noticed that over recent months that list has been very short. I have had my head down and been focusing on enduring the treatment and not really had space for much else. The path forward has been clear and obvious and the risks ever-present and known. It has been like the middle execution phases of some work projects, where distractions are unhelpful, and all energy should be focused on getting things done and handling any setbacks.
But this time it is different. I find myself waking up with my head full of questions. I haven’t started to write them down yet, but soon I will, and the poor man will surely face a barrage when he sees me, so long as the meeting agenda is not overwhelmed by fresh bad news. Most of the questions seem to fall into two categories. What can I do to make the cancer less likely to return, and what are the primary warning signs to look out for?
The first of these big questions is really one we could all ask ourselves all of them time. The answers are quite likely the same as they would have been had I my chance run into a leading neuro-oncologist before the brain tumour had developed at all.
Beyond the obvious and well-known answers such as not smoking, avoiding addictions, controlling stress and sleep as well as possible, avoiding ultra-high processed foods and too much salt and sugar, and fitting in some exercise, I am curious as to whether any answers will be forthcoming. As far as I can tell, the primary answer might be to have better luck, or at least have less susceptible genes. That would be quite frustrating, but also perhaps somewhat reassuring, because at least I could conclude that I did nothing daft to bring the cancer on. Fifty years ago, the prevailing wisdom would have suspected that the root causes of my cancer must have included a large dose of sinfulness. Part of me wonders if, twenty years from now, folk might look back at today and be astonished to recall that we currently consider the main root cause of many cancers, including mine, as plain bad luck.
The second category of questions, the ones about warning signs, should be easier to answer, and perhaps I know a few of the answers already. I am anxious because for sure I was lucky last time to spot the small change in my peripheral vision and to take some action about it. The sooner we can identify a problem, the more likely we are to be able to fix it.
My wife was probably having similar thoughts about lifestyle and behaviour when she recently encouraged me to visit an acupuncturist. She has started seeing a practitioner to help her with muscle and joint issues and is encouraged by her progress. I am an advocate of acupuncture, albeit a cautious one, after the treatment helped me fifteen years ago when I had very sore shoulders. Acupuncture helped me, but the real cure was to retire from work and to stop lugging heavy computer cases around with me all the time.
I had my first session earlier this week, and I remain curious. I am fascinated by the idea that sticking needles into an arm might offer relief to a kidney, but such wonders seem now to be generally accepted. The stretch in credibility was simpler for an aching shoulder than it is for brain tumours, but perhaps this Japanese gentleman will have something useful to offer. His answers to my questions are sure to be different to those of the oncologist, but perhaps they are also valid. The first visit failed to deliver any magic wands (how could it have?), but I came away convinced that he was not a scam artist and that if he tried a treatment, it would be because he thought it might work rather than as a ruse to take money from our insurance company.
Such diversions are probably another sign of a progression to a new phase in my cancer journey. Six months ago, buried deep in chemotherapy, I would not have been open to complementary approaches, but now I find that I am, at least a little bit. I reached a space where there is room for such alternative thoughts. That in itself is a cause for celebration.
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