Cancer in other people

  

My remarkable run of good health has continued And I feel almost as well now as I did before cancer struck. It becomes even easier to focus on feeling gratitude, while remaining aware that setbacks will surely arise eventually.

 

I lived sixty years with barely any practical understanding of cancer, because almost nobody I associated with fell victim to it. I vaguely recall one rather distant friend dying of a cancer in his forties, but I struggle to recall any other examples.

 

There is good news and bad news from a life untouched by cancer. It must be good news to avoid a common source of fear and anxiety, but the other side of the coin is that many of us are not ready to face up to cancer (in ourselves, loved ones or acquaintances) and are likely to be thrown off balance when the time comes.

 

My run of good fortune of having low exposure to cancer in others has come to an abrupt end in 2025, Scarcely a month has passed without unwelcome news of somebody we know, in some cases quite closely. It is probably primarily to do with age. Many cancers do most of their damage to people who are already sixty or over, including me. Nowadays we do have to consider sixty or even seventy a young age to die, but we should remember that some are afflicted much earlier. The toughest moments in my entire journey have occurred in the radiation therapist’s waiting room, upon realising that I was sharing the space with a sick child. Those poor children, and their parents and siblings, deprived of so much.

 

The run of bad health observed in others in 2025 has led to some new thoughts. Cancer comes in many forms and can strike at any time and any age in many different ways. It invariably triggers an emotional tsunami, for the victim, their loved ones and potential carers and for everyone else who is touched in any way. I suppose we have learned many things from our experience so far, and perhaps what we have learned might be useful to others.

 

Perhaps the most significant lesson and certainly not a thing I considered before diagnosis, is to understand that this is not just about you. If you are victim with good prospects or poor prospects, a life partner, sibling or offspring, or any friend or relative, cancer strikes in the gut where we are all vulnerable. We have to be as ready as we can be, and try to form part of a team that supports each other.

 

The life partner can be the most neglected. This is the most important relationship and one that can be a salvation or a curse. Whatever the diagnosis, both partners are victims whose lives are changing forever, but on different trajectories. Good medical professionals recognise that both partners should be treated as patients who need care, albeit different care.

 

Next, we can all take comfort if we realise thtat,that for most of us, cancer is much less physically painful than we think it will be. Our mental image from film and TV is probably of somebody bedridden and often in pain. There is some pain, but usually that is quite fleeting and easily borne. It is the emotional anguish that is the tougher challenge, and worthy of lots of discussion, even when it brings on tears.

 

Another observation is the value of trusting a medical team. That is the best way to avoid anger and other emotions that boomerang to your own detriment. Sure, doctors make mistakes and there is a lot of guessing involved in most cancer treatment, but most patients will only suffer if they do not trust their team. We have been especially fortunate, and my wife exceptionally smart, in this regard.

 

Part of trusting a medical team is avoiding putting them under unwarranted pressure. In most cases, doctors will try to avoid offering over-detailed and overly-time-specific prognoses. That will usually turn out to everyone’s benefit.

 

Anyone with a cancer diagnosis and a partner or team of supporters will be well served by hammering out a communications strategy. Increasingly, this is central to regular business situations as well as medical ones, but it certainly helps in the medical field. We chose to be open, a strategy we have maintained throughout and which I believe has served us well. We try to recognise that most people have issues with openness. Most are able to cope well with our openness and even come to appreciate it, but a lot of people, especially younger people, find it hard to talk about cancer in somebody they know well. We have generally been able to respect this reticence and hold back from sharing when the outcome might discomfort people with different communications preferences.

 

There have been many lessons from our own cancer experience. The cancer of others has reinforced some of these lessons and created opportunities to learn more. That can help me, it can help my partner and the rest of my close team, and perhaps it can help other sufferers as well.       

Anniversaries

 Anniversaries

 

Last weekend, at Easter, offered me by chance a trio of very different anniversaries. It is strange how these coincidences come along from time to time. When they do, they give us a chance to reflect and learn.

 

The first anniversary that I noticed was fifty years of Lenten fasting. I first gave up alcohol for lent as soon I had started drinking alcohol at all, let us assume when I was rising fifteen. At school there was talk among some of the religious teachers about the virtue and benefits of fasting.

 

The dangers of alcohol had been impressed on me by my mum long before this. Alcoholism really did seem to run through my family. My suspicion is that this dependence made my family more normal rather than more exceptional, and this may still be true across parts of the world. I don’t think I ever saw my Dad’s sister sober, and Dad himself had a history of alcohol abuse before allowing himself to be “saved” by Mum.

 

Whatever brought on the pledge, I decided one day at school that I could happily do without alcohol between ash Wednesday and easter Saturday, and duly proved it without serious difficulty. And my guess is that this Easter marked the end of my fiftieth consecutive such fast. The logic was always the same. If I could live without alcohol for six or seven weeks each year with no cheating, then I could be sure that I had no alcohol problem. It still works beautifully.

 

Despite my pledge, alcohol and its dependence continued to play a central role among people close to me, including some of those I held most closely. At one point I embraced Al Anon, a sister organisation to AA, and that choice did me a lot of good for a few years. Addiction is a horrible affliction, for the addict and those close to them, and I am grateful to mum and the teachers and proud of myself to have kept up such an effective antidote for so long. Nowadays my wife joins my fast. The first glass of wine at Easter is one of the joys of every year too.

 

The second anniversary that came to mind recalls an event of two and a half years ago, just one twentieth of the Lenten fasting period. All the anniversaries refer to times around the third or fourth weeks of April or October. For some reason those weeks seem to have assumed unusual significance in my life. I can think of others long after fifty years ago but long before two and a half years ago. My first marriage was during the fourth week of October, thirty six and a half years ago. And the Portuguese villa, now at last our home, was purchased in the fourth week of October too, nineteen and a half years ago.

 

Two and a half years ago was when a CT scan first revealed a mass in my brain, a mass later described as lesion, then tumour, and later on confirmed as the sort of tumour that usually resulted in death within eighteen months, a Glioblastoma. I had noticed a slight change in my vision during that summer and managed to find enough common sense to tell an ophthalmologist about it. I cannot be sure, but I suspect I would no longer be alive if I hadn’t made that move, because the tumour would have been present and doing damage for too long before meaningful treatment.

 

I Carry around a lot of medical quotes in my head. The first neurosurgeon, among other unhelpful proclamations, declared that in cases like mine sometimes people lasted years while others lasted only months. Our research also came up with a 6-18 month median survival window and a five year survival rate of less than 10%. I make assumptions based on some of these statistics and on what has transpired, which by happy chance is the passage of half of the five year period without really serious illness or near miss. Does the clock start again, or accelerate? Is 6-18 months still valid as a median survival window or is that now too long? Time will tell, and I try to avoid becoming fixated by such ideas.

 

The third April 2025 anniversary marked six months since our arrival in Portugal. It has been a remarkable time. We had deliberated over many years about whether and when to decamp to Portugal, and, despite both of us claiming to be good planners, the project went far from smoothly. Last summer involved some health setbacks so during the critical months I was not much help for my wife, and she had to execute many practical things while fragile emotionally and harbouring doubts and anxieties about the whole venture. Yet somehow we made it without calamity, my health reached a good plateau and has remained resilient, and, little by little, we move forward.

 

We remain aware of our ABC model, and that provides the context for everything we do in Portugal. We strive to enjoy every healthy day to its fullest, and to do that together. Then we both know there will be a transition to a period, short or long, where I will need progressively more care and support, and when my wife will have to put some of her own plans on hold. After that she will have to find a way to build a different life, a way that works for her. No matter how much anticipation and planning has been possible, that will surely be a shock and a challenge that persists for months and years.

 

Still, we have successfully reached our first six-month anniversary in Portugal, and can enjoy each day together while trying to be ready for what must follow. When we arrived here, six months seemed a long time ahead, yet we made it and used the time well. Now we are into the second interval of six months, and, who knows, maybe there can even be a few more to look forward to. Throughout my illness we have continually found ourselves changing our time horizon for planning, and our moods have also swung with the seasons and events.

 

This constant adjustment of our time horizon is something we are well used to by now, but it does catch some people out. If somebody is thinking of visiting us, they might make their plans without considering our strange situation, only to panic when factoring in what my cancer may or may not do before their visit. Should they leave it until the last minute to book, just in case? Should they come at all? What questions should they ask? Of course our preference would be for them to plan as normal, but not everybody finds it easy to talk about serious illness.

 

In any case, six months in Portugal feels like a milestone to celebrate as well as the start of another six month period, whatever time horizons we may end up using during that interval. Six hundred, thirty and six months form a neat triad of anniversaries for now, and each contributes to our mood in a positive way.