A Gear Change

The process of cancer management can be mystifying.You put your trust in the doctor, of course. But each doctor we see seems to have a completely different understanding of what's going on than the last. As we never see any of them more than twice, we're left feeling a bit confused and uncertain.

Just over a month ago, the surgeon Mr Lawrence gave us the breezy "you're doing fine, see you in 3 months" speech, before mentioning almost in passing that he would have a chat with the oncologist about my future management. He seemed confident that the surgery had sorted me out for the time being, despite knowing that there were probably tumour cells remaining on my side of the incision site. We went home feeling reasonably happy. We felt that all was well, at least for the next few months. When we got an appointment for another CT scan through the post we just noted it in the diary and carried on with the process of recovery from the operation. Then we got a phone call. The CT scan needed to be brought forward, before the oncology appointment.

"What oncology appointment?" "The one with Dr Carnell, on 6th August, on her first day back from holiday." Oh shit. Suddenly the future looked a bit more complicated.

So off we went, to meet Dr Carnell. Her opinion is, the tumour cells at the surgery site will re-grow into another tumour.There's no ifs and buts, they will definitely re-grow. This time the tumour won't be encapsulated. Meaning it will be invasive, and malignant. Also, there may be microscopic tumour cells inside my pleural cavity where the tumour was pushing against surrounding tissue. Also, there may be some seeding of tumour cells because of the biopsy. All of which means radiotherapy, urgently.

Type B2 Cortical Thymoma

The problem is, my age. I'm just too young and gorgeous (!) and full of life. Thymomas are slow growing, and it might take another 5 or 10 years to grow into something that affected me. If I was already 80, that maybe wouldn't matter. As it is though, I'm hoping to still be young and gorgeous and full of life for at least another 20 years and I don't want an invasive, malignant cancer eating into my spine or heart or lungs in the meantime. Who does?

So of course we've agreed to the radiotherapy. The trouble is, it's not a risk-free procedure. There'll be permanent scarring on my lung and heart tissue, which we hope won't affect my quality of life too much. In the short term, I'm going to have skin reddening and soreness, problems with swallowing, possibly nausea, and exhaustion to deal with. All of these will gradually get more acute, continuing to worsen after the therapy has finished. But I'll get better eventually, and after the treatment the odds of the cancer recurring will be reduced from 100% to around 10%. It's a no-brainer, really.

I'm not looking forward to the process, though. We've got the treatment planning meeting later this week, then a lung function test to establish a baseline, then an echocardiogram to likewise, all at UCH. Then starting on 3rd September, 5-and-a-half weeks of daily radiotherapy, 15 minutes a time, also at UCH.

In the meantime, I'm feeling better that I have done for ages. The tiredness I was feeling post-surgery seems to have gone. The pain had largely disappeared. For the next few weeks I can have some normal life! In  September when the treatments start, I'll still be feeling OK for a while. I've got a space to go back to work,and get out in the countryside (even if the walks are shorter than we'd like), and have some fun.

I feel like a  real whingeing ninny to mind that my window of good health is so small.

While I've been recovering from the surgery, I've been watching a lot of daytime TV. Recently, that's meant a lot of the Olympics. Although I'm no sports fan, I've been blown away by the courage, dexterity, strength, skill, and sheer doggedness of the athletes. They all seem so nice, as well. It amazes and astonishes me that someone can devote years of their life to jumping further or running faster than everyone else: I marvel at the glorious pointlessness of it all. But of course we all spend acres of time doing pointless things: at least the athletes know what their aim is.

Sir Chris Hoy 2012

The true heroism of the competitors has been brought home to me by Sir Chris Hoy describing his training regime. Two punishing session of weight training in the gym each week, three hours on the track every day, work in the lab building up lactic tolerance (and in so much pain after these sessions that he is writhing on the floor in the foetal position for 15 minutes afterwards, vomiting). Then there's the resistance training so that he can, for an instant, produce more torque than a Ferrari.  And the physio, the diet, the wind tunnel, the psychologists. The mind-numbing repetitiveness of practicising the same technical points for hours, day in, day out. Of course, it's not just him doing all of this, but the entire team. Including those who didn't even expect to gain medals.

If they can do that for years and years just to win races, I'm sure I can do 5 weeks of radiotherapy to kill off my uninvited guest!