Intermission 2: How a Cancer Recurrence Changes Everything
Posted December 21, 2017, Revised January 1, 2018
By Glenn Ward
"Beating" Cancer and the Diagnosis of a Recurrence
My apologies are overdue to those readers who’ve been waiting patiently (or is it impatiently?) for the next blog entry. It’s been 8 months since my first postings and several months since the most recent one. My initial goal in this blog was to explore my experience as a cancer patient by describing the experiences in chronological order. I still hope to keep the entries in some form of chronological order but I feel the need to show you why it’s been so difficult to keep up with the blog entries.
As most of you know if you’re kept up with the blog, my cancer was pronounced “beaten” back in early 2015. My family and I then began to celebrate in ways appropriate for those who’ve learned how precious life can be (see photo). Then, at the end of March, 2016, I went to my family doctor because of a sore back and she sent me for x-rays before deciding whether or not to refer me for physiotherapy.
My family and I (and our dog) celebrating life near Tobermory in the Spring of 2015. (Photo taken by my oldest daughter.)
A day or two later, she phoned me and, although I didn’t record the call or take notes, the conversation went something like this.
“The x-rays showed that your cancer is back, and it’s metastasized throughout the local lymph nodes” she said. “I’m so sorry, I really am”. We’ve gotten to know each other quite well and she sounded very sincere.
“That’s okay,” I reassured her. After all, it wasn’t her fault. “I’ve beaten it before.” I used to hate that term for its underlying sentiment, but here I was, expressing it to someone to make them feel better, including my doctor.
“I’ve already called your wife, and she’s trying to find people to fill in for her so that she can come home as soon as possible.” She and my wife and I have an agreement in that she calls my wife and explains any problems I might be having, results of tests, etc., and then my wife will explain things to me, but this was different: my wife’s never taken the day off work before unless I had to go to the hospital or something like that. Something big was going on here.
We said our goodbyes and about 30 minutes later, my wife called me and said that she would be home in time for lunch. She repeated what the doctor had said and kept saying how sorry she was that the cancer had come back. Later on, we sometimes discussed the ease with which I took the bad news but, to be honest, I had difficulty understanding why returning cancer in the lymph nodes was more than just a new chapter in my story, one in which my chemo had been stopped too soon. After all, I‘d had cancer in the lymph nodes before and the chemotherapy had successfully dealt with it. I said so and then listened to my wife explain that there were few drugs that could be used this time since we’d already tried them before and the cancer obviously didn’t respond sufficiently to them (in fact, the cancer did respond in the sense that it became resistant to the drugs). Cancer resistance to treatment was something I used to teach undergrads and here I’d pushed it out of my mind when it was in regard to my own cancer. Idiot, I thought.
Anyway, that was a year and nine months ago and here is a short summary of that interval:
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confirmation of the spreading of resistant cancer cells to my lymph nodes and other regions
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return to chemotherapy which has successfully kept the growth and spread of the cancer to a minimum but has not actually destroyed the tumours.
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a new drug regimen in which most of the drugs are designed to counter the side effects of the powerful chemotherapy drugs and drugs to reduce the pain due to a series of fractures in my spine (attributable indirectly to the chemotherapy drugs), and which leave me feeling stoned most of my waking hours.
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a new heart-felt respect for my personal physician (also known as my wife) who, on several occasions, demonstrably saved my life or at least prolonged it when it would have been easier to allow nature to take its early course
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CT scans four times a year, followed by visits to my oncologist which resemble, to me at least, being on trial for a capital crime and awaiting for the jury to return with it’s verdict. Will the verdict be guilty (guilty of being in bad health?) and the sentence, death, or not guilty, at least not for now, and acquittal, to be followed by a new trial in another three months?
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the new reality that, one day, the verdict will be guilty and the sentence, death sometime during the following year or so
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a (somewhat) unexpected death of a (somewhat) close family member and the resulting visitation upon me of the realization of the inevitability of my own mortality
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preparation for leaving “this mortal coil” and the search for someone to deliver a eulogy. This includes a start of a friendship between me, a scientific agnostic (or is it an atheist?) and my new friend, a church minister
In other words, I’ve been collecting new stories to tell but with a reduced ability to tell them coherently or, at least articulately. Still, I’m working on them or, at least, taking notes of my experiences in the hope that I will be well enough at some later time to write them in a form to be posted in this blog. In the meantime, I’m living in the poem by Charles Bukowski:
“waiting
in a life full of little stories
for a death to come”
Here’s a little story to hold you until my next posting. Last week, my wife and I went to see a movie. We checked the trailers of many current movies playing at local theatres and selected “Three Billboards Outside Ebbing, Missouri”. If you look up the trailer on YouTube, you can see that it looks like a darkly funny movie with many examples of black humour and a few sad parts. We even managed to convince two of our girls to come with us, which was a major coup for our family. Anyway, it turned out that the actual movie was a tearjerker from beginning to end and, of course, it also turns out that one of the main characters, the police chief played by Woody Harrelson, has pancreatic cancer (it seems that every time we see a movie at home on Netflix as a family, one of the characters turns out to be dying of cancer. It leaves me wondering if there is a cosmic force determined to make any attempt to be entertained, or at least to find a meagre two hours' relief, into a ghoulish reminder of my own dark fate). In this case (spoiler alert if you’re planning to see the movie), the police chief kills himself 2/3 of the way through the movie by shooting himself with his service revolver (I guess the police don’t use revolvers anymore, but I digress). He leaves behind a note and, through a voice-over in which you hear him explain everything (thanks to Woody Harrelson’s portrayal, he is the warmest character in the movie). He describes how his daughters were the light of his life, and how much he loved them, etc. etc. Well, one of my daughters was sitting on one side of my wife and I was sitting on the other side and we both found ourselves losing it at that point. We were both sobbing and sniffling and trying to be quiet about it but weren’t being too successful while my poor wife, the rock of the family but who’s lost it by now too, is trying to put her arms around both of us which is pretty hard to do in movie theatre seats. The only one who didn’t cry was my youngest daughter sitting at the end of the row, trying to pretend that she didn’t know us. There were people sitting behind us who must of thought that they were seated behind the biggest wimps ever to see a movie. When the movie was over, I turned around when I put on my coat and tried to show as much saggy loose skin as possible so they’d see that I was sick myself and they could put the pieces together, but I don’t know if they noticed that I may have had a reason to fall apart during that particular scene. After we got home that night, we discussed it as if that scene never happened but I thought we should address a few issues it raised, for my daughters’ sakes. I mentioned that pancreatic cancer is a very brutal form of cancer (much worse that colon cancer) whereas someone with colon cancer may be able to take drugs to avoid the worst symptoms, so it’s not unreasonable that someone with pancreatic cancer would try to end their life while they still could, especially if they owned guns, which we don’t.
“We own a pellet gun”, my daughter reminded me, helpfully.
“It’s a pellet gun with a muzzle velocity of under 500 feet per second”, I reminded her in turn, “so if I did want to kill myself with it, I’d have to shoot myself a few hundred times and then wait to die of lead poisoning.” I thanked her for the information though and told her that I hoped I hadn’t disappointed her.
“It’s okay,” she replied.
My other daughter piped up at that point. “If a pellet gun isn’t enough to kill yourself with, then how did you kill that rat that was under our sink.” I knew what was coming next. “Remember how the pellet went right through the rat’s body into the dish pan underneath it? You and Mom couldn’t use that pan any more since the water would flow right through the hole. Remember how we had to buy another pan?"
I remembered the incident. They hadn’t had this much fun planning for my post-mortem existence since they helped my wife and I pick a burial plot at the local church cemetery “But that was just an unlucky break. It was an old plastic dish pan and it was very brittle. That’s the reason the pellet went through it.”
That quieted them for a while, but only a while. “But what about your eyes? They always say a pellet gun can take out your eyes. If you held the barrel close to your eyes and pulled the trigger, could the pellet go through your eyes and into your brain and kill you?”
Why don’t they think this hard when they’re writing exams, I wondered. I looked over at my wife who looked back at me with a look that said "okay Sherlock, argue your way out of this one". I said “Maybe, but it would probably just render me blind and in pain for the last couple of years of my life, while lead poisoning slowly killed my brain and then the rest of me. Would you like to take care of a blind demented cancer patient for the last months of his life?”
Sometimes,without our realizing it until it's too late, we find ourselves flattened by the truth our stories tell, and we found ourselves in just such a situation. My wife and I knew something that our daughters either didn’t know or knew but didn’t yet grasp: as much as we didn’t want to admit it, they likely were going to have to take care of a demented cancer patient for the last chapter of this story. Everyone became silent at such an understanding as it left us with our silence as the only proper response. As Kurt Vonnegut said, “Don’t truth me and I won’t truth you”.
My wife and I have been spending more and more time discussing the fact that, in the coming months, we'll have to decide what my plans are. The plans are made possible by the fact that my oncologist has advised me that I can end chemo anytime by simply telling him that I've decided to do so. It's a topic that will get easier over time, especially now that I see the effects that the chemo and other drug therapies are having on my decision-making abilities. My wife has made it clear that she will respect my decision. However, suspended overhead like a storm cloud is the fact that my decision will have an effect on my daughters, and the nature of that effect will be dependent on my decision in ways that I find difficult to determine. I want to spare them the reality of the final stages by reducing the length of time I spend in those stages. At the same time, I believe that my life has been, and still is, a precious time, and one of those things that makes it special is my time with them, and I don't want them to think that I considered that time to be one that I would sell cheaply.
