It wasn’t a sudden shock. It arrived strangely and gradually, building like a summer storm; gathering clouds, darkening light, rumblings, and a few closeby lightning strikes.
Cancer came out of the blue. A sign here, followed by a hint there. The conversations my wife and I had at first were almost hypothetical, removed from reality; implications didn’t arrive straight away. The chaos and emotional swings arrived later.
A bit of context first. I have known I have had a slow growing form of leukemia for more than two years now. No big deal, although we looked at our wills again and asked ourselves a few ‘what if’ questions. What we didn’t know, but maybe should have known, is that leukemia, because of the associated lowering of one’s immunity, exposes one to increased frequency of skin cancers of all types.
This is a short personal account of the quick and unexpected arrival of a second cancer diagnosis. I don’t know if this will help anyone. It’s helped me though, to write it down.
Early February
After months of ignoring a scaly lumpy, and increasingly ‘angry’ area on top of my scalp, I had it checked. Biopsies completed and sent off for pathological analysis. Diagnosis was that I had two large and deep squamous cell carcinomas (scc) on my scalp that would need to be removed as soon as possible.
12 March
Excision of said scc’s was executed (and I use the word intentionally) by a registrar, an offsider, several theatre nurses and what appeared a student who practised her first scalpel cut on my neck to peel off a patch of skin for a graft. Through my twilight anaesthetic I could clearly hear her hesitation and the person supervising telling her not to worry, that he would show her where to cut. None of them would have been over 25. I was well awake by the time they were driving the staples into my scalp with much frustration over how difficult it was to stop my bleeding.
Traumatic is a word that seems to fit the experience quite well.
Mid March
Staples removed from my scalp by what felt like a pair of pliers. More trauma. Resolved to avoid surgical procedures thenceforth.
Later in March
Visited G.P. with a swollen lymph node about the size of a duck egg, just above my left collar bone. Doctor Google had already prepared me that this might not be altogether a good thing. The G.P. agreed, although warned me off Doctor Google. I was referred to have two new diagnostic procedures.
26 March
PET whole body scan.
27 March
Fine needle biopsy of the swollen lymph node.
Early April
Results of the two procedures were received. The PET scan showed ‘hot spots’ on my left cheek and where the swollen lymph node was. Everywhere else in my body seemed clear. Good news, in part. The fine needle biopsy results were inconclusive, but the the lymph node looked necrotic, and it was recommended it be examined further.
Visited a skin cancer G.P, to have a couple of skin lesions removed from my face. I was due to have a couple more excised a week later. Routine. Except I had a prior phone call from the G.P. An earlier “scc” excised from my cheek had shown up as a melanoma. Could I come in earlier?
10th April
Things moved up a gear.
He had some undecorated, off the record, advice. Which I guess he thought was helpful:
“If you’d had this ten years ago, you’d have been dead within a year. There’s lots of newer, more effective treatments now, so there’s a much better outlook.”
So I guess this means our holiday is off, was what came out of my mouth.
“Once you go down the rabbit hole of appointments, diagnoses, and interventions, you may never come out the other side. You’ll follow the directions, endure the procedures, and at the end you’ll possibly die anyway. Consider taking that holiday first.”
Quite matter of factly, I thanked him, paid, and walked out. Sharing the news with my wife on the walk to the car, emotions escaped in tears and took some recapturing. The world changed in an instant. After that, things have happened quickly and a touch chaotically.
11th April
Appointment squeezed in with a medical oncologist. Promptly referred on to a surgeon.
16th April
Surgeon was empathetic, which was nice. I would need to have the lymph nodes removed from the left side of my neck, as well as the melanoma excised from my left cheek. Surgery date would be the following week, followed by a few nights in hospital.
24th April
The surgeon was the ‘best’, I was told, and I was also told he did a clean and tidy job. Even called my wife to tell her all had gone well. I now had a drain in my neck which meant I had to sleep on my back. I snore when I sleep on my back. It wasn’t my fault. He saw me the next day and told me that he had had to remove quite a few other lymph nodes which were also swollen, and that they had not looked very ‘good’, meaning, I guess, that he was looking forward to the pathology report. I’’m not at my best in a hospital bed so I didn’t have the presence of mind to question him further.
27th April
Drain removed, I was discharged into the care of my wife at home. I would have danced out of the ward but low blood pressure made that an unsafe thing to do.
And now we wait again for pathology test results which tell us . . . What?
Right now, I am happy to leave worry behind and live each day. Next week, the tests might suggest the rabbit hole is deeper than hoped and the ultimate exit might be not the one we hope for. If not the test next week, then the one next month might be the one, or next year, or next . . .
Somewhere along the way, pushed and pulled between prescriptions and advice, you can lose perspective, and ultimately yourself. You can become a victim; things are done to you, rather than by you. I don’t want to be a victim. I sit here, praying that circumstances allow me that priviledge.
So, cancer has had its first stab at me. I’ve moved from spectator to participant (not victim). Empathy is no longer a second hand thing, felt at a distance. It’s real, it’s close, it’s there freely for other people who are having a much harder journey than I am.
For the last six to eight weeks I’ve spent a lot of time sorting out feelings, praying, worrying about possible outcomes, the effect on those I love, and sometimes withdrawing into myself, looking for solutions, or at least principles for dealing with it all. Other people handle this stuff differently. Me? I look for underlying principles.
Faith
I am a Christian. I am a created being. I matter to God, who will never let go of me. As for death, I’ve thought about that a fair bit. What does death mean? I honestly don’t know. What does eternal life mean? I honestly don’t know. What I cling to is the faith that God, having made me, will not abandon me. Just how that comes about I need to leave to him/her. Makes sense to me anyway.
Love
Matters hugely. Things don’t matter. People do. Family and friends give me more than my identity. They share love and life with me. I grow more aware as days pass of the enormous gift of the love from my wife, children, extended family and friends. Short messages of love from all sorts of places have made recent days sing for my wife and I. Where would we be without live? Without hope. Alone and dead.
Love does not need to shout its virtues. Love comes in small things: like the moments of trust and intimacy felt only by a husband and wife after many years of marriage; the simple trust of a child; the acceptance of faults in friends (and in myself); the comfort of knowing I matter and showing others they matter.
Courage
To withstand doubt; to face truth; to meet what comes squarely in the face. To feel and acknowledge emotions but not let them rule me.
Dignity
It’s a little harder to define this one. I may be ill, or I may be well, but I do not want to be a victim. I do not want to plead, whimpering for my life. I want to stand rather than simper. I do not want to need anyone to shower or toilet me, or to treat me like a child because I have trouble making decisions. Get the drift?
I will mention that I am not comfortable with the practice called ‘assisted dying’ or any of its variants. No thanks. My life was and remains a gift. No earlier departure for me (see ‘Courage’ above).
Principles are great things, and we hope they will stay with us when we need them.
I have to admit, that in the operating theatre and afterwards in the ward, some of those principles wavered a bit, and another factor entered the frame: Fear.
As the oxygen mask was pressed down on my face this week, I began to feel fear. As I lay in the recovery room, the fear did not lessen. It gripped my chest, and faith, love, courage and dignity seemed further away than I wanted them to be.
I remember trusting the fear would pass, but its claws were well embedded at the time. I am human. Humans get cancer. Humans have principles. Humans feel fear for very good reasons. We read cancer recovery statistics and fear is never far away. We wait for pathology results and we feel anxiety. We wait on the operating table or in a treatment room, and disturbing thoughts seep in.
This human hopes other humans can know there are things much more powerful than cancer and fear.
This human has found faith and love, for instance, for all his imperfections, to be his salvation.
I hope your salvation finds you.
Life is a gift.