After waiting that long week for the results of my post-chemo scan, the answer to the hovering question about the effect it had on the tumour in my lung and the affected lymph nodes was much the same as most eagerly awaited answers to important questions. Inconclusive. As I’m learning to expect, nothing very decisive has resulted from the treatment. After three cycles of chemotherapy, the tumour has shrunk a little, but, onc doc said swiftly, it was small to start with. The lymph nodes too have decreased a little in size. There was neither excitement nor disappointment in his manner. It may be that he has the same air of studied neutrality in his everyday life, when eating a delicious meal or going over the top on a rollercoaster. Or, more likely, it is for work purposes alone, in order to prevent over-excitement or crashing disappointment in patients with unrealistically high hopes or fears. I imagine that his ‘but the tumour was small to start with’ was intended to prevent disappointment at the seeming slightness of its reduction: a small reduction in a small tumour is not to be sneezed at. It seems I am to think that the cancer that can be seen hasn’t got worse, indeed it has improved, and if I were the right sort of character I could take heart from that. To me, being the sort of character I am, it means I’ve got cancer (‘So what took you so long to arrive?’), and I won’t not have cancer, but as the doc said at our first appointment, a certain amount of time can be added to my life by the treatment (two to three years instead of perhaps 14 months) before the symptoms begin and the dying process starts. I smiled and said ‘that’s good’ in a way that I hoped showed I hadn’t got any unrealistic hopes up, and that I was grateful for his, the nurses’ and the radiographers’ efforts. The team. And, of course, I am grateful. I try to feel grateful.
As far as I understand it, the main problem is with the spreading of the cancer via my lymph nodes – this is what happens most commonly with lung cancer – to brain, to bone, who knows where? When I asked, the onc doc said that they hadn’t seen any new cancer sites, but they couldn’t know if there were cancers too small yet for the scan to pick up. ‘We can only see what we can see with the instruments we’ve got.’ I assume that the cancer spreading minutely through my body, like microscopic pig iron in diminutive goods trains, is the reason, even with treatment, that my life expectancy is still only a fairly abbreviated two to three years. It’s a travelling cancer sending its cells here and there so that only when they have taken root and grown can they be seen, by which time, I imagine, new invisible seeds will have been planted elsewhere. Etcetera. Still, if onc doc’s super cool is not just professional and he maintains his chill when hurtling down Kingda Ka, the world’s highest rollercoaster, then I might be wrong and I should rejoice at least somewhat in the diminishment of the visible cancer cells. Anyway (I’m working hard on attitude here), it must be better than the tumour staying as it was or getting worse. So, as planned, the radiotherapy has begun. First the measurements and then the daily dose. Each treatment, twenty minutes of zapping. A month of treatments, Monday to Friday with weekends off, throughout November. (Here comes Melville: ‘Whenever it is a damp, drizzly November in my soul; whenever I find myself involuntarily pausing before coffin warehouses
There is a sense of things going to plan, but no magic. There’s nothing to be done except wait while the medics keep everything as contained as possible with radiation, and see whether, three months after the end of radiotherapy, the tumour has reduced, and, more important, if the cancer has spread and grown visible. There was no new mention of that original two-to-three year prognosis if I had treatment. I didn’t ask, because I was fairly sure from his manner and what he didn’t say, that the prognosis hadn’t improved, even if it hadn’t got worse. In other words, I will continue to live with uncertainty and my inability to do anything about it, the condition I’ve been trying to wriggle away from all my life.
It’s absurd to complain about the uncertainty of life expectancy – we’re all just a breath away from the end of our lives – but it’s especially absurd from someone in their late sixties. For almost a year before the diagnosis, I’d been plagued by thoughts of the possible not-so-far-in-the-future depletions of body and mind of one of us, me or the Poet. The future played out, in my mind, with each of us having innumerable strokes, serial heart attacks or one of the other less decisive but nonetheless disabling illnesses of old age. Turn and turn about I’d have in my mind one of us debilitated or dead, then the other. The urgent question was: which would I prefer, to be the carer or the sufferer? The dead or the survivor? How long before one or other of us could no longer live in our two-storied house with its steep stairs? When might it be necessary for one of us to be looked after by professionals in a care home? We’ve lived together more or less for sixteen years. Sixteen years ago, the future still seemed a long time ahead, even if to our young selves back in our thirties, either of us in our fifties and now sixties would have seemed as old as we could imagine without picturing mobility aids and incontinence pads. Getting myself to imagine us as our young selves might imagine us was enough of a jolt to make the mind accept the present not at all terrible reality of time and the body.
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