On supporting a friend with cancer

Over on my main blog I have posted a reply I wrote to one of the many people who have asked for advice on how to care for a friend who has received a cancer diagnosis.

One in a million? So why me?

The GP I saw last week (concerning my 'flu and chest infection) wasn't my usual one, so I had the same conversation I have with every medical professional who has read my history for the first time. First they don't believe that I'm not (or wasn't) a smoker and then they tell me how unusual I am. I've been meaning to ask someone who might have a clue just how unusual (statistically) this actually is. Am I one in a million? Or even less common than that? My Australian oncologist (who was the most senior figure in the department of a large hospital) said he'd never seen or heard of any analogous cases. The GP last week said that even if I had been a "champion smoker" since being a teenager I would have been desperately unlucky to have ended up with my cancer at that age.

This raised for me an issue that I deliberately put aside early on, namely, the cause of my cancer. If I am really so rare, am a just a total fluke or were there certain triggers in my genes and/or and environment that are to blame? My decision early on to avoid attempting to answer the scientific question of causation was based on asking a few of the top experts and finding they had no clue whatsoever, especially given my lifelong failure to consume even a single tobacco product (except second-hand, of course, which comes free of charge, though perhaps not of consequence). So I figured that if the experts had nothing to suggest, then my own search would likely prove either fruitless or a source of paranoia (rather than finding one cause, I would be likely to find hundreds of potential culprits, namely the carcinogens scattered throughout modern life that are almost impossible to avoid). I simply said to myself, "I am a man of cancer and I live amongst a people of carcinogenic lifestyles".

Theologically, based on the books of Job and Ecclesiastes and also John 9, I affirmed that the consequences of particular sins do not always fall on the wrongdoers, but that there is a tragic element to the world's brokenness in which suffering is unevenly and unjustly distributed. Not that any are innocent of wrongdoing, but many who suffer are innocent of the wrongdoing that caused or contributed to that particular suffering. Thus, asking "why me?" is often not a very productive question.

There is of course far more to say about this, but the comments from my GP briefly opened these questions and let me think again about why I had put them down again.

'Flu and me

Since I had a significant amount of radiation to my oesophagus and trachea, neither of these are quite what they once were. Radiation results in scarring and so the usual functions of these very important little tubes are somewhat impaired. In particular, I predictably get acid reflux if I bend over too quickly after eating (and at random other times), coughing often turns into small vomits, and I get chest infections every time I have the 'flu. The first two are because my oesophagus is less effective at keeping things down in my stomach, but the third is because my trachea is less effective at keeping phlegm up in my sinuses (and my cough reflex kicks in too late - I don't cough when the stuff is running down the back of my throat, but then get persistent coughs for weeks afterwards).

I also get the impression that my immune system is not what it once was (or perhaps it is just being in a different (and colder) country), which means I manage to pick up every 'flu that comes around and they knock me out for longer. When combined with the failure of my body to keep fluid out of my lungs, the result is that I've probably taken more antibiotics for chest infections in the last few years than the rest of my life's antibiotic consumption put together.

As antibiotic overuse is a very serious global issue, I am aware that I don't wish to be part of the problem, yet doctors keep telling me that they have no hesitation in prescribing such drugs in my case. After the latest iteration of 'flu plus chest infection, from which I am currently recovering, I am now even eligible for the 'flu shot each year here in the UK along with other vulnerable people such as the elderly, pregnant women and those with heart or lung conditions.

One more

I have only one more oncology appointment left. In January, I will see a specialist for the last time, get the same string of questions and the same poking and prodding for the last time, and walk out of the oncology ward without a future appointment (providing all goes well, of course).

I was going to call this post "X down, one more to go", where x is the total number of oncology appointments I've had over the years, but I'm really not sure how many that is. Not as many as some, but probably more than most.