I didn’t really expect the hormones to be so disruptive of my daily activities, but there are times when the “hot flashes” interrupt everything. They tire me out, sometimes making even simple tasks a chore, making my breathing more difficult. And, of course, they wake me at random times during the night, during which I throw off the bedcovers as I toss and turn until I cool down again. And along with the covers any cat or dog who was sleeping against me. Then I flap about to pull them back up when the heat has passed and I cool down.
Uninterrupted sleep is a fondly remembered dream of the past. And I still have the rest of the year on Lupron.
I can only hope it proves to be less disruptive in the warm weather when there isn’t such a jarring difference between the room temperature and mine. We turn the thermostat down at night to 16C or 61F; I’m pretty sure that my hot flashes are in the same temperature range as a blast furnace. I am becoming a believer in spontaneous human combustion.
Sometimes I know they’re coming, these surges of heat and sweat. They well up at a modest pace; a creeping ivy of warmth that climbs my trunk to my limbs and unfurls itself in a swelter. Other times they arrive unannounced, rising abruptly from some mysterious magma within, a lightning strike to make me immediately uncomfortable. I become feverish, my clothes clinging damp and uncomfortable. More sultry than torrid.
There seems no rhyme nor reason to guide me as to why or when either happens. Sometimes they’re just annoyances, other times they’re weakening, making it difficult to breathe and walk. Continue reading “The Cancer Diaries, Part 27”
That rather handsome, 17-year-old young man to the left was Watts William Chadwick. My father, although he wouldn’t become that for many more years. So serious, so formal looking. A lot more so than I was at his age (I can’t say for sure that I even owned a tie or sports jacket at 17!). I was remembering my father of late as I go through my belongings for downsizing. I’ve been putting aside to keep anything that might continue to connect me to my family. There’s not a lot of it.
And I was also thinking about the recent pandemic. As a child, my father went through another pandemic: the “Spanish” Flu that killed an estimated 70 millions starting in 1918 and continuing until the spring of 1920. Back then there were squabbles over lockdowns and wearing masks among the ignorati, as there are today, even in the Manchester region where my father grew up. What must it have been like for a young boy? What would he have to say about those arguments today?
I don’t have a copy of that photograph, though, just a digital scan. The original photograph was taken in 1931, between the world wars and in the middle of the Great Depression. In the UK it lasted from 1929 to 32. It was an era also dominated by radio and film, but TV wouldn’t take hold for another two decades. What did he watch or listen to? What music did he like, what actors did he admire? What books and newspapers did he read then?
My father was known as Bill to his friends and family, and he always used his middle name as his first when he moved to Canada. He passed away in Toronto at 92, dying slowly in hospital of esophageal cancer. I thought, too, about his struggle with the cancer that claimed him. He also had prostate cancer, as did his father, but for my father, it never became the mortal threat that it did with me. But I was never able to share my experiences with cancer with him, or ask him very much about his.
Cancer changes everything — and nothing at all.
That’s a profound comment, coming from a TV character. The “rabbi” in question is a fictional patient in hospital, played by George Wyner in the TV series, New Amsterdam (Season 1 Episode 8). He is talking to the hospital’s medical director, Dr. Max Goodwin (played by Ryan Eggold). Cancer — its diagnosis, treatment, and impact on people — plays a pivotal role in the series, and offers some food for thought for viewers. This episode stayed with me for quite some time.
Skillman suffers from terminal pancreatic cancer. It’s a nasty cancer with a mere 9% five-year survival rate.* Max wants Skillman to undergo a risky surgery. The oncologist, Dr. Sharpe (played by Freema Agyeman), recommends he go home and live the remaining year or so of his life in comfort there, with drugs to ease his deteriorating condition. Either way, Skillman doesn’t want to remain a patient in the hospital to die there.
Helen warns the rabbi, “There’s a 90% chance of dying during surgery.’ Max chimes in, saying, “Or a 10% chance that you’ll live.” Skillman looks bemused and says, “Not good odds.” He chooses to go home. But sometime during the episode, Skillman opts for the surgery. When Max asks him why, Skillman says, with a certain Stoic shrug, “Tomorrow I’ll be better or I’ll be dead, but I won’t be a patient.”
I suspect every patent diagnosed with cancer has to come to terms with similar decisions, whether it be surgery, radiation, chemotherapy, or a combination of them. I certainly did. You have to weigh whether the treatment offers a better chance of survival than the discomfort or disability it will cause. But for many cancers, there is no effective treatment, only palliative care. Or dying in hospital. Continue reading “The Cancer Diaries, Part 26”
It was with a strong sense of trepidation that I went to my latest meeting with the urologist, earlier this month. Although it was still rather too early to make a fulsome diagnosis, I was anxious about what my latest blood test might show. My biggest worry was that I would need further treatment, including chemotherapy. I have to admit that on the drive to Barrie, I was frankly asking myself if it would be worth it to do more.
Although I was a couple of weeks past my last radiation treatment, I was still having side effects, albeit slowly diminishing. And I was still on hormone therapy: I got my second shot of Lupron in his office that day. I’ve read hormone therapy described as “chemical castration” because it is meant to stop the testes from producing testosterone (the hormone that fuels the growth of the prostate cancer cells). Better, of course, than surgical castration, although at my age and treatment my testicles are more decorative than functional.
My final week of radiation treatment is here. I should have felt elated that I would no longer be required to drive every day for an hour or more each way as I have for the past six weeks. Everyone told me it would go by in a flash, but it seems to have dragged on and on. I felt curiously empty when the new week dawned and the end was in sight.
It’s been a difficult time — almost a year since my PSA test showed something was seriously wrong, and seven months since my surgery. While most of the time, I’m optimistic, some days it’s hard to be upbeat. I guess that’s in part because there are still a lot of unknowables about my condition; I don’t know yet what my future holds. There is still more hormone treatment coming, and a likelihood of further treatment, like chemotherapy. Not looking forward to that.
Yet man is born to trouble as surely as sparks fly upward. Job 5:7
Emotionally, physically, and mentally this treatment process has sometimes been draining. A lot like walking uphill in knee-deep snow: you have to keep pushing yourself forward, one step at a time. Some days I feel fine; others I drag myself out of bed, stumble through my ablutions, and fall into the car to drive for treatment. All without any enthusiasm or optimism.
It’s been modestly expensive for a retiree, too. The cost of drugs, diapers, and pads, coupled with the daily cost of driving and parking have added up. I keep reminding myself that if we lived in the USA and had to pay the full costs of everything rather than have most of it covered by our healthcare system, we would either have become bankrupt, or I would have died without treatment. Probably the latter, since I would not want to put Susan into poverty. The number of Americans who claim bankruptcy because of medical bills is staggering. I am glad to live in Canada.
During the past year, I’ve not engaged in several of the activities I have previously enjoyed, because I was either in a frail, post-operative state, encumbered with a catheter and urine bag, or simply feeling listless and sore. I can’t recall the last time I made bread or pasta, two things I used to love to do. I missed a lot of long walks around town with Susan and our dog, too. I didn’t exercise — the rowing machine in the basement went unused. At least I’ve kept up my reading. Perhaps come spring I will be back to a more ‘normal’ life and recovered enough so that I can do everything as I did in the past.
I can take heart that my fears about bad weather have not materialized this winter. It’s been unseasonably dry and warm these past few weeks. Were I a religious man, I would thank whatever weather god(s) I followed for the lack of snow — Wikipedia lists dozens of weather deities, including Thor, Jupiter, Raijin, K’awiil, Horus, Marduk, and many more, but none listed specifically as a snow (or no-snow) god. However, different searches gave me Chione (Khione), Ullr, Frau Holle, Morana, Skadi, Boreas, Hoder, Iokul Frosti, Morozko, Polivah, and a few others who controlled the snow. Who knew there were so many? I suppose I should just thank them all. Isn’t it usual to sacrifice a politician at an altar for this?
Are we so stymied by the present that we neglect learning about the past? Or are we so consumed by the present that we cannot collectively imagine a positive future? And why, for instance, is science and expertise viewed by many with suspicion or as a threat?
Traditional winter weather will come later in the month, starting a day or two after my treatment is over. I take heart that spring is only seven weeks away (cue the laugh track). The next big, province-wide lockdown also gets put in place this week.
I started the New Year with another welcome three days off, with the final third of my radiation treatment ahead in the next few weeks.
I can’t say I’ve ever been quite as happy to see a year pass as I have with 2020. As if the widening pandemic, lockdowns, Trump’s madness and treason, the nail-biting US elections, the stupid and selfishanti-maskers and anti-vaxxers, the QAnon idiocy spreading among the gullible, Brexit, Jason Kenney and the UCP destroying Canadian unity as well as Alberta, the waste of $9 million locally for the Saunderson Vindictive Judicial Inquiry (SVJI), and Erin O’Toole’s election as Conservative leader weren’t enough to drive a person around the bend or at least into despair, I had to get cancer as well. It has been the worst year of my life, but I suspect a lot of people feel that way about it, even without having cancer.
Susan and I had a subdued New Year’s Eve, Thursday, ordering a takeout meal from a local restaurant. In previous years we would have gone out to celebrate the New Year and toast the anniversary since we met. This was our 38th, and we celebrated over dinner at home and a glass of wine from a box (at least it’s Ontario wine). Susan has been the continued light in my dark year.
We capped off the night with a mediocre movie, then a Star Trek: Next Generation episode (we’re re-watching the series for the third time), followed by an hour or so of reading in bed. Exciting, aren’t we? Didn’t even stay up until midnight to see in the start of the new decade. But it’s not like I got a full night’s sleep: my hot “flashes” and full bladder woke me up several times, as they do every night.
I would like to see my way through the next decade — 2021-2030 — assuming that my various treatments kill off, or at least manage my cancer sufficiently. I’d like to live to at least 80, although both my parents reached their 90s, as did my maternal grandfather and paternal aunt. I figure it’ll take the next decade just to finish reading all the books I’ve bought in the past few years. I have a duty to read them all. The average life expectancy for men in Canada is 79.9 years. I’d like to be at least average in this aspect.
The five-year survival rate for prostate cancer that is restricted to the prostate and immediate area is almost 100%. That’s a cause for hope. But it falls to a low 31% if the cancer has spread to other parts of the body. I don’t know where I fit in that, but suspect from comments made by my urologist after surgery, and the need for subsequent, lengthy treatment after it, that it may have spread further. So I may be in the latter group. If in the former, then my chances of reaching the next decade are 98% and 15 years is 96%. I live in hope. But less than one in three if it has spread. It’s a question I’ll have to ask either my urologist or the oncologist at our next meeting.
A recent study in the USA showed that “…people who have survived cancer in adulthood have a greater risk of developing and dying from new cancers than people in the general population.” That’s not encouraging. The article added,
It is well-known that people who have survived cancer typically have a greater risk of being diagnosed with the disease again, even if their first cancer has been successfully treated. In many cases, this is recurrence of the original cancer or metastatic disease related to the original cancer. It is also not uncommon for treatments for the primary cancer to unfortunately cause another cancer, but in many cases this link is hard to definitively prove. The American Cancer Society study looked at new cancers thought to be unrelated to the first cancer diagnosis.
Three days off over Xmas from the daily drive felt like a longer holiday, although it wasn’t enough time for my bowels to heal properly. So far an irritable bowel, reduced urine stream, and my hot “flashes” (or surges) are the only side effects I’ve noticed. They are, however, enough to make me less than comfortable at times.
I was warned I might feel fatigued, too; not just the normal state of being tired from too little sleep (what with pets and hot “flashes”), but deep fatigue. Not yet, but I still have three weeks of treatment to go, so perhaps it will come in the future.
For anyone wishing a “white Christmas” this year, we certainly got it. Starting Friday, Dec. 25, it snowed continually for three days and I shovelled or blew snow from the front walk and driveway numerous times. The snow and cold curtailled our dogwalking somewhat since Bella is a small, shorthaired dog and gets cold feet easily. Most walks were a mere circle around two or three blocks (800-1,300 m). We did manage one nice, long walk through Harbourview Park on Sunday, the only real outing we had. But it was a pretty weekend: I spent my time indoors: blogging, and playing World of Tanks and some other computer games when not reading. Outside, I shovelled.
And while it’s not cancer-related, as my Xmas present to myself, I ordered an ASUS gaming monitor (on sale) for my laptop, in large part to be able to both play games and to watch movies (the former on my laptop, the later through a Blu-ray/DVD player). I like the B-films from my large collection of scifi and monster B-films. Susan doesn’t care to watch, so I have to see them by myself. The gaming monitor has a headphone jack that will let me watch them without disturbing her with the sounds of some rubber-suited monster stomping on papier mâché cities.
What worries me is the weather forecast for the coming week: snow, wind, and cold. That doesn’t bode well for traffic conditions. But perhaps the weather will be mild enough it doesn’t stay around for very long.
Radiation treatment, 21st session
Warmer temperatures brought rain that has begun to wash away the snow. The ski hills at Blue Mountain would be weeping over the warm weather, if it weren’t for the fact they are closed for the COVID lockdown. The drive to Barrie was quick, dry, and painless. The treatment was quick, and painless, too.
The hospital coffee shops, gift shops, and a lot of the medical and social services were shut down for Boxing Day. The cancer care treatment centre remained open. No big lineup was at the entrance waiting to get in, today, and almost everyone ahead of me was headed for the cancer centre, as I was. The atrium was eerily empty of people.
Today, it seemed the waiting rooms held mostly people in poor condition, suffering, and perhaps in pain. It felt more like a place where people wait to die rather than come to get treatment. Compared to most of the people I saw in my short time there, I am very much alive. Still, it is somewhat depressing to again be reminded that everyone in this room is here for one reason: we all have cancer.
I didn’t have too long to wait for my treatment, but I did manage to get a few pages further into Edward Humes’ Door to Door: The Magnificent, Maddening, Mysterious World of Transportation. it’s a fascinating book that gives me a whole new insight into shipping, consumer goods, transportation, cargo containers, and all things related. Got my schedule for next week, and spoke to the nurse to briefly review my treatment, as we usually do every Monday.
Hot flashes are becoming more frequent, but I was warned they would be thus in the latter part of the treatment. I’m about halfway through the first stage of the hormone therapy process. My next hormone treatment (Lupron shot) will be given in about six weeks, shortly after my next blood test. I won’t know if I need more treatment (like chemotherapy or more hormones), however, for several more months after that.
I’m not sure why they’re called hot “flashes” as if they were lightning — they’re more like swelling eruptions from within; at least for me they arrive not abruptly but like a wave that builds as it reaches shore, then breaks and dissipates as the next wave is forming in the water behind it. I would have called them flares or surges, not flashes.
Susan and I took a long walk with our dog, Bella, into the downtown and back on Saturday, and on Sunday we walked to and through Harbourview Park; three to four kilometres each time. During those walks, I had hot “flares” several times, making me uncomfortably warm despite the winter weather. And, of course, I wake up with them at night. (If not them, then the cats and dog jockeying for a position to lie beside me will waken me.) And then they’re gone, leaving me cold and dragging the covers back over my exposed flesh (we keep our house cool at night, the thermostat set to 61F/16C).
This weekend, I suffered a tad more from an irritable bowel than earlier, if that’s the proper description. The radiation is affecting my intestines, and I am expressing mucous when I excrete or urinate. Not sure if this will get better and my body will recover when the treatment stops, but I suspect my bowels will never fully recover. Radiation kills cells. And possibly my gut flora won’t recover, either. Damn, but I need to ask about it’ find out if there’s anything I can or should do to help my intestinal fauna. I hate to think the cure is worse than the disease.
Meanwhile, I’ve started reading (among the many books on the go) the first of the second of Len Deighton’s spy thriller trilogies: Hook, Line, and Sinker. I first read it back in the 1980s, but wanted to re-read it as I had re-read the first trilogy (Game, Set, and Match, finished this fall) and plan to go on to the final trilogy, Faith, Hope, and Charity (which I have not read) when done. As Prospero says, in Shakespeare’s The Tempest, “My library/Was dukedom large enough.”
I was fortunate in being able to get my tooth fixed within 48 hours of losing a portion of it. I hadn’t expected to be able to see my dentist for at least a week, maybe even more, but there was an opening, a cancellation, and I grabbed it. I had a vision of having to spend a week or more eschewing tough or crunchy foods to avoid having another piece of enamel break away from around the old filling. No morning muesli, no peanuts or crunchy peanut butter, nothing too chewy or crusty like the sort of bread I prefer, no olives in case one had a fragment of pit in it. Sigh. Thinking about that on top of my daily drive to treatment made me rather tetchy. But I was spared the distress and now have a repaired tooth. Tip of my hat to Dr. Kemp and his staff.
Still, I was feeling a bit low, over the weekend. Not depressed; just off my feed. Sluggish, tired, lacking my usual oomph. Not sure if it’s a side effect of treatment, the grey, dreary weather, or my general lack of deep sleep. I am missing our usual morning walks, our cups of tea together, and our chatting. Susan and I normally walk our dog 2-4 km every morning after breakfast, often into the parks or along our trails, but since I’m off for early treatment, I don’t get to join her. It’s not just the exercise I miss, but the enjoyment of being with her, and the calming effect of walking in the woods or by the water, or just the pleasure of walking around my small home town. And I regularly play online games with a friend out of province, often daily (when time and circumstances permit), but of late he’s been recovering from eye surgery and unable to play, so even the fun of that stress relief has been missing. At least I still have my books to read.
To top it all off, I’ve had a bit of upset stomach/bowels this weekend, possibly a side effect of the radiation, although it seems a bit early for that. Might be food, or stress-related, too.
Controlling one’s bladder and bowels is the first step we make towards independence as a human; a significant milestone in our development. It is the moment we, as a species, can metaphorically start to leave the nest, and not be entirely dependent on others. Anything affecting that control later in life, let alone losing it, has a deep psychological effect. It feels like we’ve fallen back a step, become dependent again. That only adds to the stress and anxiety of having cancer.
And now I begin my second week of daily radiation treatments.