The Cancer Diaries, Part 21

Solar flareHot 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.”

Radiation treatment, 17th session

George Orwell Essays: Everyman's Library editionAn unusually mild day for December 21: starting at 1C and promising to reach a cloudy 3C. This time of year we normally have much colder weather and at least two dozen centimetres of snow. I’m not complaining: it means I don’t have to shovel the driveway before I leave, and the roads are clean and clean for my drive. but snow is predicted for later this week. Unfortunately, the promised conjunction of Jupiter and Saturn won’t be visible here tonight unless the cloud cover breaks. 

I got my schedule for next week (the final week of 2020) when I checked in, and ended up back in the room of the older, noisier equipment. I think of it as the “Das Boot” room now. I asked for some classical music, and the therapist offered Chopin, except that the playlist started with a segment of a piece by Tchaikovsky. I like his work, just hadn’t expected it. But for the ten or so minutes on the bed, it was fine.

After the treatment, I met with the nurse and then the new oncologist who took over my case from the departing doctor. We discussed my care and treatment to date, and I raised the problems with my bowels, the only major side effect I’m feeling. I ended up with a prescription for some steroid rectal/hemorrhoid cream to help ease the discomfort. She told me it and my bowels would get better after treatment, although they would get worse before it ended. Sigh, Both comforting and dismaying. I managed to get the prescription filled in town, but it cost $40. Ouch. I hope it works to ease the discomfort.

I was reading in The Emperor of All Maladies (by Siddhartha Mukherjee) today that metastasis comes from two Latin words which together mean “beyond stillness” and that oncology comes from the Greek onkos, a word for a mass, load, or burden. That fits: cancer is a burden. He also wrote,

“Cancer is an expansionist disease; it invades through tissues, sets up colonies in hostile landscapes, seeking ‘sanctuary’ in one organ and then immigrating to another. It lives desperately, inventively, fiercely, territorially, cannily, and defensively — at times, as if teaching us how to survive. To confront cancer is to encounter a parallel species, one perhaps more adapted to survival than even we are.”

Mukherjee’s descriptions are brilliant and evocative, although, speaking as someone who has metastasized cancer, a bit troubling to contemplate. I don’t know whether to be scared of cancer or awed by its resilience and adaptability. Am I fighting a losing battle against it? Can it, in fact, be beaten, or merely delayed?

I got to read several pages of his book this morning in the waiting areas, as well as two pages of The Simulation Hypothesis.

This marks the halfway point in my treatment. This and next week have only four days of treatment (Xmas and New Year’s day off). I continue to wish for good weather that doesn’t force me to stay at home during the remainder of my time.

I have begun disc 33 and expect to finish it Wednesday. As an added bonus, today I received the copy of the Everyman edition of George Orwell’s essays from the UK (image above): a 1,400-page book of his best writing I had not expected to see until January or later. Unfortunately, it’s a bit too bulky to take with me to treatment. Just FYI, I have several other editions Everyman’s works, including my favourite essayist, Michel de Montaigne. They are superbly produced: well-bound, on good paper, with a cloth ribbon bookmark sewn in.

Radiation treatment, 18th session

I begin most mornings, after I’ve had a cup of tea and showered, with the same thing: a bowl of Dorset Cereals’ muesli, topped with some bran flakes, plain kefir, and usually a dollop of some flavoured yogurt, and fruit (I prefer blueberries). With that breakfast, I take my second cuppa, check the online news, social media, and read a bit from a book I keep on the kitchen island. Like most people, I am a creature of my habits.

I like the Dorset muesli not merely because is it a nice blend of oats, nuts, and dried fruit, but because it does not have any added sugar. That is a rare find in local stores. Most cereals — muesli and granola in particular — have added sugar. Sometimes lots of it, and always more than is necessary. I simply won’t buy cereal with sugar in it. Some boxes even have chocolate, which in my mind makes them candy, not cereal. Awful idea, that. Only two local stores sell Dorset Cereal that I know of (Metro — which has a wider selection of their line — and Freshco, which just sells the blue box mix). 

I usually pour plain kefir on my cereal and add a spoonful of flavoured yogurt to give it more taste, but sometimes I just use a flavoured kefir alone (vanilla is my first choice, followed by blueberry, but I’ve used mango and strawberry, too). I can only get blueberry kefir at Metro and vanilla at Loblaws. And no store in town sells effervescent kefir, only the still kind. Too bad, because it’s actually quite enjoyable. I can also get lassi at Freshco. I’ve tried the sweetened lassi, but find it too sweet for my morning taste. I haven’t tried the salted version yet. We don’t cook with salt and restrict it in our diet, so I tend to stay away from added-salt products as much as added-sugar. But I digress.

I was tempted to take my recently-acquired Orwell essay collection with me to the hospital this morning, and continue reading from where I left off last night, but it’s simply too big and bulky for comfort, so I chose a couple of smaller books.

Last night I came across a poem by William Ernest Henley (1849–1903) written in 1873, called Invictus, the Latin word for invincible. I had not read it before, but when I did it affected me, more so when I learned the history behind it. Henly had lost a leg to tuberculosis at age 16, and at 21 was going to lose his other leg to it. Instead, he underwent experimental surgery that was able to save it. And in recovery, he wrote this poem:

Out of the night that covers me
Black as the pit from pole to pole,
I thank whatever gods may be
For my unconquerable soul.

In the fell clutch of circumstance,
I have not winced nor cried aloud.
Under the bludgeonings of chance
My head is bloody, but unbowed.

Beyond this place of wrath and tears
Looms but the Horror of the shade,
And yet the menace of the years
Finds, and shall find, me unafraid.

It matters not how strait the gate,
How charged with punishments the scroll,
I am the master of my fate:
I am the captain of my soul.

It struck a chord in me because of my own circumstances, dealing with cancer, but also an anthem for everyone fighting to contain the coronavirus. I also felt a resonance with Henley’s dispassionate distance from conventional religion, in the first stanza, and the overall sense of Stoicism toward adversity and death, from which he emerges unbowed. I can only hope to have his courage and will.

In Collingwood this morning, the weather was clear but cold as I set out for Barrie. By the time I was approaching Edenvale, it had started to blow and snow, driving the white precipitation in gusty horizontal streaks across the road. Visibility was limited, the fields and farms along the highway lost from sight. Barrie was snowy and traffic slowed to a crawl. But I arrived safely, and with enough time to read more in The Soul of an Octopus before treatment.

Several hot flashes discomfited me on the drive. I reached home at the start of disc 34. Did I mention that because our new Toyota lacks a CD player, I had to rip each of the 35 discs to MP3 so I could play them in my car? That took me several hours. The customer-hostile decision to stop installing CD players, and not even include an audio port so I can plug a portable one in; simply to provide an inadequate AM/FM radio in new vehicles has cost Toyota my loyalty as a customer. I digress again.

Radiation treatment, 19th session

You know what I miss most? Sleep. Long, deep, uninterrupted sleep for several hours at a time. I get bits and pieces of sleep at night, like a string of naps. REM sleep without the deep, dreamless sleep I need. My night is punctuated by wake-up calls from hot flashes, then the cold return that demands I replace the shed covers; with cats and a dog shifting against me (and the cats often demanding attention), and the urges of my bladder and bowels to get up. And then the 7 a.m. news lights the alarm clock, and I have to get up.

Today I was back into the “Das Boot” treatment room. It was fast and easy; in and out, barely enough time to read a couple of pages of Arthur Herman’s The Cave and the Light. And the trip there and back was clear and quick. I stopped at the excellent Asian market, Centra, before heading home, to buy some ginger ice cream, and some green tea ice cream. It’s the only store I know of within 100 km that sells these ice creams (Centra also sells red and black sesame ice creams and other delightful varieties, but these two are my favourites). I don’t eat a lot of ice cream or often, so these two small containers will last me a couple of months.

I finished listening to the Don Quixote audiobook on the way home. The ending is bittersweet. I started to listen to a BBC podcast of A Midsummer’s Nights Dream, performed live. Fun stuff, but since you can’t see the person speaking, it’s a bit confusing when there are several people in a scene. I might find another audiobook in my collection to rip and listen to starting tomorrow.

Radiation treatment, 20th session

High winds created a noisy night, waking me up several times when tree branches brushed against the house or pinecones fell on the roof above the bedroom. Just to add to all the other things that keep waking me up. By the time I was up and having my first cuppa, the winds were still gusting strongly from the south.

Amazing Colossal Man, 1957I was a child during the Cold War and remember practicing air raid drills in my elementary school, crouched under my desk in case the USSR hit us with the “bomb.” The atomic bomb (or worse, a hydrogen bomb) threatened that if it didn’t kill you with the blast, or the wall of fire, it would do so by raining down toxic radiation for miles and miles around the epicentre. And radiation was a scary thing; the topic of many a scifi B-film, the sort I eagerly watched then, and still like to see. In those movies, radiation created monsters and twisted giants, attracted hostile aliens, revived prehistoric creatures, and turned the earth into a scorched hell. So to be lying on a bed being dosed with radiation as a medical treatment is a bit at odds with my upbringing. I keep thinking about the guy in the 1957 film, The Amazing Colossal Man, who is turned into an angry, disfigured giant by radiation…

I was back with the “Das Boot” machine today, almost as soon as I arrived. I barely had time to open my book (Door to Door: The Magnificent, Maddening, Mysterious World of Transportation, by Edward Humes) before I was escorted into the treatment room. In and out, and I was back home by 11:30 a.m.

I get the next three days off. While we’re not religious, we used to like the holiday/Xmas season because families and friends got together, renewed relationships, ate well, and we had days off together. This year if we do anything it will be virtual. A zoom Xmas? Possibly, but more likely just phone calls. It has a sadness about it, but better safe than sorry or even dead. I have absolutely no respect for those who will gather despite the pandemic, who won’t wear masks, or who will refuse the vaccine. We have far too many ignorant, selfish, stupid people in this world, and they are to blame for the continued spread of COVID-19.

I suspect I will be playing my computer games (World of Tanks in particular) a lot this weekend. Three more weeks of treatment left.

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