Friday 4th May 2012
Dear Terry,
Me again. Thought I’d let you know how I’m getting on. It’s a while since I last wrote to you (Dear Terry, Letter to a friend).
At my clinical meeting in February they dropped the bombshell that the cancer had moved into the bones. My PSA had shot up from 4.2 to 40. I’ve arrived. I’m now a stage 4, fully metastasised cancer patient. There is no stage 5, Terry – this is it.
I thought it would be at least another year before the cancer entered the bones, but hey, … that’s cancer. The truth is that my prostate cancer has been a vicious, aggressive bastard from the start. That was obvious from the Gleason scores following my biopsy. Yet somehow I’d hoped that all the medication would have some impact. But even the six months of chemo seemed to do bugger all. The cancer just laughs at the efforts of the doctors.
So now they’ve put me on this new anti-cancer drug called Zytiga. There’s been a huge fuss about whether it will be available on the NHS. Well I’ve got it so I suppose they can’t just take it away. Whether it will work is another story. So far my PSA has continued to rise even though I take the new medicine daily. Next week there’s a clinical meeting and perhaps the doctors will have some view on whether it’s working or not.
If it’s not working they’re going to offer me yet more chemo. I really don’t want any more chemo, Terry. I don’t want to go down to the chemo ward and have them put the line in me and pump me full of poison week after week after week. I don’t want to feel like shit. Now that I’m stage 4, quality of life is much more of an issue. What time I’ve got left I want to enjoy.
I’ve had some pain from a secondary tumour in my right arm. They gave me some radiotherapy but the pain is still there. It’s a funny sort of pain – well not funny ha-ha. I can only describe it as having toothache in my arm. Movement and touch doesn’t seem to make any difference. Like my cancer it just shrugs off the feeble attempts of the medical profession to control it.
I have to accept that pain will be my constant companion now. A couple of weeks ago I had a bout of excruciating back pain and was in A&E. They even kept me in overnight at the Royal Free. The only other time I can remember being in hospital is when I had my appendix out back in my early twenties. The medical staff were very good and I must say that I think I got excellent treatment. Having said that, I was very happy to be allowed to go home the following day, albeit with another box of medication.
Terry, I’m on so much medication at the moment that it’s easy to lose track of what I should take and when. I spoke to my palliative nurse and we’ve agreed to start cutting down the medication, especially the morphine, which makes me very sleepy (and constipated).
Palliative. That means they can’t stop the cancer they can only try to ameliorate the worst effects. So now I suppose I get ready to die. I’ve already spoken to Sue about my initial thoughts about funeral arrangements. This is what the cancer has done to me. I’m planning my own death.
How do you come to terms with your own death, when you know it’s slowing approaching nearer every day? What’s the best attitude to take? What’s the most positive slant that you can put on something that is negative in every way?
I suppose I could rant and rage in some sort of Dylan Thomas ‘do not go gentle into that good night’ fury. The trouble with anger is that you can’t keep it up for very long. At some point you run out of energy.
I could weep and wail, hoping that something as insubstantial as tears could wash away the fear of my impending doom. But tears dry up eventually as well and then what are you left with?
I could become more pious, seek God (where did I leave him?) or adopt a kind of Buddhist stoic acceptance of my fate. Bugger that!
I could of course sink into depression and ask what’s the point? But whether I’m angry or sad makes no difference to the cancer at all. I am powerless before its implacable and relentless progress.
In reality I probably feel all those things and go through all those emotions one after another within the space of an hour or less, twenty-four hours a day, seven days a week – rant, rant, weep, weep, pray, pray, cry, cry – on and on and on. Perhaps more worrying is a sense of emotionless that overcomes me when I just feel empty and dry, like autumn leaves blown about on the wind. Somehow I think you would have coped much better than I am. It often seems to me that anybody else would cope better.
I can’t help feeling that I’ve let everybody down, my family, friends and work colleagues. I should be here to help and support them. I’ve spent all my professional life helping and supporting others. Now it’s me that needs support and it makes me feel powerless and depressed. My career is over – thirty-four years ended just like that. What was it all about?
It’s difficult not to feel resentful about being cheated out of an old age. Not that old age holds much appeal but even so, why should I miss out? But then you missed out so much yourself dying so young. I should be grateful for what I’ve got and what I’ve achieved but it’s hard. My achievements seem pathetic and paltry – what do they really matter?
In the past I had thought that I’d like some grand funeral, with weeping and wailing of people distraught at my passing. But you know what? I’ve come to understand what solace there is in obscurity. At the end of the day we are all dust whether we led a good or bad life, whether we were dullards or geniuses. I will join that immeasurable throng that has gone before me and accept the inheritance that all humanity has earned.
I hate crowds. But then at least you’ll be there – a friendly face. That, perhaps is worth waiting for.
See you soon.
Love Chris