Cancer 19: laughing at cancer
I'm nearing the end of my first chemotherapy cycle, or at least I'm in the third week, in which I don't have to take any drugs for seven days. It's a part of the cycle in which most chemotherapy patients can expect some relief from side effects, except in my case I've barely had any side effects. I experienced a very mild increase in sensitivity to cold in the first few days, which has long since eased, and the occasional tingling in my fingers, as well as some mild nausea. My hair seems to be intact, such as it is. My skin is a little drier, but not flaking. The drugs initially squashed my rheumatoid arthritis pains but in the last few days those pains have been creeping back, which ironically is a welcome sign that my immune system has started up again.
I started writing this blog series in the hope it might be useful to share my experiences with others facing a similar condition or treatment. So far I seem to have got off remarkably lightly, which I realise could limit its usefulness for those who are having more normal experiences, though I suppose it's also useful to assert the possibility of a light encounter with the disease. And to be fair on myself, it's not all been easy. I have gone through some serious doubt and worry, and some discomfort (after all I still had that major four hour operation to remove the tumour and a section of my bowel).
I would incidentally urge patients to be cautious about reading the briefing notes you're handed in advance of any procedure or treatment. Or at least if you do be aware that they necessarily try to cover all the worst possibilities, and can cause unnecessary dread. As far as I can understand, cancer treatment is always an individual experience. The notes will be important if you find yourself having symptoms, because although you're likely to have been warned about those symptoms in any pre-treatment discussions it's unlikely you'll take all the information in. The notes then become a useful check about what you're going through, but I think it's counter-productive to assume the worst. It may happen, it might not, and whatever it is you're just going to have to get through it. If you're feeling a symptom check it out without delay; you'll soon find out whether it's cause for alarm.
Not normal
We'll see if the second cycle is any different. I'm moderately optimistic that it won't be, and I'm glad of that. It has to be said all the same that I'm hardly back to living a normal life. For the duration of the chemotherapy I'm having to stay in something close to isolation. I can go for walks, and I imagine in this week in the cycle when my immune system has started to function a bit once more it would be reasonable to sit outside with other people, though sadly that seems less feasible as the weather turns against us. I'm missing social interaction, let alone things like music performance, and it still seems a long haul through to the end of November when I'll be out the other side of this treatment.
We'll see if the second cycle is any different. I'm moderately optimistic that it won't be, and I'm glad of that. It has to be said all the same that I'm hardly back to living a normal life. For the duration of the chemotherapy I'm having to stay in something close to isolation. I can go for walks, and I imagine in this week in the cycle when my immune system has started to function a bit once more it would be reasonable to sit outside with other people, though sadly that seems less feasible as the weather turns against us. I'm missing social interaction, let alone things like music performance, and it still seems a long haul through to the end of November when I'll be out the other side of this treatment.
Cancer is still one of the big fear words in our culture, even if recovery rates have improved dramatically in the last twenty years (and especially the last ten). There are of course still particular types of cancer (pancreatic, brain, lung) which can be difficult if not impossible to treat. I was told that by having this adjunctive chemotherapy the chances of my bowel cancer not returning are improved from around 50 per cent up to something like 80 per cent, which is mostly reassuring, though statistics can be a false comfort. An 80 per cent chance of full and permanent recovery sounds pretty good, until you convert that to people and reflect on what it means for the 20 per cent who won't. It's always possible I'll be one of them, so I have to live with that shadow, which I will, taking comfort from annual checks for the next few years.
A healthy attitude
So I'm not exactly out of the woods yet, and certainly don't feel complacent. At the same time I've always had a dark sense of humour. It's not because I'm uncaring or insensitive (I hope) but it is a way of dealing with life's little joys, and perhaps too the tedium of ordinary things. In the past if I had any kind of ailment, particularly when it wasn't clear what the exact problem was, I was likely to say "oh it's probably cancer". This, if it needs to be said, is how such irony works: far from belittling the seriousness of cancer it was a way emphasising how trivial any problem I might have was, as well as playing on the fact that cancer is generally an unmentionable thought (which really isn't helpful).
So I'm not exactly out of the woods yet, and certainly don't feel complacent. At the same time I've always had a dark sense of humour. It's not because I'm uncaring or insensitive (I hope) but it is a way of dealing with life's little joys, and perhaps too the tedium of ordinary things. In the past if I had any kind of ailment, particularly when it wasn't clear what the exact problem was, I was likely to say "oh it's probably cancer". This, if it needs to be said, is how such irony works: far from belittling the seriousness of cancer it was a way emphasising how trivial any problem I might have was, as well as playing on the fact that cancer is generally an unmentionable thought (which really isn't helpful).
The weight of the joke has shifted a little now that I've had cancer (or indeed am still going through the treatment). It complicates the reaction from other people, apparently unsure now what kind of response would be appropriate.
I like that. Unsettling you is exactly what comedy at its best should do. I don't like jokes that rest on an affirmed prejudice (typically racist jokes): that's about as far as you can get from comedy at its best. But with that proviso in mind I don't believe any topic is off limits. It just depends how the joke itself works.
And dark humour is good because it tends to bring us up against our fears, the things we don't want to think about but which can be usefully thought about. Certainly, in the right time and place (you probably shouldn't make a joke when someone announces she or he has been diagnosed with cancer), laughter seems to me a better, healthier response than all that idiotic fighting talk about "battling cancer".
The next cycle begins on Monday. It may cause things to take a turn for the worse, and I'm half expecting that, while hoping not. A week today if I'm still feeling well I'll be able to count myself extremely fortunate (and I'm really curious to know why or how the treatment can affect different people so differently). But whatever happens, I hope I'll be able to laugh about it.
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