Tuesday, 18 November 2014

73. The guessing game

Tomorrow would have been chemo day, but I've been given an eight day reprieve. You may remember, I'm due to chair a conference next week. It's in Scotland. I'll need enough energy to get that far: the train to Glasgow takes twice as long as the train to Paris.

It is hard to exaggerate the relief I feel at having a week off.

It's not even a proper week off, because that would imply not feeling ill. The past week was meant to be my Good Week, but Good clearly is a moveable feast. I vaguely remember how during chemo cycle 1, my Good Week involved long active days reminiscent of how things were, once, when I was at the peak of health.

Nowadays, good means not in bed.

It no longer seems to include long walks/swims/bike rides. Or, for that matter, short walks/swims/bike rides.

I am managing the sedentary parts of my life quite well (working at my desk, reading the newspaper, chopping onions, chatting to teenagers, that kind of thing), giving me an enjoyable illusion of not-being-ill. Until I get on my bike, as I did this morning.

I hadn't cycled for weeks. Worried that my tiredness is partly due to a lack of physical activity (well, doesn't that seize up your muscles and stiffen your skeleton?), I thought I'd do the five minute ride to the swimming pool. It took me twice that long. I almost got off to walk the rest. Short of breath, palpitations, and worst of all, leg muscles screaming at me that I should stop. It is not any better than last week; if anything, it's worse.

I never, ever thought that this might happen to me. Getting off my bike after five minutes? I never even thought that cycling qualified as exercise. It was just an easy means of getting from A to B. What happened to the girl who merrily cycled to England at the age of 19, from Amsterdam to Belgium and from Dover to Milton Keynes?

Swimming was better, but only just. Ten minutes is about as much as I can manage these days.

Mind you, it did make me feel better. But it also brought home how weak and fragile I am, and how glad I am to have this week's grace. With each round of chemo it takes longer to crawl back from the brink. This time, I have been much more of a hermit than before. I've been more careful about going out, not only because of the exhaustion but also because of the infection risk.

It wouldn't take much to dip into feeling useless, low, or even depressed.

Thankfully, I have avoided that pitfall so far (well, apart from the sudden collapses and the weeping in woods), but I can see how easily it can happen to the most cheerful of cancer patients.

We had quite a discussion with my consultant about the wisdom of delaying the final dose of chemo.

She was keen on giving me the highest possible doses of poison in the shorted possible time frame. I was keen on making it to Scotland, but not if it risked scuppering my chances of a long life. Would it?

Well, here's the difficulty: nobody quite knows. It seems unlikely that a couple of sneaky cancer cells escape extermination because the final attack was delayed by a week, but I suppose you never know. Chemotherapy, I have now realised, is an imprecise art.

"There might not have been any cancer cells to begin with," said my consultant. "Or if there were, they may all have been killed off with the first cycle of chemotherapy. Who knows."

Now there's a thought. I can't decide whether it's a happy thought (Hurray! No cancer cells! I'm cured!) or a sad thought (All that effort for nothing!).

There is a whole world of research out there. I've read some of the papers, but it doesn't really help. What do these studies show? Percentages of women who survive for 5 years, 10 years, 20 years. I don't like looking at the statistics, because in my mind, I have a 100% chance of surviving 20 years. Actually, make that 40 years.

Research papers on treating women with early stage breast cancer talk about survival rates of anything between, oh, 65% and 98%. (I notice that none of them say 100%. Shame.) It depends on the cancer, the treatment, the era, the country. So many imponderables - it's best not to ponder.

I remember discussing with my surgeon whether I could delay my mastectomy. She rattled off some statistics (they sounded quite good), but then she said, wisely: "It's only numbers, Irene, and you know it could just be your number."

So they're guessing, really, all these cancer doctors.

And because it's so complicated, I'm happy to leave the guessing to them - most of the time. But in the case of this week's delay, I listened to my breast care nurse instead.

"Oh, she would say that," she laughed dismissively when I told her that the consultant wasn't keen. "She's a doctor. But honestly, lots of people miss a week. They pick up an infection so they have to delay things. It happens all the time. And if going to your conference makes you feel like a normal human being again, that's worth something, isn't it?"

I wouldn't go as far as predicting that I'll feel normal, but in this case, I'm happy to risk my chances of living another 40 years.

I am not completely let off going into hospital tomorrow, because I have been given an appointment for the Breast Prostheses Clinic.

That's what it says on the letter, Prostheses, plural. I suppose some women do need them in plural.

And yes, you've guessed it: it's in Clinic 2. Right next door to Wish You Were Hair, presumably. I'll let you know.

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