An Unexpected Gratitude

Two days ago I was due to have major abdominal surgery but instead I have been enjoying the spring sunshine and finding myself strangely grateful to my cancer.

Back in January I was told that both of my cancers had returned. The breast cancer had reappeared in my spine as I always knew it could. The surprise was to find that the cervical cancer had returned in a new area of lymph nodes in my abdomen. This was not good news but I felt it was manageable and there were still lots of treatment options available to me which meant that both diseases could in theory still be curable. The recommended treatment plan was to have surgery to remove the cancerous lymph nodes located near my kidneys along with as many lymph nodes in the same lymph chain as could be reached. The surgery was to be followed by five weeks of radiotherapy to my abdomen as well as my spine where the breast cancer had returned. The aim of this radical treatment was to halt both diseases and hope that they did not return.

With this plan in mind I went to hospital for my pre-op assessment last week fully expecting to finalise the plan and sign my consent forms. My body however had other ideas. My new CT scan results showed that whilst the breast cancer in my spine remains unchanged there is a lymph node in my chest near my right lung which has grown by two millimetres since my last scan two months ago. This lymph node has cervical cancer which means there is now systemic disease (multiple sites) rather than isolated disease. In cancer terms this is when medical options change. There are a growing number of opinions that say that isolated metastatic disease can in some cases be cured but once you have confirmed systemic disease you will struggle to find an oncologist who would bet on a cure. Oncologists make treatment decisions based in part on probabilities and my new scan results changed the odds. This meant my treatment plan was no longer a sensible option. Two millimetres of growth in a single lymph node had moved me into a different category in my doctors’ eyes. I am now regarded as incurable. Oddly, although I have had metastatic cancer for some time now this is the first time this has been said. Up until now my medical teams have agreed with me that single sites of disease are theoretically curable and so we have always worked from this principle. Systemic disease however is a game-changer from a purely medical perspective. There are still treatment options available to me – various different chemos – but they are unlikely to provide a permanent cure. My oncologist’s preferred approach is known as ‘active surveillance’ which is a nice way of saying ‘do nothing until it gets worse’. Chemo options are limited and so it is quite common to keep them in reserve until the cancer becomes more active. I will continue to have scans to monitor and look for any developments but for now no major treatment is planned.

This probably all sounds very depressing but I’ve had a bit of time to think about it all and I have found myself feeling grateful to my new little bit of cancer. Those two millimetres of growth have saved me from having to have major surgery, a prospect I was dreading. I never really wanted it but I have never felt I could take the risk of turning down treatment recommended by my doctors. Medically speaking I may be seen as incurable but I do not see it that way. I continue to have faith in the possibility that I can heal. I know that my teams have done everything they can over the last two years to save my life but it just wasn’t quite enough. Despite all the radical treatments I have had the cancers keep coming back. I don’t regret any of the choices I have made but I feel the time has come for making different choices. I am not going to walk away from conventional treatments but I know that on their own they cannot cure me. It is time for me to take control of my health. This one little lymph node has changed things but not necessarily for the worse. Instead of major surgery followed by a gruelling recovery and then weeks of debilitating radiotherapy I am free to find my own path to healing and I feel unburdened by the heavy weight of medical treatment for the first time since this all began. I have always believed that everything happens at just the moment it should and I feel I have been given a space in which to live again and to find new hope.