not dead yet

Someone pointed out that I have a responsibility to update this blog regularly. Because I have cancer, when things go silent for months on end, a reasonable assumption is that I've died. That hadn't occurred to me, so I apoligize to all of you who mourned my demise.

To be honest, I don't have much news in the cancer realm: no new tumours, no dramatic treatment decisions, no enlightening information from my stable of superstar doctors. I think they're bored with my case because it's not immediately life-threatening, and so they can't rationalize trying more surgery or chemo. For statistical purposes, they've done all they can do until something particularly nasty pops up.

In February 2011, I have the three-month follow-up for my surgery of June 2010. I know, I know, that's seven months, but we all appreciate the insanely busy, hectic schedule of a dedicated and hardworkng medical professional.

I am convinced that I have another tumour growing in my lung because of these ominous, periodic but regular symptoms: a stabbing pain in my chest, joint and bone aches, pain when I move and pain when I stay still, night sweats, insomnia, weakness, brutal headaches, fatigue, an annoying little cough, shortness of breath, nausea, and some days I simply can't get out of bed. Yep, it's gotta be the return of lung cancer.

Never being one to sit back and do nothing, I start smoking again. Ahhh, bliss! In the months of daily jonesing, obsessing and tweaking for a smoke, I develop a tremendous respect for those who quit for good. I respect accountants, too, for the work they do, but I know myself well enough to accept the fact that accounting is not a realistic goal for me. Same thing with spotless housekeeping, telephone sales, a life dedicated to Christ and non-smoking.

On a roll, I start drinking wine every day. Then comes smoking pot. Next, my diet goes all to hell with juicy steaks pan-fried in butter, greasy pizza and Kraft Dinner. Worst of all, I start playing Dragons of Atlantis, a fantasy role-playing war game online. As you can clearly see, I am in a bad way.

Oddly, this degenerate, unhealthy lifestyle doesn't make me feel any worse. The daily discomforts are still here, but at least now I enjoy a nice dinner with wine and a cigarette afterwards, then a joint and a couple of hours lost in the cyber-realms of Atlantis, slaughtering the enemy's battle dragons and raiding their outposts while the dirty laundry and dishes wait for tomorrow. Or the next day.

So, off to meet with Dr. Wadge for, I am certain, the dire news that lung cancer is still with me. Dr. Wadge is an internal medicine specialist in Sechelt here on the Sunshine Coast (the BC Cancer Agency wanted me to travel to Vancouver for followup appointments, but I declined).

It's a grey and drizzly morning, the weather in solemn harmony with my morbid outlook. Hank Williams Sr. sings the saddest song I've ever heard while I make the half-hour drive south on Hwy. 101 and smoke cigarettes.



In the peaceful waiting room, I pick up a local newspaper and choose one of the uncomfortable little chairs, the one furthest from the reception window and the other patiently waiting patients. I try to read but don't comprehend a word. Classical music plays at a low volume from tiny grey speakers bolted unobtrusively in the corners. I contemplate a long, black hair on the polished floor and wonder if it fell from from someone undergoing chemotherapy. I sneak a look at the person sitting across from me-- she knits something from a skein or ball of bile-green wool hidden in her black purse-- and wonder if she has cancer. I imagine a prisoner facing the guillotine, innocent of the crime he's accused of, feeling this same dreadful finality.

"Mizz... Winchester?" Now it's hurry down the hallway and into the little consult room with the doctor, with the test results already up and shimmering on her monitor...

Not a trace of lung cancer, no tumours visible, so the January 2010 wedge resection was a success. Too bad they took out all that perfectly healthy lung six months later but, oh well, I guess it's always best to take precautionary measures. Better safe than sorry. Perhaps I'll request a leg amputation. You just never know when something could go amiss with a leg, and if the leg is gone, well, then it won't cause any problems.

The CT scan shows two enlarged lymph nodes, but a size of 1.5 cm is not alarming given that the normal size is 50 mm. My missing oncologist (she took maternity leave in May 2010 and I haven't heard from her since) assumes it's an inoldent lymphoma, cancer, but the type and stage is unknown because a biopsy has not been taken. Apparently it's a deep and difficult surgery, removing either of these nodes, so I'm okay with keeping them for now. I've had quite enough, thank you, of having bits of me cut out this past year or so.

Dr. Wadge asks how I'm feeling, so I tell her.

"Well," she says with no small degree of resignation, "look what you've been through," and summarizes my last surgery with the disturbingly vivid phrase, "flayed open," which fails to reassure me. In other words, this is your life, so suck it up buttercup.

I tell her I've started smoking again and she replies that I can always quit again.

I express concern about the reoccuring nausea and abdominal pain, and she heads for the rubber gloves and jelly for a rectal examination, so I quickly change the subject before she can get me out of my pants.

I ask for something to help me sleep, and she orders a cousin of the tricyclic anti-depressant, amitriptyline. It puts me to sleep but the nightmares are so horror-show frightening that I'd much rather spend the night tossing, turning, aching and sweating than screaming silently in absolute terror, immobilized with fear, unable to wake up. Sometimes a little perspective is all that's needed to solve a problem.

I will have regular blood tests looking for anemia (common with lymphoma) and elevated white blood counts, and I will have a CT scan every three months, still looking for the return of lung cancer in my lung and other organs to which it likes to travel (the brain and liver are particular favourites).

When I exit Dr. Wadge's office, the rain has stopped, the sun is shining and the day looks much cheerier now that I don't have lung cancer again, and it's the Proclaimers in the CD player for the drive home.



I know some of you are wondering if I quit smoking again. Don't be silly.

The reactions to my smoking range from shock to horror to a deeply personal disappointment in my weakness, recklessness and willingness to, apparently, kill myself. Only my closest friends accept, and understand, my decision. Or at least they tell me they do, but I believe them because they too are Evil Smokers.

Honestly, my decision to start smoking (or quit quitting) isn't as impulsive as you think. I researched smoking and lung cancer, and learned that the lung cancer patient who quits smoking upon diagnosis will increase his lifespan. So far so good, but by the end of the lengthy study, you learn that the lifespan increase is three weeks. Three measly weeks? I guess you know what I decided they could do with those three weeks.

I quit smoking in mid-January of 2010, just before my first surgery. The first days were the easiest, but that likely had something to do with the initial trauma of the cancer diagnosis, lung surgery and the generous amounts of narcotics I was fed to keep the pain at bay. I was also physically unable to get out of bed to walk the four blocks to get off hospital property, the only place a patient is allowed to smoke.

At any rate, it didn't get easier, it got harder. The craving would hit, and although I knew how to distract myself from it, and although it worked for a few minutes, it was right back again a few minutes later. I became aware that there are a lot of minutes in a day.

Besides, I'm not convinced that cigarettes are the highly-toxic, guaranteed-deadly little items that health organizations and the government tell us they are.

When I pick up a pack of cigarettes and read, SMOKING CAUSES CANCER, I wonder why milk cartons don't say MILK CAUSES ALLERGIC REACTIONS (because it does, in some people) or, on a bag of Planter's Mixed Nuts, EATING NUTS KILLS PEOPLE (because nuts can kill some people).

I wonder why automobiles don't have big red stickers saying, DRIVING KILLS (because, indirectly, it can) or DRIVING CAUSES CANCER, because automobile emissions are far more carcinogenic than cigarette smoke.

I wonder why airports aren't targeted by the environmentally conscious, because the amount of fuel burned and dumped (regularly, to reduce weight) should be a much greater concern than a farmer and driving his Ford F-250 pickup truck around the pasture. And let's not even think of the fuel burned by the air force hotshots in their training exercises and shows to impress the public.

I don't understand why cigarettes are targeted so strongly, and I'm not enough of a conspiracy theorist to believe it's a backroom deal by the government and tobacco companies to charge a ridiculously high price for a pack of smokes.

I know that smoking is not a "healthy" habit, and I know that, these days, it's not socially acceptable in most situations. I suspect that a number of well-meaning, righteous people on various volunteer boards and in low-level government offices have simply allowed their enthusiasm to get out of control in a caring, heartfelt desire to do good for everyone. I'm sure they all use the word "proactive" at every opportunity and have no idea that there's a deep and wide, gaping chasm between statistical probability and scientific fact.

The problem is, I cannot find any reliable science to back up claims that smoking will kill you. There's a strong link between smoking and some types of cancer, but there's an even stronger link between drinking milk as a child and becoming a heroin addict as an adult. It suggests a connection, but it's misleading. One in three people will get cancer but fewer than one in three people smoke, and not all smokers get cancer.

There's more to the cancer story than smoking, and we don't know yet what it is. Even though we hate to be haters, we love to be blamers and we've been conditioned to blame cigarettes for the fact that we can't live forever and we're likely going to die of cancer or heart disease.

It surely wouldn't be a good idea to publicize the inconvenient truth that living in a high-density urban area exposes a non-smoker to more carcinogens than a pack-a-day smoker living in a rural area with minimal pollution.

Here's what has been proven: to maybe but not definitely get cancer, one needs a specific genetic marker that allows uncontrolled cell growth, plus regular, long-term exposure to a carcinogen. One without the other means no cancer; both must be present and it's still no sure thing.

If one could live in a carcinogen-free environment, cancer would not be a problem, but we swallow, breathe and touch carcinogenic materials every day of our lives. Food additives, air pollution, water pollution and natural carcinogens (arsenic in water) all contribute, and we can't escape them.

Bottom line, I smoked for over 40 years before I got lung cancer (ironically, the kind that non-smokers get). Whether or not my cancer was caused by smoking, the damage is done and I'm not really interested in quitting so I can prolong my life three more weeks.