Just in time for a happy holiday, on Monday I popped into the Beatson for my latest scan results. And, like a crap 80s band, it seems the tumour has been reforming for a bit of a Christmas comeback tour.
Not in a big way. Not with the full original line-up. But there's something there which wasn't when I had the last scan back in September. That's why I felt so tired for a few weeks there. It wasn't so terrible, but it left me unfocussed and too weary to work, although I felt better again once I was back on the steroids, and after I'd got over the highs and crashes they threw into the mix. I feel OK again now.
But my early unwelcome Christmas pressie from the oncologists was a shock. While I always knew a return was likely, I'd been hoping that because of my age and resilience it might be quite a bit away for a while. I'd been hoping for, pretty much expecting, a festive all-clear.
But no. So there we go. Something else to be dealt with. So let's get on with it.
I'll know soon how that will be done. So far, I know of some options.
The first is more surgery, the door in the side of my skull gets swung open once more and the Southern General's neurosurgical crack troops get in there and scrape out as much as possible of the new head that glioblastoma just loves to try to regrow, and maybe apply some chemo directly to my brain while they're in there. If surgery is possible, there will be a new flavour of chemo to follow and, if it's appropriate, I may also be given a trial drug which is currently being pioneered at the Beatson, and which they think is pretty effective. So that, I suppose, is the one to hope for. Get it out, get the surrounding area severely poisoned with as many harsh chemicals as it takes, and get on with things. It seems I'm good at coping with major surgery, so if that's the one, bring it on.
What I suppose is the next option to desire is the surgery and the chemo without the trial drug, if it's not appropriate for whatever reason. I don't yet know why it might not be, but I'll find out soon.
The other is that if the neurosurgeons feel they can't get the new stuff out without doing me too much damage, I go straight onto the new chemo regime. That one at the moment is my least favourite, simply because I can't help feeling "better out than in" (as Jo Brand said about Simon Cowell and a life raft).
Looks like the new chemo isn't much different in terms of side-effects to the Temozolomide: fatigue, possible nausea (and I escaped that one last time) and, rarely, actual sickness. Still just capsules to swallow, none of the long sessions plugged into a venom sac with hours of pain and illness that so many other cancer patients have to endure, so no biggie. This one will be, if I remember this correctly, on a two-monthly cycle rather than monthly, but each session will last eleven days rather than five, and there are some dietary restrictions – no alcohol, no cheese, and none of quite a few of my other favourite things. So that's a bit of a bugger, but just something else to put up with. And only during the eleven day cycle – for the rest of the time, I can carry on as normal.
So there are still treatments I can have, and good ones.
This Friday, the oncologists will meet with the neurosurgeons, and take a view on their approach. They've told me they'll give me a call once they've had that meeting and keep me updated. But I'll know everything on Monday (yep, Happy Hogmanay, Graeme) when I have to head back into the Beatson first thing for a full and frank chat about the whole thing. If they do go for surgery, I think it will happen pretty quickly after that.
This time I'll go prepared with more and better questions, too. On Christmas Eve I was a bit too shaken to ask everything I probably should, and my reporter's instincts to haul out the whole story deserted me a bit. I'll let you know more when I know myself.
Anyway, I got over that quickly enough. By the time I was on the bus home I'd converted the panic into fury, and that in turn to my usual equanimity. By the time I was home, I was ready to explain it all clearly and calmly to Clare. And she, my rock that she is, took the news with her usual incredible kindness and strength. She hadn't been able to come with me to the appointment for once – she'd had a dose of something, and while it might just have been something she ate, it's just not fair to take what could equally have been norovirus into a hospital full of sick, vulnerable people – but she still ran me up to my parents so I could let them know. And they took it with their usual support and calmness, too. They're good like that, we're a strong breed.
And, after all, there isn't so much to worry about. There are all those tried-and-tested, effective treatments to have. It's kind of like I've had my head MoT'd and they've found something which needs sorting, so I now need to pop it in for a service.
So, I'll cope with it. Just another battle to fight and win.
Christopher Hitchens wrote during his final illness that he wasn't fond of the combat metaphor so often used in dealing with cancer – everyone's always said to be fighting or battling it, while he said something about seeing it more as being under siege: "I am not fighting or battling cancer - it is fighting me".
He had a point, since there isn't much I can physically fight myself. But I have the best possible army of highly-trained specialists at the Beatson and the Southern General to fight my war for me. Which I know they will do to the best of their great abilities.
And anyway, there is a battle for me to fight. It's not one I've found too hard so far, and I'll keep it up: I will maintain my optimism and equanimity. I just will.
I won't be doing depression, because life is so precious that it would be almost criminal to waste it being miserable. And I won't be doing self-pity either, for the same reason. And just watch the news: there are so many people in the world facing terrible inevitabilities I will never have to, every day, and it would be self-indulgent – and not even in a good way, but in a destructive, wasteful one – to spend time on whining about myself. Better to watch, and understand, and feel compassion instead. Negative emotions are the things to be fought, and in my own mind I will be rising to the mountaintop, clad in anger, spitting iron and fire, to drive them away. And if I'm going to be self-indulgent, it'll be in enjoying myself when I get the chance. It is, as the song says, later than you think. (But not that late).
So, I had a lovely Christmas Day. Clare and I had a nice breakfast, and opened our presents, and then we went up to my mum and dad's, where we had an excellent feed and some very pleasant drinks, opened some more presents, gave others, chatted with the relatives, played with my sister's kids, and had a comfy, warm Christmas time. Then we came home and watched Doctor Who.
As good as it gets, all in.