Blog: The Big J vs The Big C

Making the breast of a bad situation ...
On 4 October 2016, I was diagnosed with breast cancer. This blog will chart my progress through treatment, and continued enjoyment of life, love and friendship.
​Expect humour, irreverance, occasional sadness, and staunch defence of the National Health Service.
​Btw, that picture is not me. :-)

Behind the Headlines: Tories' Cancer Drugs Fund Exposed as Rip-Off

Today’s headline is that the Cancer Drugs Fund, which was announced by the Tories in 2010 and ran until 2016, was a ‘huge waste of money’. The Annals of Oncology journal has published a study led by Professor Richard Sullivan of King’s College London, who also described the Fund as a ‘major policy error’.

The Conservatives thought they could pick up a few votes in 2010 by promising to fund expensive cancer drugs that the NHS was not funding, and the CDF was the result. It funded cancer patients to receive medications which had not yet been approved by the National Institute of Health and Care Excellence (NICE). Launched in 2011 with a budget of £200 million, the Fund was supposed to be a stopgap while alternatives were developed, and was initially scheduled to run until 2014. However, the government did not pursue its alternative policy, the ominous-sounding Value-Based Pricing, and instead extended the CDF until 2016, by which time it had been denounced by the Cancer Taskforce and the National Audit Office as unsustainable, and some doctors - including Richard Sullivan - were calling it an ‘unethical fix’ and a ‘waste of public money’. Still the Conservatives promised in their 2015 election manifesto that ‘We will continue to invest in our lifesaving Cancer Drugs Fund’ and issued the poster pictured, only to scrap the CDF a year later, absorbing it into NICE.

Back at Bart's

Today I was back at Bart's for my radiotherapy follow-up appointment, to check how I coped with the treatment and any problems I have had since. The appointment can be summarised thus: Hi. How are you? Show us your boob. Oh, that looks great. See you in December. Bye. (I may have had encounters like this in the past, although not with doctors.)

Please do not infer from this summary any dismissiveness or rush on the part of the doc. Rather, feel free to infer the splendid news that I am heading at a rapid rate towards the light at the end of cancer's tunnel. The marvellous oncologist Doctor Wolstenholme checked me over, reassured me that everything was healing just as it should and that the oedema is on its way out. She was mightily impressed with my tales of my randomly-leaking nipple and squirting antics. I have the feeling that oedema does not usually happen this way. Once again, my breasts function in a very different dimension to the average mammary.

Mind the Gap: Cancer and Class

... or 'The Lumpen Proletariat' ...

Over recent decades, UK cancer death rates have fallen significantly. They began falling in the late 1980s, and by 2006 had fallen by 17%. More people than ever before are surviving cancer, with 78% of women in England and Wales still alive ten years after their breast cancer diagnosis (2010-11).

But there are still big differences between cancer outcomes depending on how wealthy you are. Economic inequality - the polite term for 'class divisions' - is linked to 19,000 cancer deaths per year.

Overdoing It?

Since resuming my membership of the sports centre five days ago, I have visited every day - and no, not just to check the timetable or use the vending machine. 

Two days ago, I reached untold heights of pleasure by swimming for the first time since before my breast ceased to be watertight and fully encased in skin and began its six months of being pierced, sliced, stitched, infected, creamed, irradiated, peeled and cooked. The wounds are still sore but they have sealed themselves up, so there is no risk of swimming pool water and/or germs getting in through fissures in my skin, nor of bits of my boob leaking out into a communal, municipal facility. Just when you thought it was safe to go back in the water - it is!

Working Out Towards Recovery

Six months after I 'froze' my sports centre membership when I was too biopsied to work out, today was the day that I felt thawed enough to unfreeze it. Yes, I returned to the gym.

And oh yes, it was good to be back. The familiar smell of foam mats, body odour and attempts to disguise it; the row of TVs with subtitles; the queue for the drinking water; and the motivational tunes: Skepta is going to get me exercising. It was good to get my muscles moving and endorphins flowing, and it was good just to get back to another thing that I used to do before cancer so rudely interrupted my routines.

Returning to the gym after six months' cancer treatment gave me measurements of the deterioration of my physical fitness that I was already aware had taken place. Where I used to pedal at level 7, I could only now only sustain level 3. The stretching machine which would hold my leg at a 100-degree angle could only take it to 80. And even without a way of precisely measuring it, I could feel in my bones that my bendiness was significantly less bendy, and my flexibility was down to about the level of a stick of rock. It's a very good job that the clientele of the gym I go to is very diverse, from the greek gods bench pressing to hone their already perfectly-honed figures to the noticeably out-of-shape doing a bit of light movement to stop themselves seizing up altogether.

Back to Work

Last night, I returned to duty in my proper job, as a London Underground 'Night Tube' station supervisor. These days, the official title is 'Customer Service Supervisor', but I prefer it if you have some idea of what I actually do ie. supervise a station, rather than imagining that I'm some kind of whip-cracker in the complaints department.

The last shift I did was on Halloween weekend, when one of the toughest challenges was distinguishing the passengers who were actually injured and bleeding from those who were simply wearing gory make-up. I have been working on London Underground stations for 20 years, and I would not have stuck at it if I did not enjoy it and value it. But cancer surgery and follow-up treatment were not compatible with the demands of the job, so since the start of November I have been either off sick or carrying out 'light duties' (in my case, planning a new set of hosted visits by autistic people to London Underground). As recently reported, I have not yet fully recovered from said treatment, but I have recovered sufficiently to make a start at returning to work. And working in a job which has - thanks to the past efforts of the union - 100% sick pay, I have been able to decide when to return to work on the basis of my condition not my income.

Can Prayer Cure Cancer?

After visiting the hospital yesterday to get my oedema looked at, I sat for a while in the small church of St. Bartholomew-the-Less, conveniently located on the way out of the hospital on the way to the bus stop. I am not a religious person, and I can not even claim that it was an oasis of calm, as the sound of construction work blasted past the big wooden doors and bellowed around the nave. But I fancied a ponder on matters theological.

Barts-the-Less is a chapel of ease, meaning a church building that is accessible to parishioners who can not make it to the proper parish church (in this case, St. Bartholomew-the-Great). The clients and residents of Bart's hospital, and their visitors, surely qualify. For clarity, there was one St. Bartholomew, who had one great church and one lesser one; rather than two St. Bartholomews, one greater in some important respect than his lesser namesake.

It is, as are most places of worship, rather beautiful - unusually light due to its strikingly large windows, and its walls adorned with resolute plaques memorialising some of the Bart's hospital staff through the centuries who saved many lives and then lost their own. I sat on the crimson cushion on the wooden pew. The only other person there was, I think, praying.

That Can't Be Right

A retrospective blog post today, looking back at when I noticed that something was wrong. I didn't write about this at the time because I didn't want to alarm anyone without reason. The blogging only started once the diagnosis was confirmed. So, it went like this ...

Oh Dear, It's Oedema

Yesterday evening, something rather alarming happened. There I was, minding my own business, watching telly, when my T-shirt suddenly became soaking wet, in a patch from above the nipple downwards. 

I remember something similar on the occasions when I had newborn babies and the milk gushed out in excitement, but this was definitely not that. Ah well, I thought, chucking said T-shirt in the laundry basket (an excellent device: I throw dirty clothes in there and a day or so later they come back to my room clean).Fresh T-shirt on, return to couch potato duties.

An hour later, it happened again. Another change of T-shirt and a bit of a worry. But I cleaned up and it didn't happen again.

Until this afternoon.

So, What's Radiotherapy Like Then?

Lie back, gown down, naked from the waist up but clothed from there down to my shoed feet. It really is most remarkably comfortable. Even my raised arms get cushioned rests that not only bear their weight but also bring my hands together without a hint of pain or even effort.

Two sounds compete. One, the background whirr of presumably the air conditioning, whose breath occasionally registers on my skin and makes me feel even more comfortable, if that were possible. And two, the radio, one of those commercial stations with music that is pretty much guaranteed to offend no-one but will probably inspire no-one either.


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