Two years ago I had a severe pain in the left side of my chest.  I first noticed it climbing the stairs at work.  It came on very suddenly and I had to sit down and wait for it to pass.  It happened a few more times after that.  Possible causes flew thick and fast; heart attack, embolism, cracked rib, pleurisy, referred pain  …. and so on.  My imagination ran wild.  What I did not consider was a tumour in my lung.  Why should I?  A course of pain killers and it had gone.  I mentioned it almost in passing to the oncologist at my 6-monthly check up a few weeks later.  He took it far more seriously.  Thank goodness.

And now – here I am again.  The pain is on the right side this time.  No messing about with possible causes – my head says ‘tumour’. Especially at 4.00 am.  Later on, at a more civilized time and with a coffee inside me, I try to think more rationally about it.

The day before, I’d been wrestling with a couple of suitcases in the loft.  Or rather, the few feet of rapidly sloping roof space that passes for a loft.  It was shortly after this that began to I feel the aches and pains.  So – muscle strain?  Joint strain?  Fear of flying?

We’re less than two weeks away from a holiday.  It’s a big trip (for us) – one of those ‘we’ll only do this once, so let’s do it now’ sort of affair:  The Grand Canyon, Monument Valley and Route 66.  Or – John Wayne meets Chuck Berry in an all-American Diner.  I’ve wanted to see Monument Valley ever since I first saw John Wayne in Stagecoach¹ and I seem to have been listening to Chuck Berry singing about Route 66 forever.  And the Grand Canyon?  Because it’s halfway between Monument and Route 66.   And it is, by all accounts, grand.

We booked this trip last September when the oncologist confirmed that the shadow on my left lung was fibrosis and not a tumour.   It seemed a good idea at the time. A bold idea.  An adventure.  We felt we could do with one of those.  Now I’m not so sure.  No chance of a refund if we have to cancel; travel insurance doesn’t cover pre-existing conditions.  They’ll pay up if I lose a suitcase – but they won’t pay up if I lose a lung.  As Oscar Wilde might have said, had he worked in travel insurance, ‘to lose one lung is unfortunate, to lose both is careless’².  And if it is another tumour and we don’t cancel – does it really deserve to come on holiday with us?  I think not.

Why am I thinking like this?  I know that cancer cells can survive surgery and chemotherapy.  I am living proof of that.

I know – what are the chances …?  What are the chances?  But I guess at the forefront of my mind is the expectation that in less than 2 weeks time we’ll be miles from home – not an ideal place at a time like this.

But I’m getting ahead of myself; perhaps it won’t come to that.  It may be something quite innocent.  One of the less well-publicised side effects of cancer is hypochondria.  The slightest ache or pain and I’m Googling away like crazy.  I know from talking to other members of the cancer family that I’m not alone in this.

There’s no persistent cough this time.  And the pain is different.  But it still hurts when I prod the affected area.  (Well don’t prod it then).  It’s not there when I wake in the mornings.  But as I swing my legs over the edge of the bed, it’s rise and shine for Mr Pain.

I conduct a number of experiments; I try singing.  No problem.  I make some train noises on my harmonica.  My lung seems fine but next door’s dog freaks out as the 10.45 from Kansas City to Santa Fe blows through the garden.

She tries not to let on but I can see that Annie’s worried.  She urges me to see my GP.  I feel as if I’m wasting his time, but I go anyway.  He’s his usual calming self.  He listens to my chest, has a prod around and announces that he can’t hear anything untoward.  He suggests a strain of some sort among the muscles lining the cavity wall.  We leave it at that.  As it happens, I had a routine MRI scan a couple of weeks ago and am due to see the oncologist for a follow-up.  My GP has the results of a recent blood test requested by the oncologist.  He prints off a copy for me and draws my attention to the CEA³ reading; it’s 1.0 – well with in the normal range (0.0-4.0).

When I get home I look at the other readings; my serum bicarbonate level is high and the lymphocyte level is low.  Oh boy – Google throws up a lot of new conditions to worry about.  I take stock and try and think about it logically.

So – too much CO2 in my blood and a depressed immune system.  The former cannot be unexpected following a lung resection – the conversion of oxygen to CO2 can’t be as efficient as it would be with a fully functioning lung.  I’m not sure about the immune system though.  Another thought occurs – my readings are only just outside of the normal range.  And statistically speaking it must be possible to get ‘outliers’ in a normal population simply by chance.  I give it a rest – there’s not much I can do until I see the oncologist.

This is the bit I hate.  No matter how many times I’ve done this, sitting in the consulting room waiting for the oncologist never gets any easier.  It’s about 10 minutes before he arrives.  He asks how I am and I explain that I always feel a little tense until we’ve got the scan results out of the way.  “Your scan is fine”.  I relax and then look down my list of questions.  I’ve must have relaxed too much – nodded off perhaps – because the next minute he’s talking about the need for a PET scan.  There is something after all.  Where did that come from?  Later on, in the car on the way home I ask Annie how we got from ‘the scan is fine’ to the need for a PET scan.  Did I miss anything?  She has no idea either.

I ask if this ‘something’ is in the right lung or the left lung; “The left lung.”  I explain about the recent chest pain.  There appears to be nothing wrong with my right lung.  It’s the left that is causing the problem.  It is, apparently, a bit of a puzzle.  “It’s not presenting as a tumour.  It could be something to do with the original surgery, the radiotherapy or a clot.”  The other possibility – the one I really don’t want to think about – is left hanging.  “A PET scan is more appropriate for this sort of thing”.

We go through the possibilities.  We quickly dismiss a clot.  The low dose aspirin should be taking care of that.  He runs through the usual litany; weight loss? breathing difficulties? appetite loss?  Annie laughs at ‘appetite loss’; “there’s nothing wrong with his appetite”.  Eventually she mentions the blood test results and the cancer marker.  It appears that normal CEA levels do not rule out cancer reoccurring.  I can’t help thinking why bother with the test then.

I explain that we’re about to go on holiday.  “Go on holiday – you can have a PET scan as soon as you get back”.  We check diaries and pencil in the 5^th July for the follow-up consultation.  Back home I offer to cancel the holiday and try for an earlier scan.  Annie asks how I’m feeling.  I don’t really know – nothing I guess.  Neither optimistic nor pessimistic.  But I worry about Annie.  She’s a ‘grin and bear it’ sort of person.  Which is why I worry about her.  We decide to try and put it to the back of our minds and carry on as ‘normal’.  It remains to be seen just how successful this strategy will be.  We’ve been here before – and it’s a right pain.