March 7th 2011
A Horror Story (or two)
I’m not really a fan of the genre – I’ve read Dracula and The Millennium Trilogy (horror of a different sort) – but my latest bedtime reading is, quite frankly, giving me the willies. It’s neither horror of the Gothic kind nor horror resulting from the violent things that human beings do to each other – although there is a bit of that in it. The book is described by its author as a ‘biography of Cancer’. And it’s in the use of the word ‘biography’ that the horror lies. In the author’s lab in New York there are breast cancer cells, very much alive and kicking – although their host died over 40 years ago.
The first thing ‘The Emperor of all Diseases’ does is to knock on the head the idea that cancer is a new disease, perhaps brought on by our extravagant, exuberant life style. Cancer has been around a long time – perhaps as long as mankind itself. When life expectancy was just 40 (as in the UK in the 19th century), TB and various plagues and buboes had finished us off before cancer could really get a look in. Now that life expectancy (in the Developed World at least) has more or less doubled, cancer is at last showing its hand. Because cancer is predominately a disease of old age – not always – but usually.
We know it’s an old disease because we find ancient bones with tumours attached; Egyptian and Greek documents describe mastectomies and other radical surgical procedures; and the disease was named in 400BC by Hippocrates after he found a tumour on a man’s chest which resembled the shape of a crab.
Cells grow by physically getting larger (as in muscles) or by division (as in organs, blood and bone). It’s in cell division that the problem arises – a cancerous cell is one that divides at a much faster rate than the body’s normal feedback mechanisms can deal with. Not only that, they exemplify Darwinian principles – once established they continually evolve into new forms. By the time chemotherapy drugs have been administered, some of the cells have moved on. This explains – to me at least – why bowel cancer cells turned up in my left lung around 4 years after a dose of chemotherapy that was supposed to kill everything within a hundred miles.
And the real horror, as far as I’m concerned, is in what seems like an inevitability about it all. Before I give you sleepless nights as well, I should point out that the removal of ‘localized’ tumours by surgery, chemo or radiotherapy (alone or in combination) has a high success rate. But those that escape into the lymph system or blood stream are trickier to deal with. The emphasis turns from curing cancer to living with cancer.
It’s while reading this book that I’ve realised, probably for the first time, that cancer frightens me. I’ve been pretty gung-ho about it up to now. Cut it out and move on. To be sure – I’ve been frightened at some of the processes that I’ve gone through – but the ‘thing’ itself, not so. Now it’s as if there’s an alien life force living within me with an agenda all of its own. Is it going to burst out of my shirt when we all sit down for Sunday lunch? I doubt it. Are there cancer cells still lurking about somewhere, perhaps having evolved from those that were zapped by the radiotherapy? I’ve moved from a definite ‘nah’ to a tentative ‘possibly’. On a bad day – ‘probably’.
Another horror story; Annie rings the hospital to check on the progress for the ‘urgent’ catheter ablation procedure. ‘Urgent’ in NHS terms means within 2 weeks. The consultant’s secretary knows nothing about it. Eventually she finds a letter, which has not yet been sent. This is last August all over again.
As it turns out, I can’t have it done yet anyway – I’ve had a lung infection and the antibiotics have messed with the warfarin so my INR is all over the place. It’s nowhere near the range 2-3. I’m getting massive bruises every time I have a blood test (4 in the last 2 weeks). What would Dracula make of this I wonder?
Tales of the unexpected.
A few weeks ago I discover a radiator leaking. Not from a valve or pipe but slam bang in the middle of the front panel. Not in a ‘blueberries erupting from a stoma’ sort of way (see Thar she blows, April 2006) but enough to stain the carpet. I turn off the valves and fetch a plastic bowl to catch the drips.
I remember that our British Gas Boiler policy covers the radiators, so call for an engineer. Engineer 1 duly turns up, confirms the radiator is actually leaking and orders a new one. I ask if he can just go to the local plumber’s yard and get one. No – it has to be ordered. I ask if I can go and get one. No – it has to be ordered.
It arrives a week later. A couple of days after that Engineer 2 arrives to fit it. Having removed the old one, he discovers that a couple of parts for the new one are missing. So we book yet another visit. Today is the scheduled day. We get a call – he’s been to the stores and can’t find the ordered parts. Where are they? He doesn’t know – the person who ordered them has since left the company. So they’re re-ordered and we book what will be a fourth visit.
Is this a record I wonder? Or perhaps it’s a little known clause in the British Gas Homecare policy – we guarantee a screw up to take your mind of your real worries. You pay extra for this of course, but it works for me.