End of cycle

THE END OF CYCLE 1

Today was the last day of cycle one of my chemotherapy, One down five to go. Tomorrow I start cycle two with the blessing of my oncologist who we visited today. The man who made a pact with the devil looked at my CT scan and showed me how I have cancerous spots in my lymph system, nothing ping pong ball or cricket ball size but nevertheless sitting there inside me being threatening. He also showed me once again the bone scan with its nasty black patches on my spine in three places, I find these more macarbre as it brings to mind an old advert for spine health that stated “If this goes the lot goes”. Not a pleasant thought.

We also had a chat about hot flushes. He listened kindly and offered the suggestion of Primrose oil. In my head I thought, “Stuff that I’ve read the research, it is no better than a placebo”, but nobody likes a swot and a know all so I said “Its okay so far its manageable.” I said I woke a couple of times a night in a sweat and he continued “we can always give you fluoxitene, ” I think “the fuck you will that’s an anitdepressant, I’m not having that shit in me,” and say “I would like to avoid that as I do not want to put anymore in my body than I need. Like I say, so far they (the hot flushes) are manageable.” End of conversation. After all I had sat in his stuffy waiting areas faning myself with my black silk fan and getting the usual weirdo looks from fellow cancer club members. If I can do that hot flushes are the least of my worries.

The meat of the conversation was around me trying to get some sort of timetable for my mortality. I had spent time looking at prostate prediction tools and aids to prognosis. I had also been looking at survival curves. I had a crack at the nhs prostate predictor. I put in my details and some of the figures I have for me. I got to my Gleason score of 9 and it politley told me the tool was not for those with metastatic prostate cancer. No joy there. I explained to he who had formed a pact with the devil that in my head it was like a satnav prediction of a journey. My satnav gives me an expected arrival time and being a bloke I try to get there earlier. With my cancer I want some sort of death arrival time that I can then be late for. It helps me plan and prioritise my life, balance my effort and undertake the most meaningful things in my life. He nodded and then we got into the “it is a difficult thing to predict, no two cases are the same.” type of conversation. I had already read that 30% of men with a Gleason score of 7 do not make it to five years. Mine is 9. We went back and forth but all he could really say was that when my cancer returns (it aways fucking does) the only thing they can say is that the chemo will give me about 12 to 18 months more, I reckon that’s eight months. We will see, no escaping the empirical data on this one, but either way I won’t be a round to say I told you so. So the game has changed, its all about how long the hormone depletion therapy works. As long as the PSA score goes down and stays down I’m winning. If it goes up I’m in trouble. I will keep you all posted. All the time we talked my partner listened and helpful clarified some things that I missed or did not get right. The specialist nurse, who had done my care plan sat in too and nodded at the right times and I think tried to be supportive. So there we all were metaphorially looking down my trousers and guessing how long…

***“metaphorially looking down my trousers and guessing how long…”***

The time came to an end and as a parting gift I was presented with what is in effect my “go to cycle two pass”. It comes as a blood test specimen envelope with instruction as to what is to be tested before I see the oncologist at the end of the coming cycle in order for him to declare me fit for poisioning. For those interested, my next one is below with an explanation for those curious about what the abbreviations means.

the blood test pass
the test abbreviation

So its home time, lunch and as my partner goes back to work I start the preparation for cycle two. In truth there is not much to do apart from turn up tomorrow, but I check the paper work, make sure I take my second block dose of steriods in the afternoon. They suggest this because apparently it “wires” some people and they do not sleep. Me, not a thing, I sleep, I hot flush, I wake up, I go for a pee, I sleep and so on. To date nothing else. Except that my Fitbit tells me that I am having more deep sleep and REM since being on chemo. Prior to chemo I used to have regular nights with out either deep or REM sleep. I was going 5 or six nights without either but now I get nightly doses of both.

There is one thing that I will do as a result of my pre chemo course. It was very clear that a soft toothbrush was recommended. Baby ones were said to be good and that they should be changed for each cycle. So when I finnish here tonight I shall brush my teeth for the last time with my faithful baby Cycle 1 toothbrush and ruthlessly discard it for a new one. Cycle 2 will start with more steriods and a new toothbrush.

Today is the autumn equinox

As I come to the end of a chemo cycle so the autumn equinox arrives. That time of equal day and night. A sort of fifty fifty situation, one that feels very like mine at the moment. It is a reminder that in this process the balance is always changeing and it is the rare moments that a true balance exists. It is the struggle to maintain mental and personal balance within this usually out of balance environment that takes the energy and the reflective effort to keep ones direction. When balance comes it is a moment to savour and for me provides sancuary from the ever changeing nature of the real world.