THE NEW NORMAL #39 – GROUNDHOG DAY

Hey, how was your day? Same as yesterday? Same as tomorrow? Not sure if it’s a weekday, weekend or Christmas day?  Yeah, this coronavirus lockdown thing is getting pretty samey, isn’t it? It occurred to me and my family the other day just how similar to the classic Bill Murray film Groundhog Day the current world is but with the key difference that we’re all playing Phil Connors with an acute and unnerving awareness of the repetitive nature of life. I mean, if I wake up tomorrow and Alexa is playing ‘I Got You Babe’ then I’m not getting out of bed for all the PPE in China.

It was at this point, however, that my wife picked up that thought and spun it around as she so often does; “I’ll take this day over and over again right now”, she said. You see, for us and so many others (maybe even you) just getting through each day in good health, with full bellies, under a solid roof and with our loved ones around us counts as a massive win. Yeah, the process of waking up, getting all the kids fed and dressed and set up to do something resembling schoolwork (this week alone we’ve made a massive stick man, done a huge amount of spelling, constructed a scarecrow called Popeye and embraced the nationalism of St George in a way that I had never before entertained) can get a bit monotonous but is that really so different to normal life? I mean, I have to admit that I’m loving the fact that I don’t have make a single packed lunch, there are no afterschool clubs to ferry children to and from, and although I am missing the peace of my commute I haven’t spent any time staring at the back of a tractor for over 5 weeks so that’s a big fat win.

Anyway, coronavirus aside, there have been further developments in the cancer house, so I thought I’d pen you an update because, well, what else are you going to do? Seriously, you can’t really prefer to watch another version of the Baked Potato song, can you? Today, I spoke with an incredibly lovely and knowledgeable cancer specialist in London who is working as part of the team at Guy’s and St Thomas’ and there was a key phrase uttered in amongst this conversation; “There’s no point pretending this isn’t an extremely serious situation but it is not one without hope”. Hope. That’s a word that has come to mean so much more recently, so any offer of hope is as welcome as a bag of flour or a box of doughnuts. The hope in this instance comes in a number of forms which I’ll try to outline below:

  1. Immunotherapy – I’m continuing with the treatment as previously documented but what I hadn’t realised is the dose of Nivolumab has now been trebled. The key message from today though was that I shouldn’t be too disheartened that the treatment to date hasn’t worked. Treatment should and will continue to make sure that the tumour doesn’t haven’t a chance to spread unchallenged. In addition, it seems that although the cancer has grown, it hasn’t grown as rapidly as you might expect an aggressive melanoma to grow and at the centre of the growth there is something crucial: necrosis. This essentially means that the heart or the centre of the tumour is dying which could be really good news as you might expect but there is potentially a downside too. Necrosis can mean that the cancer has decided to move on, much like early settlers who realised that the although the pancreas lake was good for an initial base camp but they’ve decided to up sticks and move on to the port of lungs/kidneys/liver or somewhere else with more fruitful farming land to exploit.
  2. Surgery – not completely off the table if immunotherapy can help to diminish the tumour but there is some serious untangling to be done first, particularly if the tumour has wrapped itself round the portal vein. If the portal vein is involved then it gets tricky as this is the key vein that moves nutrients and toxins in and out of the gallbladder, pancreas, spleen and liver – you really don’t want to damage that sucker.
  3. Embolisation – this is essentially the option of cutting off the blood stream to the tumour which would stop it getting the energy and nutrients that it needs to grow and spread. Again, because of where the tumour is, this is a risky option but would buy me some time in the search for another option.
  4. Radiotherapy – we’re keeping this one in our back pocket for now. It won’t present any kind of cure but like the first wave of uncredited actors in a World War II film, it might just knock a few holes in the defences to allow the immunotherapy and my immune system (aka the second wave of actors in khaki) a better chance at actually inflicting some real damage.

All of the above, however, is just stalling tactics; medical kettling, if you will. There are clinical trials out there which might help me beyond just treading water but I can’t get on to any of these during the coronavirus so everything else is about delaying, holding, distracting. I’ve thought about trying the “hey, cancer, look over there, what’s that?” rouse but as cancer doesn’t have eyes (or ears for that matter), I don’t hold out much hope. Also, no medical professionals have suggested this so it’s probably a non-starter.

The other big theme of my conversation today was my big toe. New readers may be utterly confused by this but I’m not going to repeat the whole sorry saga apart from saying that considerations for a title of the book version of this blog haven’t got far beyond ‘My Big Toe is Killing Me’. A few weeks ago, just before that phonecall, I noticed that I had once again developed a dark mark under the toenail of my right big toe. I did the responsible thing and sent photos to my team at the hospital and they, in turn, sent it on to London which feels a little weird – I mean, I’ve hardly left the house for five weeks but my toe has been all the way to London. Just hopping along with a tiny, toe-sized nap-sack. The two photos I sent in have drawn the unanimous conclusion that this is probably a recurrence of the same melanoma that started this whole sorry affair back in the day.

So, here we are again. Groundhog day, week, month, year. I have something black and cancerous under my toenail that needs removing, I have some medical treatment that may or may not deal with the cancer living inside me and I have a little boy who is insanely excited about a Friday afternoon dance party which is on his timetable for tomorrow afternoon. I am less thrilled given that his favourite two songs at the moment feature a bald man singing about a baked potato and singing stick insect from Hey Duggee. Then again, would I take that over not being there to dance with him or being stuck in a hospital ward and only having that experience over Facetime? Oh you bet your ass I would, every single day. Altogether now, “Stick, stick, stick, stick, sticky, sticky, stick, stick”.

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