The diagnosis
At 1.10 p.m. on May 22nd 1996, I was told I had cancer in my right lung. I was not terribly surprised since I'd had a battery of tests the preceding week after an abnormality was spotted on a routine chest X-ray. I had neither signs nor symptoms - no high temperature, no night sweats, no pain, no coughing up of blood; just the usual tiredness and a whacking smoker's cough in the morning. And was not everybody I knew knackered with exhaustion also?
I had been smoking since I was 14 and never gave up cigarettes even for a day. I bought at least 60 every morning but this was frequently supplemented. I loved cigarettes, could not imagine life without them. I had always assumed I would get cancer - but not until I was 70 or so.
Cancer is not for wimps. But neither is it in the misanthropic league of gloom and doom that usually occurs when word gets round that so-and-so is about to peg it. A favourite and satisfactorily despairing and defeatist ologon is: "Ah sure, they just opened and closed him/her." I first heard that said more than 30 years ago. It is still the prevailing view. Or, if you survive, you are still viewed with a bit of "weakness". The blind fear and ignorance lingers on.
Cancer is a right royal jelly of a pain in the neck. You have to be in the whole of rude good health, mental and physical, to deal with the endlessly boring, anxious-making thing. A belly-aching sense of good humour will tide you over the day-times plus a Walkman and a selection of book tapes or music. Forget about being able to concentrate on the written word.
What was interesting was the way it was diagnosed. A few weeks previously I met a friend who is a consultant in another field of medicine. While we were chatting about thrillers and other trivia, he leaned across and tweaked my lower eyelid down - a commonplace, almost routine thing for most doctors to do since anaemia can be picked up if the tissue is not a healthy shade of red. Unbelievably careless about my health, it was easily three years since I'd had a blood test. He told me to go to the local doctor, Dr Matt Lynch in Pimlico, and have a general check-up since I was a bit pale. The most amazing thing was that I followed his advice. The upshot was that the hospital radiologist contacted Dr Lynch on Thursday afternoon. There was "something" on the chest X-ray. Within a day I saw Dr Luke Clancy in St James's Hospital and in a week I was installed in Mary Mercer Ward in my new pyjamas.
The earth did not move when Dr Clancy confirmed that I had a tumour in my right lung. I had been extra busy trying to get things at work sorted. I did not think about it much because there was little time and no point in worrying until there was good reason to do so.
I had qualified as a nurse before going into journalism and was used to hysterical doctors. Mostly, I was annoyed and angry that it was upsetting my life at a time when I enjoyed my work, friends and freedom again since my daughter had moved into a flat. Life was slipping into comfortable spinsterhood even though I still nurtured a few great plans for the future. I wished I could do John Cleese histrionics, but had to make do with the videos instead.
Other things to help you through include developing a soot-black, iron-laced sense of focused anger, and shouting at the heavens: "Why me?" You can draw up a list of all the hale and hearty people swanning around with not-even-the-titchiest verruca to give them an itch. Many a happy hour can be passed in such a way. Learn the Serenity prayer off by heart and have the complete works of Dorothy Parker within easy reach - "Life is a bitch/And then you die" etc, etc.
But first, as Mrs Beeton once said in a totally different context, catch your doctor. Not knowing any and living about 10 minutes from St James's Hospital, I was extremely lucky to get Dr Clancy. He is one of those rare consultants who is also a real person: interested in a plethora of issues outside the hospital wards as well as taking scrupulous care to talk, eyeball to eyeball, in realspeak, unlike those control maniacs who delight in keeping their patients in as much ignorance as possible and waft around like some elderly Johnny-Head-in-Air. I firmly believe in taking every scapular, novena, bottle of holy water, rosary beads, mass card (whether offered by Catholics, Protestents, Presbyterians, the Religious Society of Friends [Quakers] or any other Western religion). Lean too on the mantras of Islam, Buddhism or any other eastern doctrines. Like it or not, my generation of Catholics relax better with worry beads to badger. Go vegetarian or become a raving carnivore. Get aromatherapy or reflexology, or both - in short, do anything that will create an aura of pleasurable, peaceful calm around you. Is it not mad that we have to develop a serious illness before we set about pampering ourselves?
As in Alcoholics Anonymous, get yourself a sponsor, living or dead. I opted for St Anthony for no great reason other than that he has always come up trumps over the years in finding things for me. One is advised to offer him money and by now I owe him millions. This time I wanted him to lose the tumour. So far he is living up to his reputation.
The treatment
Treatment for cancer is selectively individual. It depends on the type of cancer, where it is sited, how fast it is growing, your age and things of that ilk. The choice between surgery, chemotherapy, radiotherapy, or all three, is equally eclectic. You will need the stoicism of a Sahara-full of camels to get through the nights of weeks and months strapped up to endless drips of chemo, units of blood, bags of white cells (to fight infection) or packs of platelets (to make the blood clot). While you are having chemotherapy you should drink about three litres of fluid a day so that the hours spent on the loo flushing out all the liquid you have imbibed - one way or another - are infinite. Lesser quantities of fluid are also recommended with surgery or radiotherapy.
It is a great boon if you can learn to numb yourself to deal with the hundreds of needles that get stuck into your veins; for specimens of blood or to take yet another drip or whatever. My veins are in such bad shape that there's not a hope in hell that I can now start shooting up heroin or something.
As after childbirth, you never forget the absolutely hellish tiredness that overcomes you about a week after each dose of chemo/radium/cobalt. It has done its work so that all your few blood cells are all hanging around in your big toe or something. You become a leaden lump. You want to stay in the same clothes forever. Who needs to wash every day? You do not care if you never eat again. You do not care if we are in the path of the mother and father of all manic hurricanes.
With chemotherapy, most patients lose their hair. I began having mine cut gradually until the last few strands were littering my pillows in the mornings, and when phrases like "I feel like tearing my hair out" began to wear very thin, I decided to have the rest shaved off. Looking in the mirror at the enormous lugs of ears and brutal square skull, was, I swear, worse than the fright of the diagnosis. Foolishly, I had assumed that under every mop of hair was a skull resembling something like that of the perfect head of Sinead O'Connor. Dream on.
I found the fear and half-baked notions about chemotherapy and radiotherapy the most baffling. If you mentioned the "chemo" word to most people in the early weeks they tended to roll their eyes and go into a sort of predictable trance.
"You poor thing," they would wail. "You'll be terribly sick, vomiting, not able to keep a thing down. They say it is worse than the cure." "They" were usually third cousins four times removed who lived in Australia.
When visitors dispensed information with such an air of authority I usually asked them what they imagined the C-word meant. They tended to flounder a bit, and then carry on with more daftness. "Well, it's like going into a sort of machine and . . . well, be given injections or something . . . terrible injections," they added, with more conviction.
One day, having heard such twaddle for the umpteenth time, I pointed to the intravenous drip going into my right arm and asked sweetly what they thought it was. "Oh, sure that's just a drip. They give everyone a drip . . . for nourishment, I suppose . . ."
No, my dear, I said viciously. It contained my second course of chemotherapy. The word just meant that it comprised a combination of anti-cancer drugs given over a period - in my case - over three days every 29 days. The drugs were extremely potent, I went on while I had the floor. They killed everything before and behind them. Good cells went with the bad, which meant that until the effects of each course levelled out, one was extremely vulnerable to infection. "A bit like having AIDS, I suppose," I speculated. "Oh," sez she blankly. I went on to tell her that I would also be getting three weeks of daily treatments of radiotherapy. Maybe that is where she got her misinformation since the radium or cobalt is given in a darkened room. You lay on a sort of stretcher - 20 minutes each side - and the huge machine zapped you, aiming its rays directly on the tumour. The nauseating effects of chemo had been greatly tempered or removed with the use of stronger and better developed antisickness drugs given before and during the course of chemo, I added triumphantly. However, there were still a significant number of people whose bodies rejected the treatment; still a significant number of people who could be blown away by this disease. More to the point, it could recur in me in another organ. It did not help that other journalists around my age were dropping like ninepins - troubled hearts and more such stuff.
Rooted to the bed I was open to visitors from far and wide and soon had more gossip or angles to different stories than I had ever heard in an average week or month.
The very worst part of the treatment was when the radium and chemo were deliberately given together in one week. Monday to Friday were okay until the pain hit on Friday night. Doctors were called; they ordered a couple of paracetemol and left. After a couple of days of the worst and most desperate pain imaginable, I was taken to theatre sometime after the weekend. The surgeon was carrying out a gastroscopy - putting a scope down from the mouth to the stomach. The mirror on the end would show up what was going on down there. He found a grand canyon of an ulcer in my oesophagus - caused, it was assumed, by the radium alone or by the combination of it with the chemo.
I could not eat and could barely drink for over six weeks and I lost over three stone in that time. The palliative care unit in the hospital arrived at some stage and for the first time in weeks took the pain away with a combination of methods, from slow-acting pain-killers to injections of morphine. For the first time in weeks I felt like a human being again and began the journey back to reality.
Here and now
The PC unit and its staff were invaluable. Also they linked me into an outpatient programme which is run from the Hospice in Harold's Cross. If I ever win the Lotto I would heap money and more on the individuals and the service. Currently, there is a sort of Chernobyl cloud hovering over the patch of the lung where the tumour grew. Numerous biopsies have been done. There is not a trace of malignancy so instead of whipping out my lung, Dr Clancy and others have decided to leave well enough alone. But they will pounce if the slightest change occurs.
Mary Cummins will share her story of living with lung cancer on The Health Report, RTE Radio One, tomorrow at 3.30 p.m.
