All I want for Christmas is chemo…

I haven’t done a truly factual update for you all so far. It hasn’t felt that important and all the medical staff have told me not to worry too much about the details of this bit of my diagnosis or that bit of it. So i haven’t. And to date the journey has primarily been an emotionally and inter-personal one. That changes tomorrow.

For various reasons my treatment plan has changed. There’s been no change in my diagnosis or prognosis – still have cancer and it’s still curable. But my surgeon advised that while he could take the tumour out as it is and it would “probably” be fine, he thought we could do better than “probably”. So to achieve that we’ll do chemo first for three months to shrink the tumour and then remove it. This has the added bonus of getting stronger chemo into me earlier that will mop up any microscopic spread of cancer cells. All good stuff. Yes please. Thank you.

The strangest part of this switcheroo was that i was given a choice about my treatment plan. Chemo first or surgery first. It took me a while to realize the consultant was waiting for me to decide. Through work I’ve made a fair amount of consequential decisions. I think I’m good at decision making but mainly because i’m comfortable taking advice from experts, encouraging challenge and weighing up uncertain risks. So being given a choice on something where i have no experience, expertise or access to underlying information by somebody who had spent a career specializing in exactly the issue and had discussed it with a team of other experts felt a bit unfair (also he was just about to insert quite a large piece of medical equipment up my arse which led me to assess that undermining his judgement might be a poor choice). So i checked. I asked the surgeon what he recommended, asked him what the oncologist recommended and asked my specialist nurse what she recommended. They all said chemo first. I asked if anybody in my position had made a different choice and if so, why. Yes they had, quite a few, mainly because some people were scared of chemo and others just wanted the cancer out. Makes sense. But me, i like experts using empirical evidence to tell me what the best course of action is. So here we are.

Tomorrow, Christmas Eve, is the first of 6, two-week, cycles of a drug cocktail called FOLFOXIRI. My oncologist said that my “reward” for being young, fit, otherwise healthy and, critically, pre-op, was that he could “throw everything at [me]”. Awesome. Cheers. Merry Christmas. Now this isn’t how i saw myself spending my first Christmas back in the UK for 4 years but it’s where we are and actually it a blessing. Badass Chemo = best long-term outcomes. So far we have found the enemy, we have understood its intent and we have formed the best available plan to do it grave damage before it does so to me. But all this is drum roll. Tomorrow we act. The outcomes and collateral damage remain uncertain but are managed effectively. It feels good to be seizing the initiative. Tomorrow, at 1000Z in a drab room in Rickmansworth, we go and we fight.

Oh and also while we’re here. Off the back on my last blog….it turns out people will provide feedback on plenty of stuff if they sniff a chance to do so….or if you call them a “lunatic” in public. But on the upside a lot more people have offered me holidays since then and apologized for not having done so earlier. So we’re rolling in even more offers now. To those of you who haven’t offered us a free holiday yet this is your last chance to do so. After that you’re officially the person who didn’t offer a holiday* to the guy with cancer…Santa won’t like that.

*homemade artwork remains my preference!