Chronicles from Chemo-Land Number 5: “All Aboard!”

One afternoon during my extensive travels with a friend through Europe and Africa, I was on a train from London to Kingston upon Hull. Hull is located on the north shore of the River Humber close to its mouth into the North Sea and was “home base” for us while traveling. I had made the trip often but, this time, I was by myself. The trip involved changing trains at Doncaster. Since the schedule was “tight”, I was happy to see my Hull-bound train in the station. So I quickly got off the one from London and hopped onto the one bound for Hull.

As we pulled out of the station, I noted that it was an older style train and had fewer passengers than usual, but I was not concerned. Who was I to question British Rail? A good half hour passed before the conductor came to check my ticket. Picture a tall, slender, distinguished-looking man with half glasses and a perfect upper class British accent. Here is our conversation.

CONDUCTOR looking at me over the top of his glasses:  “And where is it, exactly, that you think you are going?”

 

VAL, confident and unperturbed:  “I am going to Hull.”

 

CONDUCTOR , rather cryptically:  “Nooo, you’re not.”  

 

VAL:  “Oh. Well in that case, would you be so kind as to tell me where I am going?” (I had been in England long enough to know how important polite phraseology was!)

 

CONDUCTOR (not giving much away):  “You are going to Grimsby.”

 

VAL: “Where is Grimsby and how can I get back en route to Hull? I’m expected     for dinner.”

 

CONDUCTOR , suddenly cheerful:  “Ah well, you will definitely miss dinner. Grimsby is the port on the south side of the Humber. Now, you could get off at one of these little stops, wait for another train coming back from Grimsby, go back to Doncaster, blah, blah…But, you probably won’t get to Hull before midnight.” After a pause, he says, “But, if you carry on to Grimsby, there is a commuter ferry you can catch that will take you across the river to Hull and you won’t be more than an hour late for dinner!”

That is exactly what I did. And, the ferry ride was an unexpected enjoyment.

Since last Tuesday, I’ve felt like I’m on the wrong train.

When I first saw the oncologist in August, I was on a train with heavy-duty stops—chemo, Herceptin, radiation, Letrazole—because of a very serious, stage 4 recurrence that likely had systemically circulating cancer cells even though all my scans were clear. The radiation oncologist was planning on 5 weeks of radiation beamed in from 3 different directions and depths with a 10% risk of lymphedema developing. The oncologist urged me to accept this treatment plan because of the seriousness of my recurrence.

I knew that chemo might end after four treatments but I was surprised when Dr. Brandes said last Tuesday that, since my chest was clear and my blood work was excellent, he didn’t think I needed radiation. He also said that my hormone receptivity was too low to worry about, so he wasn’t going to prescribe Letrazole at this time.

So, the train I’m on now is Herceptin every three weeks with more tests scheduled in early February to see where things are at. Dr. Brandes said he would consult with the radiation oncologist but felt that I was in remission and that the Herceptin was the most important on-going treatment.

Amanda and I were stunned. I’m still trying to get a grip on this unexpected turn of events. Of course, I am relieved. But like that trip to Grimsby, traveling along in life often takes us to peculiar, unknown and unexpected places.

I am still a cancer patient but suddenly I am a different kind of cancer patient. I was struggling not only with accepting the diagnosis but also with adapting and coping with the side effects of treatment, and I was anticipating setting aside major aspects of my life that even recovery from hip replacement surgery had not sidelined completely. I was adapting to cancer being a “full-time job” for which tests, treatments, side effects and fatigue took precedence over everything else.

Now I’m a “part-time” cancer patient; a patient who requires IV Herceptin every 3 weeks to stay in remission. Once again, modern medicine has given me a reprieve. But I am vulnerable because breast cancer’s chronic nature remains my reality.

Being a cancer patient has become a part of my self-identity. I think this is inevitable with any chronic condition or disease. Like anything else that we associate ourselves with, it does not have to be negative or dominate one’s life. It is just a fact. My friend’s comment about “walking with cancer” makes perfect sense in this context. One can’t get back to “normal”, whatever that might have been or meant.

Cancer is deadly. Chronic disease, in general is deadly. Life is deadly. Trains derail and crash, and sometimes you change trains and head off in a new direction.

I’m deeply thankful for this positive turn of events, and I’ll do my best to enjoy the trip.