Alan Titchall says he’s not an expert on cancer but, from experience, he offers this existentialist advice: Cancer is not to be feared but managed, and early detection is a very positive start to that journey.
Who doesn’t fear the ‘C’ word and doesn’t know someone with, or who has died from, cancer?
It is very common, particularly among the elderly, and it doesn’t help that the traditional media often trumpet the condition as a black and white ‘battle’. It is better to focus on its management; medically and mentally.
If you don’t already do so, make an appointment to see your doctor every six months for a check-up and a full blood test. Don’t wait for something to feel not right.
Cancers are as varied in types and conditions as their treatments. Detection is only the start of, often, a long journey that involves a roller-coaster of treatments and emotions.
My journey started six years ago – from the PSA results of a regular blood test that suggested a need for further testing, which began a life-changing voyage that is still in progress, and has involved treatments that you would not want to read in detail – suffice to add they always sound far worse than they actually are performed under very caring and professional medical staff.
Just to iterate the importance of early detection – cancer can be very advanced before it is felt. Renal cancer, for instance, is often detected by scans for other reasons – such as for car crash victims. During my first prostate scan they found a very large, and unrelated, cancer tumour in my left kidney (since lost to surgery), adding renal cancer to my journey!
For many, treatment is simply prolonging an inevitable end – short or long – signalled by a condition called metastasis, when the cancer has spread from its origins to other parts of the body. Different cancers fancy different body organs to find a home. Prostate cancer, like mine, commonly goes to the bone, which it did for me about a year ago.
By the end of last year, I had exhausted the public health treatment options (which are not many) and went private to undergo another course of unfunded chemo that is publicly funded in places like Australia. I never had faith in our Kiwi-unique Pharmac agency and had set up an interest-bearing ‘welfare’ fund years ago in anticipation of such a day.
Chemo might be a word that conjures up horrors, but there are different chemos for different treatments, and each of us reacts differently to them. Personally, I found comfort being on this treatment, once I got a grip on managing my reactions, knowing it was prolonging my journey. In fact, when I came off the public treatment, I became quite anxious waiting for the cancer to show signs of returning. And, in my case, it came back quickly.
Cancer treatment is a journey shared with others. The frontline staff who administer the chemo are hard-working angels – mostly immigrants during my first round, overworked and underpaid, and probably eyeing up employment in Australia.
Overall, treatment involves many caring professionals who work very close to you, face-to-face with numerous consultations, needles, pills, and scans. Your life is laid bare in terms of medical and mental welfare. There are always tissues handy if you want to cry. There is even a caring member of the Cancer Society who calls regularly to have a supportive chat. The society also provides a lunch cart with sandwiches and hot beverages that daily cruises around the chemo wards. My taste buds had taken a hit during my first seven rounds of chemo but, boy, did I look forward to those cheese and chow-chow pickle sandwiches.
I also used to go back to work at my editorial desk and feel saddened at the number of press releases and folks touting the miracles of impersonal AI, like demented parrots (building up to another computer-tech hysteria like Y2K). It’s a computerised data-information analysis tool that needs a specific software application – not a new ‘artificial source of omniscient wisdom’. Meanwhile, we remain a gregarious species that will always be at our best when we huddle together face-to-face – for work, leisure, welfare and prayer.
On that note, mentally, cancer is also a stoic, solo journey where you start to look at society from the outside in. You may also feel you have a sign on your forehead that says, ‘I’m no fun anymore’. I found three types of reaction from family and friends. There are those who avoid you – that’s okay, I used to be like that and very uncomfortable around ‘sick’ folks. There are those that want to become your journey partner as a comforting supporter – works for some, but not for me. The third type accept your condition and treat you no differently – my sort.
It is a journey we all face at some stage through various medical conditions and circumstances, but a different journey for everyone. For me, it is like the anxiety you feel gate-side at boarding processing at an airport, or on the platform at a train or bus station. You become obsessed with one overbearing thought – just get me to my seat. Where that journey goes after that, if anywhere at all, is not as relevant as the travel preparation. And when you hit that seat, there is comfort in the knowledge you are finally going somewhere and closing your mind to all that has just passed.
I also take personal comfort in knowing that as we take our last breath someone around the world takes their first, and life goes on.
If only we could convince ourselves – life is not to be taken for granted. It is a miracle of circumstance to be born at all. Don’t waste it. If you haven’t made that appointment at your doctor’s for a general check-up – do it now.
Government left behind on prostate cancer
There is consensus among health advocates and medical professionals that prostate cancer is under-resourced here, given it is the most commonly diagnosed cancer among Kiwi men.
Critics point to gaps in screening, unfunded medications, and diagnostic inequities. This includes a lack of nationwide screening. We do not currently have a publicly funded, organised national screening programme for prostate cancer (unlike breast and cervical cancers).
While countries like Australia subsidise advanced treatments, such as Cabazitaxel chemo, our Pharmac agency funds far fewer options, leaving some patients either paying tens of thousands of dollars for life-extending care, or left to go without.
The Prostate Cancer Foundation of NZ actively advocates for nationwide screening rollouts and better access to modern diagnostic technologies, such as improved MRI-based pathways.
Research initiative funding from organisations like the Movember Foundation and the Cancer Society supports registries (PCOR-NZ) and local clinical research to improve patient outcomes, but the Government needs to urgently catch up on cancer trends and treatments if this country is to claim it has a workable health system.