Health news update: Oh, bugger!

I feel a bit self-important posting all this information in a public space, but I'm so knackered, it would take me ages to email everyone who's been in touch individually. I had my first appointment with the oncologists at Hammersmith Hospital. My wife was with me, thank God, because the whole process took over three hours, there was so much stuff to take in that I'm sure I'd only have remembered a fraction of it if she hadn't noted down the key points - and I was so whacked after the first two hours that, if it hadn't been for Mrs. G, I'd probably still be slumped in a seat in one of the hospital waiting-areas trying to summon up enough energy to get home. Here, for those of you who are interested, is where I'm at:

Yes, I do indeed have pancreatic cancer. It hasn’t invaded any other part of my body so far, but they can’t get rid of the disease by removing the pancreas (and related organs) because the cancer has, as the doctor put it, “wrapped itself around a blood vessel”. This, apparently, makes an operation all but impossible. (I didn't really fancy having a major part of my innards scooped out, in any case - my only disappointment is that I'd always promised myself that, if they ever removed my pancreas, the first thing I'd do would be to pour myself an enormous Scotch on the rocks with two fingers of water, followed by a meal accompanied by red wine, ending with a couple of glasses of port. Ah, well!)

They presented four possible ways forward to try to retard the cancer’s progress, including two clinical trials involving a variety of medical weaponry, and a more standard course of treatment.  But each requires fairly hefty doses of chemotherapy, and my state of enfeeblement - caused by CFS/ME - makes them all next to impossible in my case, as the one thing chemotherapy is bound to do is to exhaust the patient. (It can also weaken the immune system, and I'm convinced that Chronic Fatigue Syndrome is the result of a malfunctioning immune system.) The suggestion was that vigorous chemotherapy and, possibly, radiotherapy, could leave me in a zombie-state for long periods, unable to recover from the side-effects of the various treatments. Even if I was strong enough to withstand one of these courses of treatment, and they proved successful, it’s unlikely I’d last more than another two years in any case - and it could be a lot less than that. I don't see the point in "buying" extra time if I have to spend most of it practically unconscious!

I asked what would happen if they just sent me home and let the cancer takes its course. I’d be dead in a matter of months - a year at most. The problem is that the cancer would probably gum up my stent before I conked out, and I’d be faced with jaundice and everything that goes with it just months or weeks before dying.

What they might be able to do - and it depends on my liver functions having normalised sufficiently to allow them to operate - is to perform an endoscopy during which they'd burn the cancer cells at either end of the stent, followed by a relatively mild form of chemotherapy to stop the cancer instantly recolonising those areas. I think that's the closest they can come to just sending me home to await the inevitable, and it’s what I would prefer to happen. They took blood samples yesterday which should indicate how the liver is performing, and I’ll undergo another CT scan in two weeks which should give them the rest of the information they need to come up with a plan.

Being an inveterate coward, I asked whether dying of pancreatic cancer was a horribly degrading and painful experience, but they assured me that palliative care has come on by leaps and bounds in recent years, and they have expert teams who’ll supply me with all the medicine and advice to ensure it’s a relatively painless and undistressing experience for me, and that it won't be an absolute  nightmare for my family. (I must say the department chief, the doctor and the nurse who dealt with us couldn't have been more sensitive or considerate. Dealing with pancreatic cancer can't be a whole heap of fun, given that you presumably spend most of your time having to give frightened people really shitty news.)

The bottom line is that I'll most likely be around this Christmas - but it's unlikely I'll be around for the next one.

I've hugely appreciated all the kind messages I've received in recent weeks - but, please, no more expressions of sympathy, because they tend to unman me! Besides, as I'm beginning to realise, it's the people closest to you who really deserve sympathy (I'm not going to write about my family here, because then I would really lose it).

The oddest thing about all this is that I somehow feel it's all my fault (unsurprising, given my Lutheran and Presbyterian roots), and that I'm letting my nearest and dearest down. I wonder if that's a common reaction?

One last health thing: I didn't bother asking when they thought the cancer may have started - mainly because I suspect I know the answer to that. On my very first night in Charing Cross Hospital - 15th August - a young English doctor asked me whether, despite what I was going through, I basically felt well. Sounds like a mad question, I know - but I instantly knew what he meant, and I was able to report that, despite suffering from Chronic Fatigue Syndrome for several years up till then, and despite having experienced a prolonged attack of acute pancreatitis 18 months earlier, I only started to feel genuinely, profoundly ill towards the end of last year. That's when I gave up any hope of ever recovering from CFS, and when I became convinced that something major had gone wrong inside me - I'm probably talking nonsense, but I can't help wondering whether that "something" wasn't cancer. Who knows?

Anyhow,  to quote that great soldier, Kirk Lazarus, "Ain't nothin' but a thang!" Unless something dramatic happens, health-wise, this blog will for the foreseeable future be dedicated to films, music, books, TV programmes, art, nostalgia and the occasional dollop of politics (but less of that, I suspect, as time goes on - it's all getting far too silly).