Wednesday 9 July 2014

Why Not Me?

I quite expected to get cancer. Even though I prefer my glass most definitely half full, I've always been a, 'Why not me?', rather than a, 'Why me?' kind of girl. I think accepting the unsavoury situations which jump out at us unbidden, is the first step to giving them a great big slap in the chops.

And 1 in 3 people will contract cancer at some point in their life so why wouldn't one of those people be me? I guess I just hoped that I'd be 109 when it knocked and so short on faculties that I wouldn't really notice. But no matter, I'm here, having treatment for cancer and this is how I intend to move forward.

I thank my lucky stars that I developed cancer in 2014 rather than 1974 because the treatment available these days means that chances of survival for most - alas not all - cancers are so much better than when I was growing up, and rising all the time. But treatment is brutal, expensive and not fool-proof and thus prevention would be infinitely preferable.

Whilst the experts know how cancers are formed, they don't always know why one person contracts cancer and another doesn't. Once the well-publicised triggers such as smoking, excessive alcohol, obesity, sun exposure and genetics have been discounted, medicine puts it down to bad luck. In this case we're grateful for the brilliance of modern treatment and hope that we're not unlucky again.

However, this is the one area of science which doesn't work for me. I get twitchy putting my life in the care of luck. The body is clever but cancer cells are evil little blighters. We're back to my, 'Why not me?' scenario. Something about the mix of my body, my diet, my environment, my genetics, even my character meant that I developed cancer. And I cannot see any logic that says that if I change nothing, this won't happen again. I needed an action plan.

But to be able to hatch my plan, I had to understand how cancer was formed.

I shall endeavour to explain it how I understand it, in my – spent longer revising to scrape through, I reckon it's the easiest science so I'll choose that one, Biology o-level than all my other subjects put together – kind of way. I apologise in advance to those who know their stamen from their stigma or what the periodic table was actually for.

It's all about cells. I imagine our body like a small town inhabited by cells; a little like an ant colony. There are hospitals equipping white blood cells with the tools to fight infection. There's the train collecting and depositing oxygen around the body so that it functions efficiently and productively. Constant building work is going on to make new bones or repair over-stressed muscles and joints. Then of course there are the big organs made up of lots of cells and commanding great respect. If the body gets over-taxed, the lesser organs are ordered to go into standby to ensure the brain and the heart stay in control and manage the body out of the crisis.

It's a very harmonious town. Yes, things go wrong. The control centre for each cell - its DNA - can become damaged and feed it the wrong instructions so that it becomes a faulty cell and be no use to the body. This happens fairly regularly, it would seem, but these Bad Cells are generally expelled; a very necessary and common process in the body's continual pursuit of good health.

However, the body's defences don't always work as effectively as they should do and sometimes a Bad Cell isn't ejected but instead reproduces uncontrollably. Left unchecked (and the body has many checking systems; we are talking a perfect storm here) Bad Cells will eventually grow too powerful for the body's defences. Eventually, our town faces more than a cluster of Bad Cells but instead, a cancerous lump. Now, the most effective tool open to the body is to call in the heavies, the medical profession, who come with a big spade to uproot the lump and cast it from the body forever.

That can be the end of it but if the cancer has been around a while or is a particularly fast growing cancer – like mine, many thanks for that, body – it might have got cocky and started throwing out baby cancer cells which could be hiding somewhere in the body. Or the lump could have taken root in a very built up, hard to reach area and the spade couldn’t get near it. Any chance at all of this and the super powers come in, launching chemo, a bomb which reverberates right around the body. It  kills off all fast growing cells (we hope) such as our hair and disease fighting cells and within this group of fast growing cells are, you betcha, the most fast growing of them all: cancer cells. See you bad boys. In the super power's army are other fighters such as radiotherapy which attack locally and the peace keeping forces such as Herceptin and Tamoxifen (protein and hormone inhibitors without which some types of breast cancer struggle to divide and conquer) which are there to maintain the status quo.

So, back to my action plan. What was it that I did that created an environment in which the Bad Cell thrived? Why didn't my defence system work quite as well as it should have done? And the, 'Why not me?' question: why wouldn't this happen again?

I'm quite a healthy soul. I've always loved sport and spend hours every week doing it. Much to the constant consternation of my sisters and friends (I'll whisper it) I don't much care for cake, am happier munching my way through a bowl of salad. So, she says, glossing over the daughter's warm banana cake devoured last night, my diet is naturally fairly healthy. Breast cancer doesn't run in my family. I've never smoked and when it comes to alcohol, I'm generally considered a, 'bit of a lightweight'. But more about that later.

I'm very wary of scare stories and don’t tend to trust information unless it's endorsed by recognised cancer charities and bodies. My favourites are Cancer Research UK  and Macmillan Cancer Support not least because I know that on their sites, I would have to actively search for statistics, none of which I have any interest in knowing, the very idea of them terrifies me. I've read up on diet, environment and the validity and otherwise of well-documented cancer triggers we hear of in the news and this is what I've come up with. I'm not saying it's a check list of what every person needs to do to prevent cancer or to stop it coming back, nor indeed is it a catch-all list. After all, if it was, I'd be very rich and decorated with various honours, not least the Nobel Prize for Science - and did I mention my lack of aptitude for science? But, in addition to some small diet tweaks, broccoli and walnuts to name but two, here are two changes I've chosen to make based on my own research and lifestyle.

There has been much in the press about shift workers living less long than day time workers and there is some evidence that not allowing the body enough time to regenerate can increase the risk of some serious ailments including stroke, obesity, diabetes and, interestingly, the recurrence of aggressive breast cancers.Click for more info. This is early research but to see any link at all when I am someone who's rarely slept more than five hours a night since my teens, was enough for me to make a definite change to my sleeping habits. Before midnight is when I now got to bed, seven hours later is when I wake. Much as I lament that with the new regime has come a loss of ten hours of my old writing time every week, I can't write a book from the next life can I? 

Well, I don't think I can, anyway.

And, an unexpected bi-product was that after only a few nights of better sleep, people noticed. I recognise that people may have expected me to have grown three noses after my diagnosis but nonetheless, I had many comments on how well I looked including one friend who'd said she'd spotted I'd been looking tired (oh the shame) but she'd put it down to us all getting older. Pah! Forget anti-wrinkle cream, my advice for serious, and not so serious reasons, is that if you're skimping on the zzz, get thee to bed!

Remember when I said that I was a bit of a lightweight when it came to alcohol? Unfortunately, women drinking any more than 2-3 units of alcohol a day put themselves at a slightly higher risk of developing breast and other cancers. For men the safe limit is 3-4 units. Click for more info. That's fine, I thought, no need to make any changes there. But then I looked into what a unit really is and realised that 2-3 units per day is actually more like one standard drink a day. I didn't drink every night of the week, nor did I binge drink before, but I did regularly drink more than one glass of alcohol in one sitting. Now I don't drink more than seven units a week and it's been surprisingly easy to make the shift.

No longer do my husband and I crack open a bottle of wine during the week - it would last us a couple of nights, like I say, we're not talking your classic high risk here - unless we have someone round to supper. If we go out at the weekend, I'll have a glass of wine. It's all I need. I just like that first taste, like the first chocolate; always the best and downhill from there. I like the fact that I can join in a toast for someone's birthday, have a splash of wine in the sun, a glass of red with a Sunday roast, but I also like the fact that I don't wake up next morning with the horrendous sinking feeling that I might have increased my risk of breast cancer.

That said, all the advice I've read and been given in hospital is that these are lifetime choices. Break the rules now and again and the result will not be automatic cancer. Nor will all heavy and even light drinkers get breast cancer. Remember, cancerous cells are the result of a perfect storm; a multitude of ongoing factors, only some of which we can influence.

Please don’t have nightmares! And, as always, I'd love to hear your thoughts.