Growing old(er) with CANCER

Cancer, our insidious companion in life for so many of us, can occur at any age, the worst being the young and the very young. This is an attempt to describe some of the confusing, uncertainties, real setbacks, false recoveries and yet real recoveries of one person. While clearly limited to one specific case, it should be easier than generalizing about many as there can be such a variety of different responses, even from the same cancer. This one personal experience can then be compared to your own, particularly in terms of the range and variety of those things caused by cancer that challenge your health and attitude as you get older.

I have had cancer in my life for almost 30 years, first with a malignant melanoma, then prostate cancer (cured of both) and finally multiple myeloma (incurable). In between these cancers i was almost knocked off- several times- by the treatment side-effects or accompanying pneumonia. I am now in my 80s, so old age has also become a close companion for some years as well.

With these two major influences on my life over the last six years, clearly the cancer and its treatment has been the most onerous factor on my health and outlook- from the original impossible shock of the diagnosis on my wife and i (tears for a week just the beginning…) to the rushed plan to get treatment underway at Peter Mac with intense drug-based use with some dangerous side-effects(blood clots) and implacable constipation at the center of your life. This went on for a couple of years; some good progress noted, but two key drugs were withdrawn due to poor side-effects. Then another remarkable period of more than two years occurred in which “stability” was reached with ‘all key indicators under control and no change to the medication required’ (treatment now based at the Bendigo hospital). I had reached my new normal.

Then recently, my condition began to show a rising trend on one of the key indicators; a new drug was discussed and administered and over 16 weeks of regular Monday treatment the trend was corrected; i am now awaiting the details of a maintenance program. (Multiple Myeloma is a cancer of the bone marrow- hence the word ‘multiple’, as it is potentially everywhere in your bone skleleton, especially the larger bones. Treatment relies on drugs that get a response from the cancer, blood analysis indicating the degree to which it is having some positive effect.)

Cancer and old age are about getting along, with the cancer perceptibly slowing with effective treatment, or as often, savagely attacking the body, damaging the immune system and throwing an enormous blanket of deep tiredness/weakness overyour life. While the cancer seems to make such an emphatic impression on every cell of your body (and most of your mind), at the same time old age imposes itself on everything you do and think as well. You can’t escape its reach and constant presence.

As you age, you have less personal and physical freedom. Your dependence on others increases and you fine that you don’t recover from any illness the way you did when younger. The past ideal of returning to where you were before getting sick of ill, has gone forever. We seem destined to carry the burden of that extra illness with us now, in one form or another. It can even set us back further that when we started treatment. It wears us down suddenly and badly at times. You become aware that you may deteriorate further or die from this position. This truth is both shocking and empowering. Strong, bold awareness of your destiny can bring with it total acceptance and the enlightening realization that life at this very moment is still very much with you. It can unexpectedly lift and push your spirits along with a potent sense of goodwill and purpose.

However, despite the deep and deepening scars from both the cancers and old age, the remarkable thing is that it is difficult to continue this story without recognizing the “good things” that have also occurred. YES, there are plusses in this story too. For example, it is “good” that myeloma came last as i’d been cleared of the other two cancers; it is good or lucky that there was a quick diagnosis from which almost immediate and concentrated treatment began; there was no bone pain, either before of after treatment. There were no other complicating illnesses and i believe (still do) that i;m in the hands of the best doctors and nurses available to us. So myeloma and the conditions outlined above have been with me for 6 years; no stem cell transplant was considered as i was seen as ‘too old’.

Within this confusing and conflicting mass of thoughts and emotions in which we daily live, there appears to be an equation or principle that suggests that the more pressure life puts on you, the more potential there is for a comeback, a positive response of some kind, intellectual and/or emotional. The key word is ‘potential’ as you may ignore the opportunity altogether- it’s entirely up to you. But i know that any attempt to express yourself honestly can stimulate a range of thoughts that might take you anywhere. Go with the flow- without a second’s hesitation.

At this point we can enter difficult terrain. The influences and changes that can occur to you are both tangible/physical or intangible/mental/spiritual, etc. It has to be said clearly that the last group of factors can be the most compelling on your ongoing condition and progress. That is, those lifelong and current influences on your attitudes and perspective of the world are primary to your outlook and prospects. This is not to imply that the treatment itself is not also causing huge disruptions.

But once again this experience can also be a powerful ally in the struggle to make the best of the situation. Your life experiences, your storehouse of memories, some very recent knowledge or idea, all help to build an independent and very personal conviction as to who you are and what you stand for in the facwe of your age and illness. This awareness can be self-generating. It can lead you to try and express in some way- to yourself and others- what it is to concede ground to the cancer and old age while at the same time holding fast to your convictions and those activities which demonstrate your success and growth, mainly in your head, and pushing them in the direction of further growth.

This ‘marking out’ your achievements, however small, is extremely important. Up front we know that death is a foregone destiny. We don’t need to embrace or posture to it or seek a deal, but rather accept it quietly, then almost neglect it altogether. Other changes are occurring. You tend to remain and feel ill constantly, find yourself breathless almost at all times, even while you adjust and learn to cope. You are aware that you may deteriorate further or die from this position. This truth is both shocking and empowering. Awareness of your destiny can bring a form of reconciliation, from accptance to a strong, clear realization that life at this very moment is still very much with you.

But then we need to push for those things that re-affirm our present life and give it meaning and the impetus to live and develop your life further; for example: Search for the best moment in your day. Even on a ‘bad’ day, there’s a point when the pain can ease, when you had an uninterrupted nap, when you could enjoy a snack or cupps, when you managed to walk the block or do a little exercise, when you called or met an old friend for a coffee, enjoyed a piece of music or lines in a book, watched the sun’s shifting glitter through the trees outside your window…

Be sure these moments reflect you, that they are genuine reflections of your own ideas and sensibilities. Don’t mistake the fabricated world of entertainment as a substitute for your own. How to achieve this? Possiblyavoid radio and TV (and those pesky mobile phones) altogether for large chunks of the day and return to those books, music or DVDs that can inspire and move you in the right direction.

Express yourself creatively in some way in a hobby, reading, writing or music program, a new skill or area of knowledge you’ve wanted to explore… You may never get beyond thinking about these things for days or weeks. That’s OK. The moment may surprise you when you tentatively begin a genuine attempt at recapturing the real you again.

‘The real You’ is the gold coin- don’t accept anything else. The more you push around what life has to offer- now and in the past- in search of thoughts, memories, new ideas and inspiation that may strike a chord with your deeper self, the more life will push back and challenge you in turn. Ask not, and you will receive nothing- the ‘unjexamined life’ remains in limbo, going nowhere. Many however seem to prefer it as they find the task of searching for someting else becomes too much. They may lock in to a long-term distrust about anything or anyone to do with their cancer and subside into negativity and depression.

Is this the effect of old age or illness and disease? Easier to concede to old age than to blame illness as old age is finally the protector or guardian of your illness, dispensing benefits that can lift and sustain you through the dark hours of night or pain, the staggering weakness and crippling tiredness- a total absence of energy or motivation for anything. Old age in fact seems to gather strength from the contest; it is the more durable partner for quite some years a those years may be longer due to the added pressure placed upon it by your attitude and approach. Ultimately of course, it too will fail, but by that time the illness will also fail to plaque the body further- or, it will have been cured.

For me my cancers have been a fact of life for many years. Fortunately, after the original highly emotional and negative reaction to the ugly reality of my current disease, the period of stunned non-acceptance finally gave way to a phase which could be called ‘picking up the pieces’. Who knows how we do this or what combination of influences guide our ‘thinking’, such as it is? Ultimately, it was a need to know more about my condition that pushed me where i am now. And it has always been that curiosity in order to know more that has driven the human species in general, despite the numbers that refuse or deny any such need.

Not sure any of this is making sense, but i can experience a deep well of ‘happiness’ (whatever that means to you) and more that that- a glimpse beyond our past and present lives that is other-worldly- and by incremental steps a spiritual insight, free of the material and physical restrictions of our ordinary world. But nothing works as you might wish for long. Know when to take a break or to say ‘no’ to the day, to give ground to either the cancer or old age, to allow for those bad periods to finally pass you by- and then live again, with renewed interest and some energy.. perhaps.

So, here we are back at the beginning- with something of a personal summary- avoiding any of Rob’s wild mystical or magical comments from here on…

I have avoided the tendency to express our plight in military terms- eg, ‘we will fight this disease and eventually win the battle with all the might and power at our disposal’, etc. But it is a hell of struggle nevertheless to place on anyone, anytime.

We were stunned and useless for months; could hardly function at all. We didn’t quite slip into denial, but found ourselves in a noman’s land, almost without a shred of identity or purpose. All we could do was ‘hang in there’.
Eventually, we did two good things:

I belatedly joined a Cancer Support Guop in order to try and understand the what and how of my disease that the doctors didn’t have time to explain and the literature left me with more unknowns. I have gained greatly from this association ever since.

I gradually returned to the reading and writing i’d previously been engaged with; it was hard work at the outset, but have since managed to work on those things long neglected. Here you build ideas that can reverberate in small and large ways in your life.

I believe that the struggle itself and your own puny efforts to even understand a little, do positively contribute to your attitude and progress, to your life in fact. And unquestionably therefore that effort persuades your old age to persever a while longer and carry that cancer with care!

This piece is finally also a tribute to Cath Harwood, who with husband Bob, resurrected and earlier version of the Bendigo Cancer Support Group some years ago. As Cath had the same cancer as myself, her keen intelligence, wide knowledge and international network of contacts and research, impacted my whole life was enomously. Most importantly, Cath’s ceaseless daily efforts to assist others personally and through community organizations, returned such dehrees of love and appreciation that another four years can be added to her remarkable achievement. No one has bested an impossible cancer as she did.

Rob Boniwell, July- August 2013.