Wednesday, March 14, 2012

Easy Decisions



It's funny the things that pop into your head. Cycling into work a few weeks ago I got rather upset about this whole chemotherapy malarkey. From nowhere the Eddie Izzard "Cake or Death" sketch popped into my head. It's all about easy decisions.

"Chemo or death?"

"Chemo please".

Simple.

I've had two more tactical decisions to make. Both have been easy.

The Alien spread her tentacles to a single solitary vertebra, L4. But that's it. She's isolated and hasn't made it to L3 or even the one above (whatever that's called). I've been offered an infusion, which sounds like it might be something nice, like a bath or a posh tea. It isn't nice. It is reasonably "safe".

I had to go and see a dentist to check I'm okay to take it. Zometa, the infusion, has one woeful side effect which hits about 8% of people: osteonecrosis of the jaw. This is where being a classicist has its drawbacks. I worked out what "osteonecrosis of the jaw" means before the junior doctor had the chance to look it up. Dead bone. The chances of getting osteonecrosis increase the longer you have to take the zometa and the higher the doses of it you are given. Zometa shuts down the osteoclasts which are the things that break down your bone. Your bones are constantly being broken down and rebuilt. Osteoblasts rebuild them. Shutting down the osteoclasts can have nasty implications for your jaw. It's still an easy decision: "Cake or death?"

The geneticist I saw last Thursday didn't even wait for an answer. He opened our conversation with "I hear you're some kind of classicist?" It sounded like an accusation. I should have responded, "I hear you are some kind of doctor!" But I bit my tongue.

He looked like a medical Sherlock Holmes. He was well dressed but dishevelled, clearly exhausted but well-spoken and sharply intelligent.  One of the Angels. He was interested to hear that my mother has recently been treated for ovarian cancer.  The chances of this happening and the pair of us both having breast cancer are really very small.  He thinks I have a gene mutation.  Did I want my blood taken so that he can find out?  "Cake or death?"

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