Week 59-60 - Season of mists

Windy Autumn leaves

I have not had much to say relevant to melanoma and interferon, except that it is SO........ nice to feel normal again, be able to exercise without fatigue, and get back to all the things I want to do.

We have had a very mild Autumn here on the highveld - "... think warm days will never cease" - But the winter has at last arrived, and with a vengeance. From daily temperatures around 23-25 C, our minimum this morning was -1.2 C, and now at midday it has got as high as 7.5 C! Lovely blue skies, and I am working in my study with two very happy dogs lying on the carpet in the sun.

I have always loved Keats' work, and I'm sure you won't mind a little reminder...

Enjoy!

To Autumn
by John Keats

Season of mists and mellow fruitfulness,
Close bosom-friend of the maturing sun;
Conspiring with him how to load and bless
With fruit the vines that round the thatch-eves run;
To bend with apples the moss'd cottage-trees,
And fill all fruit with ripeness to the core;
To swell the gourd, and plump the hazel shells
With a sweet kernel; to set budding more,
And still more, later flowers for the bees,
Until they think warm days will never cease,
For summer has o'er-brimm'd their clammy cells.

Who hath not seen thee oft amid thy store?
Sometimes whoever seeks abroad may find
Thee sitting careless on a granary floor,
Thy hair soft-lifted by the winnowing wind;
Or on a half-reap'd furrow sound asleep,
Drows'd with the fume of poppies,
while thy hook spares the next swath
and all its twined flowers:
And sometimes like a gleaner thou dost keep
Steady thy laden head across a brook;
Or by a cyder-press, with patient look,
Thou watchest the last oozings hours by hours.

Where are the songs of spring? Ay,where are they?
Think not of them, thou hast thy music too, -
While barred clouds bloom the soft-dying day,
And touch the stubble-plains with rosy hue;
Then in a wailful choir the small gnats mourn
Among the river sallows, borne aloft
Or sinking as the light wind lives or dies;
And full-grown lambs loud bleat from hilly bourn;
Hedge-crickets sing; and now with treble soft
The red-breast whistles from a garden-croft;
And gathering swallows twitter in the skies.

Weeks 56-58 – Cancer can be good for you

Apologies for not updating for the last couple of weeks. Just been very busy!

Read an interesting article last week, on prostate cancer. According to a study at the Audie L Murphy Veterans Hospital in San Antonio, men diagnosed with prostate cancer live as long as or longer than those without this diagnosis. They speculate that this is thanks to increased preventive and other therapeutic interventions for other medical problems. [Walsh RM and Thompson IM. Prostate cancer screening and disease management: How screening may have an unintended effect on survival and mortality—The camel’s nose**. The Journal of Urology 2007;177:1303-1306.]

The argument is basically as follows: After diagnosis with prostate cancer, which may not be immediately life-threatening, the patient is subject to other investigations, with a view to improving his chances of success if any surgery or other treatment is attempted. These investigations uncover other unrelated problems, which can then be treated. For example, heart problems would place the patient at further risk. Treatment to reduce or avoid these risks then leads to an improved survival rate, quite apart from the treatment for the basic condition.

Now this rang a strong chord for me. When I was diagnosed with melanoma, and had got over the initial shock, and started understanding what it was all about, I asked “What can I do to improve my chances of survival?”. The answer was not very encouraging. It appears that once you have melanoma cells floating around in your body, there are very few treatments which will guarantee to expunge those cells. Some treatments such as interferon appear to improve the chances of success. But, one study even went so far as to say something like “If you are destined to suffer recurrence, there is no treatment which we can currently apply to change this situation”. In other words, medical science really has very little to offer melanoma patients.

I investigated further. Surely there is something I can do? These are a few of the actions I came up with…

I was a bit overweight, and probably not eating very well. So I had some sessions with a professional dietician, lost a whole lot of weight, and in the process changed my habits to a much more sensible and healthy diet which I am continuing to this day. It may not have any direct effect on the melanoma, but it will make a large difference to my general life expectancy: I now have my BMI down to about 25, which allows me to say “I am not overweight”. [You don’t know your BMI, or you don’t even know what it is? …]

Get some exercise! It doesn’t matter what you do, whether it is cycling, walking, pushing weights, gardening,…. Just so long as you get some regular exercise. In my case I spend long hours sitting in front of my computer. This is what I do for a living! It is so easy to be lazy, and only get up to go to the toilet, or get a cup of tea! Or open the fridge and find something to eat… While I was on interferon I found this very difficult – Any excessive exercise made me really ill for the next couple of days. But after some experimentation I found a level which worked for me on a regular basis. And the funny thing about exercise: Whatever the level, it actually gives you more energy in all your other activities. So get off that couch and start doing something – anything!

Live a more relaxed life. Not so easy… Particularly when you are on interferon, what with the bad effects on sleep patterns, and the reduced physical and mental stamina. I was getting extremely irritable at not being able to do the things I wanted to, even though I had more “free time” at home. With help from everyone I came to accept, (albeit kicking and screaming…) that my ability to do things had been reduced, and I just had to plan accordingly. However, what I was also doing was building up a backlog of things which I wanted to do… Not so easy to come to terms with!

So, what is the result of all this good advice? Well, I am looking after myself better, even if there is not much that I can do about the melanoma except hope and pray. And looking after myself must contribute to living longer, and having a better life.