There’s a hierarchy, and it’s not a pretty one. I was “lucky” to have been diagnosed eleven years ago with breast cancer at an early stage. A mastectomy, three months of chemo, no side effects, plenty of energy and only a 13% chance of reoccurrence in the next ten years, hardly higher than the normal rate. I retired a few years later, and as a mystery author, published nine more books. My twelfth will be out in May.
Now things have changed. At sixty seven, weight loss and minor abdominal pains in late November led me to an ultrasound, then a CT scan a few weeks ago. Only a month before, I had had my routine yearly blood tests and mammogram, and all were clear. “Hope you don’t have any bad news for me,” I told my doctor.
“Actually, I do. You have a tumour on your pancreas.”
I swallowed. “That’s not the best kind of cancer to have,” I said.
He looked at me with his boyish face and threw up his hands. “It’s horrible!”
Consultation with a surgeon sent me for an ERCP, where a surgeon sends a probe into the stomach for pictures and tissue samples, which will be in six days. I’m not happy that this gastroenterologist has a poor on-line rating, mainly for colonoscopies, which isn’t what he’s doing to me, but others liked him.
The stats are, as my sincere but tactless GP said, “horrible.” People often die within days of diagnosis. They must be the bricks of the world, carrying on doggedly. Seventy-five percent don’t make it to the first year. Sally Ride got only seventeen months, Pavarotti less than that. Ninety-four percent don’t survive through year five. That’s because early symptoms of pancreatic cancer are vague or absent. Diagnosis comes only after the disease has spread.
What are the options? If you are VERY lucky and have a localized tumour that isn’t copulating with a blood vessel, you will get the Whipple Operation, gutting you like a cod, taking the bad half of the pancreas, the gall bladder, maybe the spleen, and rearranging the plumbing. A minority are in this group, and sometimes, after unzipping, the surgeon sees that all is lost and closes on the spot. Barring that, you will be days if not weeks in the hospital, and later have to follow a special, albeit not too harsh, diet. Huge meals are out. Better hope that you don’t become an instant diabetic.
If you cannot have the dream operation, you may apply for clinical trials, which may shrink your tumours and curb the spreading. Then down the line you may take a number for the Whipple. That’s the goal.
Chemotherapy seems to do little good, although it’s still around, as is radiation. While that’s an improvement over 1950, little progress has been made in comparison to other kinds of cancers, such as bowel cancer, which took my mother but is now very curable in early stages. And if eight times the money is spent on finding a cure for breast cancer, it’s also true that more than eight times as many people get breast cancer. I guess that’s fair on a bang-for-buck basis.
And yet despite this horror show, a few people do survive for five, ten, and even more years. And not just those diagnosed really early, like Supreme Court Justice Ruth Bader Ginsburg, whose one-centimetre tumour was found in a routine catscan. Her prognosis is excellent. Others contracted pancreatic cancer twenty or more years ago, when the Whipple was more experimental, and are alive to tell about it.
Who can say? I’m going off now with my border collies and blind mini-poodle to the clear-cuts on Vancouver Island with the intention of walking as long as I can today and every day. Animals don’t feel sorry for themselves. I’m not going to either.