My cancer's worse than yours (10)

Sir Chris, me and Amelia

Picture by Alexandra Arlett

WHEN A sports figure, especially one aged just 48, especially one named Sir Chris Hoy and highly placed in the Pantheon of Britain’s strongest and most successful Olympians, tells you they have a life-limiting cancer, the sense of personal and national shock is going to be palpable. How can it be that one so fit, so seemingly healthy, invincible even, is not going to live out a long life?

It is a sadness, indeed; primarily for him and his family, which, sadness upon sadness, comprises a wife with multiple sclerosis and two young children. It also shows how cancer is no respecter of status nor background, be it commoner or King, Sunday morning lycra pedaller or six-time gold medallist. Genes may mean more than lifestyle. It is these days likely, according to medical projection, that one in two of us will get cancer in our lifetimes.

This is partly due to better diagnosis, which includes people being willing to submit to tests as a result of less stigma and more public information around the disease. Sadly, however, while not all cancers are terminal and many can be cured, outcomes have become much worse over the past decade and longer as a result of underfunding and mismanagement of a stretched and squeezed NHS that struggles in certain areas to begin treatment quickly enough after diagnosis.

That word terminal… It has been widely, dramatically, used in Sir Chris’s case, notably in the headline on the front of the Sunday Times, to whose brilliant interviewer Decca Aitkenhead he gave the story that he had been told he has between two and four years to live. It is important to highlight the difference between incurable and terminal, though, in line with Sir Chris’s laudable aim to inform people about what Stage 4 cancer actually means.

And trust me, I do have a fair bit of experience of this…

Sir Chris went for a check-up on what he thought was a shoulder strain 13 months ago only for a tumour to be discovered. And it proved not to be the primary source. That was in his prostate, and from there it had also spread to pelvis, hip, spine and rib. Once that happens, we are into life-extension territory rather than eradication of disease. Announcing the cancer in February he underwent chemotherapy, which will have been to interrupt the spread of the disease for as long as possible, fooling it until it finds new sites to latch on to, at which point there will be another drug treatment in the sequence of them that currently exists. And so on, with hopefully new options being developed. Until they run out. That will be the point where incurable moves to terminal. Where treatment is replaced by palliative care.

I know all this because I am in Sir Chris’s peloton, though my ride has been longer and luckier. I was first diagnosed with prostate cancer in 2009 and underwent 35 days of radiotherapy, which all of us hoped would banish it for good. In 2012, however, scans showed that it had moved to pelvic lymph nodes and I was put on hormone treatment aimed at lowering levels of testosterone, on which prostate cancer thrives. And for seven years, that kept the cancer in check.

Then, a few months after my Vikki died in 2019 of her own secondary breast cancer, having been through Stage 4 and running out of treatment options, new scans showed a spread of my disease to more lymph nodes and to the rib cage. A remarkable hormone drug, just 10 years old, called Abiraterone, then worked for more than four years to halt its movement. Until it didn’t. Such is cancer treatment for those with secondaries. A bone scan earlier this year showed its spread to hips and lower back.

Chemotherapy – in the form of a drug by the name of Docetaxel – was next on the checklist of treatments. Six cycles later, I begin to feel I have had enough of it, with me questioning whether draining side effects of a couple more cycles – exhaustion and aching, quite apart from loss of hair and neuropathy -  are worth the potential extension of a month or two before more spread. Maybe it is best to get sooner to the next, potentially less demanding, treatment, this one coming through a quick ‘shot’ of a drug through a cannula targeted at the offending bone areas. And maybe it is best to give my family a break, too. My son and daughter have been wonderfully supportive, physically and emotionally, but this drains them too.

The aim is to keep me going until any new drugs arrive - and I am on a trial of one alongside the chemo - or the current crop are no longer effective. Like Sir Chris, I know roughly how long I have left, having interrogated my oncologists - old journalistic habits, um, die hard - but they cannot be certain. This is a skill test for them, a mix of art and science, and also depends the unpredictability of my unreliable body.

Despite this whole tortuous process, I can relate to the admirable Sir Chris’s stated sentiments suggesting acceptance of his lot, even a contentment, though I have been more fortunate in living longer than he. A secondary cancer, particularly when it reaches Stage 4, does introduce a person to their mortality. It also introduces them to what matters in life, and what to do with what is left of it.

I had a wonderful teacher in Vikki. Not only did she show me how to die, through her dignified departure over her last few months, but she also illustrated how to live. For her, until her physical decline finally prevented it, travel was her ‘thing’, the more remote and exotic the better; Bhutan, Angkor Wat, Machu Picchu, the Iguazo Falls. She covered three Olympic Games – Beijing, London and Rio – with cancer.

I have places to see too, more to revisit really, from Northumberland to Paris to Liguria, but my ‘thing’ is my family, my children and my grandchildren, seeing them and seeing them set up. I love little Amelia welcoming me at her house with: “you’re here, Gwandad!” and trying to kiss better the bruises on the back of my hand that treatment has caused to erupt. I hold back a tear at her saying” “I ruv you Gwandad.”

I have been blessed. I loved the sports writing career I chose and which took me to World Cups, European Championships and Champions League finals. I have written the books I wanted to write and publish. I have met the most remarkable people in sport and literature, thanks mainly to 35 years of sobriety and a Twelve Step fellowship to which I have given a little but been given so much more in return. I have earned a Masters from Cambridge University in my 60s.  

Once this chemo is over, I will do more in the hopeful hiatus before any subsequent treatment that might debilitate me anew. I will write more regularly again, I hope. I will go back to the cinema and the theatre and to more football. I will walk more, reconnect with friends. Smell the flowers. Like Sir Chris, I feel oddly fortunate actually to know that time is finite. I can prepare, plan and provide, put my affairs in order. That becomes… I was going to say vital.

Time and treatment options will run out, and, as Vikki did, I will surely know moments of terror. In my case, it doesn’t help that I discovered during a post-surgery period a while back that morphine (administered with me in a bit of state and in no position to decline) gives me terrible hallucinations. As a recovering addict, I want to go sober and clean; with integrity. But that bridge is not for now. Just for today, there is nothing to cross. We pedal on along the scenic bank of the river.

“One day, the guards will come for us, Ian” my therapist says. “Until then, we’ll continue to read our books and sing our songs.”

*After I was diagnosed with prostate cancer in 2009, Vikki suggested that we should write a book together, entitled ‘My Cancer’s Worse Than Yours’. Alternate chapters, each reacting to our own and the other’s cancer. We both had too much on at that stage of our journalistic careers, however, though after she died I found some material she had written. I might even publish some of it on here. She was right by the way – her cancer was worse than mine. She, smilingly, used to call it ‘a bit of man cancer’. She always was right. Even when she was wrong.