Were I as orderly as I like the world to be in general, I’d have posted two days ago, on Day +31, as I had a rare combination of both news and a time-relevant theme to write about. However, I’m pleased to say that the news – that I was out of hospital again – meant I was far too busy enjoying being back home to submit myself to the keyboard to spread the news. I had forgotten nobody really knew I was out until towards the end of a decently long conversation with Mariacristina’s mother last night, when she asked me: “When do you think you’ll be going home?”
Although doctors had – as ever – been careful to couch prophecies of being discharged over the weekend in cautious, caveated language, it had been looking hopeful. Sure enough, the on-call registrar came bounding in on Saturday morning to say she had LOTS of good news, which is what I’d love to hear doctors say every single morning. Blood counts were good, CRP infection markers were back down to a normal level, and my skin biopsy was showing my rash was likely to be spongiotic dermatitis, rather than GvHD (or a drug allergy). Although there are silver linings to GvHD (showing the immune system is working; graft vs leukaemia effect), it is still a cloud, as it involves your organs being attacked, which isn’t such a good thing.
The diagnosis of spongiotic dermatitis isn’t a huge help, though, as the potential causes seem to be endless (they include food, laundry detergent, hormonal fluctuations, insect bites, drugs, viral infections, etc…). The doctors haven’t completely ruled out some GvHD either, but as the response to all these skin changes seems to be steroids and steroid creams, they seem quite happy to deal with the symptoms without an exact understanding of what’s behind them. The good news is that the rash has pretty much gone, and my head has deflated to a more normal size, reducing the chance of scaring small children and Mariacristina.
Day +31 seemed significant in another way, too: on Saturday I realised I was 31 years old (admittedly I had been for nine months already), while my new bone marrow had reached the age of 31 days. Pedants may suggest that the new bone marrow was only ‘born’ on the day of engraftment, but it’s hard to argue against counting from Day 0 – the day the stem cells were infused. I rather like the parallel of being 31 years old with 31-day-old bone marrow, and felt more strongly than ever that in some way this transplant has provided a new start for my body – and particularly my blood system. Second birthday? Perhaps.
Age is a funny thing when it comes to cancer. As with life in general, there are no rules, although everyone has his/her own idea of what ‘young’ means in the context of a cancer diagnosis. It’s all relative, though. I was 23 when first diagnosed, and I don’t think anybody would have argued that this was ‘young’ to get cancer. But compare that to children such as Team Margot’s Margot Martini – diagnosed with a rare form of leukaemia aged just 14 months, and now recovering from her own stem cell transplant. Or 19-year-old Stephen Sutton, whose account of his terminal diagnosis and treatment of colorectal cancer – Stephen’s Story – has so far prompted donations of almost £3m to the Teenage Cancer Trust. And they’re just two high-profile cases, of course.
There is no right age to get cancer. There are gaps and inconsistencies in the support structures provided for cancer patients, as there is a huge focus on childhood cancers and the elderly – but not always so much for those of us in the middle. It’s therefore great to see the establishment of charities such as Shine Cancer Support, which is targeting the perceived shortfall in support for cancer patients in their 20s, 30s and 40s. But this is all about the response; cancer itself couldn’t care less how well supported you are likely to be when it swoops: and age is irrelevant.
Nobody is ever old enough to deserve cancer; but nobody is young enough to avoid the possibility. All we can do is muster our strength and supporters, face the cancer as it comes and stick two fingers up to it by living life to the full – however old you are.