Monday, 14 July 2008

1. The diagnosis

This blog is about my last days or weeks or months. Right now, I have no way of knowing.
I'm writing here because it's convenient for family and friends and because I want everyone to hear the facts directly from me.
I think it's best if I start with the email I sent to old friends when the diagnosis was confirmed on July 7th 2008.

Hi all,

I know I haven't been in touch for some time - and actually I wish I wasn't getting in touch right now. This is not an email I'd ever want to write, but word is getting out now, and because each of you is special to me, I want to tell you myself.

This isn't pleasant, so if you're feeling fragile, better look away now.

On June 4, following weeks of intermittent (but not debilitating) pain, an ultrasound examination discovered I had a gallstone. So, on June 17, I had a small operation to remove my gallbladder by keyhole surgery . Not a big deal. Just another troublesome body part to shed (and I've shed a few of them). I went home the following morning feeling fine.

A week passed, the operation wounds healed, but the underlying pain was worse. Normal painkillers wouldn't shift it. On Wednesday June 25, I went back to hospital for a CT scan. I was asked to hang around for the result and went off for a sandwich.

Two hours after the scan, I was surprised to find the doctor greeting me with a strangely pitying look. He handed me the pathology report. The scan revealed a 5cm tumour on my pancreas with lots of other little tumours on the liver. Pancreatic cancer is known as a silent killer. You get the symptoms when it's too late. And it's quick. Once it has spread to the liver or other organs, life expectancy is less than 6 months.

Mary called her sister, who's a cancer expert for the NHS, and asked her for the best pancreatic cancer man in London. She gave us the name of Prof Brian Davidson who happens to be at the Royal Free, just up the road from me. He saw me the following day and ordered blood tests and an MRI scan. I got the results last Thursday.

Pancreatic cancer is extremely complicated. There are many different kinds and they affect people in different ways. Mine is inoperable. The only treatment I can be offered is chemotherapy to slow the progress of the disease. The effectiveness of this can only be guaged by a liver biopsy, which I will have in the next few days. I'll then be referred to the Royal Marsden.

I've no idea how people normally react in these circumstances, but I'm completely calm. My offal may be, well, awful - but my brain is untouched. I've never been scared of living and I'm not afraid of dying.

From now on, it just has to be one day at a time, and there are important things in my favour. I've got a fantastic wife and kids, superb back-up from friends and family, and the best care the NHS can provide and Bupa can buy. The pain is tolerable and controllable. I haven't lost my sense of humour (although it may be a bit black for most people's tastes) and I'm still eating OK. In fact, I look and feel quite well.

Obviously, my main concern is Mary and the kids and I'm extremely busy rushing around trying to tidy up everything for them. It's not easy instilling a sense of urgency in banks and building societies. When institutions say they'll send you details in seven to ten days, it's quite difficult to restrain myself. On the other hand, I saw an advert in the paper today offering 42" plasma TVs with nothing to pay until 2009. Pretty tempting for someone in my position.

For the immediate future, I plan to concentrate on Mary and the kids. Their pain is far greater than mine. In the longer term, I would like you come to my funeral and make it a boisterous affair. I'll get my sister to do the catering, so the food should be fabulous.

In the meantime, no pity please. I've had a wonderful life - full of fun and warmth and laughter - and blessed by great family and friends, great work, and great adventures. I've never been one for mawkish sentimentality. Years ago, I wrote in some dreadful student magazine that my epitaph should be "if nothing else he was good for a laugh". Still seems about right.

I'll automatically put you on an email list for updates of what's happening, which Mary will take over when I'm in hospital. We know there's nothing anybody can say. It's OK to just say that.

Look after yourself and everyone else,