A shock diagnosis is awful enough, but then comes the challenge of passing on the sombre news. By Jo Lennan.

Guys, I have cancer!

The sudden realities of treatment  for cancer.
The sudden realities of treatment for cancer.

On a recent Saturday, I learnt that I have cancer. The surgeon broke the news in my room at St Vincent’s Public, where I was recovering after an operation. I thought hospitals had bad decor but my room was almost chic, with a park-and-skyline view to the Sydney Tower thimble, a Harry Seidler high-rise and the step-roofed Deutsche Bank Place.

The surgeon was on his rounds, never mind the warm weekend. A self-deprecating person in an open-collared shirt, he looked apologetic. “It isn’t what you want,” he said. The pathology results were back and, though he was just “the dumb surgeon” and the experts would know more, he spoke of lymph nodes and more tests and chemotherapy. Which wouldn’t be, as he assured me, the hair-shedding affair of, say, leukaemia treatment. Instead, I would get a portacath installed below my shoulder and, like a car at a petrol pump, go in each fortnight for a top-up dose.

All this had happened quickly. I was supposed to be in London and New York but had cancelled at the last minute. I also had to buy pyjamas, because what person under 60 actually owns any, apart from scuzzy old track pants and skimpy camisoles? Then it was into hospital and under anaesthetic. I regained consciousness in time to watch Scotland vote “no” and to see, closer to home, coverage of dawn raids in the ’burbs as authorities searched for supporters of the Islamic State.

I had never previously spent a night in a hospital. St Vincent’s gave me a first-class ride, which made me reflect. There are some things social democracies don’t do – erect grand buildings on the scale of the pyramids, for instance. But they do build hospitals, and staff and equip them. They hire highly skilled and highly admirable nurses. They serve terrible lime jelly in small plastic cups. Such are the signal achievements of our system of government.

I was soon making good progress, losing the drip and starting liquids. Without noticing, I had gone a week without a coffee hit. Hint to caffeine addicts: a spell on morphine will do wonders if you want to kick the habit. You’re just left with the wee problem of giving up opiates. Come Monday, I relinquished that nice friendly green button (a “PCA”, they call it, or patient-controlled analgesia); that night I sat awake crunching ice-cubes and snivelling.

The passing days brought a dilemma. Who do you tell when you get cancer? Immediate family, yes. Ditto for close friends. But then what about other friends and editors and colleagues? It’s a pretty dreary prospect, repeating the details ad infinitum and encountering dismay. My partner was there throughout, so he learned things as I did. My parents took the news like two bewildered puppies, blinking as they tried in vain to take things in. My younger sister, who flew in from Exmouth in the west, was mercifully low-key. A physiotherapist, she took me for turns about the ward, expertly steering my intransigent drip stand.

I really didn’t feel like talking; my throat was sore from tubes. I left my phone switched off, but this did not ring-fence the story. Kind people sent me flowers; one spray was the size of a small pony. One relative (we’re not close) sent a barrage of texts and, when they went unanswered, sought to friend me on Facebook. She must have imagined I’d be posting updates there. As in, “Guys, I have cancer!” Or, with a selfie showing my newly gaunt figure: “Me in hospital, note the new pyjamas!”

When they hear you have cancer, invariably people say, “If there’s anything I can do…” Probably not unless you’re a doctor or health professional. Or unless you fancy coming over to sort out paperwork. Often more details are sought. “Cancer of the what?” Churlishly I think, that’s my anatomy, thank you. If we weren’t already in the habit of discussing each other’s bits, would you mind awfully if we did not start now?

I was glad of one friend who retained her sense of humour. When I sent her a photo of my hospital footwear, she replied in mock appreciation, “That compression sock + sandal combo is a dream.” Later, when I got out, she would feel free to say such things as, “Don’t think that just because you have cancer you get to eat all the crackers.” (If anyone had heard they would have been appalled, because jokes about cancer are considered about as funny as jokes about Josef Fritzl, the Austrian dungeoner.) 

Some people want to know more than there is to know, resisting the idea that knowledge is finite. My cancer is unusual. The evidence base is almost nil, meaning I probably won’t get a prognosis. Telling me as much, one oncologist then added, “This is also unusual because you’re young, although you’re not that young. I don’t mean to offend you.” Keep digging, I might have said, and yet I took his point. Because I’m no longer in my 20s, my teens were long ago, and many a sufferer is much younger than I am.

Going home was surreal, more so than the hospital. Home is a flat at Bondi Beach, in a Spanish Mission building. Returning felt like going back to my former, normal life, with the glaring exception that I was not normal. That night, a Friday, I woke to hear voices below. Just your ordinary, mildly drunk Friday-night voices, but I’d never felt more distant from such goings-on.

The more prosaic problem with home was the three flights of stairs. Still feeble from surgery, I could not dash up and down. So my partner and a neighbour had me sit on a kitchen chair, then they carried me downstairs like a tsarina on a litter. Taking the chance to be properly imperious, I said they should sing while they were at it. They did so loudly and tunelessly, filling the stairwell with their noise. The following day when I went out, I managed the stairs myself.

I don’t mean to make it sound as though having cancer is one big lark. Waiting to see a GP a few days after my discharge, I sat at a Chilean diner on Anzac Parade and, as the radio played Jeff Buckley and the Rabbitohs flags fluttered, I felt immeasurably sad that I might give up the ghost. But then I saw the doctor, a loud-shirt-wearing Kiwi I met in the Kimberley. He said sensible things. He also sketched a flowchart that included the word “cured” and shocked his med student by swearing and being blunt (“Eat foods that you like eating and that don’t rocket out your arse.”).

One month after the diagnosis, I went for a PET scan. That’s the scan that shows if cancer has spread. It works by registering cells that are chewing through lots of glucose, as cancer cells are wont to do. On the day, a punk-haired nurse showed me to a recliner in a small rubber-lined room. I was given a cannula attached to a syringe of almost novelty proportions, like an outsized prop intended for use in a school play. This was shortly filled with saline and fluorodeoxyglucose, a radioactive tracer isotope. After an hour – the half-life of FDG – I went to lie in a whirring tube where, as the scanner scanned, I contemplated praying and decided that on balance it would be hypocritical. Anyway, if God existed, he’d make up his own mind.

That afternoon, I checked my email. Against advice, I had chosen to receive the report straight away instead of waiting to see the doctor. There were dozens of images of my body in soft greys, with black masses for the brain and some post-surgical healing. The report started out with the encouraging observation, “There are no large mass lesions in the brain”, and went on to give the tick to my liver and other organs. On my DIY reading, they were saying things looked good. My oncologist would affirm this two days afterwards, though it’s not quite the all clear. It means that after chemo (borrowing stats from other cancers and making some assumptions) I get more or less even odds of surviving the next five years.

I’ve since told a few more people about the diagnosis. Not always by phone, which can be wearying. I am pretty good with texts and have taken to using lots of exclamation marks. Inappropriate, I know, but who wants to be ponderous? I’ll fire off a few lines and, if I’m watching my iPhone screen, see it display that telltale ellipsis. At the other end, someone is drafting and deleting, drafting and deleting. They grope for the right words until I intervene, tapping back, “Don’t worry!!! Really. I’m okay.”

This article was first published in the print edition of The Saturday Paper on November 8, 2014 as "Guys, I have cancer!".

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Jo Lennan writes for the Monthly and The Economist Group.

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