Chapter 4 - Treatment

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There were many times when I found people outside the Unit could not countenance the likelihood of a relapse. They accused me of being pessimistic. I was not. I was just facing the reality of the situation.

There is another curious paradox with cancer treatment. With most illnesses, the outward appearance of wellbeing of the patient reflects the effectiveness and progress of the treatment. This rule of thumb does not apply in treating cancer. The outward appearance of the patient often reflects the patient's tolerance towards the chemotherapy and associated complications. There is not necessarily any outward indication of how the cancer is reacting to the treatment unless the disease is proving resistant and the patient is showing direct symptoms of the illness.

This leads to two possible extremes. A child can go through chemotherapy with no illness at all and appear very well throughout. The child then may die because the chemotherapy has been ineffective. By the same token, the child could be exceptionally ill throughout treatment, but be cured because the chemotherapy has been completely effective. It is very difficult to reconcile either of these options with what is really happening to the patient. As a parent you focus totally on the immediate condition of your child, but you have to keep reminding yourself that it is superficial. The course of the disease is announced periodically after scans or tests. These are the milestones which really matter.

Treatment. Your understanding of the word has to be radically changed when treating cancer. Normally treatment is the avenging angel which cuts down the illness and restores health to the individual. Treatment can only be good. It’s not quite like that with cancer. Treatment is often a double edged sword. It offers hope with one hand and potential death with the other. The treatment can be very dangerous, a knife edge which may lead to complications that will strike you down as easily as the cancer. There are times when the worst symptoms you see are not caused by the illness but by the drugs. It is difficult for all concerned to differentiate the two.

Some of the drugs used in cancer treatment are horrendous. There are drugs derived from mustard gas which was used as a chemical weapon in the First World War. There are drugs which can only be delivered using a glass syringe because they dissolve the plastic syringes. These are the drugs which are pumped into your child. It leaves you feeling very ambivalent towards the whole process of treatment.

I remember when Max was first given morphine and being horrified that this fragile child was being given as much morphine as he required. My reaction was very irrational. It was a case of my real world perceptions colliding with those of cancer treatment. Max had had drugs which were immeasurably worse than morphine, but the spectre of addiction came to mind. There is no logic here at all. He had cancer. He was in great pain so they gave morphine. Addiction was completely irrelevant.

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