Six months can roll around so quickly, especially when the sun is shining.
It was six months ago that I had an MRI scan which revealed an increase in the spread of blood vessels (vascularity) in my brain tumour. Coupled with a radical increase in the number of seizures I was having, it led to my having a biopsy to pin down the type of tumour I have.
The biopsy revealed I have an oligodendroglioma, but it only recovered grade two cells (on a scale of 1 to 4). That in itself was good news.
But my multidisciplinary team couldn’t rule out the tumour might have grade three elements, and therefore be turning into a malignant cancer.
My neurologist advised we should treat the tumour as if it was grade three, and that meant starting treatment soon: a 42 week programme of radiotherapy and chemotherapy.
I decided, with the agreement of my oncologist, to wait until the summer was over. The holidays were approaching, the kids would be off school and I had some cycling events and challenges planned (seizures permitting).
Well, now the summer holidays are almost over. Most of my cycling challenges are satisfyingly complete. In a couple of weeks, school starts again.
On Wednesday will be my next MRI scan. A couple of weeks later, my neurologist will tell me whether the tumour has increased its vascularity further, or if it has grown.
If it has done either, he’s likely to ramp up his advice to start treatment.
I’ve may have made hay while the sun shines this summer, but where will this next scan leave me?
I reckon I’m going to take some serious convincing to start treatment any time soon.
I feel well, my cycling fitness is probably better than it has ever been and – inexplicably – my seizures are under better control than they have been for almost a year. I’ve only had one in the last month, though I know that could change any time.
Even if the tumour does show an increase in vascularity or growth, outwardly I’m showing no signs of it. And in some sense, that’s all that matters.
Over the last six months, I’ve developed a philosophy about my tumour, my treatment and the end of my life.
I do not know – because no one can tell me – how long I have to live.
I do not know – because no one can tell me – how long, if at all or for how long treatment may extend my life.
I don’t even know the extent of the side-effects that may result from the radiotherapy and chemotherapy I’ll have.
In that context – where the progress of my condition and the time until end of my life is unknown, and even the ability to postpone the inevitable is not known either – what does it even mean to make decisions about what I should and shouldn’t do?
I’d be basing them on no knowledge at all. All I have is known unknowables.
So for me I can only make decisions based on how I feel right now: my ability to get most out of my family life, my work, my cycling. Those are things I do know.
Of course, if my neurologist says things have gone so far that treatment really is necessary, and that it will make a significant difference to get underway as soon as possible, I’ll take notice.
But as long as things hang in the balance, after this Wednesday’s MRI and the results day two weeks later, I’m planning to go with what I know right now. I’ll leave the known unknowables for another day.