Wednesday, September 26, 2018

Topic of Cancer

I am very lucky.
I have cancer.

These are two sentences that on first analysis don’t fit particularly well together. At least, until recently, I didn’t think they did, but they do.

Perhaps I should be more specific.
I had cancer.
Past tense.

Earlier this summer I underwent a small procedure to excise a lesion from my forehead. The biopsy confirmed that I had squamous cell carcinoma. It’s gone now, but it might be back. While I won’t require chemotherapy or radiotherapy, I will be under intense monitoring for at least the next year.

Appropriate Beach Wear

As cancers go, this isn’t a bad one to have. It could have been so much worse. I really am very lucky.

It all started about a year ago when I got a spot on my forehead. Not a big deal! … except that it didn’t heal up. I realised that this was my fault – I kept picking at it. Not deliberately of course but I’d frequently find that, despite my best efforts, I’d have picked at it in a distracted moment and there I was – back to square one. It wasn’t healing and it was getting bigger. I spoke to my GP about it and they made some concerned noises and prescribed some cream, suggesting that if things didn’t improve I might need to see a specialist.

Things didn’t improve. The cream didn’t work. The spot grew larger. I didn’t go back to my GP. I grew my fringe out to cover it up.

When I did go back to the GP it was to mention it almost as an afterthought at a consultation for one of my children. By that stage, I had to lift up a big, shaggy fringe so she could examine it. I declined the GP’s (a different one from before) offer of a prescription for some more cream. Well, things moved pretty quickly after that. There was the consultation with the dermatologist. They started the ball rolling with a simple question: “Is there a history of cancer in your family?”. I’d been expecting something along the lines of “have you been picking at this?”, but the barrage of questions all revolved around cancer. Did I enjoy beach holidays? Did I use tanning salons?

San Diego, CA April 2018. Who doesn't wear a large, black hat, scarf, and long-sleeved shirt to the beach?

Me? In a tanning salon? I’ve been called Orange before, just not in that sense.

The questions continued and the response to my stammered ‘So, you think this is cancerous?’ was a definite ‘Yes, but we need to understand how bad it is’. While I have nothing but respect for the specialist’s medical knowledge and ability, their suggestion to ‘prepare for every inevitability’ was, perhaps, not as helpful as they had intended. There was another session for the excision (the smell of my own cauterising flesh is not nearly as delicious as I might have hoped).

And then there was the wait for the results.

In preparing this piece I’ve made several attempts at describing what it was like, but I just can’t do justice to the swings from terror to optimism and back again, seemingly forever, waiting for an unseen and unknown enemy to advance into view and attack. It took a couple of rather hellish weeks, but the enemy did show itself and was much more manageable than I had feared. Today, I’ve got a sizeable divot in my forehead, decorated with stitch marks that, in the right light, look quite ‘Frankensteinesque’. I can live with it. I’m not totally out of the woods, but I’m getting there.

I am very lucky.

But here’s the thing … my story with this cancer didn’t start ‘about a year ago’. As the site notes that although there may be a complex set of reasons why these develop “Most basal cell and squamous cell skin cancers are caused by repeated and unprotected skin exposure to ultraviolet (UV) rays from sunlight, as well as from man-made sources such as tanning beds.” Although we can probably rule out sunbeds as a factor in my case, the contribution of two decades as a field archaeologist are somewhat harder to dismiss. I had long believed that the combination of near mandatory use of hard hats, frequently poor weather, and my personal preference for the shade made me an unlikely candidate for this form of affliction. Turns out I was wrong. Turns out that my delay in seeking treatment significantly increased my risk of the cancer spreading to my lymphatic system. Thankfully, that hasn’t happened.

I really am very lucky.

My point in writing this is not to elicit sympathy. I’ve had brilliant support from my family, colleagues, and various close friends I’ve burdened with my story. I’ve received excellent care from remarkable professionals. I’ve no complaints on any of these counts. Instead, I want to acknowledge that cancer isn’t something (in my experience, at least) we talk about all that often in field archaeology.

Perhaps we should.

Try bringing it up in conversation in the site hut – talk about it. Talk about how to lower your risk. Talk about the signs to look for. Talk about seeking treatment in time. If you’re reading this and you have any lumps or bumps that shouldn’t be there or just a spot that persistently won’t heal – don’t delay. Go see your doctor immediately.

I had cancer.
I’m very lucky.

You can be lucky too.

The title of this post is a play on Henry Miller’s 1934 novel ‘Tropic of Cancer’, but, of course, you knew that.

I’d like to mention that while I love and cherish the NHS, I also have private medical care provided through my current employer. That private insurance allowed me to see the specialists I needed and receive the care I required in a very short space of time. I’m also very much aware that, had I remained in field archaeology, I would have been unlikely to have had such a benefit as part of my basic employment package. Just like the issue of low wages, the quality of employment benefits for archaeologists will only change through collective action. Go join a union today – your life might really depend on it!