There’s a scene in Master and Commander: Far Side of the World which seems apt given my pending decision about chemotherapy. Russell Crowe’s character asks his friend, the scientist Dr Stephen Maturin, played by Paul Bettany, which of the two beetles crawling on the table he’d choose. Dr Maturin, ever the academic, splutters about the fact they are the same species and there’s nothing to decide between them. Aubrey pushes and Dr Maturin reluctantly picks one that is marginally larger. Aubrey’s response is to tell him that he’s completely missed the point, and that in service “You should always pick the lesser of two weevils”.

"I've used my 50/50 so can I ask the audience?"

Now, I don’t mean to trivialise what is clearly a huge decision but the fact of the matter is, there is so little to choose between my decision to go ahead with the chemotherapy as to make it impossible to ever settle. But more importantly, I’ve dealt with the whole boring debacle with as much humour and self-deprecation that cancer allows so that’s why I have decided to put it to you. I’m not saying I’m signing a binding contract to your decision. You could all play a joke on me and I’d be pretty unhappy about that, but it’s also interesting to see what you’d do, given the circumstances. So I’ve decided to try and write as fair an appraisal for both sides of the argument that I can and then leave you with a poll. I just thank Dawkins that I don’t have David fucking Hasselhoff sat there SHOUTING EVERYTHING FOR NO REAL REASON OTHER THAN THE FACT HE’S DEFINITELY NOT DRUNK BUT I’M GOING TO USE THE BUZZER ON YOU REAL GOOD LEO WHAT SHOW IS THIS AGAIN WHERE AM I AND CAN I DO IT IN SLOW MOTION? After all, it’s only Cancer, LOL.

So as it stands, after my pant-droppingly awesome meeting with my oncologist last week, I have been told that as far as they can tell, the cancer is more or less out of my system. The CT scan, ultrasound and blood tests all show it in remission. The last of these shows that a cancer ‘marker’, specifically a protein created in the liver, that shoots up when cancer is in the system, had dropped by half since the surgery and sat only slightly higher than normal. I was told that this was good news and even more so in that it means that I have a strong indicator of when/if the cancer returns. Apparently not everyone has this. WIN! But wait *cue dramatic music* I have also been given some pretty juicy statistics to really fuck with my mind. Currently, there is a 25% chance of the cancer recurring within the next 3 years. If I pass that point, I’m essentially clear and anything I get in the future would have no relation to this ordeal. This percentage decreases every month. So by this time next year it would be down to about 10% and the year after that about 5%. However, if I were to choose preventative chemotherapy, ‘adjuvant’ treatment,  then this drops to 1% immediately. Now I’m going to attempt to play a game of decisional chess against myself for your viewing pleasure…

Chemo – I want you in me

Katy Perry (she of boobs) released a song with the lyrics “Infect me with your love, fill me with your poison”. She was talking about this very conundrum I’m sure.

What do you mean? This picture is RELEVANT!

The percentages basically speak for themselves. I’m giving myself the best possible chance of being free of cancer. Forever. I’ve already had a month off serious training so it wouldn’t be the worst thing in the world simply to disappear for a couple more months and hope that I’m able to rebuild myself, free in the knowledge that it won’t recur and I can have a good few years training hard to reach my potential before retiring from my sport.

What it also offers me over any other option is the advantage of control. If I were simply to leave it and hope it didn’t recur, if it did return I could potentially have to go through a worse dose of chemotherapy at a more critical stage of my training, leading up to a particular competition or championship that was important to me.

The final point is that I would only need one single dose of chemo. Although it wouldn’t mean a lot less time out of training, it would be a slightly less intense period. A single ‘dose’ is a 3 day stint in hospital before returning home to feel like Coleen Rooney the moment Wayne calls for ‘playtime’. This would be at its worst for the first few weeks before I’m left with all the side effects of lethargy, sickness etc. for as long as it takes (up to a few months).  If I chose not to have the chemo immediately and it returned I’d need 3 doses over 9 weeks with roughly the same recovery but the symptoms are elevated.

Uh. No thanks.

It needs to be made very clear here that I made some poor choices with regards to my athletics early on in my career. I was a promising junior athlete. I won the English Schools at both the hurdles and multi-events (Octathlon), also breaking the British age-group record in the latter. I represented both England and Great Britain at Junior and Senior level before I was 19. Things looked pretty good. Some very good coaches told me I could go a long way and talked about real chance of success at major championships. However a mixture of injuries and hedonism veered me down a different path. When I wasn’t injured I always consoled myself with the thought that I would always slip back into athletics easily and fulfil my potential once I’d had all the fun that University and freedom from school would allow me. Obviously, it doesn’t work like that. I barely competed for 7-8 years, keeping myself in only moderate shape. When I did return to athletics I would have only managed a few months of training (punctuated with various injuries made more likely with my absence) and proceeded to post results that weren’t indicative of my potential in the slightest. Disheartened, I would go back to enjoying myself elsewhere. It has only been the past two years, realising I’m running out of time, that I have begun to eschew all other temptations and dedicate myself to the sport. This has also resulted in me being as happy as I’ve ever been. I have a routine that works, the injuries haven’t been so severe and, with my first full winter of training behind me, I’ve started to post times and distances that look like I’m not only on the right track but could still do some damage in the sport. All of this needs to be understood, so that you realise the gravity of what I’d have to give up in order to miss 3 months of training or more at a time when I need to capitalise on my improvements and fitness. This amount of time off training completely, added to the fact that I may be left with lasting side effects that could stay with me for up to a year, would really compromise my athletics.

How could you poison this? HOW COULD YOU?

On first glance the odds don’t look great. 25% is a lot higher than 1%. But then, when you look it further, 75% is a lot higher than 25%. In fact, you should remember that it’s essentially 3-4 times more likely that the cancer won’t return than it will, even without interference. Every month that passes, these odds improve further. Yes, there is still a chance that it might come back, but if it did then fine, I have the chemo. This eradicates it just as effectively as the ‘preventative’ dose and doesn’t risk anything more. The only issue to consider then is the timing of the recurrence. Obviously, if I was in shape to qualify for something huge, that I’d worked incredibly hard for, I would rather avoid a dose of chemotherapy that would ruin this for me. However, the chances of it coming back again at that time (perhaps 2 years or more down the line) are particularly low – around 2-3%. The last thing to say here is that I’m not in any way ‘playing God’ with the decision. The chemotherapy has an equal effectiveness whether it is done as a preventative measure, or as a reaction to it being picked up very quickly in the 4-6 week blood tests that I’ll have over the next few years.

Essentially, I have worked too hard for this to let it interfere any further. I have enough regrets about the way in which I missed out truly realising my potential over the past 10 years. I’m not sure I could live particularly well with the thought that if I hadn’t taken that 3 months of chemotherapy and knocked myself so far back off course, I might have actually done something I’m proud of, rather than just shown promise.

Conclusion

So there you have it. I think that basically covers it all. My appointment is later today and I will have the opportunity to ask a few more questions before I decide what to do. People of the internets, it’s over to you.

P.S. I have kept the results hidden so you aren’t tempted simply to play devil’s advocate you sneaky little Moomins.

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