It's been over a week since I received my first chemotherapy treatment with dacarbazine and I'm really surprised and pleased with how well I've been feeling. I've had fewer side effects so far in this cycle than with any of the previous treatments. My oncologist gave me a lower dose of dacarbazine than would ordinarily be used as he wanted to see what problems it might cause me, I would guess that next cycle we'll be upping the dose to the normal level. This may result in more side effects but given how well this cycle has gone I'm hopeful that they won't be a major problem.
We don't know if the treatment is having a positive impact on the tumours. I have several small sub-cutaneous metastases that are visible on the surface of my skin. I've been watching these closely to see if they show any sign of shrinkage but I've not been able to detect any. It's quite possible that the tumours in my liver, abdomen and lungs will respond differently to those on my skin so this does not mean the drug is not working. I'll have to wait until after the next two cycles in order to get a CT scan to definitively determine if there has been a positive response.
Iain Banks, the Scottish author who died last June of gall bladder cancer, remarked that he and his partner found "ghoulish humour" to be a useful part of their strategy for coping with a terminal prognosis. In the public statement issued on receiving his diagnosis, Banks wrote:
"I've asked my partner Adele if she will do me the honour of becoming my widow (sorry - but we find ghoulish humour helps)."
Katie and I have also come to find this type of humour to be useful. Some people will consider it to be in bad taste, but sometimes there is very little that is as effective at changing a mood or closing out a discussion on a difficult or depressing topic than a really good piece of black humour. I emphasise here that I'm referring to making these kind of jokes about my own condition - not about other peoples, clearly that is something else entirely.
Here are a couple of examples that stick in my mind, I hope you see the funny side!
In September 2011 Katie and I were at the cinema watching the trailers for forthcoming films. The film being advertised was "The Iron Lady", the biopic of Margaret Thatcher. I've always found Thatcher to be an interesting character which is in total contrast to Katie who really had no time for her at all, our conversation went something like this:
Paul: "Let's come and see this film, it looks really interesting".
Katie: "It's not out until February, hopefully you'll be dead by then".
(We never did go and see the film!).
Then there is the birthday card I bought for Katie last year, it featured the following cartoon which seemed extremely apt given the love of wine both Katie and I share.