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Life after Cancer

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I began to feel feisty after the fifth month of cancer remission and – googling the internet – found that the Truffle festival in Alba, Italy was on in October.  I knew I would feel better by then, it was a month away, five months after my last treatment.     I decided to go for it.  My friend Sweetpea, a great traveling companion, took a week off from her shops in Miami and we met at Heathrow and flew to Milan. Then a train to Turin and a car rental and we were there.  I arrived tired but not too tired to have dinner at the organic restaurant “La Contea” which adjoined the inn. Then Sweetpea walked into Neive and I went to sleep.

Truffles for sale!

The next day we drove into Alba. Truffles, salami, porcinis: at the Truffle fair; one drowns in them.  I used to think white truffles were rare, but having seen at least a million that day, I’m not so sure. Every stand had hundreds of truffkes and there were enough left over to stuff mega salamis.   I saw truffles that cost over one hundred euros each, but that was just the first week of the month-long festivities.  I guess the thousand-dollar truffles come out later  for the arrival of the stars attending the famous truffle auction.

My first close encounter with the white truffle came when I had about 4 grams (think about 30 Euros) shaved on my lovely soft-boiled duck’s egg at the organic restaurant the night before.  Delicious if you love fresh eggs, which I do.  I basked in the delicious smell of white truffle, but then the whole restaurant had a truffle kind of odor.  It is the taste I’m not sure about.  It seemed like the emperor’s new clothes.  I decided that the restaurant owner (also the waiter and maitre d’) had been too parsimonious when shaving off the thin layers and the dish needed many more grams – big bucks, big tastes – but it also might have been that chemo was still interfering with my taste buds. The ritual is that the waiter, or owner in this case, brings out a small scale and weighs the truffle before it has been shaved.  As the dinner went on more and more shavings are taken from the truffle.  At bill-paying time what remains of the truffle is weighed again and the cost calculated, this is added to the cost of the food and the service charge.

Shavings of white truffle make even a pile of raw meat look like art

The next day we went for the big experience: Piazza Duomo,  a restaurant which had just won two Michelin stars.  If you can’t taste the truffles here forget it.  The restaurant is my idea of perfection.  It serves about 40 people about eight tables; six were taken.  The walls were very light, pastel murals done by Francesco Clemente. The service was supportive without being pompous or over zealous.  There were many different tasting menus and even à la carte. We chose the truffle menu, of course: this was why we were in Alba.

The ritual of the weighing of the truffle commenced.  We had a truffle the size of a golf ball to start with and we were going to have the waiter shave away.  This time it was completely at our discretion.

For the first half hour we were offered one after another fabulous amuse-bouches.

The first sounds uninteresting but was delicious:  the very ends of cauliflower served with a light broth and the smallest leaves of the flower for decoration;  this is the way to get children to eat vegetables.  Then we had a small portion of potato soup (very thick, like jelly) with a quail’s egg lurking at the bottom, served in a glass dish in the shape of an egg shell.  The top is removed for serving. A few shavings of truffle went over this. I think I got a bit of truffle taste, but the smell and the taste are so closely aligned it is difficult to know.

The New Yorkers at the next table ordered à la carte and had the most tantalizing salad. (I was asked not to photograph them, but althoughI have chutzpah when it comes to food pictures I never had the nerve.)  From my vantage point, a glass dish holding a small green hill of tiny salad leaves was visible.  A dentist’s utensil, like a pincer, was provided for eating this delicate masterpiece of baby green leaves. A saucer in the bottom caught the dressing so that it could be drunk. I was jealous.

Next came scallops with a black truffle and anchovy sauce, and I gilded the lily with more shavings of white truffles.  Then came the carne crudo, which was outstanding.  Again I piled on the truffles because I had eaten beef tartare once before and thought the truffles would improve my negative feelings about it.  I need not have bothered – with or without the truffles this was memorable.

Then came the home-made pasta – of course, pile on the truffles.  At this point you would think everything would have tasted the same since every course had truffles.  It doesn’t, because white truffles are like transparent paint on canvas, where you can distinctly see hints of the color beneath.

Out came the partridge, in a fois gras tree (not pears this time).  I had cooked partridge twice in the last weeks because it was in season and I kept buying it at our farmers’ market (the first time mistaking it for pheasant).  Just the breast and the leg were served making it easy to eat and even with the fois gras sauce it was very subtly flavored.  I tend to go heavy on the thyme and lemon, but here it would have overpowered the very, very subtle truffle; and if you have it at my house you have to tackle the whole damned bird.

Mont Blanc Better to eat than climb

The main dessert was a Mont Blanc, a chestnut ice cream, with a chestnut pudding topped with snow, and a chestnut-flavored chantilly cream. I stuffed the extras (cookies, chocolates) in my handbag, but ate the angelic chocolate foam.  And then the bill came and I realized the taste of truffles is the taste of money. (Approx. $400.00 for two – and my friend doesn’t drink wine.)

Walking through Heathrow on the way home,  I realized that I couldn’t carry all my paraphernalia, and I worried (needlessly) that there would be no porters.  But I was right to worry for another reason:  Dr Spittle knew immediately that my cancer was back.  Lucky I got away when did.


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My worst fear – cancer returns

I would like to say that I’ve spent the last few months in a stress-free remission, climbing mountains for charity, but anyone who has been through this will know I am lying.  Just because you are in a remission doesn’t mean you are not stressed, exhausted and plain old sick.

I list the stages I went through during my five months of remission.

Reality sucks – first stage

I wondered why I didn’t feel elated.  I should have been over the moon, plotting my next trip to the five star resorts, spend it now! Instead I was doing what I had been doing over the last year or more, that is I was comatose, nauseous, vomiting, bowel problems, the usual. The treatments were finished but the side effects lingered on. I kept telling my body the treatments were over but it wouldn’t listen.  I was still seeing my oncologist, Dr Spittle, who kept encouraging me to get out of bed and start moving around before I forgot how to walk.

Escape second stage

So doing my best to feel more positive, I signed up for a Pilates weekend at an expensive health resort.  I curmudgeoned the weekend away, and found it difficult to get to Pilates, much less do exercises.  I had a list of what I couldn’t do which included all the activities on offer, like hiking and aerobics, and I hated the food, and I growled at the other guests. My optimistic phase had become my over-optimistic phase and when I got home I went back to bed to rest up from my weekend.

Smart ass third stage

I spend hours looking for the next cure and futilely try to keep one step ahead of my oncologist.  This stage began thirteen years ago when my first cancer sprouted and will continue until my last breath, with diminishing returns and diminishing enthusiasm. I won’t go into the details of my findings but let’s just say the new cancer doesn’t conform to anything I came up with in my research, so trips to Japan and the leading medical centers of the world are cancelled.  I should have gone when I had the chance, now I couldn’t do the traveling. I need to go to the website ‘cancer to order’ and ask them to send cancer that allows for extensive travel.

Getting it before it gets you fourth stage

After five months I thought it was time to have fun.  My friend in Miami had air miles and a week off. This happened at the same time as the white truffle festival in Alba. It would be great to celebrate a weekend of gourmet food after months of nausea. It was a wonderful week for me, but I was tired and not my usual adventurous self. I had a feeling cancer was looming.

The final charge fifth stage

I decided to make a huge effort to be a superwoman. I kept up acupuncture, went to Pilates four times a week, and signed up at a place called Bowskill Clinic for physical therapy and serious training. Everything was going well for about a month, which is a long time in stage 4 cancer remission.

Maybe I was stretching my luck,  signing up for 20 sessions at Pilates.  Just as I was about to ask for heavier weights so I could have a macho moment, my right arm folded.  It couldn’t lift an ounce.  My teacher looked at me with pity.  I looked at my arm in amazement.  What happened?

By the time I got home I was in severe pain.  I figured I had broken my arm; but how?

This was the first time I had a physical problem that I didn’t immediately think was to do with cancer.  I took every medication I could find in my apartment and nothing worked, not even the codeine pills I had left over from one of my cancer operations.  Not even my Adval smuggled from USA.

Sixth stage no, seventh Cancer returns

How did I know cancer was back?  Even after months of remission and seeing my oncologist every week. Dr Spittle has the manner of a psychoanalyst. She always greets me brightly, dressed as if she was greeting a great dignity rather than a woebegone patient; ‘Dr Walker’ she says, beckoning me into her consulting room.  She felt the lump on my throat and immediately concluded that I needed a biopsy and of course her instinct was right.  The tests showed cancer.

I’m writing this waiting to go into see Dr Spittle and start my treatment. I’ve had my Pet/CT scan and MRI. Cancer is back with a vengeance.  Good news it hasn’t gone to my vital organs; bad news the cancer can now be seen: lumps on my neck, bumps on my chest and a lifeless right arm. Cancer ought to at least stay out of sight.

I can think of many things to write about and will try to keep on to ‘restore sanity’.  This feels like a sequel;  ’The Revenge of the Cell”.  There will be more to come.

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It is cancer remission time and any intelligent person would be happy to have a break from the big ‘C’.  But here I am, planning my next attack on the enemy. That is not as dumb as it sounds because, for me, there has always been a next time, and I want to know where I can find the ‘cutting edge’ treatment and sign my name on the dotted line.

I showed up full of hope and wonder at an all day conference on The Future of Medicine put on by Intelligence Squared in London.   Prof. Bleddyn Jones spoke about curing cancer, not just getting rid of symptoms. Sounded good to me. With Stage 4 cancer no one ever uses the ‘c’ word ‘cure’ in conjunction with the other ‘c’ word ‘cancer’.   His first slide was a picture of the earliest airplane, an image that resonated with how I feel about radiation and chemo, which seem brutal and archaic treatments. Then he showed some photos of the latest supersonic jets and asked “Which would you rather fly in, the oldest technology or the newest?” I think of myself as super cool and cutting edge even though I’m 71 so I immediately chose to get on board the supersonic jet.

He went on to talk about particle therapy, a new form of radiation which targets the exact cancer cell and doesn’t involve any surrounding tissues. As he said, “It lands the dose on a dime with little, if any, collateral damage.”  I’m all right with that as long the targeting is not done by the twenty-somethings in Texas who have gained their experience aiming ‘drones’ at Pakistan and Afghanistan.  My faith was fading.

He went on to say that this treatment is fabulous for prostate cancer and as you can imagine the elderly male audience leaned forward and patted their checkbooks. Apparently everyone looking for research funds says that their treatment cures prostate cancer:  that’s where the money is since most men over 80 have prostate problems.

OK, what is the down side?  From my foggy understanding, the treatment involves walking into a cavernous room where the machine itself takes up acres of floor space;  they cost several fortunes to build).  There are ten machines in the US and a few in Japan and Germany.  Even if more machines were ordered, they would take years to build, by which time someone might have found another, better machine for the end of the 21st Century.

I spoke to my oncologist who was less than enthusiastic.  I wanted to sign up immediately and go on the waiting list for Japan. Who knows?  The day my name came up might be the day my cancer wakes up.

The next stop was the TED convention: this is the place to find all fascinating inventions and innovative ideas.

If you can pronounce the word Antiangiogenic, you are eligible for treatment.  Cutting it down to bare essentials, there are many blood vessels around the breast that feed cancer cells, and you need to stop the blood supply to stop feeding the cancer. These treatments aim at targeting the specific blood cells.  I was treated with an antiangiogenic therapy called ‘Avastin’ and was now in remission,  so I listened intently.  His question was  “…what we can be adding to our diet that would inhibit Angiogenisis?’

Can we eat to starve cancer? Wow, good words. I know how to eat. Now I can eat lots of fun food and stop the cancer.

Any list with chocolate on it is good with me. Don’t know about sea cucumbers.  Aren’t they the things you squish in the ocean?  The next day I topped my cereal with a mountain of berries.  My health insurance paid for my Avastin but not for my berry supply.  After a few weeks I forgot about this and went back to my normal diet.  Oprah seems to believe this diet will ‘cure’ cancer, but she is more positive then the researchers.

Then a friend turned me on to Pingyangmycin.  It fits nicely into my travel fantasies since it is a cure only available in China, which is fine by me. “I think it’s good that Chinese scientists are working on cancer drugs, because if my kid got cancer, I wouldn’t look at the label that says ‘made in China’” as Bill Gates said.

I don’t think it even is used on breast cancer patients but what the hell, China beckons and I like the name.  It sounds like a new ‘dim sum..’

Despite all the mad scientists and all their ideas, my conclusion is that I have to submit. Stage 4 breast cancer and I will have to fight it out with the old-fashioned treatments: chemotherapy and radiation. My oncologist, Dr Margaret Spittle, has done heroic work so far.  I know she would like to have more tricks up her sleeve but it is not to be.  That is why breast cancer needs tons more innovative research.

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Once long long ago a lovely Jewish Princess decided to be fashionable and do Pilates.  It was very difficult for her and she needed many fairy trainers to follow her from one exercise to another because she couldn’t remember what exercise followed what, or what position she should take.  After doing this four days a week for almost a year, she decided she might try to lift more than her Harrods shopping bag and went across the street to the gym.  There she found a handsome trainer, and so it went on until she became fit, in fact she was so fit that her cancer cells grew along with her muscles and she finally reached the point where they grew so large that she could exercise no longer.  The cancer cells won.

So after taking to my bed for a very long time I reemerged closer to a frog than a princess, but ready to fight another day, and began again on the long road to fitness.

I put on my sneakers, excuse me trainers, and the same outfit I wore on my last Pilates’ foray except that my t shirt had shrunk.

A journey of a billion miles begins with one step, I thought as I did my first work out, if you can call it that.  I’m going to try to do it every day until I bore myself to death. My breathing was supposed to be like bellows going in and out; bollocks to that  I say. I’ve signed up for ten sessions and will come back again tomorrow.  One hour of breathing can only help when ne thinks of the alternative.

Feeling much fitter after my session, I took a slow walk to the Serpentine (a lake in Hyde Park about fifteen minutes from the Pilates studio)  and contemplated throwing myself in the lake or taking out a row boat.  The row boats looked huge and forbidding, so  I walked back to the car and getting into the spirit of the new regime I drove the five minutes to my flat and took a nap (not before lunch).

Still wanting to be fashionable, I think the sport for me is ping pong.  After a couple years of cancer, operations, radiation and chemo I can’t walk very far but I can still stand up. I think if you can stand up, you can play ping pong on some level  (actually people even play in wheelchairs).

Ping pong has officially become fashionable.  The Standard Hotel, fashionista hangout in Miami Beach, has installed ping pong tables in one of their restaurants.  I haven’t played there yet, but I did play the table outside the Serpentine Gallery in London last week.  Our trendy London mayor  supported ping pong installations all over London this summer. Between cycles and ping pong he is determined to make London healthy.

You don’t need a trainer and unlike golf, it doesn’t take the whole day and as far as I know there is no handicapping system.  I played with an old friend Martin who is twenty some years younger and a million times stronger than me.  We’ve had a few ups and downs in our friendship and I have to say I enjoyed smashing the ball across the table at him.  He didn’t expect my aggressiveness after seeing me as bed ridden for most of this year.  I might not have won but I enjoyed the fight.

At the Standard hotel in LA LA land they broadcast the residents’ tournaments in the bedrooms.  I must remember to call the BBC the next time I play.

The next time I played (Serpentine again) I was clobbered by a ten year old. So much for life as a ping pong pro.

As you may have read, when you are trying to get into shape you need a plan.  Here is mine:

First I’m going to do ten Pilates sessions, and then a weekend of Qi Gong.  Qi Gong is really easy at the level I do it.  You get to act like an animal and jump around for as long as you can, and no one notices if you leave early.  It is the stuff you do before Tai Chi but I can’t remember the forms so forget Tai Chi.  I will also do some gyrotonics which sounds really athletic.  It is really just light stretching on a fancy machine which looks complex but again at my level it is easy.

(How about ping pong Pilates?  Breath in ping, stomach contracts, breath out pong and so forth.)

Second… well never mind that.  At 71 the exercise plan goes no further.

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When death did not knock, I decided to take friends who helped me through the last few cancer years out to dinner.  I found out quickly that reserving tables in London was like playing roulette in Las Vegas,  I never knew if the dialed number was a winner, or if I would leave the restaurant, head drooping, pockets turned inside out, after an expensive dismal experience.

On my first trip out to the real world I took my oncologist to my neighborhood  Michelin-starred restaurant, L’Autre Pied.

Dr Margaret Spittle is the true hero of my cancer remission, having managed to preserve my life through fifteen years of cancer bouts.  It seemed appropriate to have a first rate dinner.   We decided on the seven course tasting menu. The first courses were delightful, but after forty five minutes the tables on either side of us filled up, and the service slowed to a snail’s pace.  We had four more courses to go.

A late middle age couple and their guest sat on my left side.  The table was piled high with catalogues from the art auctions which were being held in London during that week.  The men talked throughout and ordered one course while the woman ate three courses in silence, ignored.

On the other side sat a couple of tourists, and like gamblers hedging their bets they ordered everything to be shared between them. When the first course arrived, a slice of tomato with a few other ingredients in a short stack, they hit the roof.  Our waiter was completely out of his depth. How do you explain the minimal cooking philosophy to heathens, in your second language, with hungry customers waiting for their fifth course.

By the third hour, our waiter completely folded, service stopped, and we had run out of conversation.   Dessert – an elaborate ending was promised – became a peach with whipped cream, thrown at us.  I limped out, with the ever unflappable Dr Spittle raving about the food.

My second bet was on Scotts, where I was told they needed the table back in two hours. After spending three hours at Pied I thought two sounded about right.

The first hour at Scotts was impeccable.  We arrived at 6.30 when the restaurant was quiet.  The cocktails were lovely and the waiter offered a pillow to my pregnant friend. (No toilet paper in the ladies room balanced that out.) The waiter was helpful and we ordered the shellfish platter for one, which more that adequately served three.  It took a long time coming and when the waiter whisked the platter away and brought it back with new ice, no one seemed to be in a hurry. We had our mains and that, too, was delicious.

The betting was going my way until the waiter came, cleared our table and abruptly offered coffee. I thought it strange but assumed the dessert menu would follow in some strange custom of the establishment.

Suddenly a man in a flamboyant suit appeared and in a preposterously camp manner asked for the host, and when I confessed drilled me on whether I enjoyed the meal and if the service had been good.  I said it was very good, which at this point I meant.

Then he dropped the bomb.  The table was needed immediately:  the people it was reserved for had arrived.  I asked if this is why we hadn’t been offered dessert and he was not apologetic at all.  The bill came to over 200 pounds for three of us and a cover charge to boot.  At least at home your table doesn’t get repossessed until the bank manager sees your bills.

Now gambling at the tables had become an addiction and for my third try I volunteered to organize dinner at the Royal Opera House.  My friend had gotten some fabulous free tickets so I thought dinner should be up to me.   The hurdle of booking and  pre ordering a menu on line proved insurmountable, but the old telephone worked amazingly well.  But it is always difficult to book for another person, no matter how well you think you know them.

The first course went well:  smoked salmon and a glass of rose – perfect.

The main course sounded good on paper: cold filet of beef and I had ordered sides of salad and potatoes, harmless enough.  As much as I enjoyed Manon (the opera) I was feeling sick (nothing unusual there) and when I came back from the ladies, my friend had rejected the beef out of hand and instructed the waiter to wrap it for his cats.  OK it wasn’t the sliced cold roast beef I had expected and a whole filet eaten cold is not perfect, but it wasn’t that bad.

After the second act, sung beautifully, the dessert arrived and since my guest had announced that he didn’t like strawberries I dug into the strawberry sundae and left him the amazing chocolate concoction. He returned from the men’s to have a look at my sundae and declared it his.   So I lost the bet and my dessert as well!

It is great to be alive and to be able to complain about first class restaurants.  I’m privileged  to be able to gamble at their tables.  Let’s face it the alternative (death) seems to be no fun at all.

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