Devastating
Cancer Diagnosis
How I learned about my pancreactic cancer
8 February 2019: A devastating diagnosis
Can you die more than once? A seemingly bizarre question that I would not have even contemplated until a few months ago, the 8th February 2019. That is the day I died for the first time, aged 46.
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Of course, I’m still alive as I’m writing this but something definite and apparently irreversible that I can only compare to death occurred on the day an otherwise extremely sympathetic gastroenterologist delivered his cruel diagnosis to me and my wife Jane.
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That morning, I got up at the usual time, around 7am, to get ready to go to work. In the shower, I had continuous flashbacks from the previous day when halfway through a check-up ultrasound of my abdomen, which had caused me some discomfort during the previous couple of weeks, I was swiftly and unexpectedly transferred to do a CT scan, “since the pancreas was not sufficiently visible to rule out things like pancreatisis”. At the end of the procedure, I left the hospital, feeling quite unnerved about the whole experience.
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Luckily, I had managed to get an appointment with the gastroenterologist less than 24 hours later to discuss the outcome of the examinations, and while still in the shower, I ended up giving myself a 50:50 probability that things would work out fine. Despite my generally optimistic nature, I could not give myself a better chance, mostly due to the suspiciously sudden CT scan I had been asked to go through the day before.
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My wife Jane was more positive and happily proposed to come to the appointment with me. We got the kids ready to go to school, had breakfast together, and then I made my way to the office as usual, trying not to think too much about the forthcoming doctor appointment, but succeeding in doing so only to some extent.
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Jane and I met at the hospital 10 minutes before the agreed 1:30pm appointment, and had a relatively casual chat about the traffic she found on the way there and the weather that was getting worse. It was indeed very windy and raining outside.
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At exactly 1:30pm, the gastroenterologist opened his door and came to collect us. His face did not look good at all. I had only met him twice before and he always had a reassuring smile on his face. Not this time – he looked troubled as he let us in his office, closed the door and asked me and Jane to take a seat.
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To break the ice, I started by thanking him for organising the meeting at such short notice, stressing how much I appreciated it. He barely acknowledged my words. Sitting at the other side of his desk, he said with a genuinely concerned voice:
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“I’m afraid the CT scan revealed a worrying large growth in the pancreas as well as several lesions in the liver”.
“When you say growth, you mean cancer, right?” I queried.
“I’m afraid so”.
“Is it operable?”
“Unfortunately not. The illness is too advanced for that. But I have already organised a biopsy for next Monday to shed a bit more light on the exact nature of the cancer cells. I will not be following you going forward, you will need an oncologist and I am happy to suggest to you a possible option”.
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Life as I knew it ended there and then.
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I was aware that pancreatic cancer was one of the most deadly ones. I remember reading somewhere that it is typically diagnosed after it has already spread and that survival rates in this situation are extremely unfavourable, in the order of just a few months.
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I quickly turned to look at Jane, who seemed completely shell-shocked. Perhaps surprisingly given the circumstances, I did not experience any sense of panic and there were no tears.
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On the contrary, my brain remained fully functional, allowing me to ask pertinent questions about possible treatments, whilst at the same time thinking about how on earth I was going to communicate the news to my children, my parents and my sister. The adrenaline in my body had clearly taken charge of the situation.
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By the time the doctor had told me that, in all likelihood, I would need to undergo a hard-core chemotherapy regime with highly uncertain prospects, I had already decided that I would tell the family that same day, and had already realised that my day to day life would, with immediate effect, lose much of the breadth that I so much enjoyed and valued.
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All my plans for the future, and most agonisingly, the prospect of continuing together with Jane our job of helping and supporting our children throughout their development, felt well and truly over.
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By the end of the consultation with the gastroenterologist, I had already asked for sleeping tablets, in full knowledge that there was no way I would be able to rest that night, or the following nights, without chemical help.
8 February 2019: Sharing the news
As expected, calling my parents, who are in their late seventies and live on their own in Italy, was excruciating, the despair coming from the other end of the phone being as palpable as if we had been in the same room.
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The call was short, as there was not really much anyone was able to say after the full extent of the problem had become clear to them. We agreed to talk the following day and left it like that, knowing that, despite its brevity, this call would permanently change the rest of their life in the worst possible way.
A similar call took place shortly after with my sister Ilaria, with whom I have always been very close. Ilaria is only one year older than me and her husband Giuseppe died in 2013 of kidney cancer leaving her with two young kids. My phone call to her was horrible enough on its own but, inevitably, it also reopened wounds that were still healing from this earlier tragedy.
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With no time to spare, Jane and I had to start focussing on the conversation that we were about to have with our children, Thomas, Alberto and Giorgio, aged respectively 15, 13, and 9, who would shortly get back home from school.
We gathered them together and, whilst they were sitting down at the dinner table, I told them I had some bad news, that I had cancer, I would undergo chemotherapy treatment for three months and get rid of the tumour with surgery afterwards.
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I had decided, in agreement with Jane, that this was as far as I was prepared to go in terms of disclosing the news. I did not mention the pancreas, in order to stop them from finding things about it on the Internet, I deliberately understated the severity of the situation and gave them a sense of certainty about my full recovery in a not so distant future.
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My goal was clear: I wanted to protect my children, I did not want their life to be turned upside down. More precisely, I wanted to delay that moment until it would become unavoidable. Until then, I was prepared to do anything to defend their right to continue to be as happy and serene as possible.
There were immediate tears from Thomas and even more from Giorgio, while Alberto went incredibly pale and quiet. Regardless of the slight differences in their manifestations, there was no doubt that they were all equally shocked by the news.
Their reaction was to be expected, in particular because our enlarged family and circle of friends have been so dramatically affected by cancer over the years that my children are fully aware that this type of diagnosis is not something to be taken lightly. In turn, this reinforced my conviction that there would be no merit in disclosing any further details about the gravity of my particular situation.
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In the end, Jane and I somehow managed to reassure the children that things would be fine. We did not really talk about it for the rest of the afternoon, dinner was surprisingly uneventful with the usual conversations about what they had done at school, and the day finally came to an end. With a sleeping tablet.
