European Journal of Clinical Oncology

A Cancer Patient Cook

John Hanley^{* *}Correspondence: John Hanley, The Times of London, Aigburth, Liverpool, Sports, Riversdale Technical College, England, Email:

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Introduction

Indeed, we soak up every single aspect of our journey, from the drugs to the scans, and from the nuclear treatment to the impact food and drink can have on us. We learn. How we learn!

As a person living with cancer, in my case locally advanced prostate cancer, Gleason score 8, T3a, 4x4, 12/12 cores, 100% involvement, I sailed perilously close to the wind of a metastatic Stage 4 diagnosis. I know now that the spectre of being upgraded would not be the biggest surprise in the world. The statistics, as with all cancer statistics, are frighteningly worrying. But, I haven’t got time to worry; it would be another waste of emotional energy. What I have got time for is to put my experience (of well over four years) to good use now to try to arm fellow patients with essential advice based on the very things I’ve learned.

I’m not suggesting for a single moment that I could successfully complete a dissertation, or indeed display the intelligence, aptitude and dedication required to reach the levels of excellence that thousands of oncology experts have done, do and will do forever and a day. On the contrary, I’m just a mere patient taking a serious interest in my own diagnosis, and hopefully attempting to process what I can, and try (like so many others do) to pass on what I know, however insignificant.

But, I will never stop respecting the professionals who have sacrificed so much to attain the qualifications necessary to save lives minute by minute, day by day and year by year. I’m qualified to make them cups of tea whilst they work and no more. However, one of the many positive aspects of being on your own cancer journey is that you develop levels of empathy that are well deep, and that alone is a great quality. So perhaps I can make their sandwiches as well. I manage a UK based project called Chemo Cookery (Twitter handle @ChemoCookery) which is based around fact based nutritional tips, uncomplicated recipes, health and well being and, crucially mental health. As a young man, I did some chef training (starting with sandwiches perhaps) and as somebody who has always been relatively fit, played sport and studied nutrition, It’s no major surprise that I folded together what little skills I have and the genesis of my project was under way. It commenced in May 2018.

I’m confident that based on my interactions with highly trained professionals in the sector, professors, clinical nurse specialists, radiographers, oncologists and cancer dietitians that they all learn just a little from us. But, and it’s a big but, I see myself as a conduit between these wonderful, dedicated experts and patients like myself. I’m not the expert, I’m just passing on what I believe to be important ‘in depth’ aspects of my own treatment and, to reiterate, my experience.

This is no sojourn for me, this will last a lifetime now, but I’m cool with that, I’m used to it and, if we, as patients, can all bring something the table in terms of ingredients to help others, then ultimately the recipe for a better understanding for everybody will be more palatable.

I also feel strongly that having a world-wide cancer community is of enormous benefit. So being asked by the European Journal of Clinical Oncology fills me with a pride even bigger. Until I take my last breath, whenever that may be, I’ll learn a million times more from cancer professionals than they will learn from me, but, and I speak for all patients, we may just be able to equip you with nuggets of information that may not have been part of your training way back then. It’s all about respect, and my respect for the ladies and gentlemen of the sector who save thousands of lives is off the scale. Even stretching high above the Brussels Tour Du Midi.

Cancer and the nuances of cancer treatment are a lot for people to take on board, and as every person touched by the illness knows, it’s a long journey, and, as in life itself, long journeys usually mean people getting off at different stops, whilst you have to stay on until the very end. So, from an emotional aspect, not all friends, and indeed family members will stick it out with you. Yes, it’s true, some won’t be able to cope with ‘your’ illness, and they’ll jump off at a station when you’re not looking. How you deal with that is up to you, MY own view is to let them go, let them alight and find their own different means of life transport, they make that choice and it’s crucial you don’t doubt yourself if someone else can’t handle your trauma.

So, a little more about Chemo Cookery. In its infancy, it was about creating nutritional meals to prepare me for the onset of chemotherapy, in conjunction with a rigorous fitness campaign focusing on building strength and stamina. So the focus was on food rich in protein, chicken, fish, steak (in moderation), and vegetables with generous protein content like chick peas for example.

I studied hard , quickly realizing that my bone health was also going to be a major factor, so including foods high in calcium and certain vitamins was a prerequisite. It was as clear as crystal that a diet with copious amounts of leafy greens, such as kale, broccoli and fresh spring vegetables (it was May after all) was of huge importance.

I then created recipes. Also I trained exceedingly hard, with the emphasis on building my strength and stamina. I was lucky in that I was already relatively fit anyway, but I knew in my heart of hearts that I needed more. My research led me to believe that the dosage of cancer medication would be largely influenced by my physical condition. So for that four week hiatus period from diagnosis to treatment commencing, I trained like never before, with, of course, sensible rest periods.

Then, a hammer blow. A torn meniscus in my right knee, which happened around a week after my second cycle of docetaxol. I’d even timed my training regime to coincide with the end of the allimportant nadir period of each cycle. Subsequently, my training came to an abrupt stop, but luckily, I think, I’d reached a decent level of fitness, boosting my immune system, my stamina and my strength. Furthermore, although the injury had a monumental impact on my mental health, I had built up coping mechanisms which I knew would stand me in good stead. The chemotherapy treatment went well; apart from a terrifying anaphylactic shock seconds after the cannula entered my veins on cycle two. I thought that was the end, I woke up to a half moon of blue screens and seemingly half of the emergency department looking on as lifesaving drugs were administered, or so it seemed. If there was a wakeup call, that was quite literally it. *One of my oncology nurses explained that sometimes the body will reject the second dosage because it remembers the first one. Then, 7 months down the line the preparation for 30 sessions of targeted radiotherapy began in earnest. Chemo Cookery was being well received on social media; I was studying hard and even agreed to appear in a mainstream TV programme dancing in London to raise awareness for prostate and testicular cancer. The routine involved removing items of clothing in front of a large audience at a historic venue called the Alexander Palace. With hindsight (yes that word again) I shouldn’t have done it, I broke down being interviewed but thankfully the cutting room floor was the chief benefactor of my mini meltdown. My emotions. My fragile emotions.

So began the radiotherapy at the Rosemere Cancer Centre in Preston, Lancashire UK. A whole month of it, and after the first two weeks of smooth progress, I began to appear in the firing line for a barrage of side effects. Serious fecal incontinence, which crept up on me like a sniper hiding in the bushes, (and if I’m honest, to this day, three years on, is still happening), and a plethora of other niggling issues, seemingly laying in wait since chemotherapy. Onycholisis, crumbling teeth, insomnia and a meniscal tear which was clearly worsening, and preventing me from training.

Here comes another ‘but’! Nobody sails through cancer treatment without having to ride the waves, ricochet against stray rocks and get caught up in storms of biblical proportions, but as Billy Ocean (artist intended pun) sang ‘when the going gets tough, the tough get going.’ *I felt it was important to share a little of the background of my treatment to contextualise this article. I like to use musical connotations with my Chemo Cookery posts, I like to add a flavour of humour, a splash of colour and to spice it up now and again (inadvisable on radiotherapy, as I found much to my chagrin). I’m the polar opposite of scientist, the thought of coming across as some kind of expert fills me with dread; I spent my physics and chemistry lessons watching the football out of the window in school. Perhaps this is why I feel like a speciality ‘Belgian Miserable’ Sponge Cake these days, soaking up all the ingredients (information in this case) that I can. Basically making up for lost time. Hindsight again!

My CC idea began as a tiny seed, mostly designed to help me cope, but the genesis of the project has grown in popularity. I wouldn’t say I have orchards full of fibre filled fabulous fruit from all around the globe, but I do have several little flourishing trees providing an appetising distraction from the debilitating subject matter of cancer. In the UK, an estimated 30 million people are likely to be affected by the illness in their lifetime, doing the math for Europe, and beyond, is terrifying beyond belief.

I’ll continue to try and create unique angles for Chemo Cookery. I’m attempting at present to take it to the next level, with extensive focus on helping men of every colour and creed realise that a PSA test should be rebranded to PSA Blood Test, in my humble opinion, most men untouched by Prostate Cancer think the test automatically involves an uncomfortable digital, embarrassing examination whilst you’re curled up like a Japanese Spider Crab on a doctors bed. Wrong. Totally wrong. It’s likelier to be a simple sharp scratch with a tiny needle lasting a mere few seconds. As delicious as crabs are to eat, (this version is not ideal incidentally, and fiercely protected) they are not suitable for patients on chemotherapy, like all shellfish. Furthermore, It seems rather unusual to vacillate from a serious medical exam to talking protein crammed fish, but that’s Chemo Cookery for you, unique and hopefully here to stay. I enjoy my maverick outlook, it makes every day different, and different is good. For cancer patients, it’s a distraction.

Thank you for taking the time to read my musings and thanks again to the European Journal of Clinical Oncology for inviting me to write a few words