The answer to life the universe and everything

The odds are changing on living with cancer, says Jim Pollard.

Cancer seems to have been around me my whole life. One of my earliest memories is of the athlete Lillian Board dying of bowel cancer aged 22, the hushed tones of the newsreader on our black and white telly reaching out into our living room as a dull pallor fell over the Christmas celebrations. The 'Golden Girl' of British athletics, she'd won Olympic silver at Mexico 1968. At about the same time I discovered the reason why I only had one grandma - my mum’s mum had died of the same disease.

I saw cancer as this big black thing, a ghostly shadow rubbing people out like an artist’s rubber (I was very keen on drawing back then). As an eight year-old I was, as I wrote in the book I wrote after my own cancer All Right, Mate?, ‘left with the feeling that you had to be terribly unlucky to get cancer but that once you did, death was inevitable’.

Things had already moved on when a quarter of a century or so later I was diagnosed with cancer myself and they continue to change.

Frying tonight

We don’t have a great deal of data on cancer before the 1920s since, before the development of fractionated radiotherapy (radiotherapy in a series of doses), there wasn’t much that could be done about the disease. In the very early years of the twentieth century radiotherapy, if used, was given as a single dose with treatment lasting an hour or so. The side effects were serious. Frying tonight, you might say.

We didn’t even have an effective, reliable national record of cancer registrations until the 1970s. In 1971, the year after the death of Lillian Board, right, there were 143,893 cancer registrations. By 2009, this was up to 264,679 - an increase of 84%. A lot more people are getting the disease. But in a way even this is good news since it reflects earlier diagnosis and, more importantly, the fact that people who live longer have more time to get cancer in the first place.

Cancer survival statistics lag behind incidence ones. But survival rates at five years and ten years are, for most cancers, improving. In prostate cancer, for example, five-year relative survival rates increased between 1986 and 1999 from 42% to 65%, according to Cancer Research UK (CRUK).

For my cancer, Hodgkin’s Disease, around 78% of patients diagnosed in England and Wales in 2007 are now predicted by CRUK to survive their disease for at least ten years or more. This compares to around 49% in the early 1970s.

Can't be smug

But there are still some areas where we don’t seem to be getting any better: brain cancer, bladder cancer, pancreatic cancer. So we can’t be smug or pretend we really understand the disease. We don’t. The treatments I had in the 1990s are no longer used in the same way because of the side-effects that are just beginning to be seen in patients like me. They’re not a lot of fun but they are better than the alternative I think. So, yes, it looks as if cancer will be with me for the rest of my life too.

But, and this is where things have really changed, that’s not the end of the world. Cancer will be with all of us for all our lives.

There was consternation earlier this year when the much quoted figure from Macmillan Cancer Support that one in three of us (33%) will get cancer at some time in our lives was revised upwards to 42%. No surprise really - 42 is, after all, as Douglas Adams, right, taught us in the Hitchhiker’s Guide to the Universe, the answer to the meaning of life, the universe and everything. At this rate, pretty soon, you’ll be lucky if you don’t get it. But, as Adams also taught us, Don't Panic. There is a silver lining.

Cancer is different today - not the disease but what it means. When I was a kid it was relatively rare and a killer, now it’s relatively common and it can often be treated.

Common and treatable

For all of us, this is good news but for men it’s doubly good news. Those two words ‘common’ and ‘treatable’ make all the difference. Since it’s common, you should have no worry about bothering your GP with any symptoms that concern you. Frankly you’d be daft not to given that 42% chance of getting the disease at some point. And, because cancer is treatable, you’re not condemning yourself to a death sentence if it turns out you have got the disease. Rather you're giving yourself every chance of recovering from it.

Forget those stupid articles about people battling against cancer. We’ve all read them and thought that if it happened to us we wouldn’t be that strong and that has made us even more frightened of a cancer diagnosis. But they’re rubbish, these articles. Journalists who should know better. Nobody with cancer thinks they got better because they fought back. They know they got better because they got lucky and that luck usually comes down to one thing: early diagnosis.

If you’re one of those blokes who thinks ‘I’d rather not know’, I understand that. But it’s time to think again. The odds are changing. These days, if you’re worried, it makes more sense than ever to seek advice.

• Decent articles about living with cancer from:
  John (prostate), Martin (testicle), Simon (bowel) and Denis (penis)
• More on Blue September campaign on the MHF website
• More on cancer from malehealth.co.uk