‘After the first round of chemo, I was chipper … then I hated it with a vengeance’

In the 1961 film The Day The Earth Caught Fire, the world’s climate is thrown into apocalyptic disarray when the US and Russia carry out simultaneous nuclear bomb tests, knocking the Earth out of its orbit and leading to an existential crisis for the whole planet.

Fiction and drama requires reasons for things happening, and the novelist in me looks for the same concordance in real life, especially with my cancer of the oesophagus, with which I was diagnosed in October.

Why, I asked of different people, did the 6cm tumour lodged in my gullet form? What caused it? Where did it come from? I needed a back-story. I needed some kind of character arc for my cancer. To understand that, I felt, would make it easier to go on the journey to shrink it through chemotherapy and remove it through surgery.

Life, of course, isn’t as tidy as fiction. Tumours can develop for a variety of external reasons… drinking, diet, smoking. Or they can just happen. Cells mutate, become cancerous, and swim around the body until they alight in tissue – such as my oesophagus – where conditions are ripe for growth.

It’s an unsatisfying, if thankfully non-judgmental, answer, and something I – a horror writer who likes even the worst monster to have justification – have learned to accept. Cancer has just happened, and now to deal with it.

Today, I turn 56 years old. Since writing about my diagnosis in The Observer, I have had it said to me more than once that your 50s is akin to navigating Sniper’s Alley.

When that piece came out, I had a multitude of messages of support, but something else as well. A guy I trained in journalism with at what was then Preston Polytechnic in 1988 emailed to say he had been diagnosed with cancer at the same time. A woman I worked with a decade ago had, just a few days after me, been told she had breast cancer. People I didn’t even know had been through cancer shared their stories.

Suddenly it felt like something I was tackling alone, albeit with the unwavering support of family and friends, wasn’t that unusual after all.

When I last wrote about my cancer, I had been through the whole diagnosis and had just started chemotherapy. The treatment plan was for eight weeks of chemo, followed by major surgery in February, in which the majority of my oesophagus and some of my stomach will be removed. There’s a sense that during the diagnosis phase you are the star of the show. The various teams at Airedale hospital in West Yorkshire rolled out the oncological red carpet for me.

Following diagnosis in the middle of October there were scans, tests, meetings, phone calls… And then treatment began, in my case FLOT chemotherapy. It perhaps sounds like some eastern European children’s cartoon popular in the 1970s, but in fact takes its name from the four doses of drugs administered at each session: Fluorouracil, Leucovorin, Oxaliplatin and Docetaxel. They were dripped into my body over several hours, with the final one coming home with me in a pump I had to wear in a bum bag for 24 hours.

Sitting in Airedale hospital’s chemo lounge, attached to the drips, any sense of feeling “special” evaporated. Men and women from all walks of life were there, quietly getting on with their cancer treatments. Cancer is certainly an equal opportunities illness. Most were my age or older. As a friend opined: “Your 50s, man. Something’s out to get all of us.”

I went into chemotherapy with a jolly, stiff upper lip pragmatism. Up until 17 November I was dying of cancer, in the sense that if I did nothing, the tumour would expand and probably spread and absolutely kill me. The minute the first bag of drugs started dripping into my body, the fightback had begun.

In The Day The Earth Caught Fire, the answer to the extreme weather brought on by the nuclear tests is to repeat that which caused the problem: setting off more nuclear bombs to stabilise the planet’s orbit.

Chemotherapy also feels like the nuclear option. The drugs are designed to target the tumour, but they target everything else in your body as well.

After the first round of chemo, I was inordinately chipper. At a meeting with my oncologist I declared I was fighting fit with no side-effects. Was this stuff even strong enough? He didn’t laugh, just added mildly that the effects were cumulative.

After the second round two weeks later I understood what he meant. I felt like I had been hit by a truck. I had to take to my bed in the afternoons (while trying to write and work my hair started to come out in clumps, though to date I haven’t gone completely bald).

By the third round, I hated chemo with a vengeance. I was feeling dreadful, and the cold weather brought on intense neuropathy – extreme pins and needles in hands, feet and throat. There’s chemo brain fog to contend with, and I would sit at my desk, rubbing my numb hands, staring at the blank document on my laptop, wondering if I would ever be able to string a sentence together again.

The final round of chemo came on New Year’s Eve. I’m just coming out of the two-week period, my body cautiously sticking its head above the parapet, wondering why another four bags of poison aren’t being pumped into it. For the first time in two months, feeling well seems a distinct possibility.

Of course, chemotherapy is just a prelude to the main event – surgery in February – and that isn’t yet a given. As I write this, I am about to leave for a scan that will look at how effective, if at all, the chemo has been.

The best-case scenario is that the drugs have shrunk the tumour in my gullet. There’s a possibility that things are exactly as they were before I started chemotherapy, and there’s always a chance that the chemo has been utterly ineffective and the tumour has grown – perhaps even that the cancer has spread.

If the latter is the case, then surgery won’t be an option. A multi-disciplinary team will meet at Airedale hospital this coming week to look at the scan results and make a final decision regarding surgery.

At the end of The Day The Earth Caught Fire, Edward Judd’s hard-bitten news reporter Peter Stenning, through whose eyes we have watched the apocalypse develop, walks out of the offices of the Daily Express on the day that the nuclear bombs have been set off to right the wrongs man had previously committed.

Nobody knows whether it’s going to work, much like my chemo. Stenning walks into a preternaturally deserted London, leaving behind his colleagues who – professional to what might well be the end – have prepared two front pages of the newspaper.

On one, the headline is “World Saved”. The other, of course, “World Doomed”. We never know which paper people will be reading the next morning. I feel a little like Stenning as I await the results of the scan, and whether the nuclear bombs that have been ravaging my body over the past eight weeks have done their job.

Photograph by Gary Calton for The Observer