I will be back at work tomorrow, and like everyone else, when asked how my holiday was, I will say it was lovely and quickly move the conversation on. I don’t have the time or words to explain that although it was indeed lovely, I wept my way through Christmas and held my breath through the first week of the year.
After an initial cancellation due to infection, my partner was finally admitted for a planned open lung biopsy shortly after New Year. As most of the world recovered from the seasonal pleasures of food, drink and late nights, a surgeon and his team cut out a wedge from my partner’s diseased lung. He then spent the rest of the week being cared for by an amazing team of clinicians as they made sure his lung didn’t collapse (it didn’t) or develop an infection (he did). Because of this, he stayed much longer than we’d hoped in a hospital far from home. But despite the obvious winter pressures, he received excellent care from the skilled, patient and kind people that make up the NHS and was finally discharged last night.
My partner is now on a lot of pain killers, because as the surgeon explained, the lung is not like an arm or leg that you can rest. We all need to breathe – up to twenty-two thousand times a day – so his wounded organ is constantly moving. He is tired, sore and won’t be able to lift a kettle let alone drive for several weeks, and yet, we are happy.
Because once again, we have hope.
The lung biopsy was not a diagnostic or curative procedure. We know that he has inoperable lung cancer and that although two lines of chemotherapy have temporarily (and amazingly) pushed it back, the list of options gets smaller each time the cancer grows. We are hoping that his wedge of lung tissue will provide enough information to participate in the National Lung Matrix Trial, which is looking at new drugs depending upon the changes to genes in cancer cells. The aim is to match treatments to particular genetic changes, a much more personalised and targeted approach known as stratified medicine, rather than the rather blunt hit-and-miss approach of chemotherapy.
All the risks were explained to my partner, but he readily agreed to the open lung biopsy, because for us it is an act of hope. And I am not going to lie: there is a perverse kind of comfort in having a wound to look after, medicines to administer, a regime to follow – something to do. The alternative is to passively wait and worry about the cancer growing back, hyper-alert to the coughs that echo throughout the house, wondering whether an increase in breathlessness is due to the cancer or a common cold.
Of course, the cruel thing about hope is that it can so easily be dashed. There is no guarantee that the biopsy will yield sufficient amounts of tissue (two needle biopsies have so far failed) and he may not have the ‘right’ genetic changes that will make him eligible for some of the new drugs on trial. But by participating in research, we know that even if he cannot personally benefit from the genetic knowledge his tissue provides, someone, somewhere might.
Our lungs are an amazing feat of biological engineering, drawing oxygen into our bodies and dispersing carbon dioxide into the world. With over six hundred million alveoli, if they were stretched out flat they would be the size of a tennis court. The biology text books will tell you that it is your diaphragm and rib cage that makes you breathe in and out.
But I am learning that those twenty-two thousand breaths a day are much easier to take if you have hope.