No 132 - The Bengal Lancer - Keith's Story

By Dominic Horton

I work for a mental health charity, Rethink Mental Illness. Due to the work of Rethink, and other like organisations, the stigma and misconceptions about mental illness have reduced in recent times. Although there is still a lot of work to do, people are better educated about mental illness and more accepting of those who have mental health issues. The subject of mental illness is becoming less scary. And people will more readily talk about it.

It is often said that people can be less willing to talk about or engage with information about mental illness than that of physical illnesses. But there is still one physical illness that can be a taboo subject, that strikes fear into the minds of people. To such a degree that they shy away from learning about it or talking about it to others, even those that have experienced the condition.

This is the case even though nearly all of us will either get this condition or know someone who has experienced it. Just the mere mention of the name of the condition in question can lead people to turn over the TV or radio station or skip past a newspaper article. I didn’t even want to use the word in the title of this piece for fear it might turn people away. The word is one which even has negative connotations in our language beyond its original meaning. The word is short but powerful, to some even shocking. The word is cancer.

I hope you continue reading.

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Keith Tandy is a friend of mine and he’s a youthful 70 years of age. He has a certain sense of style and always dresses younger than his years, but in a dignified, tasteful way. Keith can be quick with a witty, cutting quip when you meet him in our local pub. But he's a warm, kind and friendly individual. He exudes, more than anything, love.

Keith with his sister Ann and his son Luke

Keith recently ended intensive treatment for cancer. I spoke to him as I wanted to learn more about his experiences of the illness. Like many people with health issues Keith's experience was not straightforward. He was first diagnosed with skin cancer that affected his head. But soon after he was separately diagnosed with mantel cell non-Hodgkin lymphoma. There was no evidence of any link between the two conditions.

Keith accidentally banged his head which lead to a blister that wouldn't heal. He was told after tests that it was skin cancer. But this didn't come as too much of a surprise to Keith as he used to be a lorry driver. This meant that the right side of his head particularly was often exposed to sunlight. Although the diagnosis of skin cancer wasn't a massive shock to Keith, the way the news was delivered could have been better. The specialist said to a nurse, without addressing Keith, “It's cancer.” The words were audible to Keith though. He had a similar experience when he was later diagnosed with mantel cell non-Hodgkin lymphoma.

Keith's skin cancer was successfully treated. But soon after he developed severe diarrhea resulting in a loss of weight of two stones in only two weeks. Originally it was thought Keith had contracted norovirus. But the GP found lumps in Keith's glands and so referred him to a specialist for tests. The weight loss meant the lumps were clearly evident.

After a blood test proved inconclusive a biopsy was done and then came one of the most difficult times – waiting for the results. But Keith said it was worse for his family than for him. Especially as the severe diarrhea that Keith experienced had by then subsided and his weight began to stabilise.

Keith was eventually called to see a specialist consultant who he saw with his son Luke and his daughter Bekki. To begin with a more junior doctor told Keith that he had 'mantel cell'. She didn't use the word cancer or explain more about what mantel cell meant but said she'd get the consultant. With Keith and his family not knowing what mantel cell is, Bekki naturally researched it on her mobile phone while waiting. Which is not an ideal way to learn about a serious health condition.

Keith in hospital with his daughter Bekki

But the consultant made it clear to Keith what condition he had and the way forward: “You have mantel cell non-Hodgkin lymphoma. You have a serious illness, it's cancer. It is not curable but it is treatable. Do you understand what I am saying?” The consultant explained that to begin with Keith would receive six treatments of strong chemotherapy in twenty one days. He also explained that it was a close decision whether to treat Keith at all as he has angina and was 69 years old at the time – the cut of age for the treatment is 70. But Keith was considered fit enough to undergo the treatment.

But Keith immediately saw the positive in the consultant's words. He explained: “The words that registered with me when the doctor was telling me was 'it is treatable'. There are two 'T's' with cancer diagnoses - terminal and treatable.”

Keith's family were obviously upset by the news but they were very supportive. But even at this early stage Keith had a plan with how to deal with the situation: “I told my children and my family that for the rest of the year I would be concentrating on my treatment and getting better. I said that if they had problems or issues they would need to sort them out among themselves. I had a goal too – to see my grandchildren grow up.” This strategy of looking forward, being organised and setting goals ultimately played a big part in Keith's recovery.

Keith explained that he had to think carefully about what to say when it came to telling the news of his diagnosis to his sister Ann: “Ann is 10 years older than me. She's from a generation where they still whisper the word cancer. My parents and older brother were the same.” Keith was concerned that Ann would immediately think the worst about his outcome. And he was worried about the effect that would have on her.

Ann was so terrified of what cancer meant to her that she wouldn't visit Keith in hospital. But she did care about his welfare and called him every day. But Keith explained, “She was convinced I was not telling her everything – she still is now.” Keith thinks this is because Ann and people from her generation automatically equate cancer with death: “That's how it used to be.”

After being diagnosed Keith went through seven months of treatment. This started with the six strong chemotherapy sessions under the care of his consultant, nurses and other staff who were “absolutely fantastic.”

Feeling in control of what was going on was important to Keith in his recovery. He wrote everything down, the medication he’d taken, the food and fluid he’d had. This not only made the nurses' job easier, for which they were grateful, but also meant Keith was playing an active part in his recovery. He planned his own medication intake – instead of taking all 14 tablets in the morning he spaced them out throughout the day, keeping a careful record.

Keith valued making his own decisions and choices about his treatment. He was encouraged to inject himself at times and to take eye drops, as the treatment generally dries people’s eyes up. But Keith decided against both of these things: “I usually have watery eyes anyway and the eye drops made it worse.”

Having a set routine also helped Keith to feel in control of his days when in hospital. He was up at 6am and showered by 6.30. And then he dressed properly, opting to stay out of his pajamas and dressing gown. Keith would go downstairs to get a newspaper and to walk around as much as he could. This all gave Keith a greater sense of normality.

Keith back in the day, pint in hand

But Keith's routine was disrupted when his treatment meant at times that he had to be in isolation, because his immune system was down. This meant that he had to use other ways of coping. Keith has a lifelong passion for music and he used to work in the industry as a roadie in the late 1960's, the 70's and the 80's.  And listening to to his favourite music was his therapy while he was in isolation.

Another technique also helped. One day a nurse said to Keith he looked miles away. He replied, “I am. I am parked up in a lay-by in Scotland in my lorry. I'm looking right down the Glen – it's beautiful.” So Keith had the ability to dissociate himself from his immediate surroundings and transport himself to somewhere more appealing.

Keith told me he was fortunate as he never lost his appetite, which was a great help. He was talking about food of course. But actually I could see that he never lost his appetite for life. That seemed to be his chief driver and motivation, the thing that meant that he kept his humour and positivity in a difficult situation. Everything constructive and helpful that he did seemed to flow from this.

Keith's positivity, energy and humour was not only of use to himself as it always improved the moral of the wards he was on. One doctor told Keith, “If we could find out how you keep your positive attitude we could bottle it.” Keith told me about advising and cheering up one particular patient. The patient's daughter told Keith, “If I had a million pounds I'd give it to you Keith because of the way you have helped Dad. You have perked him up a hell of a lot.”

As Keith explained to another patient, “Nobody likes being diagnosed with cancer. But it's not all doom and gloom.” In fact Keith found some useful aspects of his situation. It gave him a greater appreciation of the simple things in life. Like going to the toilet without having to drag a drip stand behind him. Or at the end of isolation being able to go outside the hospital to a stall to buy some fruit and breathe in the fresh air.

Keith is now thankfully in remission and getting on with living his life. He still has regular treatment though, which was part of his treatment plan.

Not all cancers are treatable of course. But according to Cancer Research UK survival rates in the UK have doubled in the last 40 years. And the understanding and treatment of cancer is improving all the time.

I asked Keith what his advice would be to anyone who finds themselves in similar circumstances: “Set yourself a goal, get your family involved and communicate with the doctors and the people treating you. And remember there is light at the end of the tunnel.”

© Dominic Horton, 2018.

* Lowlife is dedicated to the memory of the late Jonathan Rendall