Survival of the fittest?

I've just got back from my so called 'morning miles'. I headed out around seven thirty, when it was still dark, cold and damp. And then something happened which made me question whether there's actually any point in trying to keep fit at all.

I started a couple of years ago, running just one mile through the village. Then one of the fittest people I know, (morning Jo...) started coaching me on the 'couch to 5K' programme. All good.

A health blip meant I had to stop for a while, for some treatment. Then I got back out there. These days, I feel great and have more time, so I try a mix of running and walking four or five miles, as often as I can.

Today I ignored the gloom and was soon strolling, then speeding along to a ridiculous mix of Springsteen, the Stones, and some vintage soul. In fact, I felt so good, I even slowed down to let Kenny Rogers croon 'Lady' to me, just by the Shelton water tower.

I was about a mile and a half from home when I saw a bloke I know vaguely. Our kids went to school together. He was walking his dog, so I pulled the headphones off, grinned and asked if he'd 'survived Christmas' ok.

Bad choice of words. He had. But one of his children, it turned out, has been fighting cancer. The 'child' is now mid twenties, a lifelong runner, one of the kids that would bring everyone at sports day to their feet as they pounded round the track to another first place ticket, way ahead of the field. Young. Strong. Fast. Lean. And fit? The treatment's gone well, apparently, and they're hoping a scan soon will confirm things are improving.

But as the runner's dad walked away with his dog, I just wondered: 'what's the point?' If someone so much younger, leaner, fitter than most of us can get a knock on the door from the Big C, why bother? Same goes for any number of people you and I know. Too young. Too careful with their diets, too conscientious with their lifestyles to fall foul of nasty diseases, surely.

And then they do.

I contemplated abandoning my run, strolling over to the bus stop and scraping the small change from my running belt into something like my fare home.

I glimpsed back and saw the runner's dad turn into his lane, shoulders down. I slammed my music back on loud, and ran the hardest and fastest I'd ever done, all the way home.

And so I'm here. Shaking a bit. Freezing now, and wrapped in a huge jumper and so dizzy I'm seeing stars.

I'm wondering what the answer is. For me, I think it's this. You can only do your best, and look after yourself as well as you can, and take responsibility for your own health. Even then, some people will smoke forty a day from the age of thirteen and die peacefully in their sleep at 103, with nary a cough. Good luck to them. Nobody 'deserves' cancer. It's a vile disease. Others will eat pies all day and carry the additional avoirdupois with them into their dotage, without a twinge or a palpitation. Hooray for them, too.

Meanwhile, some will live a textbook 'healthy' lifestyle, and get the worst news they could hear; early doors. Life ain't fair. It turns horrible right-angles sometimes. So do what makes you happy. And live for today.

What do you reckon?

The sun's shining now, by the way. Have a good day.

Comments:

This one from a friend of mine who's being treated for breast cancer:  1One of the people I see in the waiting room when I go for radiotherapy is a little lad of no more than about 5, with no hair. Chirpy little fella. Always on his iPad, playing games. Cancer's just so bloody indiscriminate1.

Netherton Foundry has left a new comment on your post "Survival of the fittest?":
That's a tough one - I think we each have to do what feels right for us, whilst taking responsibilty for our lives and our wellbeing. Cancer is non discriminatory, but we can't use that as an excuse not to take care of ourselves

Shrewsbury Morris ‏@shrewsmorris37m

@janemcintyre12 @IronbridgeAAC nice one Jane :)

Dear David: A tale of two parents.

Dear David Cameron and all at the G8 dementia summit. Got five minutes to hear about my mum and dad?

First: Jeannie.

She was 48 when she developed breast cancer. It was found just weeks before she was due to get married (to a man whose wife, sadly, had died of breast cancer). They went ahead with the wedding. A Londoner, Jeannie had worked in the city since her teens. She met Bertie at one of the big banks. She travelled to some fantastic places on business with him - on Concorde once. And when she needed it, the care Jeannie received at London teaching hospitals was among the best available anywhere in the world.

Although Jeannie had some good, 'clear' years, the cancer was to return in a very aggressive form, and she died seven years after diagnosis. She never knew her grandchildren: all of them lovely and sources of great pride.

The disease had claimed the life of one of her five sisters, and was to prove fatal, later, for another. A third sister has beaten breast cancer twice, and has survived into her eighties. So, it's 'in the family' and has knocked at my door too. Because of that, I have regular screening, was accepted on to a pioneering MRI research programme and another looking into DCIS. I feel 'watched over'. In a good way.

Now: John.

Down the mines near Musselburgh at 14, he 'escaped' to London to join the Met police. He was on the beat in London, then selected for royalty protection duties, often solely responsible for the security of key royals. He stayed in palaces around the world, worked the longest days, was an excellent marksman, fit and strong; protecting people. And looking after his family.

He's been battling Alzheimer's for over five years, and so now, we're doing our best to look after him. These days, he's bedridden, but at home. He needs help with every aspect of daily living. His face lights up when he sees me, but sometimes he forgets my name. He got to know the grandchildren well, but now struggles to remember their names or what they're up to.

I never expected to be standing over my big, brave dad with a toddler cup and a feeding spoon, but that's the way it is. His partner and carer, Phyllis, does an amazing job, backed up by visits from a local carer, paid for by Dad. She needs a break. Lots of breaks. Local carers' groups are helping, but it all takes planning, and Dad's not always receptive to newcomers who might 'sit' with him. He's had some bad days lately. Sleepy weeks. Not sure what the future holds, really. It scares me.


I was shocked, Mr Cameron, to see a report by Fergus Walsh on BBC news last night. It contained a statistic from the Alzheimer's Society, on how research into cancer receives eight times as much funding as research into dementia. Eight times! Is one condition more 'cruel' than the other? More deserving of investment into its prevention? I don't think so. From where I'm sitting, they both hurt like hell.

I know you've said you're working to address this, planning to double the amount of funding over the next decade or so, to £132 million, and increasing support for carers, like Phyllis.

But I'd like to hear that you're not 'just' doubling dementia funding... but quadrupling it, and then some. It seems that because dementia was for so long considered to be a sad and inevitable fact of life for some elderly people, it's slipped down the priorities list, and it shouldn't have done. You have the predictions and the projections at your fingertips now.

Cancer and dementia are equally cruel conditions in their way; for patients, and for families like mine. Both are dreaded and feared. I hope you use this G8 summit to make dementia research and care as much of a priority as that surrounding cancer, and as an opportunity to think about devoting more funds to those with other life threatening and life limiting conditions. Please keep support for carers uppermost in your mind. With the dementia timebomb ticking, you're going to need them more than ever. And they will be looking to you, to get the funding, the support, and the respite they desperately need.

Breast cancer risk? You tell me....

My mum , Jeannie Morris

So-another week ; another debate about breast screening, and whether it causes more harm than good.

An independent review into the value of mammograms  reportedly showed that for every life saved, three women had treatment for a cancer which would never have been fatal.

That treatment might be radiotherapy, chemotherapy or surgery; all with their own side effects.

More information for women will now be made available apparently; to help them make an informed choice. The national cancer director, Professor Sir Mike Richards is quoted as saying this issue has become an area of `high controversy`.

You bet your life it has, Professor.

But should I bet mine...by attempting to make my own decision about the course of treatment I should have, if a little undiscovered planet is spotted in that galaxy of stars on the radiologist`s screen?

The answer is--I don`t know. It`s like the heating engineer telling me my boiler might last another year; might not. But with a £500 overhaul.....I`ll definitely stay cosy. Or a car mechanic offering me a temporary fix,or a brand new engine to be on the safe side. Who knows?

But as far as breast cancer goes; I know too much. Mum was one of six sisters. Four of them developed breast cancer; three, including mum, died from it. Each was given the facts, and made decisions about their treatment as best they could.

The two eldest had the recommended mastectomies. One died, one went on to have a second mastectomy and has survived into her eighties.

The youngest of the six sisters watched it move through the family, and opted for a double mastectomy and reconstruction; a course of action a cousin of mine has chosen as well.

Mum wasn`t on a screening programme--she spotted her own cancerous lump at the age of 48--weeks before she was due to marry a man whose first wife had died...from breast cancer. She had her own decisions to make about her treatment, and even whether she should go ahead with the wedding. She opted for minor surgery and radiotherapy; and the wedding. Not the mastectomy that doctors suggested would have been a safer course of action.Was she right?

You can only give patients advice and ultimately leave the decision to them. I don`t doubt that what her husband-to-be had gone through, swayed her decision. But did it kill her? Should she have gone for more radical surgery to try and eliminate the risk? They had seven years together before the cancer really took an aggressive turn, went on the march, and despite every possible form of treatment available, included the mastectomy she`d tried to avoid, mum died .

My family history means I was lucky enough to be offered a place, some years ago on a clinical trial which compares mammography with MRI scanning. And then to be offered annual screening.

And then suddenly, we were talking about my generation. Last year`s scan spotted a little blip on the radar; a condition called Ductal Carcinoma in Situ. I tried to focus on the `stuck in a duct` bit, rather than that `carcinoma` word, which no one wants to hear. I had surgery to remove the affected area and some tissue around it. Then there were three weeks of intensive radiotherapy; which for the most part involved me sprinting in and out of the treatment centre in running gear and trainers. My brain told me I was *fit*; so I shouldn`t be there. The staff were brilliant. I was, compared to many waiting for treatment, completely blessed, but I hated every second and couldn`t bear to meet anyone`s eye, wearing shades most days in the waiting room, and flinching when someone called out my name. I kept the treatment a secret from all but my closest friends and colleagues. That meant carrying on working full time as a breakfast show producer, getting up at 3.30 am.

After it was over, with just a three inch scar and some tiredness, all I could feel was immense relief and good fortune: it was a high grade `blip` caught before it had invaded the surrounding tissues--at which point, apparently, I would have been advised to have a mastectomy. Would I have gone ahead with the surgery? I truly don`t know.

I know plenty of women whose cancers were found early, and who are quite sure they owe their lives to screening, and in some cases to the treatment that followed. Cancer charities seem to be recommending that you go ahead with screening if you`re called for a mammogram under the national programme.

And then, increasingly, you`ll have to make your own decision about anything they find. If you`re waiting for an incisive,well considered conclusion to all this--I don`t have one.

If the oncologist I`m booked to see in a couple of weeks,or any other doctor in the future finds something wrong with me, I want to be treated like the intelligent human being I am, to weigh up the options and statistics, and help shape the events that follow.

But --and excuse me for sounding weak here--a part of me still wants to say hey..do you know what? You`re the one in the white coat. I`m crap at stats. I truly have no idea. Please decide for me.

bbc.co.uk/health

cancerresearchuk.org

breakthrough.org.uk