KATE FIGES has been liv­ing on a knife-edge since be­ing di­ag­nosed with can­cer. But she has in­vested all her en­ergy – as well as an in­her­i­tance from her mother – in treat­ments which she hopes will buy her pre­cious time

The Mail on Sunday - You - - First Person - PHO­TO­GRAPHS VIC­TO­RIA ADAM­SON

Adi­ag­no­sis in Septem­ber 2016 of stage IV triple neg­a­tive breast can­cer – the most ag­gres­sive and dif­fi­cult breast can­cer to treat – changed every­thing. In just a few min­utes I went from be­ing a 59-year- old woman with years ahead of her to sit­ting on death row. Ad­vanced can­cer strips away cer­tainty, the con­fi­dence to plan, hopes of hold­ing your first grand­child or be­ing able to draw that state pen­sion. It means liv­ing per­ma­nently on a knife edge, star­ing into the abyss of dy­ing.

The shock faded slowly into grief, and then the de­ter­mi­na­tion to do every­thing pos­si­ble to beat the can­cer back took over. Along­side the year of oral chemo­ther­apy I’d been pre­scribed by my on­col­o­gist, I re­searched and un­der­took nu­mer­ous ‘anti- can­cer’ ac­tiv­i­ties (listed on page 35). I was in great pain be­cause can­cer had eaten its way into my bones, crack­ing three ribs, and I couldn’t eat much with nau­sea from the drugs. But grad­u­ally I re­gained a sem­blance of my for­mer life and fool­ishly be­lieved for a short time that I might even have beaten the can­cer, un­til a scan in Au­gust 2018 re­vealed nu­mer­ous small tu­mours in my liver. All the shock and height­ened emo­tions of two years pre­vi­ously came tum­bling back. I had done every­thing I could and yet some­how it wasn’t enough.

As a fam­ily, my hus­band Christoph, our two daugh­ters Eleanor and Grace and I have been liv­ing from scan to scan since 2016. Ev­ery three months ‘scanx­i­ety’ hits be­fore we face the on­col­o­gist for the re­sults. I usu­ally feel faint and on the verge of throw­ing up as we’re called into his con­sult­ing room, for the pos­si­bil­ity looms

that any hope for a fu­ture will be snatched away. When it isn’t, we leave with the thrilling prospect of weeks of nor­mal life ahead, where we can sim­ply rel­ish the joy of be­ing to­gether. My chil­dren are in their 20s and pop round reg­u­larly. I cher­ish our in­ti­mate mother- daugh­ter con­ver­sa­tions where I feel I can be use­ful as they talk about their love lives and their ca­reers (the elder is an ac­tor and a writer, the younger works for a think tank that ad­vises char­i­ties).

I put my­self first, do­ing only what I want to do on each pre­cious day – al­ways hard for a mother but sur­pris­ingly easy now. I spend time in na­ture, rel­ish­ing its beauty, healthy fresh air and the mood-boost­ing magic of trees in the lo­cal Vic­to­rian ceme­tery. There’s com­fort to be found in the cycli­cal na­ture of the nat­u­ral world, where every­thing dies and then buds again, and where even the tomb­stones are con­sol­ing, for all of this has hap­pened to oth­ers be­fore. Chats and cud­dles with our minia­ture wire-haired dachshund Zeus help, too. I keep writ­ing and work­ing to feel pur­pose, nor­mal­ity and dis­trac­tion as well as for an in­come to pay for dozens of ex­or­bi­tantly ex­pen­sive sup­ple­ments. I spend rich times with friends, cher­ish­ing the ex­tra­or­di­nary love and sup­port they have of­fered me. And I have had some of the hap­pi­est months of my life with my hus­band Christoph, laugh­ing, be­ing silly, ly­ing in bed each morn­ing play­ing Scrab­ble on our phones and binge-watch­ing boxsets to­gether at night.

Liv­ing on this knife edge re­veals un­equiv­o­cally how it is the sim­ple things in life that re­ally mat­ter and make one feel whole. And there is noth­ing I would not do now to stay alive and en­joy them. My on­col­o­gist has been con­duct­ing tri­als on pa­tients with triple neg­a­tive breast can­cer us­ing a com­bi­na­tion of Abrax­ane (chemo­ther­apy) and a new im­munother­apy drug called Ate­zolizumab (im­munother­apy works by switch­ing the body’s nat­u­ral im­mu­nity back on so that it can recog­nise can­cer cells and kill them, and it is ad­min­is­tered in­tra­venously along with the chemo). He is ex­cited by the re­sults and sees it as a ‘game changer’. So I de­cide to plunge in at the deep end, pay­ing for this new treat­ment with money in­her­ited from my mother be­cause it is new and un­li­censed, not pro­vided by the NHS nor paid for by my in­sur­ance com­pany, who re­gard it as ‘ex­per­i­men­tal’. Plenty of peo­ple spend tens of thou­sands on breast en­hance­ment, I rea­son, so why shouldn’t I try to pro­long my life? I am the first per­son on this drug com­bi­na­tion who’s not on a trial, and the data on the re­sults of the trial have only just been pub­lished. The nurses and doc­tors watch me care­fully, say­ing they have no­body to com­pare me to when it comes to side ef­fects and risks. But, hey, with the threat of death so close it’s a risk I feel is worth tak­ing.

In spite of every­thing I have done to try to beat this back I feel there must be more that I can do. I dis­cover a woman called Jane McLel­land who beat cer­vi­cal and then sec­ondary lung can­cer 20 years ago by cut­ting off the var­i­ous path­ways that can­cer feeds off with a mix­ture of sup­ple­ments such as Ber­ber­ine, which re­duces the glu­cose can­cer tends to feed on, as well as re­pur­posed drugs such as met­formin (com­monly used by di­a­bet­ics for sim­i­lar ef­fects on blood sugar). The ‘meta­bolic the­ory’ of can­cer main­tains that you can make the body’s en­vi­ron­ment hos­tile to can­cer’s spread. Jane’s book How to Starve Can­cer is fas­ci­nat­ing, her in­trepid re­search ex­tra­or­di­nary and her re­silience at a time when there was no in­ter­net or can­cer sup­port groups is awe-in­spir­ing. I wanted to meet her and I was not dis­ap­pointed. I recog­nised some­thing of my­self in her: a ve­he­ment de­ter­mi­na­tion to live. Like a soul sis­ter, she goaded me into greater ac­tion – I needed to re­ally un­der­stand my can­cer to stand a chance of get­ting on top of it. Im­munother­apy still fails more peo­ple than it helps and I couldn’t just put all my trust in that.

With greater knowl­edge comes a sense of con­trol over these de­ci­sions, where the bal­ance of risks and ben­e­fits has to be con­sid­ered so that I can live with my choices. There are so many more un­knowns than knowns when it comes to treat­ments and can­cer pro­gres­sion that the only way I can cope with this Rus­sian roulette is by re­search rather than by putting my trust in just one ex­pert. Can­cer pa­tients eas­ily get trapped be­tween two ri­val dis­ci­plines – many are fright­ened of chemo­ther­apy be­cause the doom-mon­gers in the ‘al­ter­na­tive’ world main­tain it is so toxic to the body’s im­mune sys­tem that it can kill quicker than can­cer, when in fact it of­ten buys peo­ple valu­able time. I’m scared of a sec­ond round of chemo none­the­less, but am re­as­sured a lit­tle by both a nurse and a doc­tor at the hos­pi­tal who tell me there has been some good progress in re­duc­ing the side ef­fects in the past 18 months by coat­ing Abrax­ane in al­bu­men, a pro­tein con­tained in egg white, which helps to re­duce the nau­sea. ‘You should be able to do most of the things you want to do,’ they say. And they are right. I am manag­ing to live a much hap­pier and more nor­mal life with this treat­ment than I was able to un­der the last one.

The way for­ward for can­cer pa­tients has to be


greater un­der­stand­ing of the ben­e­fits of all avail­able re­search. There is am­ple anec­do­tal ev­i­dence that health­ier liv­ing helps peo­ple do bet­ter on the med­i­cal treat­ments and live longer. The trou­ble is there is no re­search, no way of know­ing whether the dozens of ‘nat­u­ral’ sup­ple­ments I take are help­ing or hin­der­ing my treat­ment. It’s like stab­bing in the dark but that’s what liv­ing on this knife edge does – any risk seems worth tak­ing when it could help stave off the in­evitable.

And so I be­gin to track down ex­tra sup­ple­ments and re­pur­posed drugs, such as met­formin, which might be able to starve my can­cer and help the im­munother­apy to work. I find a new philo­soph­i­cal peace, too. I re­alise how lucky I am to have lived this long. I’m 61 not 41. It’s me; not one of my daugh­ters. If this is my time to go then so be it, but some­thing deep in­side tells me it isn’t. I can feel the treat­ment work­ing. There is a new light­ness, an in­ner strength and sense of en­ergy to each day that wasn’t there be­fore. I also recog­nise now that in­stead of fight­ing the side ef­fects of treat­ment I have to ac­cept them and put up with them for as long as pos­si­ble, for they are far bet­ter than the al­ter­na­tive, which is dis­ease pro­gres­sion, pain and death.

Af­ter two cy­cles of treat­ment I have an MRI scan of the liver to see if it is work­ing. I go in hope­ful be­cause I feel so much bet­ter but it’s mixed news. My blood tests show real progress with a nor­mal liver func­tion but there is a slight in­crease in the size of some of the liver tu­mours which could have hap­pened in the stress­ful six weeks be­tween the first MRI and start­ing treat­ment. There is no way of know­ing. So we de­cide to do an­other cy­cle and then scan again. It’s dis­ap­point­ing but I should know by now that the news is al­ways mixed and never com­pletely clear. Two days later, a friend di­ag­nosed with breast can­cer at the same time as me dies – and I am dev­as­tated for her and for me. The next scan re­veals bet­ter news – no new growth, which in on­co­log­i­cal terms means that the treat­ment is work­ing. No change in can­cer is al­ways good news and I spring out of the on­col­o­gist’s of­fice with fresh hope and look­ing for­ward to Christ­mas.

With ad­vanced can­cer there are these deep lows and ex­u­ber­ant highs. There is no mun­dane mid­dle any more. Real hap­pi­ness al­ways has a painful poignancy though. A week at my favourite sea­side house in Corn­wall, one I used to visit as a child with my own par­ents, is bit­ter­sweet. Will I ever share this spe­cial place with my fam­ily and friends again? I am ir­ri­tated by friends who ar­gue or worry about mi­nor things, and it’s dif­fi­cult not to feel jeal­ous lis­ten­ing to ex­cited talk of fu­ture travel plans, plans I can­not make. And the griefs in the depths of a sleep­less night cut even deeper. I let my­self sob, sens­ing per­haps that hope and time re­ally could be run­ning out, be­fore spoon­ing into Christoph for a hug and calm­ing my­self with deep breath­ing be­cause, of course, I know that fear of death is as fu­tile as wor­ry­ing whether the sun will rise in the dawn; I just don’t want it to hap­pen yet. So I wipe my eyes, swal­low an­other sup­ple­ment, plough on with my daily anti- can­cer rou­tine and make plans for the near fu­ture to look for­ward to – a birth­day lunch for our younger daugh­ter, see­ing the elder one sing in Don Quixote with the Royal Shake­speare Com­pany. For in the end what choice do I have other than to keep on liv­ing, one day at a time?

I know it’s un­fash­ion­able to talk of ‘bat­tling’ can­cer. The last thing any­one should feel is a fail­ure when they lose their life to this dread­ful dis­ease. But when you spend each day work­ing as hard as I do, it does feel like a bat­tle. If I com­mit 100 per cent to try­ing every­thing, then maybe I stand a chance. And if I fail, no­body can say I didn’t try. There is only one cer­tainty; that I will be liv­ing on this knife edge for ever. I’m fight­ing a very pow­er­ful beast and can­cer will al­ways stalk me. The only way of beat­ing it will be if some­thing else gets me first. Now that would be a tri­umph af­ter every­thing it has put me through in the past two years.

On Smaller Dogs and Larger Life Ques­tions by Kate Figes is pub­lished by Vi­rago, price £14.99*

Kate rel­ishes the joy of nor­mal days with hus­band Christoph

Kate, Christoph, their daugh­ters Eleanor and Grace with dachshund Rolo in 2002

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