I’m 74, and I have cancer – but I don’t know if I want to be cured

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Cancer is primarily a disease of old age. By the time we are 70 years old our risk of developing it is one thousand times greater than when we were 20. In that regard, there is nothing remarkable about King Charles’s cancer, whatever it might be. Three out of four people in developed societies will develop cancer at some stage in their life.

Inevitably the media and cancer charities portray it all rather differently. Of course, cancer in a child or young person is terrible. When I was diagnosed with it myself at the age of 70, however, I had to remind myself of all the brain cancer patients I had treated – with only limited success – who had been much younger than I now was.

Many of them had been children or young parents with children who were desperate to see them reach adult life. Compared to them I had been lucky and the fact that I now had cancer myself was little different from the simple and undeniable fact of my mortality.

Of course I don’t want to die, and my family want me to live longer, but I have a complete life to look back upon, and it would be selfish and grotesque for me to complain. You must be realistic. (I have used the word “complete” because I made many mistakes in the past, and acquired whatever wisdom I have painfully – painfully both for myself and for others).

The message that comes from the inevitability of our dying is not that we should consider the lilies and the birds as recommended in the Sermon on the Mount, or throw up our hands in horror, but that we should live our lives so that when the end approaches we can look back on a life lived well.

There are no pockets in the shroud – what matters at the end is what we have done for the people we love – indeed, for all living things (mosquitoes and a few other bugs perhaps excepted – although even here, what with the “insect apocalypse” we should pause for thought).

There are many ways of making the world a better place. When the last trump sounds our material possessions will count for little – indeed our obsession with them is undoubtedly making the world a worse place.

Cancer is no single disease. It is myriad diseases, each with a different prognosis, with some curable, some treatable and some with little hope. There are, for instance, many different types of breast cancer. My own prostate cancer is very much an old man’s cancer and it can be very difficult when looking at the professional literature – as I have done, anxiously, desperate to live longer – to know whether men died with it or from it.

It needs to be remembered that it is not necessarily a blessing to escape cancer or be cured of it and live into old age. Old age brings many infirmities and sorrows and, most dreadfully, an increasing risk of dementia. Beyond the age of 90, some 40 per cent of people will develop it. Long life is not necessarily a good thing, and perhaps we should not strive too hard for it.

Just as we need to have lived, when the end comes, a good life so we also need to seek a good death, which is why I, along with many others, am campaigning for a change in the law on Assisted Dying in England.

A good death is not just about reducing our own suffering, but also about leaving those we love without painful memories of a bad and protracted death, which with even the best palliative care cannot always be avoided.

These are not simply philosophical problems. All societies, including some of the poorest such as Nepal where I am working at the moment, are struggling with the financial burden of an ageing population, produced by falling infant mortality and increasing life expectancy.

The current difficulties with the NHS can only properly be understood in this context. Furthermore, it is not just that there are more old people and hence more cancers but also that advances in medical technology mean that more and more people – like myself! – can be treated for cancer, but at ever-increasing cost.

Modern medicine – chemotherapy, gene therapy, minimally invasive surgery, intensive care, focused radiotherapy – does not come cheap. Doctors all over the world are struggling with the problem of deciding when somebody is too old to qualify for cancer treatment. When do we stop? And the more we spend on the elderly, the less there is to spend on improving the quality of the lives of our children who are, after all, our future.

I wish King Charles every success with his treatment, and I hope that he can continue to campaign for the environmental and humanitarian causes for which he has been such an important and dedicated advocate.

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Jose Reber

Jose Reber is a professional writer based in Wisconsin. He guides editorial teams consisting of writers across the US to help them become more skilled and diverse writers. In his free time he enjoys spending time with his wife and children.

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