Not an April Fool - I’m now a pensioner 😬

One certainty about having Stage 4 cancer is that life is way more unpredictable. The rollercoaster analogy of riding the highs and lows doesn’t do the reality justice; at times January and February have felt more like being part of a Demolition Derby, being smashed off-course, each hit seeming like it could be the final one before you are truly stopped in your tracks. Here’s a summary of what’s happened during the first quarter of the year that has resulted in my becoming a pensioner today.

I had a scheduled MRI scan of the Head and Neck, plus a CT scan of the lungs on 19th January. These scans were to determine if my immunotherapy treatment was working or not. A follow-up phone call at the end of the month came with good news and bad news. The good news was that the lung tumours across both lobes showed shrinkage, and that no new lesions were found, providing the first evidence that immunotherapy was doing its job there. So yay.

However, the CT scan also suggested a new bony lesion at the base of my thoracic spine, that looked like it was already starting to impinge the spinal cord. A MRI scan of the spine was now needed to characterise what they found more fully.

As you might imagine this was devastating for David and I, but also perplexing. How could the immunotherapy be suppressing tumour growth in the lungs, but not in the spine? Whatever our questions, the impact was still the same – the spine is the third most likely place where cancer spreads to (after the lungs!) and spinal metastases felt like the very definite beginning of the end, as the spread of my cancer sounded text-book.

Alongside these revelations, since December 2021 I have also been going through the process of sorting out early retirement due to ill health. My plan was to retire at the end of the academic session (September 2022), which would allow me to take a final sabbatical (April-May-June) to write another paper, and then celebrate exactly 30 years of being at UCL. In terms of my pension, early retirement could have been a minefield to navigate, but the Head of Pensions at UCL took my case on and he could not have been more supportive. Lots of forms had to be filled in, including from the oncology team, but he liaised with them, my employers and USS (my pension provider) to minimise the stress to me, and for that I am hugely grateful.

It was through this process that I saw for the first time (in January) my life expectancy written down by the oncologist in black and white: 12 months on average from time of first diagnosis, meaning my life expectancy might not extend beyond the summer. Putting it bluntly, working through to the end of the academic year might have been optimistic. It was then obvious that I had to apply to retire earlier (although I still wanted to see Term 2 out, to give my students the education they deserved after a year of pandemic), hence why I appreciated the help given by Head of Pensions immensely.

As an outpatient, getting a new MRI scan of the spine proved difficult due to Covid backlog and lengthy waiting times, so eventually I was admitted as an in-patient at Barts hospital for the follow-up MRI on 3rd February. Being an in-patient meant that my scan would also be looked more quickly; indeed the next day I got the best news ever, that the lesion in my spine was actually a herniated disc protrusion, and not cancer after all.

The MRI of the herniated disc looks quite dramatic, and you can see where it is impinging on the spinal cord, but I can’t feel anything at all, and apparently this is more normal than not.

Crucially, it is also calcified, which suggests that it's an old ‘injury’ (likely decades). The neurologist told me to carry on as normal, which was a huge relief as I've a couple of major ultramarathons planned in the very near future (but more on that in the next blog post).

But since these revelations, it is absolutely the right time to stop work, as my oncologist's prognosis was irrespective of this spinal diversion. While I’ve enjoyed every last minute of teaching this term, and doing the proof corrections for our latest Baikal paper (now out!), my spare mental capacity is minimal, and I can’t imagine planning my courses for next year, or applying for a research grant to take me through the next 2-3 years. I know that I’m very lucky to able to take early retirement. But it’s still feels poignant; academia has been my life, so it’s sad to have to let it go this way.

But it's not in me to be maudlin for long. The prognosis highlighted above is only an average, which has huge amounts of caveats. And for those who know me, I’ve never been average; often the outlier. And although a lefty, I fully intend to occupy the far right of the curve below from now on.