Peter's cancer

When I first found out about my own cancer, I had just started on the wards as a medical student.
Secure as a Christian from a Christian home I had friends and a good career path ahead of me. My story is not a blueprint to follow but an example to ponder.

Another jungle

My first three years were spent in Africa where my father was a missionary doctor. Then we moved back to England to take over the family General Practice in Bristol. From eight to 18 years I was at boarding school, feeling insecure, unaccepted and different from my peers with a combination of a stammer, which I still have, and my Christian faith. My father died of cancer when I was 11. My child's mind was confident that Dad was safe in heaven, but also it closed out some of the pain and grief. Dad's suffering and death are recorded in his own book Dying - the greatest adventure of my life (CEMF).
But despite all these trials I was kept close to God, by friends, teachers and others God provided to care for our family.

Bart's and a bloody nose

I left school for St. Bartholomew's Hospital where both my father and grandfather trained. A great crowd of friends and a flourishing Christian Union accepted me and coaxed me through the first two years of exams - just!
New Year 1990 found me staying with my mum and stepfather Jim (a vicar) in Birmingham with my girlfriend. Everything in my life was going well. I had even been asked to be CU President.
But I was puzzled by a slight but persistent nose bleed which lasted all day.
On that damp Friday evening I went to see the local GP wondering if I would be OK to start my next placement. He referred me straight to hospital. He had seen a growth at the back of my throat and nose! But God's provision still amazes me. The GP had just finished six months' ENT at the hospital. He rang through to the doctor on duty who happened to be sitting next to the consultant, who immediately arranged for me to come in - for a very boring weekend! Biopsies, X-rays and scans quickly followed, but God protected me from realising it was cancer.

Chondrosarcoma

On the day of the diagnosis everyone seemed to vanish, until I collared a senior nurse who reluctantly discussed with me everything apart from the diagnosis. This was the only time being 'medical' caused me a problem.
The cancer was an aggressive Chondrosarcoma in my right cheekbone and the operation would involve losing half my upper teeth and possibly my eye as there would be no bone left to support it.
The Lord provided here too, as possibly the best technician for face reconstruction prosthetics worked locally and came to see me before the operation, alleviating many of my fears about the destructive surgery.
After the operation I was aware of the padding over my face and was too proud to ask if my eye had gone. I resorted to some tactical questions. It had indeed gone. This cost me three months of my course and my girlfriend. The college later pushed me back another nine months and I lost my direction and purpose.

Learning to cope

A year later my first prosthetic eye, cheek and teeth were fitted, which although would never be the same as the originals, certainly fooled a lot of people - especially in photos! As for coping with disfigurement, to a large extent I have accepted it as something that had to happen. Harder to accept have been the ongoing nerve pains and recurrent infections in my prosthetic implants. Chronic pain can get anyone down, and sometimes I get resentful and angry.
Life moved on. I was elected CU President. I found a new girlfriend.

Back to Birmingham

But my regular outpatients appointments proved too stressful and I eventually stopped them. Then one day in January 1992 I noticed something unusual about the light reflecting off my forehead and also felt lumps in my neck. After cancer you become hypersensitive to the least symptom, so back I went to Birmingham.
The forehead biopsy showed the old malignant tumour was invading my brain lining so I was sent back to a specialist at the RNTNE in Grays Inn Road, London. Thankfully the neck lumps were mere cysts !

Another operation

Another huge operation exploring the old site, an ear to ear incision over my head to remove the new cancer, a bone graft and a 'S' cut across my left neck took five hours. The five days of bed-rest which followed were hard, but nothing compared to the six-week course of daily radiotherapy to my forehead. My skin burnt, my fringe fell out and I felt terrible. I passed the time on the table working out the percentage of the radiotherapy completed to five decimal places and questioning every decision - such was my need to feel in control.
Meantime, I had become engaged before the operation, and my fiancee's love, faith and optimism buoyed me up. But the fear of disappointing her was a great strain. As with the first operation, letters and prayers came pouring in, some from people I had never heard of - it was very humbling. I felt very dependent on God. March saw me at a Christian Conference for the Caring Professions, but the pain and cocktail of drugs meant that I was never quite awake and never fully asleep.

Breaking down

The speaker there mentioned the wonderful absurdity of God's knowing the number of the very hairs on our heads. Everyone laughed. I broke down. My fiancee could not accept my further mutilation and that my fringe would never return. I could not cope with the conflict. Reluctantly I shared with the conference through my stammer, the complete security I felt only in God.
My assurance and confidence after this was, I believe, God's gift to me to help me face my third cancer. My radiotherapy was almost finished when I noticed a lump at the back of my orbital socket which frequently bled. Too afraid to tell my fiancee my suspicions (just before her medicine exams) I arranged yet more scans. They showed a new tumour the size of a golf ball invading my brain. It also had destroyed a face nerve which explained at least part of my pain. My consultant gently told me that this time only palliative care was appropriate. God blessed me with doctors who were hopeful and realistic. I bought some flowers and went to tell my fiancee. Then off to Torbay with a friend to pray.

A friend pushing doors

Meanwhile a Bart's consultant, under whom I had studied and had always taken a special interest in me, pushed lots of doors to find a surgeon who might be able to help me. He air-celled him as he landed at Heathrow for the weekend. I saw him the next morning and he agreed to operate when he returned from the States a week later. Again he was a surgeon who had suffered himself and would only operate to leave me with a life.
July 12 1992 saw all my scars re-opened and prepared for three weeks of unconscious existence. Miraculously the cancer was not as extensive as the scan had showed and I had a great time being a nuisance on ITU for 24 hours. I was discharged inside three days post-op ! My fiancee and friends had just passed their finals and we went off on a Lake District holiday. But I dreaded the radiotherapy to follow. It covered a wider field including my brain and my mouth. I was left depressed, sore, a broken burning mouth with thrush and only half a beard !

Failing

My engagement fell apart with the wedding imminent. I started my finals 10 weeks after the radiotherapy. I failed. I was disillusioned, depressed and lacked all motivation. But despite all this 1992 turned into a good year.
My faith was strengthened. I devoured my Bible and prayed for everything. I told my Professors about Jesus and saw God challenge others through his show of power in me. God broke some of my self-pity with Joel 2.15 'I will restore the years the locusts have eaten'. All life's scars - my stammer, father's death, cancers, disfigurement, failure and need to feel in control seemed somehow healed in him.
And though I drifted God kept me.

Reality

It took me until Christmas 94 to qualify which exposed me to the reality of being well - I had to get a job ! I did not feel confident, but despite my stammer the Lord provided me with a job at very short notice. 1995 was a busy year. Caroline and I started going out just before my house jobs started. Neither of us believed we could possibly be good enough for each other, yet finding our strength in God together helped enormously. We were married in the September.
I have had difficulty accepting that I am now well. Looking back my RNTNE consultant had told me that my scars were completely clear (with a few holes!) and he called it a miracle. It was not until the Easter conference this year of Christians in Caring Professions that I began to feel more assured about this.

Having cancer

Having cancer is about living with the grief that we usually experience after loss. It comprises all the anger, sense of theft, exposure, weakness, injustice and fear of dying that we find hard enough to cope with when loved ones die.
I coped for years with the question 'Why me?' by asking 'Why not ?' Christians are not exempt. But lately I have realised that it is OK to feel negative thoughts. That is because the pain is real and God can only minister to our needs as we are prepared to bring them to him honestly. Our negative feelings very often come back to pride, ego and selfishness which we can only confess once we have admitted them to ourselves.
God works through all kinds of situations. Cancer is miserable and humbling, yet God can use it to refine us far quicker than if we never suffered. He may use it as an opportunity to show his power and heal. He may use it to call us home. Whatever happens he can use it for his glory. 'Underneath are the everlasting arms'.

Dr. Peter Casson is a senior house officer in psychiatry at the Royal London Hospital.

Peter Casson's struggle with life and cancer