The cancer’s back, pals

The sequel only my nemesis wanted.

An audio version of this article (narrated by me) is available here:

Some things are fantastic to experience twice: a lottery win; something funny that gets funnier the more you think about it; sexy eye contact with a stranger across a dark smoky room; a really satisfying burp. Some things aren’t so great to dabble in twice. Like, say… cancer. So, obviously that’s the one I’m reliving.

A couple of weeks ago, I was diagnosed with bowel cancer again after first seeing it off in 2024. This time around, it’s an 11mm single tumour that hasn’t spread, yet is in a diabolical position. I can’t explain the situation any better than I did in a recent Instagram post, so forgive me for shamelessly recycling it here before explaining some of the fallout.

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If you’d like to drop me a tip, I’d hugely appreciate it.

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The what

Bad news. Dennis is back. I’m now officially in the Cancer Twice Club. Spoiler: the club’s benefits package is dire.

We’ve just found out that cancer has scurried back up my bowel like Richard Gere’s gerbil. (Niche ‘90s reference. Worth a google.)

After getting rid of Dennis – my 8cm by 8cm tumour – in 2024, his younger, smaller brother has rocked up very much uninvited.

Small Dennis. What a twat.

Hopefully we’ll also be able to show him the (back) door. My surgeon is a legend. He once said to me: “I’m just going to stab you with this [a 10cm needle] and see what happens” which is exactly the kind of can-do medical attitude I’m after.

This time around, it looks like I’ll need chemo and an operation again. The operation will be much more complicated because of Small Dennis’s location and therefore more dangerous, but they’ve said that if it’s successful I could still be banging about for years to come. Sorry.

We were so close to making it to the two-year all-clear mark, though. It’s exactly 23 months since I finished chemo and had the operation that reversed my stoma and removed Big Dennis. Small Dennis has many faults, but no one can accuse him of lacking dramatic timing.

Cancer recovery is measured in milestones marking how likely you are to get it again. For me, two years was a big one. After two years, my recurrence likelihood would drop dramatically. I know that’s not literally how it works. I know that at exactly 24 months my body wouldn’t have suddenly gone, “Phew! No more cancer for me!” Yet, mentally it becomes a threshold, so to stack it at this particular hurdle feels like a real kick in the gut.

Having said that, thank God this happened while I was still being regularly checked.

These milestones can become millstones around your neck. Rather than feel more hopeful as it neared, I became more fearful; increasingly anxious that the piano swinging over my head was hanging by an ever-fraying rope. There’s a dark relief in being proved right. Something I, as a default positive person and a mental-health author, have found hard to reconcile with the version of myself I know best.

But we do feel hopeful. Fucking exhausted, but hopeful. I know we have an extraordinary medical system to rely on. And the most extraordinary support network.

Besides, my arse still looks fantastic hanging out the back of a hospital gown. Who am I to withhold that from other patients? We must all do our bit.

Having cancer twice: another thing Kylie and I have in common

The why

They believe this is the same cancer as before. That a microscopic smidge was missed when they lopped out 30cm of my bowel.

We first had an inkling something was wrong when my CEA levels came back elevated during my 21-month tests in May. CEA (or carcinoembryonic antigen, if you want to titillate your pompous neighbour) is a protein that can show up in your blood for all sorts of reasons: smoking, infection, inflammation and certain cancers among them. It’s useful for monitoring some people, but far from foolproof. Plenty of people with advanced CEA-sensitive cancers never see their levels budge at all.

Mine, however, has always been a snitch. When I was first diagnosed in 2024, my CEA was well over 100. Bearing in mind a healthy level is below five, it’s no surprise this figure made my oncologists do that careful neutral face while desperately trying to control their eyebrows.

After treatment mine dropped to one and stayed there until last month when it jumped to eight. Since then, I’ve had two CT scans and a PET scan: the first CT to see if there was anything there (there was); the PET to establish whether it was a blood clot or cancer (cancer – boo); and the second CT to work out whether it’s operable (jury’s still out).

The trouble is, Small Dennis is in a hell of a tricksy place. He’s gripping onto (or into) a major vein, nestled right next to my pancreas. He’s cotched in a cushy corner surrounded by VIP organs.

The best-case scenario is chemo and an operation. If they can do that, it should be curative. If they can’t operate, though, we’re not really sure what happens. We should find out next week.

The feelings

Omg, I look fantastic

Picture me sitting atop a see-saw looking like David Bowie in Labyrinth because why not? When I rise, my head is submerged into a cloud of whistle-through-your-teeth incredulity. I can’t fucking believe this is happening to us again. I can’t work out the lesson I’m supposed to learn. I can’t reconcile the karma. I have done some dodgy crap in my time, but nothing to warrant the parade of life-altering events that keep flattening our hope. If this is retribution for a past life, I hope I was dabbling in some Rasputin-type shit.

I also can’t stop searching for meaning – because surely, surely this can’t just be “bad luck”? I have to anchor my grief to something. I don’t want to start muttering “but it’s so unfair” on repeat like Moaning Myrtle. Yet, in searching for meaning I keep tripping over magical thinking: “If I think this, I’ll be tempting fate. But if I don’t think it, I’ll also be tempting fate.” It is relentless and exhausting and devastating. Sometimes I feel like I’m watching this unfold through frosted glass. That it’s all happening to someone else’s family. This dissociation is probably not healthy, but it helps me get through the day and to be kinder to myself.

Back to the see-saw. When it plummets low, I get submerged into a swamp of terror that fills my mouth, blocks my ears, and temporarily blinds me. At the bottom of the swamp lives a giant snake that coils around me, tightening every time I breathe out. The consequences of this are so big. As someone whose parents both died in long drawn-out ways, and who has already dodged the Reaper once themselves, you’d think I might have a more philosophical view on the subject of death. I don’t.

And so, until we hear yay or nay from the doctors, and until we have a plan (even a bad-result plan is better than no plan at all), I try to hold the see-saw level. The air is clearer there, and time ticks past through moment-by-moment distractions, through finding the funny in the awful, and through appreciating the beauty found in everyday pleasures.

God, I so desperately want to live.

Just One More Thing

It’s not ideal, but needs must. It is what it is. Could be worse. Best get on with it. Let’s not make a fuss. Worse things happen at sea. Chin up. Mustn’t grumble.

There are silver linings. For one, as many of my friends have noticed, I definitely become funnier when I have cancer, so that’s a win. I will continue to write when I am able – and not just about cancer. Long-time subscribers will know I dabble in all manner of topics and that’s not going to change; it is the entire reason I set up this newsletter. I hope you’ll stick with me as we muddle through together.

Thank you, from the bottom of my heart, for all of the kind words and offers of support we have already received. They mean more than I could ever express and they truly help. (Admittedly not as much as chemotherapy, but a fair amount.)

And, if this is payback for my Rasputin years, fine. It’s worth noting, though, what he was famous for: being incredibly hard to kill.

Small Dennis, come at me, bro.

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