I finished radiation on December 23, started Tamoxifen, the estrogen-receptor blocker that I will take for five years, on January 1, and now we arrive at January 31. Fatigue from the radiation came on right around Christmas. It’s…odd how some radiation oncologists say there is no physiological reason for the fatigue. My own rad. onc. Doc said that, but then also said there is a theory that the fatigue from radiation comes from cytokine release. And if you google “radiation fatigue cytokines” several articles come up that theorize a link between radiation treatments and release of cytokines and fatigue. FYI: Cytokines are small proteins used for cell signaling and are part of the body’s immune response.
Why are women told there is no reason for them to be tired, when the experience of fatigue following radiation seems to be close to universal?
That’s just part of the cancer puzzle I’m in the middle of figuring out. Basically, I’m asking myself, what did this experience mean to me? And then I feel that calling cancer an “experience” is already at one remove from the reality of it.
Trying to understand, I find myself returning to Antoine de Saint Exupéry’s lovely children’s book The Little Prince. The page below is my favorite part of the entire book. The narrator, having just learned about boa constrictors and their unusual eating habits (consume animals whole; digest at leisure), draws a boa constrictor that has eaten an elephant. He shows it to “the grown-ups” and they misidentify the drawing as a hat. Then he draws another picture in which the boa constrictor is transparent, making the elephant clearly visible inside. The grown-ups still don’t get it.
I’m stuck because attempting to understand the experience of cancer feels like a boa constrictor slowly digesting an elephant. But part of me wants to think the whole thing is only a hat. It’s the cancer hat, sure, but you put it on for awhile and then take it off: cancer leads to treatment—et voilà, no more cancer, and then I get to take off the hat. In the back of my mind, though, I’m pretty sure that having cancer is not like wearing a hat. I’m pretty sure I will be digesting this experience for a long time. I’m pretty sure that having cancer is very much like swallowing an elephant.