Comforting habit that birthed deadly cancer

Paddy O’Brien* was the jolliest dying man I had ever met. He wheeled his fancy motorised wheelchair right up to my seat and stuck out his hand. I reached out to shake his hand but he drew mine and kissed it instead. I was definitely flattered.

I was miles away from home to gain exposure to first world medicine as a medical student but I ended up getting more than I bargained for. The learning was intense and amazing but outside of the hospital, the social life was on another level.
There was a different activity every evening with our hosts. The medical residents at the hospital had a full calendar for us and I was exposed to a whole array of experiences. This is how I found myself explaining to Paddy how far Kenya was from Ghana on a lovely Thursday evening at a Swing Dancing studio.

Paddy loved swing dancing and was a regular at this studio for years until 18 months before. He was not your typical swing dancer, but he was adamant that I should not let his current body fool me! While most dancers were lithe in build, Paddy was naturally stockier, something he attributed to his Irish descent, but he was unexpectedly light on his feet and danced well enough to be part of a professional dance troupe for a decade.

Alongside dancing, Paddy also loved the outdoors and his most cherished gift was a little cabin in the woods he had inherited from his grandfather. His parents died in a grisly accident when he was only 13 and he grew up with grandpa.
Weekends at the cabin were his respite from the pain of losing his parents. They would drive off on Friday evening after school and spend all weekend fishing and hiking. It was during these escapades that he picked up smoking from grandpa, a habit that now had him in a wheelchair on oxygen, thanks to small cell lung cancer.

High blood pressure
While most lung cancer patients visit the doctor because of persistent coughing, Paddy was concerned by the rapid weight he was gaining, especially on his face, neck, upper back and abdomen. He particularly hated the stretch marks that developed on his tummy at the age of 50. When he developed inability to sustain strenuous physical activity, curtailing his dancing and hiking, he knew it was time to pay his doctor a visit.

Paddy’s blood pressure and blood sugar levels were off-kilter, his muscle function was diminishing under his watch and he reached a point where even buttoning his shirt was becoming a challenge. He had not even noticed how breathless he would get with mild exertion. This was the most frustrating point for Paddy. He was diagnosed with advanced small cell lung cancer, also known as oat-cell carcinoma of the lung.
Although this type of cancer is highly sensitive to chemotherapy and radiotherapy, one only stands a chance when it is diagnosed early. Late diagnosis with metastasis has a pretty low survival rate, with only two per cent of patients living to see the five-year mark.

The cancer causes multiple complications in the body. For Paddy, it was overproduction of cortisol hormone, resulting in Cushing’s syndrome. This explained his weight changes, the moon-face, the stretch marks, the high blood pressure and the new-onset diabetes.
He also developed Lambert-Eaton syndrome, a condition where the body makes antibodies that attack itself, disrupting transmission of information from nerves to muscles. The muscles are then unable to function well, resulting in weakness and limited function.
Paddy’s doctors were very frank with him. There was no cure for his cancer due to its advanced stage.

Cigarette smoking
However, he would get chemotherapy to improve his quality of life and relieve his symptoms; medications to reduce the cortisol levels, treat the hypertension and the high sugar levels; and pain control.
He underwent periodic plasmapheresis, a process to remove the abnormal antibodies messing up his muscle function.

Despite his cigarette smoking being implicated as his most likely risk factor for the development of the cancer, he was convinced that he was possibly exposed to radon at his cabin where he used water from a well. 
Radon is a naturally occurring radioactive gas found in the soil and underground water sources that increase the risk of lung cancer. Paddy sounded like he was intentionally shifting the blame away from his beloved grandfather who introduced him to the one vice that had resulted in the cancer, smoking.

Paddy had accepted he was dying. He was making sure he lives every single minute of the life left, doing things that bought him happiness.
He could not dance but he would go and watch his friends dance on his behalf. He would never get to climb Mt Kenya but for those few hours we sat around, he lived the experience through my narration of our beautiful country.

Prevention
There is no sure way to prevent lung cancer, but you can reduce your risk if you:
●Stop smoking. Stop smoking now. Quitting reduces your risk of lung cancer, even if you have smoked for years. 
●Avoid secondhand smoke. If you live or work with a smoker, urge him or her to quit. At the very least, ask him or her to smoke outside. Avoid areas where people smoke, such as bars and restaurants, and seek out smoke-free options.
●Eat a diet full of fruits and vegetables. Choose a healthy diet with a variety of fruits and vegetables. Food sources of vitamins and nutrients are best. 
●Exercise most days of the week. If you do not exercise regularly, start out slowly. Try to exercise most days of the week.