Dear Chemo

Dear Chemo,

I thought I’d commit some of my thoughts about you to paper. I’ll warn you that this may make for uncomfortable reading at times and I may seem a little harsh.

There is no doubt that just under two years ago when we first encountered each other you managed to save my life. I completely get that and am deeply grateful to the doctors and nurses who helped to prescribe you and infuse you into my damaged body that was teetering on the edge of remaining alive. I had always been a little stand offish about entering into a relationship with you though. I had seen what you could do to my own patients back when I toyed with the idea of becoming a Haematologist.

The first time we came together I will never forget the nausea and vomiting you caused. It was horrendous. I didn’t eat for days and couldn’t even swallow my tablets or sip on water. You also gave me the most horrible colicky abdominal pain that I think if someone had handed me a gun I would have pulled the trigger.

You soon got bored with reeking havoc on my gastrointestinal tract and instead got to work on destroying my bone marrow. This induced the most severe apathy in me. I could barely stand up at times. Then the fevers and rigors started as my immune system came under your control. This meant I was once again incarcerated in the hospital and isolated from the world in my mutilated state. There were days and days of waiting and praying for my bone marrow to overcome the struggle with you and start to function normally again.

Then you cast your spell over my hair follicles; out fell my lovely dark, glossy hair in clumps. I remember being unable to cope with it any longer and asking the nurses to shave it all off for me. Just another mutilation taking away another little essence of Kate.

And so this went on. We learnt to counteract some of the nastier side of your personality but after five rounds in the boxing ring I surrendered and walked away from our relationship. You had left me battered and bruised but had also definitely beaten up my cancer enough for me to escape death for at least a little while.

I’m sure you felt jealous and scorned that I walked away so you left a few little reminders of our relationship on my body; the permanent numbness and tingling of my fingertips that reduced my dexterity; the subtle effects on my cognition that stopped me from being able to juggle several tasks at once; the long term immunosuppression leaving me susceptible to every virus around.

So we met again just a few weeks ago; like lovers who had argued but come together again desperately trying to forgive one another for their indiscretions. With the passage of time I had forgotten much of the less appealing side of your personality. Sadly you haven’t changed though. You still like to make me vomit. You still stop my bone marrow working leaving me hospitalised with infection yet again. You still took my hair leaving my self confidence at rock bottom.

The thing is you and I both know that you will never cure me. You can try and hold the cancer at bay for a little while but that overall fight is not one you’re going to win. So do we stay in this poisonous relationship for as long as we can both tolerate it or do we go our separate ways? It’s a near impossible choice that I’m going to have to ponder some more before I make it. In the meantime I’m afraid you will have to wait.

Kind regards,


38 thoughts on “Dear Chemo

  1. Thanks for this Dr. Granger. I’m so impressed with your courage and generosity in writing about this. I’ve made contact via Twitter (@medethicsandme) but am having message failure issues, so perhaps via email is better. I’m at I’m blogging and book writing ( and am interested in an email interview, if you’re so inclined. I look forward to your reply. Meanwhile, you might find this of interest:

  2. Dear Kate, I only know you through your blog (and thank you for your honesty) I don’t know what it’s like to have cancer and what decisions I would make. Reading about your chemo and it’s horrendous side effects, I am left wondering: is it (going through what you are experiencing) worth it? From the bottom of my heart I wish you well and many, many more opportunities to blog. Take care. Nicki

  3. As always, beautifully articulated Kate. Also incredibly helpful to me. Many thanks lovely.
    Lindy xxx
    Enjoy California!!!!!!

  4. Umm, yes, but here’s another perspective from the early 70s, before you were on this earth and I was a 17 year old pre-medic (First year, chemistry, physics, biology), working one summer as a nursing assistant at the WI, Glasgow. I remember days and nights on the cancer wards, the pain in sister’s voice as she called a relative to say their loved one might be reaching their last hours, the curtains drawn around a bed to give a spouse a little privacy.
    The patient who stays in my mind to this very day was a 17 year old lad, with CA Scrotum. It’s easily healed these days, but back then cisplatin was still in the research labs. He couldn’t leave the ward, he needed to be in hospital to control his pain, he was terminally ill. There were very few hospices then, and none suitable for him. When we changed shifts, one of us would run down to the newsagents to get him a copy of Playboy or Men Only. That was all we could do for him. That and chocolate, or Lucozade, or whatever he asked us for.
    I stood at his bedside one day, and handed over whatever it was. He looked at me with his bright blue eyes, red hair, and a face cruelly pockmarked by acne, or maybe a reaction to the drugs he had been given.
    ‘You’re new,’ he said. I nodded, and told him my name. ‘You’re going to become a nurse?’ he asked. I replied that I wasn’t, I was starting medical school in October, and working to save up some money and also to learn something about the world I hoped to be working in. I helped him to get comfortable in his bed, and made tea and toast for him before I left.
    ‘What age are you?’ he asked, as I finished. I nearly said, the same age as you, but I didn’t want to emphasis that cruel fact. I simply said, ‘I’ll be eighteen in a few days time.’
    “I’ll get you a birthday card,’ he responded, grinning, as I blinked away the tear in my eye.
    Oncology as a speciality only began a few decades ago. When cisplatin was launched, CA scrotum became cure-able. Each new chemo, horrid though it is, brings the promise of more life and less death.
    As other ways of treating cancer are developed, targeted treatments deliver better results, without the toxicity.
    Just my thoughts. I cannot imagine how you feel, because you are so young. At least I was diagnosed in my 50s. But I hope you can tolerate another treatment or two to impede the cancer, and that means you have more time to watch sunrises and sunsets in hot tubs, and hope that a targeted treatment might be found for the very rare form of cancer that you have. It’s hard I know, it takes courage to hope, but courage is something we know you have.
    Best wishes, Lxxx

    • Kate, you are so honest and open. You truly are an inspiration to those who know you closely as well as to those of us who only know you from afar through your books and blog. Keep your head up. No matter what, you are greater than cancer.

    • Thank you for sharing this.. I just had my first round of chemotherapy for very invasive breast cancer, and as much as I am trying to view it as the rainbow lights that heal me, the expected side effects scare the sh*t out of me. And people talking about the “poison”…
      Thank you, the story of the boy who didn’t have a cure back then gives me some peace of mind I am on the right track, and to stick with it…

  5. Beautifully written Kate and you are an inspiration for the development of new treatments with better side effect profiles. Your experience. Sounds horrendous and as a medic you know the details which makes it even harder, ignorance can be bliss sometimes. Hugs Helen

  6. Hi Kate,
    you are doing something no one else I am aware of is.
    Some of us will get cancer too and you are telling us what its like. I know this wont take it away, but at the very least it gives us some knowledge of what it may be like. And I for one would rather know the truth. It’s the unknown that for me that scares me. So thank you Kate. And I know you will find the strength to keep going and fighting.

  7. Dear Kate,

    What you are giving us all is beyond value. Thank you.
    The picture of you in your scarf is very beautiful, and that is the truth.

  8. Hi Kate my name is Julia -I am interested in your situation because I work at west herts & also because I have a dear sister of 50yrs old diagnosed with sarcoma which appears it has spread even though 3 months into diagnosis – will order your books and hope to give inspiration to her & family as we deal with her unexpected & difficult situation xxx

  9. Kate: Last spring after completing 10 of 12 chemo rounds and disease progression I decided against a stronger chemo and stem cell transplant to let nature takes it course. I too did not tolerate chemo well and I was down and out the entire time. Last week in desperation I gave in and decided to try oral palliative chemo. Even with just one drug I only lasted 5 days before I decided the symptoms of the cancer were more tolerable than the chemo. At least I have confirmed that I have made the correct decision in refusing chemo and my mind can be at ease. I quite often feel like a failure because I had such a hard time, but I remind myself that it also takes a great deal of courage to stop it. Although the path I have taken is not typical I still know it is right for me. I hope this round of treatment and all that you have endured brings you the relief of your symptoms and the ability to enjoy the additional time that it offers, and with a little luck maybe the next one will be much more tolerated. I want to thank you for sharing your story, being terminal is very frightening and your words make me feel a little less lonely. Julie

  10. Thinking of and praying for you and your family… My auntie had to make the same decision and decided to refuse chemo and try to enjoy the rest of her time. It was such a hard decision for her to make but only you know what is best for you xx

  11. Pingback: Dear Chemo | drkategranger | All Things Palliative - Article Feed

  12. I too have cancer and know I will probably face chemo one day. As a doctor, it scares the hell out of me. That balancing act between quality and quantity of llife that we actually need a crystal ball to evaluate.
    Thinking of you. You don’t know me but I want to offer support in whatever decision you make.

  13. thinking of you kate – it’s a year since we met and been following your blog/story as best I can. Jane and I will be back at Dying Matters this week to share another film (her dad’s journey through dementia c/o NHS psychiatric ward). Things we do seem pretty grim – where you’re at seems pretty grim but when you share that ‘essence of kate’ for all of us (even for those of us who don’t know you well), life sparkles more than anything death can bring. thank you xxxx

  14. Kate, I find your courage inspiring. I have GIST (gastrointestinal stromal tumour) and am grateful beyond words to Dr Brian Druker for his influential work in developing Gleevec, the only drug that works for GIST, that is currently keeping me NED (no evidence of disease). I hope that when the moment comes when I become Gleevec-resistant – a strong likelihood, unfortunately – that I am able to face the news with something like your courage and humour. And congratulations on your wonderful “My name is ..” campaign. Well done!

  15. Take your time deciding Kate, and do whatever feels right. I still consider the decision my Dad took to prematurely end his palliative chemo regime to be amongst his bravest. It is so hard to make that choice but he had a much better quality of life for what time he had left. As ever a thousand thanks for sharing your journey with us xx

  16. Trying to think of something sensible to write but can’t find the words. So leaving a rambling message instead (not sure how that’s helpful). Basically I want to say that despite your amazing strength and bravery I imagine it is very, very hard (maybe impossible sometimes) to stay positive – I can’t imagine. You wil make your decisions when ready, whatever they are, and people will support you in these. You are one beautiful, strong, brave and inspirational woman and I loved your photo.

  17. I wish you luck and the strength,which I know you have.My wonderful and close friend made the decision not to continue with her chemotherapy regime.One thing she always asked me was ‘Do you think I did the the right thing’?I always said she did because that is what I believed.She would ask me if I would have done the same and I was honest in saying I couldn’t say having not been through the challenging experience of chemotherapy. My friend said she just knew….instinct.You will know.Much love to you,keep strong x

  18. Pingback: Dear Chemo | Health Blog Round-up |

  19. Dear Kate,
    Thank you for your blogs. You are an inspiration. I use them when teaching our pharmacy students. However I also know a young person who is suffering from Myeloma (very rare I know). I sent him a couple of your blogs. They have been extraordinarily helpful to him because your honest reflections are so similar to his own experiences, especially that of losing ‘cancer-buddies’. It has been good for him to realise he is not alone. Thank you


  20. So poignant. My dear friend has metastatic pancreatic cancer and has been receiving chemo cocktails for a year now. Thankfully, her relationship with the toxins doesn’t resemble yours, in fact, she’s thriving so far – now on a 2nd version of mixtures. Amazing to me how it affects people differently.

  21. Pingback: Like you care what I think... » Dear Chemo

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