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Chicks Oncology Group, Melbourne, Australia
Talk and cello performance June 13, 2007



Title: live role models only please

I am delighted to have been asked by my sister-in-law Jill Farrell to speak and play for you this evening.

I would like to begin by playing the Prelude to the 3rd Suite of Johann Sebastian Bach for solo in C Major written in 1720 in Cothen, Germany. I have chosen this particular work to begin with as it most appropriately sums up the exciting and active musical part of my life for the years and months BC (before cancer)!

Play Bach

Let me give you a bit of background:

I am from Melbourne, from an academic family, the Hunts! You may know John Hunt, my brother? At the age of 18 went to study cello in Europe. Since then I have been all over the world playing and teaching. In 1986 I moved to Canada with from London where we had been for 10 years. My husband Arthur is an eminent neurophysiologist who was headhunted by the University of Alberta.

Since 1998 I have been Professor of cello and chamber music and conductor of the String and Symphony orchestras, and also head of the string program at the University of Alberta in Edmonton, Canada. This is the best job in the world for a musician where I can play, teach and conduct to my hearts and imagination’s content.

I was on my thoroughly deserved sabbatical from July 2005 when the first signs of ovarian cancer began to appear.

I had been peri-menopausal for about 4 years. I had the usual menopause and wasn’t too perturbed when my belly became unusually bloated from time to time or when I had unusual goopy bleeding at strange intervals. I played some memorable concerts despite the strange fluctuating belly: all the Bach Suites in Trinity College Chapel in Cambridge, recitals in Paris and Prague, some conducting in Mainz, Germany.

When my belly began to unrelentingly bloat last November I thought it was because of too much delicious French cheese or german sausage and sauerkraut, not to mention the beer. And when the heavy and protracted bleeding began and continued I groaned and thought, oh dear, now back to the menopausal drawing board. I was beginning to feel drained and pretty exhausted, despite the excitement of our travels through France, Germany and Austria.

We returned to Edmonton on December 17 and at last the bleeding stopped. I congratulated my belly for calming down with a gentle rub, and lo and behold, there was a large solid alien clearly palpable in my abdomen! Oh dear! Where had this come from?

Thus began the search for diagnosis. I visited my local mediclinic, GP, the U of A and Royal Alexandra hospital emergency rooms. Ultra sound, ct and mri scans were all inconclusive. They showed a toss up between a large fibroid and a cancerous mass.

But when my CA125 count showed 2000, we knew that we had cancer. Yes, the whole family had cancer. We entered the powerful new world of unpredictable emotions. It felt like climbing aboard a raft in a huge tropical storm, being buffeted on all sides, and only surviving by hanging on.

We were sideswiped!

I had my first appointment at the Cross Cancer Institute in Edmonton at the end of December, and 5 days later I was under the knife.

Dr. Faught and Dr. Hoskins were my surgeons. All went very well and they managed to remove all visible tumours, the big mama and a couple of offspring. Hey, this was good news, and it meant that we might get away with being a stage 2! I was in hospital for a week doing all the things that all of you know so well!

Then I went home.


I will now read an excerpt from my cancer story that I wrote in the months after chemo had ended.

Now I was back at home and trying to come to grips with the new order of life. I looked too sick for my own liking so I covered all the mirrors. There is no independence in serious illness and I am so fortunate to have a magnificent family, and group of friends who rallied round bringing meals, visiting and helping in every way possible. My family also became my advocates and ultimate support team. I was also lucky to have begun this whole chapter in very good general health so my physical recovery began and progressed very fast.

Ati put a wonderful large mirror covering the wall of our bedroom so that I would have a full panorama of the garden through the window and in reflection from the mirror. This was very uplifting as I felt that I was in the woods. When I was exhausted I would lie in bed just staring at the view in the mirror and gently fall asleep. Helenka came and snuggled with me in bed on frequent occasions. I couldn’t have done without this.

Ati and Helenka took me for walks every day. Walks is a big exaggeration as they began with taking me a few steps outside the front of the house. Each day I took more steps and finally after a couple of weeks I managed to get half way along the path in the ravine. This was a great triumph. Stairs were challenging as well at the beginning, but it didn’t take long before I was managing without too much trouble. I have a little exercise bike at home, very basic, and I began to sit on this very early on and push the pedals at their lightest tension, one or two rotations were enough for the abdominal muscles initially. This was probably absolutely the wrong thing to do but I am a physical compulsive and needed to be autonomous even if it were only for a few seconds at a time. I also need to generate progress, and tend to overdo this, so I was very careful to listen to the body and not push it further than it could go. I certainly didn’t want to endanger the surgery with its careful internal stitching.

Then the day of the pathology results finally arrived. Ati took me for my few steps outside in the snow to the top of the first hill and back. He was looking preoccupied and was not conversing. Something was up and I knew that he wasn’t daring to tell me something. So I asked him if the pathology had come back. The answer was yes. And yes, the cancer had metastasized and microscopic tumours cells were evident in the omentum. I was officially a stage 3 cancer patient. We both burst into tears out there in the snow in front of the house. Helenka was inside and I just couldn’t tell her immediately, so we left telling the kids till the next day when we could contain the information and face it, rather than reacting to the blow.

Those were hard days and we were all emotionally shattered, fearful, amazed, grieving and trying to put some order and sense into this catastrophe. But above and beyond the shock and sadness, we realized that we had a real battle to fight and that we had to put our heads up, face the enemy and attack with guns blazing. This we assimilated in our own very personal ways and each of us subliminally outlined our own battle plans. This is very complex as when a family member has cancer, the whole family has cancer. We have cancer! So we had cancer. Yep, the big C.

I was so sad, sad to bursting, that my beloved husband and children were suffering so much. They were so sad. I couldn’t watch them as it tore my soul to shreds. I think that I had the easier time at that stage as I was the one doing and being done to, and my role was clear. Cut the invader out and zap any remaining offspring, and work with the physical and emotional conditions of this engagement. Energy and consciousness limited my horizon of perception. I had my work to do which was clearly defined. For them it was less clear. They faced losing their mother, wife, lover, best friend. Their grief was palpable, and I had no energy to spare to console them. All I could do was love them with all my heart and keep everything out in the open.

It was the first priority for all of us not to have any mysteries or untrue conjecture. The emotional strain was enough on its own without adding the stress of guesswork, guilt or helplessness. We learned to use the words death and cancer freely, though each time they were mentioned, the pain for all of us was obvious. But they came to mean battle, and the energies became highly charged and positive. Tactics were calculated and the battlefield became more and more clearly defined day by day. Cancer bombed us, but we were alive amongst the flames and ruin. We now had to push it back by giving it no room to multiply. Surrounding and suppressing it were what we had to do. It is an invader which can consume given time and passivity. We were going to win by hook or by crook.

Where to begin to continue? We had already cut out all the visible tumours and were preparing to poison the rest with 5 months of chemo therapy. This was good. The drugs Paclitaxel and Carboplatin were the tried and true chemo drugs to use against the proliferation of the ovarian cancer cells. We are lucky to live in an age where we have this option, and where cancer treatment is now very effective. I was to begin chemo two weeks after surgery. The questions dancing around our family were all concerned with how to do everything possible to kill the cancer, how to leave no stone unturned and how to come away from success or failure with dignity and clarity, knowing that we will have done everything in our power to win.

OK, now to chemotherapy. Ati is a neuro-scientist and both Andy and Sam are computer engineers with their own business. All three are relentless researchers. Ovarian cancer was now first on the list of extensive internet information gathering. Completely coincidentally as I was having my surgery there was a worldwide news release about the results of recent research into intraperitoneal chemotherapy with carboplatin for ovarian cancer patients. This is the technique of delivering carboplatin or cisplatin through the abdomen in order to marinate the tumours directly, rather than through the normal intravenous methods. The published results looked promising and we seriously considered that I undergo this therapy. Ati spoke to the researchers directly and to my brother John who enlisted the help and knowledge of his oncologist friends and colleagues, and in the end we were advised not to go this route as the data was not inconclusively positive and the neurotoxicity of the treatment could have led to the end of my cello playing. We were all hugely relieved!


I will play the Sarabande of the 3rd Suite now for you. The time of reflection, reaction and recovery after the initial storm was beginning.

Play Bach

The 6 rounds of chemo began.

The Cross Cancer Institute is a superb hospital with exemplary staff, doctors and volunteers. Every base of care is covered. You are nurtured and embraced and can feel completely relaxed in the knowledge that you are getting the best of care and the most up to date medical attention and therapies.

The nurses and doctors were spectacularly helpful and encouraging. Every step of the way I was monitored and cared for, and I always felt that I had an unbreakable safety net beneath me in case of infection or doubt.

Of course I dreaded each round, but sailed through them relatively easily. I think it was the cocktail of ativan and benadryl at the beginning of each session that made me tipsy and mellow. Better than whisky!

I had all the usual side effects:

Hair loss. Going bareheaded initially, even at home, was quite the tough psychological battle. I felt as if I was wandering around in public with bare breasts. The awkwardness soon subsided as I got used to the new physique. I took pride in my shiny baldness. I groomed in the shower with the shaver getting rid of the last prickly bit.

Painfully slow gut, and the decision as to whether to remain nauseous or to endure constipation.

Very woolly thinking, chemo brain, though there were those who asked me “so what’s new?”

Bone and muscle aches

Changes in appetite, taste and smell and complete intolerance for certain foods.

Fatigue


Now I will read a bit more from my cancer story to describe what for me was the hardest side effect of all to endure as it had a direct affect on my future professional life. This is the taxol induced neuropathy.

Then there is what I call nerve storms which are my way of describing some of the feelings generated by the neuropathic side effect of taxol. These began usually three days after the infusion and gathered in strength over a couple of days and then subsided. They also varied in intensity from cycle to cycle being at their very worst for me after the fourth infusion. The feeling is hard to describe. I think it is the nerves being tortured by the chemo drugs and shrieking in protest and then giving up the ghost with one last extended yell. It happened mostly in my legs and arms, but elsewhere as well. It feels like a collection of internal thunder storms gathering in random places throughout the body shooting numerous short, painful and irregular shafts of lightning simultaneously in different parts of the body. Oh so strange and very uncomfortable. Pain killers didn’t touch it. Heat helped to relieve it somewhat. It was always at its worst during periods of rest, so the nights were not good. I was the least uncomfortable when I moved. But like all the other side effects it had a limited time span and subsided after a few days. It would be truly dreadful if it lasted throughout treatment, but it doesn’t.

After a couple of months the tips of my fingers and toes began to lose feeling. This was quite disconcerting. I was learning how precious normal feelings of touch and texture are. I had been told that the feeling returns in time once chemo is over, and this is indeed the case.

It had also been three months since I had played my cello, having had no energy, concentration nor real physical strength, and once the fingers reached a certain numbness threshold I thought that it was time to begin again. My logic was that I had better train my hands back to the cello whilst the neuropathy was developing so that I would be able to play with the neuropathy in place. This seemed the better alternative rather than waiting till the fingers had become truly numb which would make beginning again much harder. It was strange to observe that, once over the hump of beginning again, the numbness seemed to be alleviated with the movement and stimulation.

I had to talk myself out of being the perfectionist that I am on the cello and play regardless of ghastly noise and feeling. It took a couple of weeks for the cello to become familiar again, and I haven’t looked back since. It is truly my faithful friend. I developed a real Huntist contraption to cheat my hands into developing callouses and fine muscle control again. This consisted of a ruler with a cello string drawn end to end and fastened with tension. Then half corks were put under it at each end to increase the string tension and I could doodle with finger exercises whilst doing other mindless things like watching movies. It actually helped. I used a small double bass bow to help the right hand regain some of its acuity. Ati has now refined this original idea and used a paint stirring stick and some clothes hanger wire on one side, a dowling glued along the other and weights of Australian two dollar pieces glued at each end. So both hands can work on the same little device.

My feet weren’t so lucky, but I walked around with bare feet and kept trying to give my toes some sensory and temperature stimulation to keep them going as well. It has all helped and now they are also back in the land of the living.


May 4, 2006 was my final chemo session. I had managed to stay within schedule without any infections or extremes of neutropenia.

Throughout those months my husband and children scoured the internet and professional colleagues for any information that could help. My son Sam even registered for an ovarian cancer conference in Vancouver and attended as an oncologist! There were a few things that they discovered. One was a paper that outlined the cancer cell killing properties of the lowly ginger root. I began to eat ginger in large quantities and continue to do so. Another was a paper outlining retrospective research into the effects of nitro glycerin on the effectiveness of chemo therapy in lung cancer patients in Japan. This showed remarkable results in the resensitising of the cancer cells to the chemo drugs enabling the drugs to work again after the cells had become resistant. We consulted Dr. Faught and my GP and came to the conclusion that it would not be harmful to me to receive my final chemotherapy in conjunction with a small nitro glycerin patch. So I did!

The side effects of this round were magnified into very unpleasant proportions, but nothing was intolerable and the end result was a further drop in the CA 125 to 5! I was cured!

So how did we get through those months? Time does it, but not alone:

My dearest extended family sent emails and flowers and visited me from far and wide. My twin sister came from England and my brother John from Australia. Friends and colleagues brought food, flowers, films, music, books and love and concern.

My husband Arthur sent progress reports to our friends and close colleagues and acquaintances to keep them in the information loop and to free them up to communicate with me and us without fear.

I had an elaborate cushion of medical expertise, and thank all my doctors and nurses and medical relatives for their life saving actions and experience.

I was made aware at every turn of the power of positive thought and attitude. This is a tough one to generate and maintain through the less comfortable and more worrying times. I saw my psychiatrist on a regular basis throughout this time and felt hugely supported and encouraged.

I made sure that I did at least one thing each day that gave me joy and pleasure, despite nausea, aches and pains and general fatigue.

I learned about the glorious benefits of fresh vegetable juices, cans of ensure and the wonderful anti nausea properties of papaya. Grilled lamb chops were my favourite dish. There is no accounting for taste! Beer and coffee were out of the question.

I learned to interrupt casual cancer stories by requesting that if it is about live role models, then I can listen. Please, no dead ones!

I listened to music endlessly and fed on the great works of Beethoven and Brahms like nectar for the soul.

I watched movies, knitted scarves for each member of my family (this is my knitting expertise level), walked and eventually began to ski and jog again. My daughter Helenka took me swimming. No need for a swim cap!

We all became Canadian citizens.

I cleaned out my cello studio ready for the new beginning. This was a mammoth task involving sorting out a lifetime of photos, concert programs, letters, and a library of music and recordings.

And we celebrated each decline of the CA125 count, and the end of chemo, and my birthday, and my remission.

I am now well and am on a trial in Seattle for a drug called Ovarex, an immunotherapy drug that is showing very good results in delaying recurrence of ovarian cancer in diagnosed and cured stage 3 patients.

I have been back at full time work since January at the university teaching, conducting and playing the cello. The last CT scan 3 weeks ago was clear. Life’s colours are bright. Each day is full of magic and love.

I will finish with the Gigue from the 3rd Suite. Now for the next stage!

Thank you.

Play Bach

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