Each day is a gift: Reflections on living with cancer

Recently, I received news on Facebook from a friend who wrote that she had been diagnosed with "a trifecta of melanoma, basal, and squamous carcinoma." I am not sure how many average folk would even know what all these terms mean. I certainly don't, but most everyone will understand that this has something to do with cancer and inevitably there will be an outpouring of commiseration. Indeed, the diagnosis of cancer comes as a shock to the person who has cancer as well as to those with whom this news is shared. The friend, who happens to be a psychotherapist, wrote in her post that she was feeling "a host of emotions."

I thought back to when I first learnt I might have cancer. It was after I had had an endoscopy and the doctor said she would like to talk about something that was of concern and added that she would like my wife to be present. What was concerning her was some "thickening" in the lower part of the oesophagus, and I was referred by her to Princess Margaret Hospital, where I was to see Dr Darling, a surgeon who specialised in oesophageal cancer. Of course, my first reaction was utter disbelief, followed by the thought that the tests I was to undergo would hopefully reveal some cause other than cancer.

In many ways, my own life has become more meaningful after my diagnosis. For me, each day is a gift to be treasured. Every friend and loved one is precious to me. Everything I enjoy doing means so much to me—every book I read, every play or opera I attend, every piece of music I listen to.

The tests showed that I not only had cancer in the oesophageal area (this turned out in fact to be gastric cancer that had also spread to the oesophagus) but that I also had lung cancer. In an odd way, I was lucky because lung cancer is often not discovered until it is too late, and if I had not had the symptoms of the other cancer, we would not have known about the lung cancer. However, now that the diagnosis was certain, I still felt something like the way the Lady of Shalott felt when she cried that a "curse" had come upon her. Treatment for me was long and arduous. I first went through a few months of chemotherapy for gastric cancer. Next came surgery, a procedure that took over eleven hours. Dr Darling, whose skill and dedication are legendary, dealt with both cancers and amazingly did everything through small incisions, using video to assist her. What she removed were the upper right lobe of my lung, the lower part of my oesophagus, and half of my stomach. Over 40 lymph nodes were removed during the procedure. The reason why the surgery took such a long time was that samples of tissue had to be sent for biopsy throughout the process. I, of course, was quite unaware of what was going on. In fact, I had the most vivid dream of playing in a bridge tournament, and I understand I woke up babbling about a six-diamond contract, much to the bewilderment of the nurses tending to me.

Raza Ali

Needless to say, for several days I was too weak to walk more than a few steps and in fact had to be helped to make one or two rounds of the hospital ward. After some weeks, I had to undergo another round of chemotherapy, this time for the lung cancer. These treatments were spread out over several months. At the chemo ward, when one finishes a prescribed round of therapy, one gets to ring a bell. It was a moment of great relief for me, and when next I met Dr Darling, she said I was cancer-free. However, I was aware that the cancer could return. At every point my doctors were very encouraging and optimistic, but they were always very frank and realistic. One of the first things Dr Darling had said to me was that my cancer could not be cured, but it could be treated. She also said that I had a 50 per cent chance of surviving five years.

It has now been over five years, so I can again consider myself lucky. I realise that everyone who has cancer will have a very different experience. Not long ago, a friend of my son was diagnosed with pancreatic cancer. He died within three weeks of the diagnosis. He was an only child and only 34 years old. Then there are others, like another friend of mine who turned ninety this year. She has survived three cancers. There is no doubt that cancer can be painful and difficult, and it is not surprising that when people are told that someone has cancer, they are not quite sure what to say. I had for some time considered coming up with a list of things that one could say on receiving this news, but given the fact that the experience of cancer is so different for everyone, this is not a simple task. It is easier perhaps to list some of the things not to say. One of the most common reactions is to say that you hope the person gets better soon. "I'm sure you will beat this." "Be positive. You'll be all right." "Praying you get better." It is almost as though cancer is seen as something like a common cold. On the other hand, you may be conveying the message that cancer is a death sentence. This is usually an indirect communication: "Is your husband in a lot of pain?" "Oh no, that is terrible news." "Cancer is a terrible disease. The treatment is worse than the disease. It destroys lives and families. Share this post to show you care." What I find particularly irksome is all the well-meaning advice that is such a common reaction. I have been advised to eat chaga mushrooms, to see a naturopath, to drink milk with turmeric in it, to meditate, to drink water from the holy city of Medina. The idea that cancer treatment is worse than the disease is very prevalent. A sister of mine died of breast cancer that could have been treated. She was terrified of surgery. In the last few months of her life, she was eating forty or so apricot kernels every day, which was apparently recommended by some herbalist. On the other hand, another sister who was diagnosed with breast cancer had a mastectomy over ten years ago and is still teaching and publishing into her eighties.

So, while I have not beaten cancer, it hasn't beaten me. A lot of my friends comment on my positive attitude and attribute the fact that I still seem to be going strong to it. It appears that several studies are being done on the importance of a positive attitude and the will to live in the context of cancer treatment.

It is not just the initial response to news about someone having cancer that we need to be careful about. We also need to be aware of unconscious and unintended messages in what seem like innocuous questions and comments. Usually, when you run into an acquaintance or friend, you might say, "How are you?" or "How is it going?" but, almost invariably, the question I get asked is "How are you feeling?" The person asking the question means well, but the question conveys both the fear that I am feeling terrible and the unrealistic hope that I am feeling fine. Even my wife will ask me when I get up in the morning, "How are you feeling today?" I want to say, "No, I am not at death's door yet." What she wants to hear is that I am feeling great, but the fact is that I am neither suffering terribly nor feeling great.

Susan Sontag, who happened to die of lung cancer, wrote that all of us hold dual citizenship in the kingdom of the well and the kingdom of the ill. I remember what it was like when I had good health. I was not then aware of my health in the same way as I am now aware of my illness. I am also often greeted by friends who tell me I am looking great. Again, are they saying I look great considering I have cancer? Or did they expect to find me a complete physical wreck? I may look fine, or not as bad as you expect me to look, but I can never return to the kingdom of the well.

There will always be a slight but persistent fuzziness in my head, the congestion in my lungs, neuropathy in my toes, the fatigue, and other reminders that I am in the kingdom of the sick.

Coincidentally, the friend who was diagnosed with what she called a "trifecta" of skin cancers is one of the few people who, when they learnt I had cancer, neither recoiled instinctively nor, at the other extreme, treated my news as though I had told them I had come down with a bad cold.

She communicated concern but not horror. I do not remember the details of our conversation, but I was struck by the fact that she showed a genuine interest in my situation and seemed open to my sharing with her whatever I was comfortable sharing. I am not surprised that she would post the news of her diagnosis on social media. There should be no shame or guilt in having cancer, and I do not hesitate to tell people about my own. I feel that it is important to dispel some of the myths and fears people have about cancer and its treatment. I think it is important to recognise the seriousness of cancer, but also to see that it is not necessarily all doom and despair.

In many ways, my own life has become more meaningful after my diagnosis. For me, each day is a gift to be treasured. Every friend and loved one is precious to me. Everything I enjoy doing means so much to me—every book I read, every play or opera I attend, every piece of music I listen to. I have managed to do many of the things I kept putting off, thinking that there would, in Andrew Marvell's words, "be world enough and time." Since my diagnosis, I have been writing, painting, and even taking piano and singing lessons—all things I was going to do someday.

While unsolicited advice to someone with cancer may not be welcome, there is some advice that I have found useful. It was not unsolicited. In fact, I asked for it. The son of a friend of mine is an oncologist who happens to specialise in gastric cancer. Shortly after my diagnosis, I asked him if he had any advice for me. He had a very ready answer: "Make sure you hydrate, eat enough protein, and exercise." This advice has always been at the back of my mind. It was there when I could not walk for more than five minutes after my surgery. It is there to this day when I try to walk up a flight or two of stairs every day and add protein powder to just about everything I consume.

I described the first phase of my cancer journey above, and it may indeed seem daunting, but there is more to the journey that I should also mention. Some time back, I read a book by Cordelia Galgut, a psychotherapist who has also been a cancer patient herself. She attempts in her book to dispel myths and misconceptions about cancer, and she has indeed many important things to say. In particular, she focuses on the lingering fear that cancer patients have—and that is the fear of recurrence. Reading her book made me aware that it was not going to be easy to come up with a list of what to say to someone who has cancer. This is because everyone's experience of cancer is so different. She focused on the fact that many people minimise the seriousness of cancer, in particular not recognising the psychological impact that fear of recurrence has.

Well, what would one say to people who have cancer? What is important is that whatever you say neither conveys a sense of horror nor implies that the news is something not to be too concerned about. I think it's okay to say you are sorry. You could ask them about their treatment. You could hope that their treatment goes well. You could point out that new treatments for cancer are available.

My own experience, however, is that most people take too negative a view of the disease—and paradoxically, that really also accounts for the fact that they sometimes seem to be doing the opposite. When they say that they hope you get better, it is because they are afraid of facing the reality of what they see as a dreadful disease. This is not to deny that it is a serious illness, nor am I suggesting that I have succeeded in beating cancer. In fact, my lung cancer did return a couple of years ago, and accordingly, I was prescribed immunotherapy. Around this time, I also had two very serious emergencies, both related to my treatment. One was a serious hernia that had something to do with my surgery, which had involved what they called a gastric pull-up, details of which I will not go into. The other was severe pancreatitis, which was apparently a reaction to the immunotherapy. Both events were painful and life-threatening.

A more recent development was even more concerning, and that was that the cancer had metastasised and affected my spine and even reached my brain. This meant that the immunotherapy was not working, and so I was prescribed radiation followed by targeted drug therapy. Here again, I have to consider myself lucky because they now have a drug that targets the specific genetic mutation of my cancer. This is not something that would have been an option even a couple of years ago. What is particularly important is the fact that the drug can apparently penetrate the brain barrier, which is something previous drugs could not do.

So, while I have not beaten cancer, it hasn't beaten me. A lot of my friends comment on my positive attitude and attribute the fact that I still seem to be going strong to it. It appears that several studies are being done on the importance of a positive attitude and the will to live in the context of cancer treatment. In fact, I am presently participating in a study on this very topic. Thus, "be positive" is not bad advice, but I don't know if one can just decide to be positive. What I like about my friend's son's advice is that it gives me something I can actually do. I can go for a short walk or do chair yoga, eat a protein bar, make myself a cup of lemon ginger tea.

Well, what would one say to people who have cancer? What is important is that whatever you say neither conveys a sense of horror nor implies that the news is something not to be too concerned about. I think it's okay to say you are sorry. You could ask them about their treatment. You could hope that their treatment goes well. You could point out that new treatments for cancer are available. I still remember one of my friends very calmly saying that cancer was not necessarily a death sentence. You could ask if you can help in any way. You could, if you like, tell them to stay positive and take each day as it comes—but not to stay positive and everything will be all right. If they ask you for advice, you could pass on the advice of my friend's son and tell them to make sure they hydrate, eat protein, and exercise.

Raza Ali, an alumnus of the University of Dhaka, passed away in Toronto on August 28, 2025, after living with cancer for several years. This piece was posted on the Memories of EB/EP/Bangladesh (1947–1974) website on August 7, 2025.

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