A medical journalist’s firsthand account of her battle with terminal cancer shows hope for a new era of “one-person” illnesses.
Terminal Cancer”…What if I am told I have a “life expectancy”?
What if I am told that I have a few days left to live? –Many people may not even be able to imagine what would happen to them. However, there is a book that describes in frank and unadulterated terms how he accepted the news, went about his normal life, worked, and prepared for his final days while undergoing medical treatment.
The book is titled “Terminal Cancer, ‘Ohitorisama’ Daremo Kanri” (It’s OK to Live Alone) by Shoji Osada, 59. This is a greatly added and re-edited version of “My Prostate Cancer Report,” which appeared in the Bungei Shunju electronic edition.
In fact, Mr. Nagata has been a writer friend of the author for 15 years, a senior medical journalist, a drinking buddy, and a friend who, while fighting the disease himself, saw the author fall down the stairs of Shinjuku 3-chome Station and worried that he would die before me.
During his battle with the disease, he and Mr. Nagata drank many drinks and ate parfaits together, and even now, when I meet him for this interview, he looks as healthy as ever, so the term “terminal cancer” does not ring a bell. That is why the title of the book is so shocking.
The title of the book was chosen by the editorial staff. Neither the medical profession nor we medical writers use the term “terminal cancer” as a general rule.
It would be very rude to use it to refer to ordinary cancer patients, but since I am talking about myself, I thought it would be okay.
However, although it says ‘I’m fine,’ the truth is that I’m not fine at all (laughs). I just look fine.
The term “terminal cancer” may bring to mind the image of a bedridden patient. However, Ms. Nagata is able to do all of her own housework, continues to work, and even enjoys traveling abroad.
The stage and progression of terminal cancer varies greatly depending on the type of cancer.
If the cancer progresses further, it will eventually cause pain, and then I will not be able to move. Right now, I have pain in my left shoulder and right jaw, and I am taking painkillers to make the pain go away.
The other symptoms are shortness of breath when I run a little, hair loss due to side effects of anticancer drugs, and osteoporosis due to side effects of the hormone therapy I am receiving to slow down the progression of cancer, so I am experiencing side effects from the injections to control them.
Putting off “tests” because of his busy schedule…
Mr. Nagata’s relationship with prostate cancer began in August 2004. It all started when he found bright red urine after returning home from his hobby of running under the blazing sun. She went to a local doctor’s office for a blood test and found that it was not hematuria but dehydration, but there was a worrisome finding in the blood test she took just to be sure.
The PSA, a tumor marker for prostate cancer, was 3.5, not quite 4.0, which is considered a high probability of prostate cancer, but extremely high within the normal range.
Everyone knows, even if they are not medical journalists, that “early detection and early treatment” are crucial for any disease. However, Mr. Nagata put off the examination because of his busy schedule. He was also reluctant to expose his genitalia in public.
Then, in January ’20, he really started to urinate blood this time, and in February he underwent a cystoscopy, followed by a biopsy to extract prostate tissue, and was found to have prostate cancer.
Nevertheless, prostate cancer is often described as a relatively low-risk cancer. ……
There are prostate cancers that don’t require any treatment; they just need to be checked once every three months and no drugs are used.
In reality, about 13,000 people die from prostate cancer every year.
For example, if a person with prostate cancer subsequently dies from another cancer, such as stomach cancer or pancreatic cancer, the cause of death would be the earlier progressing cancer. But if he had not had other cancers, he might have died from prostate cancer. There is no doubt that prostate cancer is also a life-threatening disease, and it is absolutely dangerous to underestimate it.
There was still a chance of cure.”
After the cancer is discovered, treatment begins. The three pillars of cancer treatment are surgery, radiation therapy, and chemotherapy (anticancer drug treatment).
In Mr. Nagata’s case, the “Gleason score,” which identifies the malignancy of cancer, showed a high value of “8” on a 9-point scale of 2 to 10 (the higher the value, the higher the malignancy), so his doctor recommended surgery to remove the entire prostate gland.
However, Mr. Nagata refused to have a complete prostatectomy, and after persuading his reluctant doctor, he opted for High Intensity Focused Ultrasound (HIFU), the latest treatment method that his doctor was working on.
As a result, his PSA temporarily dropped, but it rose again, making surgery unavoidable. In June 2009, one and a half months before the scheduled surgery, metastasis to the thoracic vertebrae and lungs was discovered.
The choice of treatment depends on whether the cancer is at a stage where it can be cured or not,” he said.
In my case, when the doctor told me to have surgery, there was still a possibility of cure. I should have undergone surgery at this point.
But I insisted on preserving my sexual function there and dared to choose ultrasound treatment. I was told that ultrasound treatment might not be able to burn off the cancer cells sufficiently, and I knew this, but I insisted on preserving my sexual function.
I know this is a very cruel question, but when I asked him how he feels about that decision now, he replied, “I chose ultrasound therapy because it was the only treatment I could afford at the time.
I thought I could recover even with ultrasound treatment at the time. If I had been in my 70s or 80s, I wouldn’t have been so concerned about my sexual function, but I was about 55 at the time, which was still young for a prostate cancer patient.
I was 55 years old at the time, and I was still young for a prostate cancer patient. If it had been much later, I might have made a different choice. …… I think it takes a lot of determination for a man to lose his sexual function, but I hope that young prostate cancer patients will think carefully about their treatment. That’s where I failed.”
It was nothing at all like the TV dramas.”
However, when the metastasis was detected and the possibility of a cure disappeared, Mr. Nagata’s first thought was concern about money.
The first thing I thought about was whether I would be able to pay my medical bills, followed by what I would do about my work.
I am self-employed, so I can’t cause trouble for my clients, and if I don’t work, I don’t get paid, so I worry more about the immediate future.
So I can put off my own death because it’s my own thing. That’s what worried me the most, and it wasn’t at all like shedding tears like in a TV drama. In my case, I was fortunate that I was in a business that did not require much physical exertion, so I was able to continue working, and in a way I think I was lucky.
Mr. Nagata consulted with his editor about what to do with the book he had begun writing at the time, the features he was undertaking, and the serials he was continuing to write. Since his doctor had told him that he would be able to live a normal life for the next two years, he continues to make business trips and other activities as usual.
As a single person, he is also faced with the problem of housing. He considered moving in with relatives or buying an inexpensive condominium and living there, but his editors recommended that he give priority to convenience and he continues to live in the rental housing he had been living in.
In addition, even with the high-cost medical care reimbursement system, Mr. Nagata’s medical expenses in 2009 amounted to approximately 1.5 million yen (see this document for details). In the midst of all this, there was also a happy “windfall.
One day, I received a postcard from the insurance company saying something like, “Please call us if you are diagnosed with cancer,” so I called them.
It cost about 7,000 yen to order the medical certificate, but I thought I could write this in the manuscript anyway, so I ordered the medical certificate and sent it to them, and they remitted 1 million yen. I didn’t know anything about insurance because I had left it to my ex-wife, but when I contacted the insurance agency, they explained it to me in detail. They were really helpful.
Fighting illness alone…and starting “life after death” at the same time
Even though he is basically healthy, there are of course some things he can no longer do. In addition to steadily advancing “seeing the people I want to see,” he retired from his hobbies of skiing, marathon running, and grass baseball one after another, especially after bone metastasis, as he was prone to osteoporosis due to the side effects of hormone treatment, and “bone fractures” were his worst enemy.
He also retired from the chorus group he had been a member of since 1996 after singing the “Ninth” at a concert in October 2011, watched by friends and colleagues. Immediately after that, she cut her hair and began anti-cancer drug treatment.
Mr. Nagata speaks frankly about his “one-man” battle with the disease, saying, “I’m glad I’m single.
The good thing about being single is that I don’t have to worry. Especially in my case, my second wife was a nurse, and I think it would have been helpful if she had been there, but on the other hand, if I had had a wife, I would have been worried, so I am glad that the cancer was discovered after my divorce. Besides, if I had had children, I would have had a hard time worrying about what would happen afterwards, so that was a good thing.
At the same time, Mr. Nagata also began his “life after death” activities. He asked a lawyer to help him with his postmortem plans and wishes, and received the following advice.
Keep your bank accounts in a single account as much as possible.
Cash out stock holdings as soon as possible.
Write your own will while you can, since it must be handwritten.
Specify the attorney’s share in the will.
While solemnly proceeding with end-of-life planning, there is also, of course, persistence.
‘I was told to cash out my stocks, but I haven’t done that yet. Some of the stocks I own are on the rise, and I’m not sure if I should sell them now. Besides, my air conditioner broke down, and although I was unsure about it, I had no choice but to buy it to get through the recent extreme heat. I also bought a humidifier.
I still have a lot of things I want to do. I went to Hong Kong, which I love, twice last year and plan to go again this year in March. From now on, I would like to focus only on the work I want to do.
The living needs rider for life expectancy of six months (when a doctor determines that the insured person has six months or less to live, the insured person can receive all or part of the death benefit as a specified condition benefit) also came down and 9 million yen was transferred to my account, so I thought I could splurge a little, but I was surprised that I could not spend it.
So I thought I could spend some of it, but I couldn’t spend it as I had expected. I bought two frozen fried rice dishes, and that was the most I could spend. I’ve always been a stingy eater, so I can’t suddenly spend extravagantly.
Although he says he will not have a funeral, there is one thing he is looking forward to in the future.
I’m going to ask some of my good friends who are editors to hold a “party to send off Shoji Osada. I am planning to make a commemorative magazine to be distributed at that time, and the editor in charge of the magazine has been chosen. I am looking forward to the editing process, and the photo shoot for the photogravure is underway.
Mr. Nagata continues to live his days positively and cheerfully, and has many things to look forward to in the future. This new generation of “battle chronicles” that overturns the conventional image of “terminal cancer” is likely to become a source of hope for those who are fighting the disease, their families, and those who have vague fears about the disease.
Interview and text by： Wakako Tako PHOTO： Mayumi Abe
