[Updated: Feb 4, 2020]
I first wrote about my lessons as a cancer survivor back in May 2017, following a recurrence that took place during the latter part of 2016.
Unfortunately, it has not been the end facing this ferocious enemy. Cancer aggressively came back into my life in the summer of 2018 and has led to another one-year intensive battle. The last 4–5 years are leaving me more as a cancer warrior than survivor.
After a life of near perfect health, cancer first appeared in my life in May 2015. At the time, it felt more like a walk in the park on a cloudy day. I was diagnosed with testicular cancer on a Wednesday, operated on the Saturday and back at work the following Wednesday with active surveillance as follow up. In short, a little blip in a very healthy life.
The second time was a more profound life changing experience. My testicular cancer had come back and this time, the treatment was brutal with 26 days of intensive chemo over 68 days from October 24th until December 31st 2016.
It felt like I was living in a hellish, chemo infused cocoon. My family and I thought that the page would turn on January 1st 2017. It was not so simple as the results were not ideal. After a couple of months of uncertainty, stress and seeking guidance from a number of doctors, the results from a PET scan and blood tests cleared me, putting me on active surveillance and allowing me to come back to the land of the living. It felt FANTASTIC!!
In parallel, it led to major changes in my life and in our life as a family. I was now a Cancer Survivor, at least so far as I was on active surveillance for the foreseeable future with a chance of recurrence. I left my position as CHRO of Valiram, ASEAN – fastest growing premium and luxury retailer. And with Chiara, our youngest daughter, graduating from high school in June, Elisabeth (my wife), and I were completely mobile to envision the future.
Roots, family, friends and places had become more important than ever. Opportunity came knocking at our door for a complete life change. I was offered the role to co-lead the creation and development of a retail school at McGill. With the announcement of a founding gift from an ambitious benefactor, Aldo Bensadoun, we actively set out on a vision to create the leading academic institution in the world dedicated to the future of retail. So far so good in our quest to achieve this vision!
Elisabeth and I moved to Montreal, my hometown, in August 2017. It has been a gift beyond my expectations to be back home, close to my parents, our kids and family. It is cool to see Montreal live through a renaissance focused around creativity, innovation, multi-culturalism and ‘joie de vivre’ – the joy of living – after decades in the doldrums. Most importantly, it has allowed me (and Elisabeth) to find a healthier and more balanced life. I walk or bike to work and get home early enough to indulge in one of my passions – cooking.
*** *** ***
A turn of events
Unfortunately, cancer aggressively came back at the end of the summer 2018 in a renewed form – Non-Hodgkin’s Mantle Cell Lymphoma. It led to me to put on hold my exciting professional adventure at McGill for 12 months in order to undergo the first two phases of an intense and prolonged treatment.
Lasting 6–7 months, the first phase was 3–4 cycles of chemo and immunotherapy – each cycle alternating one day out-patient chemo, 3 weeks of recovery followed by 3 days of in-hospital chemo ending with 3 further weeks of recovery. The doctors were pleased enough with the results to end this phase after 3 cycles.
After 2–3 months of recovery, I entered the second phase of the treatment – stem cell transplant. Since I was technically in remission, I could fortunately be my own donor. It began with an extraction step lasting 3 full days being hooked up to an extrusion machine that as blood was pumped in and out, isolated my stem cells. After 5–6 weeks of preparation, I spent 25 brutal days in hospital for the transplant.
It started with high-powered chemo to wipe out my existing immune system. After 2 days of rest, I went through the stem cell transplant procedure, which involved high-speed infusions of 14 stem cell blood bags over 2 days. My body totally freaked out during the procedure.
This was followed by 19 days in hospital in a semi-quarantine environment with my old immune system crashing, being totally exposed to important side effects which left my body ravaged until the new stem cells started to take hold.
On June 23rd, I was finally well enough to go home and start the recovery process. In the words of one doctor, it was like living through the most brutal open-heart surgery, while having a new immune system like a baby.
Recovery was harder and slower than expected. However, I was persistent in my daily exercise routine – alternating walking and cycling. I was also extremely well surrounded and supported by Elisabeth, our daughter Chiara, my parents, my brother-in-law Jonathan, extended family and friends.
After 3 months, I was finally able to return to work full time on September 23rd 2019. I have at the same time entered the third phase of my treatment – maintenance chemo, which occurs over a couple of hours every 2 months for 2 years with very limited side effects. It feels great to lead a normal life again and hopefully, putting this pernicious disease behind me for years to come.
Many other things were happening during these intense few months. Elisabeth has successfully recovered from the first of her two hip surgeries. We have sold earlier in the summer our beloved house on Ile d’Yeu in France, which was filled with family memories of the last 20 years, but in the past couple of years, was lacking the required attention and love that such a beautiful house deserves. This allowed Elisabeth to sign, at the end of October, the purchase of a house in Stowe, Vermont, a picture post card New England town that offers a wonderful escape a couple of hours from Montreal.
We are finally and hopefully entering a wonderfully exciting, more balanced next chapter in our lives.
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Throughout both cancer treatments in 2016 and in 2018–2019, I wrote a journal of events and feelings that I shared with family and friends. Never having kept a journal before, I am not sure why I started one under these circumstances, but I can tell you with hindsight that:
- Writing was an essential way for me to cope and better understand what was happening to me; and
- By sharing the journal, it forced me not only to delve on the negativity of the experience, but also to share the positive moments and the important life lessons learnt. I cannot thank enough those who through my journalling supported me in these life-changing ordeals.
As I did back a few months after my treatment in 2016, it is now probably a good time for me to stop this journal, but before I do, I would like to revisit the 12 lessons that I shared through my first journey battling cancer. These lessons are very much valid the second time around and I’ve added new comments from my most recent experiences.
It is my hope that they may be useful to others who will, unfortunately, have to embark on a similar journey.
1. Find your own coping mechanisms
Cancer treatment is a war that takes place within your body and mind where the enemy and the saviour are the same – chemotherapy. To cope, you need to find your own means to keep going. While it is important to listen to others, especially cancer survivors, doctors and nurses, ultimately, the battle is still yours to fight on.
In my case, I wanted to know about my cancer just enough to make thoughtful decisions. I was not looking for the world’s best cancer facility, but a reputable one that was close to home and my family. Reading became an obsession, as did watching the Montreal Canadiens hockey games.
I cannot agree more on the importance of finding your own coping mechanisms. A few things changed this time around. I needed to find a better facility because the new cancer that I was fighting demanded more technical expertise. I cannot thank my lucky stars enough, as I was exceptionally well treated at the McGill University Health Centre (MUHC), certainly one of the most reputable in Canada, and very close to home.
I was also given a Bell Fund care package when I began my treatment. This fund was created by Judy Martin, an adolescence acquaintance from my squash days, who after living through her own battle, felt that she was not given some items that she would have loved to receive to better cope with the treatment. It included among other things, a comfy blue blanket with a reversible pocket so your feet could stay warm. It came with me every time I was in hospital. Thank you, Judy, from the bottom of my heart!!
And lastly during the first phase of this treatment, I was able to exercise regularly walking along the Old Port and the Mount Royal, as well as in Stowe. I discovered cross-country skiing, which my pivot nurse suggested that I do. These activities had a soothing, meditative quality that I needed to cope.
2. Find your own mindset
I was often pushed to be the perpetual optimist, to look at how others had suffered more than me. It never actually worked for me. Dwelling in negativity and slipping into depression are certainly not the desired mindset either.
Fortunately, I was able to deal with it by having an optimistically realistic approach to my fate. With cancer, I ended up many times on the wrong side of the statistics. So had I been too optimistic at every step, I believe that it would have left me shattered. By being realistic, it allowed me to cope with the negative and fight on. It taught me how to be more reflective when some piece of good news came my way. It’s always great to have won small battles, but don’t get too confident until the big war is won.
This push to be the perpetual optimist was even more prevalent as we moved back to North America. However, it did little to change my mindset as the optimistic realist. Having battled cancer three times in less than five years, I think that it is the only way that I can live with myself. I feel that I won this latest battle, hoping that it may be the last, but realistic enough to know that it may not be.
3. Trying times for you, and those who share your daily life
This is a moment in life where everything just shifted, not only for you but also for those dearest to you, especially your spouse and children. You became totally dependent on them. It required important adjustments for all.
After years of being at the pink of health, the sudden change to being at home or the hospital created a sense of helplessness. It was not only tough on me, but it demanded a lot of courage and resilience from Elisabeth and Chiara.
How true this lesson remains. In my case, the circumstances and treatment protocol changed, but still required important adjustments to the lives of the people around me. It started with Elisabeth, who as my principal caregiver had to put everything on hold, including the beginning of her much needed hip replacements. It was supposed to be her turn to receive my support and assistance. Fortunately, she was able to go through with the first hip replacement earlier this summer.
It put most of the winter plans of my mother, my father and Hilary (his wife), on hold. Chiara, our daughter, took a retail summer job in Montreal to be closer to us, as well as all our holidays from university.
Jonathan, Elisabeth’s brother, probably spent more time in Montreal that he anticipated. I don’t want to forget Olivier, my son, who did the best he could, but was just starting his professional career in Portland, Oregon. As I was already well surrounded, it was much more important to me for him to get the right start in his career, than to put his life on hold to be near me.
4. Build a community of support
I don’t believe anyone can go through this ordeal alone, at least not healthily. So find that community in family, friends, doctors, nurses and acquaintances. Their physical and emotional support will make all the difference.
Nothing to add on this point, except that I was able to – by sharing my journal more broadly – engage an even larger community that supported me throughout this ordeal. Thank you so much to all of you. You have been in your respective ways so important throughout my battles.
5. Find a way to share what is happening
It is not enough to have people supporting you; you need an avenue to talk it out. It seems that this comes more easily for women than for men. It is for one of these reasons that Sofia Davis founded an association called One for the Boys in 2013 to get men with cancer to talk more openly about what they were going through, with actor Samuel L Jackson as its ambassador.
Watch this video:
In my case, the journal helps greatly.
Starting up the journal again and sharing it was critical for me to understand what I was going through.
But unlike in 2017, I realised very early on that I would also need to seek advice from a real expert. I have, therefore, being seeing Dr. Hoffman, a psychiatrist at the MUHC specialised in patients going through intense medical treatments.
I would most probably not have chosen him as a psychologist, but because of his long experience, he was able to prescribe the right anti-stress and anti-depressant medication that I feel was critical to keeping me mentally sane.
6. The importance of second (or subsequent) opinions
Gather advice from different people, preferably from different places. This is especially true when critical decisions need to be made. It reassured me to know that all the doctors in Malaysia and Canada whom we had consulted shared the same diagnosis and treatment protocol.
More recently, it potentially saved me from possibly unnecessary cycles of chemotherapy and operations. This is thanks to a visit to my urologist who suggested that I meet a testicular cancer specialist at the National Cancer Centre of Singapore. The specialist recommended, with the support of the world’s leading testicular cancer expert in Norway, to stop all further treatment if my scan was clear and my blood sample test was okay; which turned out to be the case.
I was fortunate this time around that Dr. Aprikian, a world-renowned urologist and oncologist that follows my testicular cancer at the MUHC, had doubts early on when he saw lymph nodes appear in my lower abdomen during a CT scan in March 2018. Advancing by three months the next CT and PET scans, he found that these nodes had grown and become cancerous, but had doubts about the nature of the cancer and therefore, submitted my diagnosis to a committee of peers for review.
They unanimously concluded that it is more likely to be lymphoma, than a recurrence of testicular cancer. He transferred me to Dr. Sebag, a wonderful haematologist, who after further tests and sharing the results with other colleagues, confirmed that I had a rare and aggressive form of lymphoma requiring a long and brutal treatment protocol.
All this came as a succession of brutal blows to Elisabeth and I, as she accompanied me to the doctors’ appointments. However, I always felt well advised by medical experts in one of the most reputable teaching hospitals in North America.
7. Lovely things happen in trying times
Despite the ordeal, I am so thankful for many things. It brought our family closer together. Back in September, as a young adult, Chiara was growing more distant and independent as is the case for most people her age. But with the recurrence of my cancer, she realised the importance of family, and that brought us much closer before she furthered her studies.
I realised how unsupportive I was when Elisabeth had cancer 15 years ago. I finally apologised to her as it was something that had lingered in her heart for years.
We spent Christmas as it was intended to be spent – a special moment of love and care, instead of fighting and waiting only to open presents.
The experience also brought me closer to many friends, families and acquaintances. The messages of support were heartwarming and profoundly impactful to my wellbeing.
This lesson could not be more important and more true. You are living in extraordinary times, in this case that starts from a very negative premise. However, like anything extraordinary, there tends to be the extraordinarily bad, but also the extraordinarily good. Little is lived in the middle. And as I wrote in 2017, I have so many things to be thankful for.
I also cannot speak more highly of all the staff and volunteers at the MUHC who showed not only great expertise, but also tremendous empathy. My core doctors and the nursing staff are the dedicated people that were the psychological support that was necessary to get through this extremely trying experience.
8. Gargle religiously – water, baking soda and salt
This seems weird in this list. But let me say that it was essential to neutralise the mouth to prevent ulcers and canker sores, and to maintain appetite and a positive frame of mind. The mixture is one cup of water with one teaspoon of baking soda and one teaspoon of salt. Not very appetising, but trust me, a godsend!
This was less important this time, except during my time in hospital during the transplant. Nevertheless, trying to eat properly is so important to recovery that I would not take it out. Canker sores and ulcers in the mouth are unpleasant enough, let alone when they make it almost impossible to eat or drink.
9. Exercise to stay as strong as you can
You will lose weight and energy. In many cases, you will experience hair loss, although that quickly becomes secondary if you are a man.
In between chemotherapy sessions, work to stay healthy and exercise. It is essential to speed up your recovery, especially for your mental wellbeing. Small steps will do and as my doctor told me, your body will tell you fast enough when it cannot go on anymore.
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I can say that by working at it, I was just about back to normal after 2.5 months. And in three to four months, I should be fitter and healthier than ever.
Beyond the above comments, I am fortunate to be followed by Maryse, a physiotherapist specialised in cancer recovery. She made a couple of important and powerful statements to Elisabeth and I during one of my sessions. Elisabeth was asking about the importance for me to be followed by a naturopath. Maryse, as were most of the doctors that we talked to about this subject, was guarded in her answers about nutrition and naturopaths. Her main recommendation was to eat properly, as little (in her view) was yet scientifically proven about the impact of alternative nutritional regimens.
She did, however, say that exercise was by far the most important thing to do before, during and after chemo to accelerate recovery. I had read a recently published scientific study that echoed her comments completely. Maryse had also taught me a lot in terms of not overdoing it and doing the right things. Recovery from a transplant is a long and arduous process and going too fast or doing the wrong things in terms of exercise does not help in the recovery process.
And this time, I was able to exercise regularly, walking along the Old Port and the Mount Royal, as well as in Stowe. One thing that went beyond my expectations, was taking up cross-country skiing. It meant so much to me during the chemo phase of the treatment to be able to do so. I loved the challenge and discovering beautiful places on Mont Royal, Stowe and along the Saint Lawrence with my uncle. It brought a peace of mind and had a centering quality that was so important to me in these troubling times.
10. Beware of the financial consequences
In some cases, with less brutal treatment and more understanding bosses, you may be able to manage your state of mind better. But in other cases, you may have to stop working for months, forcing you to leave your current employment. You may also want to completely reassess your life and take a more fulfilling and healthier path. You probably need 6–12 months of financial security to make it through. Thanks to Elisabeth, we were fortunate enough to have something sold, and that has given us some of that security.
One wonderful story of support in financially trying times was told by former vice president Joe Biden regarding former president Barack Obama. When Beau Biden, Joe’s eldest son, was diagnosed with a brain tumour, Joe was unable to continue working as attorney-general of Delaware and as a result, no longer had enough money to support his family. Joe was ready to sell his family home outside Wilmington to help his son and told the president about it.
Given what Joe had been through in losing his first wife and young daughter in a car accident years before and bringing up the rest of the family in that house, the president told him that he would never allow him to sell it and would give all the money that was necessary to help him and his family through the ordeal. Such was the gesture of friendship and support from the top leader in the world.
In the dark moments of politics south of the border, it is heart-warming to re-read the story of Biden and Obama. I failed to mention that during my battle back in 2016, I received a tough blow on December 22nd when my insurance company informed me that they would not cover me under the clause of pre-existing conditions. Fortunately, we were living in Malaysia at the time and the costs, although high, were not outrageous. And one of the Valiram brothers, whose company I was working for, was understanding and allowed us to work out a mutually beneficial financial arrangement to help me cover the costs.
I cannot thank my lucky stars enough that I have been living in Montreal during this last battle and therefore, extremely well covered by the Canadian Health Care System and McGill’s insurance policy. I cannot even imagine how expensive is the treatment protocol that I have undergone. A real godsend!
Having said that, even under these circumstances, I went from short term disability status for the first six months of my treatment which meant that I received 100 per cent of my salary to long term disability for the next six months which is covered by an insurance company and paid me about 75 per cent of my salary. So it was a little dicey at times, but nothing like it could have been if I was living in the US or even in Canada, without additional insurance.
11. Have a do-able dream and live it
In the movie Bucket List, terminally-ill cancer patient Carter Chamber (played by Morgan Freeman) had a bucket list of places he wanted to visit and things he wanted to do but did not have the means to. Together with another cancer patient Edward Cole (played by Jack Nicholson), they both lived it. It was very special for both men, especially for Edward who until that time was a bitter and intensely disliked person despite his sharp business acumen, wealth and power. It brought out in him humanity, generous spirit and the joy of life he never had before.
In my case, it was a trip to the places that I love and visits to people that I hold dear. On my 35-day journey, I travelled to Paris, Montreal, Stowe Vermont, New York, Verbier in the Swiss Alps and Ile d’Yeu off the West Coast of France. For me, it was the most powerful journey that I have ever undertaken.
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Its power came at so many levels:
- The importance of rituals.
Until the trip began, I did not understand the importance of rituals in our lives. I lived so much throughout this trip that it is now filled with memories, scents, sceneries, sounds and intense moments of friendship that have made life special and worthwhile.
- The power of relationships.
In each place that I visited, I felt like I saw everyone that I hold dear and shared at least one special moment with each of them.
- A disbelief at some of the things that I was able to do.
A heli ski day off Petit Combin in Verbier, a full run on the Cote Sauvage – the first since my chemo finished – and swimming on Easter Monday in freezing cold water in the Anse des Fontaines on Ile d’Yeu.
- An affirmation of what I want to do next.
Strongly recommended by my father, I organised 20–25 meetings/interviews with headhunters, business schools, friends, and new acquaintances. These meetings may lead to one potential offer that I would seriously consider. More importantly, I know that my future lies in people development, teaching and executive education. On where and the details of the next role(s), only the future will tell.
- A rebirth.
On Easter Sunday, I went to my favourite place in the world, la Chapelle de la Meule in Ile d’Yeu. I had the entire place to myself for 30 minutes as the sun rises that morning.For the first time since my cancer reappeared, I prayed for my late mother-in-law (who passed away on Easter Sunday and whose presence I felt intensely), my wife, our kids, our family, our loved ones and friends. Coincidentally, Easter is also a story of rebirth as I felt reborn and ready for the next step in our lives.
Wow!! How moving it was to read through what I wrote back in 2017. It clearly stands out as the trip of my lifetime. With what I did back in 2017, I started thinking during this past summer about doing something similar before returning to work in late September. During the summer, I read a wonderful book set in Tuscany and another one, about Oxford. It got me thinking about a few places and people that were important in my life and that I missed during the 2017 trip.
I had planned the entire trip with Elisabeth for about 10–14 days in September, but my doctors strongly opposed such a journey because of my exposed immune system. So we cancelled these plans, at least for now. One consolation was that my aunt, Jacqueline, decided that if we could not visit her in London, she would visit us in Montreal which was a very special few days.
I was, nevertheless, not to be deterred from doing something special before returning to work. I convinced Elisabeth that it would be great to go up the Saint Lawrence to visit Quebec City, La Malbaie and Tadoussac. I am so glad that we did. It was a trip that went beyond both our expectations.
I want to leave this lesson with a poem by Charles Bancroft that celebrates the Saint Lawrence, especially Tadoussac. It is a fitted way for me to end this lesson on living a dream.
I’ve seen the Thousand Islands
In the beauty of the dawn;
And sailed on Lake Ontario,
When shades of night were drawn;
I’ve wandered in Toronto;
Climbed the “Mount” at Montreal;
Run the great St. Lawrence rapids,
Where the waters swirl and fall.
I’ve slept up in the Chateau,
At Quebec; and known the thrill
Of rambling through the “old town”
And the fort upon the hill.
I’ve felt the sacred beauty
Of the splendor on Sag’nay;
The warmth of homespun blankets
That were made at Murray Bay.
But in my soul’s a hunger
Once again for Tadoussac;
The endless fascination
Of its quaintness draws me back.
I hear again the mission bell
That calls the folks to prayer,
And as I walk the city streets
My heart is with them there.
12. Life will never be the same, but do not give up on it. Press reset and live it to the fullest
This type of journey, no matter how painful, will change the way you look at life. Sometimes, you need trying moments like these to take hold of what had happened and to re-evaluate your life’s priorities. You may not be able to do everything you aspire to do, but hopefully, you will be able to get closer to what you want in life.
I personally would have loved to take a year off. After an exhilarating 10 years in Shanghai, the three years in Malaysia have proven to be the most challenging in my professional life, and as a direct consequence, for my health. A year off would have been great to regain my health, enjoy life and prepare better for the future. However, our financial situation has not allowed me to take a full year. Nevertheless, I am making the most of it with the amazing trip and the additional 2–3 months to organise the future.
Amazing to read what I wrote in 2017 and see where I ended up, exactly where I hoped for. I have to say that it was ‘luck by design’ as I did somewhat make it happen. However, it was still LUCK.
Bringing it all together
The end of my last journal entry is a fitting end to these 12 lessons and finding one’s way in life. I was asked during a lunch a couple of months ago by Damien, one of my new close Montreal friends, what has changed? Taking some time to answer, I told him that not a lot has changed since the major changes in our lives that took place following my last battle with cancer in Malaysia.
It has been more of an affirmation that we made the right choice to move back to Montreal. This has allowed me to work on a project that I am passionate about, for Elisabeth and I to be closer to our kids and my parents and lead much more balanced and healthier life after 15 hectic years in Asia. It will most certainly be made even better now that we have our own country house to enjoy in magical Stowe Vermont.
And as I wrote in 2017, It is a LIFE worth living!!!
I want to end by thanking all of you who have accompanied me through this journey over these last difficult and moving years.
With all my love, Charles
Editor’s note: We first published Charles’ story on 27 October 2017, and updated it on 1 February 2018. When we recently connected with him again, he shared his journey in the past year and the lessons he continues to glean from his battle with cancer. We are happy that he is currently in remission and recovery, and wish him the best of everything ahead!
Ps: Do you know World Cancer Day takes place every year on Feb 4? It is an initiative under which the entire world can unite together in the fight against the global cancer epidemic. #WorldCancerDay #WeCanICan