Wota in Translation

Searching For The Right Treatment

On the TNM staging system, my laryngeal cancer was diagnosed as being T2, also known as Stage II. Not the initial phase, but early nevertheless. I did learn, though, that the way your stage is diagnosed is actually all up to the doctor’s interpretation.

The name of my illness: “squamous cell carcinoma of the vocal cords.”

“What the heck is that?” Well, it’s more commonly known as just laryngeal cancer.

What I needed to do was start thinking about how I wanted to have it treated, but my brain wasn’t able to process the information at all. “It’s happening to me…? This has got to be a lie…” These were the only thoughts running through my head. “And I took such good care of my health! I quit smoking ages ago! I’m only 45 years old! What did I do wrong?!” I was thinking about my past, trying to find the culprit.

At the same time, I also had to think about the worst case scenario: what could I leave my kids if something was to happen to me? What are the words I should leave my wife with? It didn’t feel right to be imagining such a dreadful future, but I couldn’t stop myself from doing so.

Then there was the matter of work. If I’d have to be hospitalized and treated for a long time to come, I would have to pass on all kinds of urgent instructions to my subordinates. “Should I get out of the hospital as fast as possible so no more deadlines are missed because of me? No — I can still do what needs to be done while hospitalized. I will not miss one deadline that has to do with composing, writing lyrics or producing. I’m not going to lower my work pace.“

My brain was busy juggling so many things at the same time, I couldn’t make sense of anything. And yet, I couldn’t bring myself to think about my illness itself, nor about how it was going to be cured. I didn’t know the right path to take or who to trust. Unconsciously, I may have been trying to escape reality.

The doctor who performed my biopsy then said that “laryngeal cancer is a type of illness that doesn’t spread¹, and it’s the easiest cancer to cure. It’s going to be alright. Let’s begin your treatment right away.“

“Oh. So they found cancer, but I’m still going to be okay. I can still get better.” I finally started to drive away my sense of fear by thinking about things like that. “I’m going to be just fine.“

The hospital explained their planned course of action. “For now, let’s begin the standard treatment right away. We’ll work our hardest to find the right method of treatment as fast as possible — cancer is something that keeps growing, after all.“

Being told that doesn’t exactly help you with not feeling impatient. You do not want your cancer to get any bigger than it already is. Thinking back, when my throat started getting worse in October the year before, it’d suddenly gotten bigger, and now we were already halfway through February. In other words, we’d just left it be for four months since then. Had the tumor been in a different region of my body, I may have already been at the final stages of cancer. I found myself in a cold sweat thinking about that fact.

“What is “standard treatment” anyway?” I went to see a laryngeal cancer specialist to get answers. He was showing me data as he began to explain. “It’s stage T2, which means radiation treatment and anti-cancer agents. Radiation therapy works well with laryngeal cancer, so 80% to 90% of all patients are cured with just the radiation. But since yours is a stage T2, it would be best to use anti-cancer agents as well. That’ll better your chances by a further 3% to 5%.“

I was given all these strange numbers. Was this good or bad news I was receiving? I wasn’t in the right mental state to find out if there were any other methods of treatment available to me, what with the doctor’s words still ringing in my head: “… before it gets any bigger … 80% to 90% are cured … standard treatment …“

“I see, so a respected doctor from a good hospital is telling me most people get cured with this method. I want to go and get started right away. I’m so tired. I don’t care what you do — let’s just do it, and fast.” That’s probably close to how I felt. My circumstances at the time, my type of illness… At the time I didn’t feel able to even think about what type of treatment suited me best. Mentally, I was reeling.

I guess my wife saw that in me, because all of a sudden she just switched on. She began to fervently study my cancer.

Up until our marriage, it’d mostly been me smugly acting out the role of the boss of the house. But around the time our kids were born, that had switched around completely. Before my illness, my wife had always allowed me to think for myself, but around the time I started to get sick, that changed as well. “I can’t trust you to take care of yourself anymore. Pull yourself together! Our children are still so young, too!” She didn’t say the words out loud, but I could tell that’s what she was thinking. And yet, I didn’t know what to do. I was just absent-mindedly repeating what the doctor had told me. “Okay, right, so I’m going to be cured with the standard treatment.“

That’s when my wife began to research all kinds of different hospitals and methods of treatment using books and the internet, even sacrificing much of her sleep time. Then she’d come to my side by the hospital bed. “There’s this kind of treatment available as well. What do you think? Doesn’t this seem like the perfect fit for you? Don’t you think this might cure your cancer entirely?” Every day she would come by with lots of materials she wanted to present to me.

Heavy particle beams. Neutron radiation. Proton beams. Immunotherapy. Hyperthermia. Vaccine therapy. She researched both domestic cancer therapeutics as well as methods developed overseas — all kinds of treatment methods available for cancer. She’d get friends to refer her to doctors, discuss my cancer with them on the phone, contact acquaintances to get them to refer her to cancer specialists in faraway hospitals… She had limitless strength and speed as she worked on this, even though normally she’s the kind of person who feels shy about even phoning a restaurant to make a table reservation.

Around that time, my wife was frequently asking me this question. “What are you thinking about right now?” I didn’t know how to answer her. I was thinking about all kinds of things. About my family, about the future of our children, about my treatment, about work, about my throat… about anything and everything. But I could never answer her question straight away. Being asked “what are you thinking?” but not being able to answer her immediately… I was thinking about so many things, but what if I wasn’t thinking about the right things?

My wife was crying. “If you think it’s a bother that I’m working on this, then I want you to tell me. What do you want me to do? Please tell me.” Even then, the only thing I could say was “it’s not a bother. I’m grateful. I just don’t know what the best thing for myself is.“

It had only been some days since the biopsy at this point, so I couldn’t speak yet. Instead, I would use LINE or a whiteboard next to my bed to communicate. Perhaps if I could’ve used my voice to speak, I would’ve been able to express myself a little bit better. But when you have to “write” your feelings, it’s just impossible to find the precise words you want to use. It’s no more than a rough sketch.

Looking back on my mental state at that time, my wife was obviously in a much better place to make calm, rational decisions regarding my treatment. When it’s time to make a decision like that, too many cooks spoil the broth. The truth is that because my wife was concentrating so fully on research and finding the best treatment strategy for me, I was entrusting myself to her.

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Who Was In The Wrong?

The hospitals my wife had researched until my release were located all over the country. Besides the standard radiation therapy, other methods of treatment that would enable me to keep my voice included the proton beam treatment, heavy particle beam treatment, and neutron radiation treatment, among others. We visited hospitals who had had success in treating patients with these methods to ask if I was a suitable candidate.

For the two weeks following my release, we visited hospitals all over Fukuoka, Chiba, Tokyo… It felt like we traveled throughout the whole country. For the most part, they all told us the same things: “your type of cancer can surely be cured using the standard methods of treatment,” or “this type of machinery is too intense for your affected area, so it’s not suitable.” There were other interesting methods of treatment as well, but then they’d tell us we could only begin a trial period in six months. We weren’t about to wait six months, and even if we did, they would choose their patients by way of lottery.

Just as we were thinking about how we weren’t having luck finding the type of treatment that seemed right for me, a doctor in Fukuoka that had been referred to us by a friend said he knew of a hospital in Tokyo that does a type of radiation treatment called tomotherapy. We flew over without delay.

To explain tomotherapy briefly, it’s a type of treatment where the radiation equipment is controlled by a computer that adjusts the range and dose of radiation the equipment emits. Compared to the standard type of radiation therapy, the overall exposure to radiation can be controlled to a much finer detail, lessening the damage dealt to areas around my throat, accurately emitting radiation only to areas where it’s needed.

As I’d never heard the word before, I thought to myself “therapy? Is it like some sort of weird natural healing method?” But visiting the hospital for the first time, I actually felt very positive about it. The hospital was overflowing with light to the extent where it just made me feel like I was going to get good results there. My wife, too, felt the same, strange sensation. It had only been shy of two weeks since my release from the hospital, but it felt like it’d been ages. Now, it finally felt like we’d arrived where we needed to be. “This is the one.“

After we’d heard what they had to say at the hospital, we decided on that same day that that is where I would get treated, and we got my measurements taken for the corset that would be used during radiation. Up until finding tomotherapy, even though we’d gone all across the country, I’d never had a similar feeling of “this is it!” with any one hospital or doctor. We were nearly at our wit’s end. With all the other hospitals, when we spoke to them it always felt like they were saying “we’ll cure you,” or rather, “do your best,” like it was someone else’s problem. It just didn’t feel like we would get along with them.

But at this hospital, the first thing the doctor said to me was “let’s do our best together,” sounding very positive. His words felt like someone had shone a light on me and my wife — a married couple whose world had suddenly gotten very dark not long ago. We decided that I would start receiving tomotherapy there, and we canceled the treatment plans we’d made at the first hospital.

When I publicly announced my cancer, I heard people saying things like “he was regularly seeing his doctor, wasn’t he? Didn’t they notice that it was cancer?” and “were the doctors not doing the proper tests?” And I guess thinking that way is only natural. But I wonder: would my cancer have been discovered any earlier had I been seeing a different doctor? Was there anything I could have done to prevent this? All good questions, but it’s too late now. It’s hard to imagine that my doctor had any ill-will, or that he failed to discover my cancer on purpose.

I’m a professional who uses his voice as a tool for his work; if anything, it’s me who should’ve been more prudent in regards to my throat. Sure, I could’ve played the role of the victimized patient and said “why didn’t you discover my cancer sooner?!” But on the other hand, I could counter that argument by asking myself “were there no other doctors and hospitals available to me? Why didn’t I search them out?” For every thought I had along the lines “if you’re a doctor, then do what you’re supposed to!” the more I also blamed myself by thinking “if you’re a professional vocalist, then you do what you’re supposed to!“

“If only I’d done things differently. Maybe it’s because of that folk remedy I tried. I’ve quit now, but I still smoked quite a lot of cigarettes until I did — it must be that. Or is it because of the alcohol I drink even though I can’t hold it at all? Ah… it’s pointless to think about this. It’s only making me more miserable.”

As a producer, I always knew about CD’s that were going to be released in the next six months, and recording the demo vocals for two or three singles per month had become a routine for me. I had to stop doing so after I had my biopsy performed. Appearances on TV, too. I was worried I might be dropped from the shows I was appearing on regularly, even for missing one appearance. I’d only lost my voice for three weeks, but even that seemed unbearably hard at the time. Having to skip work for three weeks because of a sudden illness really makes no difference in the grand scheme of things, but at the time I felt like I just couldn’t accept it.

I don’t think it’s anyone’s fault that I got sick. However, I only have myself to blame for thinking something was wrong with me, and yet, opting not to get a biopsy performed right away. Ultimately, it was me who was in the wrong. Getting sick, not being able to sing, losing my voice — of course it’s frustrating. So why could I not make the right decision for my own health’s sake sooner? Sure, there were various circumstances at the time, but I was a professional singer, and in that case there are some things that just need to be done. But I couldn’t do those things.

People have described me as a “kind person,” or “someone with a great sense of responsibility.”

But the truth is, by putting off what needed to be done that time, I was nothing if not pathetic.

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My Treatment Begins!

On March 4th, I began my cancer treatment in the form of tomotherapy radiation treatment and molecularly-targeted drugs. I was to receive tomotherapy five days a week for seven weeks. In between sessions, I would receive an IV drip of molecularly-targeted drugs once a week.

The anti-cancer agents used as part of standard treatment mostly obstruct and kill activity happening in the core of cancer cells, but molecularly-targeted drugs target characteristics found only in cancer cells. Normal anti-cancer agents will inadvertently also kill healthy cells, leading to certain side effects, while molecularly-targeted drugs attack only the cancer cells, leading to less of said side effects. When you think about anti-cancer agents, you might think about TV dramas and how the patient will experience intense nausea and loss of appetite, leading to severe weight loss. But in my case with the molecularly-targeted drugs, the side effects weren’t as harsh. When we were deciding my course of action as far as treatment went, my wife and I agreed that we wanted to avoid those typical anti-cancer agents no matter what.

For seven weeks, I went to the hospital every single morning to receive my treatment. After two weeks, the area from below my chin down to my Adam’s apple was starting to burn because of the radiation. At first, it felt like the kind of stinging sensation you might experience after a bad sunburn. The week after that, it felt like a really bad burn, the kind where even turning my neck one way hurt so much I would cry out in pain.

My vocal cords hurt, too, but I think the pain on my skin may have been worse. Also, while not as bad, as a side effect from the molecularly-targeted drugs, the skin on my fingers began to crack. My arms and legs were filled with cuts. I had plasters on most of my fingers a lot of the time. Playing guitar was thus difficult as well, but as I’d been told that side effects meant that the drugs were working properly, part of me was happy that those cracks on the skin of my fingers were appearing. But while I was beginning to experience some pain in the form of those burns and cuts, my appetite remained, and up until the second week, I thought I could easily get through my treatment if that’s all I had to tolerate.

However, beginning with the third week, the burns and cuts both started to get much worse. My vocal cords themselves began to get sore and inflamed, and I began to experience considerable pain when eating. But fighting illness is something that takes physical strength, and around that time one of my wife’s most uttered phrases was “do your best and eat!” My wife would come up with nutritious and easy-to-eat meals, such as food made of yam that would slip past my throat almost by itself.

I would get my blood drawn for tests every Monday. Since you’re constantly being exposed to radiation, most people experience a drop in white blood cells and a weakened immune system during their treatment, but apparently the yam was really helping by keeping my immune system strong, and the doctor was surprised at how steady all my levels were when they’d take my samples — they remained almost unchanged from those of a healthy person. For that, I mostly have my wife to thank for her encouragements to “do your best and eat!” and thinking up my daily food menu.

But by the fourth week, I was beginning to feel very sleepy and sluggish all the time. I’d be doing some work in the daytime when I would suddenly fall asleep like a rock after 20 minutes or so. It felt like I was a robot and someone had just pushed my “OFF” button. There were times I simply could not control my sleepiness.

When I was receiving tomotherapy, I would get my treatment in the morning and then work in the afternoon. I mostly worked on writing music and lyrics for the girls of Hello! Project — something I could do all by myself. Sometimes I would also meet with directors to discuss what I wanted from the arrangers, like how I wanted the vocals recorded, if I wanted to bring in some professional backing singers, or if I wanted some added guitar or violin overdubs. I would pass on my instructions or my criticisms through the directors, and thus the CD’s could continue to be released on time. I would also have meetings with the girls’ dance instructors or designers for their CD’s and DVD’s. That was pretty much what my average day consisted of.

I wasn’t hospitalized and I wasn’t burdened with feeling very nauseous, so I wasn’t losing weight or getting weaker. I was able to keep living a normal life which made me glad. My fingers hurt quite a lot when I played the guitar, but I just kept thinking to myself “this is nothing! Who cares about a little pain in my fingers?!” as I went on writing songs. Resting upon my shoulders was not only my own family, but also the 40 employees of TNX as well as their families. I felt like I couldn’t just rest and do nothing. More than anything, I didn’t want my illness to lower the pace of new works, or have anyone think the quality was suffering as a result. I didn’t want anyone I worked with or anyone in society saying that, so I felt even more driven than usual as I kept writing songs.

On my fifth week of treatment, the burns on my vocal cords were getting worse and it was getting extremely painful. But on the other hand, my voice that had been so hoarse before was actually starting to get better which made me very excited. I felt like my voice had improved to the extent I was even thinking about recording the demo vocals for Morning Musume’s new single, “TIKI BUN.” In the end, I only recorded some voice percussion, but already my voice had improved to a level where I could do that.

However, the side effects from the molecularly-targeted drugs were no longer stopping at cracks on my fingers. I developed boils on my back that were painful and itchy. Then they appeared on my scalp as well, and shampooing would hurt both my fingers as well as my scalp.

I took some time off from writing that weekend, researched hot springs that seemed good for the scalp and went there to try and find even a tiny bit of relief for these side effects. I never thought much about it when I was healthy, but when I was sick, I realized the true power of hot springs. Going for two nights in a row brought immediate results. I poured lots of hot water at the hot springs directly on my head, and by the time I got back, although my scalp had been so itchy and painful, it suddenly felt so much better. The cracks on my fingers were pretty much healed as well. Even the burns on my throat got a lot better.

Soon enough, my seven weeks of radiation (tomotherapy) treatment and molecularly-targeted drugs were behind me, and all that was left was recovery and praying that the cancer was gone.

Around this time, I received word that Morning Musume were set to perform in New York in October. The leader of the group at the time, Michishige Sayumi, who had been a member for over 11 years was also set to graduate, and I had to start thinking about the best way I could give her the coolest and most beautiful graduation. There was a lot on the horizon.

I set myself an objective.

“I’m going to get better, and I’m going to go along with Morning Musume to their New York performance and make it a success. And my family who supported me throughout the battle with my illness, I’ll take them with me and have them experience New York as well.” There was still a long time to go until October. I felt like making the New York performance a success would also tie into Michishige’s graduation concert becoming a success as well.

I went back to working like normal. If I had time on the weekends, I’d go to the hot springs to heal myself. I’d eat my wife’s homemade meals and get regular check-ups. The doctor had warned me that with most people, throat and esophagus radiation would lead to burns and most people would experience major trouble eating around the sixth or seventh week, leading to weight loss. Yes, eating did become more difficult, but thanks to my wife’s various ideas on how to prepare my food, I was still able to eat properly and so I didn’t experience any major weight loss either. I was able to maintain the good blood levels whenever I had a test taken, too. “I’m just going to keep naturally getting better like this.” I felt relieved.

On June 8th, about a month after my radiation treatment had ended, I enjoyed a little bit of alcohol to commemorate our wedding anniversary, but also to celebrate the end of my treatment for the time being. It had been a long time since I’d last had anything to drink so I felt myself getting drunk very fast, but I didn’t mind. But the next day, it felt like the swelling on my throat had gotten a little bit worse again. “Ah, it must be because of the alcohol. I guess that means no more alcohol for me until I’m completely cured.“

One week went by. And then another. It felt like my throat had been recovering well up until some time ago, and my voice, too, was getting better until at some point it felt like it just stopped improving any further — even though the burns, my fingers and my scalp had all gotten a lot better. “But why…?” I felt worried, so I was constantly in contact with the doctor who had treated me with tomotherapy to ask him about it. “This is what my current condition is. What do you think? I still have a burning sensation in my throat. Is this normal?”

“The effects of radiation treatment continue afterwards — it still affects you a month, even two months after the actual treatment. To your body, it still feels like it’s receiving the radiation, so the burning sensation will continue. You really are getting better, so there’s no need to worry. For some people it takes up to two years for their voice to return back to normal, so you must have patience.” That’s mostly what he would tell me each time.

I was also visiting another clinic to get endoscopic checks of my throat about once a week. Similar to how I was feeling physically, the pictures seemed to indicate that the recovery process had halted around the day of our wedding anniversary. I couldn’t rid myself of that anxiousness of something still being wrong with me, so I went to another large hospital referred to me by the doctor who’d performed my tomotherapy and got them to do an endoscopic exam of my vocal cords as well. But they told me the same thing. “The influence of your radiation therapy is still in effect, so even if we did a biopsy now, the results wouldn’t be conclusive. It’s simply too early to make any kind of judgement at this point.“

“Am I just worrying too much? If so, then I just have to try not to think about it as much as possible.” Before I’d even noticed it, it was July. “My voice is still hoarse… And my throat feels somehow swollen…” I’d keep checking in with the doctor who did my tomotherapy, but he always said the same thing. “Don’t worry, it just takes time.“

But I did. I couldn’t stop myself from worrying. “Is it normal for my voice to still be this hoarse? It’s completely different compared when it was gradually getting better in May. I’m absolutely sure my throat feels swollen. Just an after-effect of the radiation?! Is that even possible…?” Everyone was telling me it was okay, but I just couldn’t shake that feeling of unease.

At the beginning of August, I once again contacted the large hospital that had been referred to me. I asked them to perform a biopsy on me at home. It was a type of biopsy where they used local anesthesia and, with the help of an endoscope, inserted a somewhat large needle to draw some cells. Using this method, it wasn’t required for me to be hospitalized. The results take around a week, but the test itself only takes about ten minutes. Following the examination, I could lead a completely normal life and wait for the results.

Around mid-August, I got my results back. “We have your results. We found no cancer cells at all. This is good news.“

I felt very glad hearing these results, and I immediately let my wife know as well. “Ah, so I really was just worrying too much. That’s good. It’s like the tomotherapy doctor told me: it’s just the radiation that’s making my throat all swollen. He said that it can take up to two years for me to get all better, and that all of the patients who have been treated with tomotherapy at that hospital have recovered. Yeah, I was just overthinking it. That’s it, no more worrying about this. Time to get ready to do a good job at Morning Musume’s New York performance!“

However, at the same time, I also couldn’t deny being aware of my voice that still wasn’t getting any better, or the swelling that still wasn’t going down.

Looking back, when they did the biopsy that time, they simply must have missed the spot.

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Complete Remission

In mid-September, I had an MRI scan taken at the tomotherapy hospital. It was to find out whether or not there was any cancer to be found not only in my vocal cords, but also my larynx and my lungs. They also drew some blood to look at my levels.

The result: no signs of cancer were found.

My August biopsy and my September MRI scan both showed that I was free of cancer. Thus, I was thinking of making a lively announcement that I was going to start appearing in public again by the end of the year — something I hadn’t been doing since February. I asked my doctor what the right term to refer to my current condition would be.

“When you’re talking about cancer, it’s said that words like “cured” or “completely recovered” should only be used five years after the end of radiation treatment. In your case, as your cancer has now been treated, the term “complete remission” would be appropriate. Congratulations.“

My wife and I felt very glad to hear these words. We were pleased. On the other hand, my voice wasn’t coming out properly, and singing was out of the question — even just the act of breathing produced a whiny noise in my throat. But even with these symptoms, the doctor told me that I was still in complete remission. Receiving that endorsement felt good. With this, I could get back to working full-time.

“But is this really the end of my treatment? Will my voice come back in time? I can’t appear on TV with a voice like this.” I was still filled with questions, feeling skeptical. There wasn’t a huge, overjoyed feeling of “my cancer has been cured! I’m all better!” Still, I had just been told I was in complete remission. Since I hadn’t been able to be physically present at work for a long time, I’m sure the fans were worried and that work colleagues and acquaintances were waiting for me. I decided it was best to let everyone know my current situation. I made a public announcement about my complete remission on September 25th.

I hadn’t physically appeared in the media for about six months, so when I made the announcement, I received lots of messages from people congratulating me, telling me they’d been waiting for my return. I received many offers to appear on different shows as well as questions about when I was going to start making regular media appearances again, which made me feel very grateful. But since I couldn’t speak properly, the only thing I could say was that I was still monitoring the condition of my voice.

My voice still hadn’t gotten any better by the end of September. Again I would think to myself if this was normal; if I was really okay. Before I’d noticed it, Morning Musume’s New York performance was right around the corner. I began to make preparations to go over there with my family as planned, and right at the end of September, I paid another visit to the hospital that had performed my biopsy in August.

“Why do I feel so worried? I’m sure anyone else who has gone through what I’ve gone through would feel really happy right about now…” I was thinking this to myself as I walked in to the doctor’s office. “I hear you announced you are in complete remission. But it looks like you still have trouble speaking, yes? Is your throat still as swollen as before? I wonder if it’s safe to really call this a complete remission…” The doctor was answering his own questions as he examined me. Suddenly, I was more worried than ever.

Next, he began the endoscopic examination. “Hmm, this doesn’t look good. We found nothing in the biopsy back in August, but it’s difficult to believe that this would still be just an after-effect of the radiation treatment.” Even the doctor looked worried. I chose to have another biopsy performed right then and there, similar to how it had been done the time before. He was right: even breathing was difficult. Even just running for a while would lead to coughing. If I slept lying down with my face up, I felt pressure on my vocal cords as if they were expanding, leading to discomfort. I had no choice but to sleep on my side every night. Even if it was true that my throat was fine and it was all just an after-effect of radiation treatment, going on living in pain like that could not have been healthy.

If it turned out that the cancer hadn’t gone away but had instead only grown bigger, that would explain everything… The more I thought about it, the more afraid I became. The doctor calmly told me that he’d gotten the cells he needed and that they would be examined promptly. He believed that I would be receiving the results around the time I was in New York.

“September is ending. I have to start packing for New York once I get back.” That’s what I was thinking as I got in the car back home.

October 1st marked the anniversary of the founding of my company. My employees who usually come to work in rugged casual wear always make an exception on this day and come in dressed sharp. Every year, all of the staff visit the neighborhood shrine and take a commemorative picture together. Then all of the staff as well as any related personnel present that day eat sekihan prepared by my wife the previous night.

However, I was still not well, and I was also planning on attending Morning Musume’s Budokan concert as well as my second daughter’s sports day, so I suggested that we just order the sekihan. Upon hearing that, my wife said “I might not be able to do it next year, but this year we’ve made everyone worry so much, I really want to make it myself.” She worked all night to make enough for 50 people and distribute it all in separate lunch boxes for everyone.

I thanked my wife, and the next morning everyone gathered at the shrine. Since it was raining outside, we made a special exception and took the year’s commemorative picture in the parking hall of the building. We then handed out the sekihan to all of the employees, to the staff that came out to take our photograph, as well as to the people from the shrine we visit every year. I then hurried over to see my daughter’s sports day. Somehow I made it in time, and it felt like it was over in no time. I went back home and began packing with my wife for New York that we were flying to the following day.

Then I had to leave to catch Morning Musume. I felt like if that Budokan performance went well, then surely they would have no issues at the New York performance either. In that sense, it would’ve been entirely possible for me to just stay behind and receive medical treatment in Japan while leaving New York to the members. But ever since my radiation treatment had just ended and Morning Musume’s New York performance was announced, I’d decided to go and witness their performance there with my own eyes. It had been an important objective for me.

I believed that going to New York would mark a major turning point in my life. What started only as a vague goal for me, I gradually came to believe that attending Morning Musume’s New York performance was going to signify me and my family’s victory over my sickness and give me a hint as to the direction my life was to go from there. Not fulfilling this objective I’d set for myself back in May was not an option. I couldn’t imagine any other path for myself.

Those were the thoughts running through my head as I arrived at Budokan to see Morning Musume perform. And just as I’d expected: the Michishige-led, newly-born Morning Musume, with its sights set on the upcoming graduation concert, gave pretty much a perfect performance at Budokan that night. “They’ve got it all under control.” I went to sleep that night, feeling confident about their success and thinking about my departure to New York the next morning.

I’d been working up until the very last moment, so I was still busy packing for New York on the morning we were set to depart. Suddenly, my cell phone began to ring. “Huh? Who could be calling me at such a busy time?” I looked at the screen and saw that it was from the doctor at the hospital who had just performed my biopsy the other day. I answered the call, thinking it was too early for him to be calling about the results quite yet.

“Are you okay to talk for a minute? How are you feeling? Has your breathing gotten any easier?” That’s how he began our conversation. I replied: “Is there something wrong? There’s been no major change since the last time we met. There’s still a whiny noise when I breathe. It’s still quite painful. But this is all because of the effects of my radiation treatment, right? Anyway, I’m keeping positive. I’m just getting ready to leave for New York, actually.“

“I see. About that New York trip… I had some fellow doctors look at the pictures I took with the endoscopic camera during your biopsy, and I must say that getting on an airplane right now and exposing your throat to pressure changes for an extended period of time could be risky. It would be very bad if you suddenly started having major difficulty breathing. I would like to ask you to give up on going to New York and letting us do more comprehensive tests. We should be getting the results from your biopsy back in three or four days, but my opinion is that it’s likely to be malignant. Could I please ask you to cancel your trip to New York and wait for the results in Japan? I feel quite worried.”

“Huh? What’s with these threats all of a sudden?” I put my wife on the phone, and the doctor gave her the same explanation. The matter of me still having cancer or not aside, it seemed that even getting on a plane for an extended period of time with such a swollen throat was a bad idea. Death by suffocation was a possibility. Hearing those words — “death by suffocation” — sent chills down my spine.

My wife stopped what she was doing. “What are you going to do? Let’s not do this. We should cancel our flights and wait for the results here.” I winced when I saw how serious the expression on my wife’s face was.

But I felt like I would not be able to proceed onwards if I wasn’t able to climb this mountain. I asked her: “do you want me to lose to my illness here? Is that really what you want?” Yes, it was possible I could suffocate. It was hard to get over hearing those words — the more I thought about the difficulty I had breathing already, the more real the possibility seemed. But just a while ago I had been told I was in complete remission. Could that really lead to me dying of suffocation? If so, then what had been the point of doing all those examinations up until now?

Had the heavens forsaken me?

I simply could not bring myself to cancel our trip to New York. I had to climb this mountain, and do it well. I needed to forge this new path together with my family. “Please, God, if you’re there, tell me what to do,” I prayed in my mind.

My wife resisted. “I’m begging you, please, just this one time do what I ask!“, she cried. Yes, many times before I’d gone against her pleas and it had led to failure.

But this was my final act of selfishness.

“I respect you, and I understand your feelings completely. The next time we have a clash of opinions, I promise to do things your way. This is my last act of selfishness. It’s my ambition as a man. And this is the man you married. So just one more time, please, go along with my selfishness!“

Somehow, I managed to convince my wife. If she had absolutely, truly been against it, she would have been disgusted and she would not have gone along with me. But she did, even though I’m sure she was still worried that something might happen. But I believe that somewhere deep in her heart, she trusted me. After I’d finished talking, my wife spoke. “Okay. But you have to swear that you’ll be fine until we come back to Japan. You have to promise me.“

“I will watch over Morning Musume as they make a success of their New York performance. I will experience it with them. My family will watch over them with me. I must go.“

As we began to head over to the airport, I truly felt that if only I could keep that promise to myself, it would lead to my life blooming once more.

---

New York Performance

We boarded our flight to New York as planned.

The level of pressure started to increase right from lift off and I was told my throat could keep getting more and more swollen the higher in altitude we climbed. Breathing did become more difficult than usual, and at 14 hours, it was an extremely long flight.

I planned to just go to sleep right away to help make the experience even a little more bearable, but my children who were sitting right next to me didn’t give any indication that they would be sleeping anytime soon. They were checking out the kids channel, happily choosing which movies to watch. “I’m gonna watch this one!” “I’ll choose this one.” That was only natural. They got to go on a vacation from school, it was an exciting life experience for them, and on top of that, we’d told them that we were going to go see the Lion King and Aladdin musicals in New York. They were visibly excited. I prepared myself for a long flight, deciding to just wait until the kids were starting to get sleepy. They would make for a good distraction.

After a few hours, one or two of the kids would be asleep. I was starting to get sleepy, too. I reclined my seat, but when I did, I started to choke when facing up like that. I was coughing and it was too painful to sleep. I turned to my side and managed to catch a little bit of sleep, but I woke up before long when it started to get too uncomfortable. I turned to the opposite side and slept a little. I woke up again from all the coughing. Next, I returned my seat to the upright position and tried to just sleep sitting down, like a student snoozing away in class with my head slumped forward. I’d wake up from the coughing again after 30 minutes or so. I repeated this cycle over and over again throughout the night.

My wife was worried. I don’t think she was able to sleep properly either, considering how she was constantly checking up on me to make sure I was still alive. She must’ve been very anxious about me. I suddenly realized it’d been months since my last, proper night of sleep. No matter what position I tried to sleep in, I would always wake up from the discomfort sooner or later.

Finally, we started to make our landing after my repeated failed attempts at sleep. The kids had woken up, too, looking lively and enjoying some refreshments as we landed. It was evening when we arrived, so in order to avoid jet lag we headed directly to our hotel to get ready for the following day. We had dinner at the hotel and were taking things out of our suitcases while thinking we probably ought to put the kids to bed soon.

Just as I was finishing the thought, my phone began to ring. It was from the hospital.

Suddenly I remembered “that day” at the hospital, and I hesitated to answer the call. We’d just arrived in New York, and now I had an incoming call from the hospital. Could it be just the doctor worrying about me, calling to ask how I’m feeling? Or…

“What happens if I answer this phone call…? What happens if I don’t…?” All kinds of thoughts were running through my mind as the voice from my iPhone began to speak.

“We just received the results of your examination. I’m sorry to have to tell you this, but we found cancer. I believe the swelling must be because the radiation in March couldn’t beat the tumor, and now it’s gotten bigger.”

It was the worst possible news, the kind I’d always avoided thinking about. To be honest, I don’t really remember how I answered the doctor or how I finished the phone call. I believe I may have handed the phone over to my wife at some point, but I have no idea what she was saying.

The one thing I do remember is the doctor telling me that I needed to get back as soon as possible so we could begin treatment; that if I left it alone the swelling would get even worse; that even the flight back was dangerous; that I really needed to get back immediately. That, I remember. But even if I was to go back “as soon as possible,” we still needed to secure our flights back, and most importantly, there was the concert on the 5th, so it would still be at least two days away.

“What do I do?” But even as I was thinking that, I knew there was no way I would agree to go back without seeing the concert first. Yet, I felt confused. “What’s the right call to make here…? I need to calm down…” Even at a time like that, the kids were starting to get loud, suffering from boredom and lack of sleep. “It can’t be helped,” I thought, as I took them to bed to get them to sleep and be quiet, my head spinning with thoughts.

“I’ve went from complete remission straight to hell. What was the point of going through all the examinations up until now? Back when I realized something was wrong, if only I’d just gone and had them detect it earlier, my throat would’ve never gotten this bad. I just knew there was something off about my throat getting so swollen! It wasn’t normal. Why did the doctors not realize the same thing?! … No, that’s my fault. I should’ve trusted myself and gone to more hospitals about it.” Again, I was thinking about all kinds of things that no longer mattered.

But compared to the feeling of disbelief upon being told that I was in complete remission, being told I still had cancer felt much more believable. Finally everything up until this moment made sense — this I could comprehend.

“Ah, I’m so pitiful.” Lying beside my children, looking at their sleeping faces, I felt that I’d done something inexcusable towards my family. “I’m sorry. I’m so sorry. I’m sorry you have to have a father like this.” I kept repeating this in my heart, over and over again. “My treatment will begin the moment we get back. I’m going to be a burden on my wife again, and the kids will have to endure a lot, too. I’ll be back to square one with work. How am I going to let the public know? I’ll be a far cry from the cool father my kids could boast about…”

At this point, I didn’t think that I would have my vocal cords removed completely. The endoscopic checks so far had always shown the problem being on the left side — the right side was flawless. “I wonder how much of the swollen section they have to remove. Maybe they don’t have to remove anything. Maybe there’s another way. … No, they’ll probably have to take some. If so, I won’t be able to sing like in the past. It sucks, but I guess that’s just something I’ll have to give up.” That’s how I was feeling about the matter then.

I was looking at the faces of my quietly sleeping children again. “Ah… I wanted to keep being a cool father to them. It’ll be unfair to these guys if I don’t manage to live a long life. It hasn’t been a month since they said I was in complete remission. I haven’t even seen the concert yet. Won’t I be able to sing ever again? I wanted to keep making my fans happy. Why me? Why? Why? Why…?” I felt so frustrated.

The kids were asleep, so I left the bedroom. Meanwhile, my wife was already speaking on the phone with her doctor acquaintance. The husband of that acquaintance was also a doctor working in an American hospital, so my wife was trying to find out if there were any treatment opportunities available for me in New York. My wife had thought that far ahead. Despite the ongoing chaos in our minds, my wife remained calm as she talked on the phone with the doctor. I admired her so much in that moment.

When the call ended and I was about to begin a conversation with my wife, the atmosphere in the room was heavy — I hadn’t known that the air around me could ever feel that heavy. “Let’s just return as soon as possible,” my wife said, as she immediately began to search for flights. Naturally, she wanted to get back right away.

“But what about our objective?” I asked her.

“This is a mountain we must climb. If we go back now, we won’t have learned anything. We won’t have experienced anything. We’ve come so far, all the way to New York. It’d be a waste. Of course, I agree: let’s go back as soon as possible. We’ll cancel Lion King and Aladdin, we’ll cancel the Wolfgang’s steaks we wanted to eat, we’ll cancel everything we wanted to do here, and we’ll go back. Right after we’ve seen Morning Musume’s performance.“

My wife booked us tickets on a flight for the day after Morning Musume’s performance. It was sudden, so our seats were scattered all over the plane, but we nevertheless decided to head back right after the concert. It wasn’t cold in the room, but little by little my wife started to tremble. I don’t know whether she recognized that it was something I had to do as a man or if she just gave up, but she said “we’ll go back after the concert. We’ll all go watch it together.“

The next afternoon, we were going to watch over Morning Musume’s members as they were filming on a cruise to see the Statue of Liberty. In the morning, my family went for a stroll in Central Park. It was only supposed to be a ten-minute walk from the hotel, but it felt like it was much further away. The air in New York was drier than in Tokyo, and just walking outside for a bit made my throat all whiny, and I was coughing a lot. It felt like I’d ran ten kilometers when in reality we’d only walked one. The kids were having fun and I was trying to keep smiling so they wouldn’t get worried, and yet, every now and then my wife would tell me my expression looked tired and that we should head back to the hotel if I felt like it was too much.

We met up with Morning Musume in the afternoon. They came to meet us straight from the airport, having arrived a day later than us. Naturally, they didn’t know about my condition. For all they knew I was in complete remission, getting better. I told them not to worry, explaining that the hoarseness of my voice was just a side-effect from the radiation. My kids were excited to be meeting Morning Musume in New York, so during breaks in filming they would talk to each of the members and happily take pictures together. The members, too, looked sort of relaxed being in an environment outside of Japan. Their expressions looked different than usual. Everyone seemed to be having fun.

It was easy to forget about everything going on as I watched over them. And yet, every now and then I would remember what was awaiting me in Japan once I got back. “Ah… what am I going to do…?” But I decided that for as long as I was there, I would be a good father to my children and a good producer to Morning Musume. I planned a schedule centered around the children until the concert. We visited the huge toy store that features in the film “Home Alone,” we had lunch with Country Musume Satoda Mai and the New York Yankees’ Masahiro Tanaka the day before the concert, and we managed to get the kids in a proper travel mood. “I want to spend more time with these kids. I have to get better and live a long life for their sake,” I thought in my heart.

But it wasn’t all happy times. My kids had really been looking forward to seeing the musicals, but I had to tell them that we wouldn’t be able to go see them after all; that we’d have to return to Japan a lot earlier than they thought. “Kids, your dad has that illness with his voice again. I’m going to have to be going to the hospital a lot again, so we have to get back home sooner than we planned. I’m sorry.” To the kids, this was the kind of news that would usually make them bawl their eyes out like it was the end of the world.

But perhaps they sensed something was different this time, because all three of them just said “okay” and immediately accepted that we had to return to Japan ahead of schedule.

Morning Musume’s concert was held in a venue called Best Buy Theater. Before the performance, I got the members together and said a few words — the same ones I always tell them. “Never forget to be grateful for being able to sing and stand on stage. Be grateful to your fans, and don’t get too self-important during your performance. People are paying money to see you, so be aware that you are all professionals.“

I hardly had a voice left when I spoke to the members about being constantly grateful about being able to sing — I hoped this would drive the point home for them. “I don’t think I’ll be able to sing with this voice ever again. I would’ve liked to one day sing in this city, too.” That’s the sort of feeling I hoped to convey to them.

Compared to the size of big arena concerts in Japan, it wasn’t a large venue and there wasn’t a possibility of doing anything special with the stage production. Still, there were around 2,500 people there, with about 80% of them being locals, or perhaps from other states of the country. Every now and then I would also catch glimpses of fans who’d come all the way from Japan, teaching locals the proper ways to enjoy the concert, which was heartwarming to see. “Thanks for coming all this way,” I thought.

The setlist of the performance itself was shorter than what Morning Musume was doing on tour in Japan at the time, but it was full of popular and energetic songs, so the crowd looked very fired-up. My kids seemed to really enjoy it as well.

I looked across the venue. “My music is playing at the center of New York, America. My loved disciples are over there, giving their all as they’re singing my songs.” Occasionally I’d catch my wife wiping a tear from the corner of her eye, and every now and then our eyes would meet. “I’m glad we came. Thank you for being here with me. I’m glad I could witness this moment.” I nodded at her, trying to convey these words to her.

“Finally, I’ve come all this way. That young boy from Osaka, pouring gasoline in the power generator so his band could perform in that street near the Osaka Castle. A group created by that same boy is at the center of New York, beaming with smiles and singing his songs that were smash hits in Japan. There were so many difficult times, but finally I’m here!”

The concert was over in no time.

Afterwards, I got to talk with the members for just a minute. Usually after their performances, I would preach to them about something or the other, criticizing their faults. But for the first time ever, I just expressed my gratitude. “That was good. You did good. You were all very cool.“

Just like I’d promised my wife, we cancelled the rest of our plans and got on a plane back to Japan the day after the concert.

 

¹ “… laryngeal cancer is a type of illness that doesn’t spread …” This is not a mistranslation — it just seems to be inaccurate. According to Wikipedia, laryngeal cancer can indeed spread, with distant metastases to the lung being most common.)