The cake was a beauty: a white chocolate log festooned with candles. As my wife, Mayu, and our two small daughters carried it to the kitchen table, the girls sang at the top of their voices, not ‘Happy Birthday’, but ‘Happy Professor to you’, and encouraged me to make a wish.
The cake was honouring the fact that, just days before, I had been promoted to professor of intercultural communication at the University of Tokyo, where we then lived, having moved from my home town of Nottingham seven years before.
It was a rare promotion, given my then tender age of 42.
Add to this the fact that my wife was wonderful, and my daughters, Julia, then eight, and Maya, then five, were the greatest joys of my life, and I should’ve been elated.
Yet that very same week I had also received other life-changing news: I had stage 4 throat cancer.
Doctors had discovered a 5.5cm cancer behind my tonsils. Smaller cancers had spread to two neighbouring lymph glands, and there was also a build-up of cancer cells in more distant lymph glands around my neck and chest.
In that initial consultation I was told my odds for surviving more than five years were around 20 per cent.
And yet, I felt completely fine. Great, in fact. My recent annual health check had revealed perfect results.
My wife was wonderful and my daughters were the greatest joys of my life, and I should’ve been elated – yet that week I received life-changing news, writes Michael Handford
Doctors had discovered a 5.5cm cancer behind Michael’s tonsils, while smaller cancers had spread to two neighbouring lymph glands
I played football every week with guys in their 20s and didn’t (regularly) feel embarrassed, and my intelligent bathroom scales – rather Japanese, I know – told me my metabolic age was just 32.
But I had developed a grape-sized swelling on the left side of my neck a few weeks before and, at Mayu’s behest, had gone to the doctor.
The cancer had spread so much into the tissue in my throat that surgery was not an option.
Instead, my treatment, doctors warned, would be brutal and physically debilitating: two week-long periods of intensive chemotherapy, with three types of drugs being fed intravenously 24 hours a day, followed by 35 days of radiotherapy.
I was told the treatment would cause me to lose significant amounts of weight, along with my sense of taste, and my salivary glands would stop working.
I would feel cold all the time, and the pain from the radiation would become excruciating.
I would suffer from long periods of fatigue and might develop depression. My ability to work might be permanently affected as there was a chance of cognitive fatigue – as well as a secondary cancer further down the line, caused by the radiation itself.
And, as the chemotherapy drugs were toxins, some patients suffered anaphylactic shock – which could be fatal.
All this for what I was told was a 20 per cent chance of survival.
The odds of me emerging from this physically and mentally unscathed were slim.
And yet, 15 years on, I am fighting fit – and my cancer is gone.
Part of this is because I took what some may regard as an unconventional approach.
First, rather than immediately starting my treatment, I asked my doctors for permission to delay it so I could embark on a period of prehabilitation (or ‘prehab’), to prepare my body and mind for what was to come.
It was a friend of mine, Maurice, a yoga teacher, who suggested this – instinctively thinking I needed time to prepare myself for the imminent ordeal.
He’s since told me how I seemed then: ‘devastated, like a sentenced man with fear and despair in your eyes,’ he remembers.
I asked to delay my treatment by a fortnight. This may not seem like a huge amount of time but is rather opposite to the usual urge to get everything started as soon as possible.
My doctors were a bit surprised but gave the go-ahead after some debate, saying it shouldn’t hinder my long-term prognosis.
As Mayu and I discussed at the time, we didn’t know whether I had a ‘long term’ anyway, so it seemed worth a try.
Second, at times I also became a ‘disagreeable patient’. Not a patient who actively sought conflict with their medics, but one who wasn’t afraid to question their plans for me.
Today, I wish I had fought the ‘system’ more than I did (more on this later).
Michael was told the odds of emerging from his cancer treatment physically and mentally unscathed were slim – with only a 20 per cent chance of survival
At times I also became a ‘disagreeable patient’ – one who wasn’t afraid to question their plans for me, writes Michael
But just making the decision to halt my treatment, albeit briefly, meant I felt I was doing something, and it was a first step out of the devastation.
Let me be clear: I am not suggesting my prehab got rid of my cancer – the chemo and radiotherapy did that. But it still had real value.
I spent my prehab largely immersed in physical activity: running, swimming, weight- training every day.
And under Mayu’s guidance, my diet was transformed: out went the cocktail shaker and in came a juicer; out went meat, in came tofu; goodbye white, hello brown – pasta, rice, bread; out went the chocolates, and in came the spirulina (an algae packed with vitamins, and antioxidants which boost the immune system and reduce inflammation).
I also committed to agonisingly painful Japanese reflexology sessions, again at Mayu’s hands, who had been an amateur reflexologist for two decades. Her version was definitely not a foot rub – rather, grinding into the soles of each foot with a thin wooden stick to find tender spots.
Reflexology teaches that each part of the foot represents specific parts of the body, and if a part is sore, there is a problem with that body part.
The neck area is represented by the inner part of the big toe. Mine was extremely tender – and therefore demanded a hammering with the Stick of Pain, until the pain subsided.
Less excruciating were the meditative yoga sessions with Maurice I started daily. Throughout our sessions, as we moved into various relaxing poses, Maurice would repeat this message of ‘there’s no resistance, accept the condition as it is’.
Through his exhortations, I began to accept my condition on an emotional level – and with that, my belief I would not die became stronger.
Yoga brought physical changes, too. At the beginning of my first 30-minute session, the gland on the left side of my neck was clearly swollen, and my neck itself was flabby. After that first session, the flabbiness had lessened, and the swollen lymph node seemed smaller.
Since my own experiment with prehabilitation, it has become more commonly discussed and it’s been shown to have significant long-term benefits in terms of recovery, and also overall mental and physical wellbeing.
One 2019 study published in the journal Clinical Medicine found prehabilitation prepares ‘individuals to “weather the storm” of their operation and to avoid or overcome complications’.
As well as this, the researchers found the pre-treatment or pre-operative period is a ‘”teachable moment” in healthcare. During this window, individuals may be more receptive to structured behavioural intervention [giving up smoking for example, or improving food choices].’
Michael’s book Lump In My Throat reflects on the author’s cancer diagnosis
Indeed, parts of the NHS are now investing in ‘prehabilitation’ for cancer patients as well as those who are about to undergo large surgical procedures.
The cancer charity Macmillan talks of five areas in prehabilitation: physical activity, eating well, drinking less alcohol, quitting smoking and mental wellbeing.
I needed the mental focus of a prehab period, so I could at least hold it together for my family.
Telling the children had been particularly awful. Looking back at everything I experienced, my conversation with Julia was the worst moment. I sat in her bedroom one afternoon in the week I had been diagnosed, waiting for her to come home from school.
‘I’ve got some bad news,’ I said. She looked at me, the worry obvious in her eight-year-old eyes. I coughed, my throat constricted. Dry tears hacked out of me. ‘I’ve got cancer.’ She began to cry and asked: ‘Are you going to die?’
Until now, I had protected my daughters from any pain I could. I was the solid, permanent force that fathers want to be. Being a father was the thing I was most proud of. At this moment, I felt myself disintegrate. ‘I don’t think so. I don’t think so, Julia.’ We sat on the bed, embracing, crying.
In hindsight, I let out too much, putting too much emotion on her little plate. While telling my youngest daughter was marginally easier – she was so small she didn’t realise about the threat to life – it still tore at my soul.
But after my prehab, I felt energised, with a degree of calm confidence I could not have imagined a fortnight before, and more in control.
I’d also lost excess weight I had put on over summer – around 6lb, making me 10st 2lb, just right for my 5ft 6in frame.
I tried to keep up my prehab habits with chemo – doing yoga in my hospital room and running when I could escape the hospital grounds. And Mayu cooked (delicious organic, wholegrain and plant-based foods) for me each day.
At the end of the first week-long round of chemo, I felt surprisingly well and my glands seemed normal-sized again.
Yet I couldn’t shake off a strong feeling that the second chemo was not going to do me any good. To me, it seemed simple: with all the short-term and long-term dangers that chemo presented, surely it was worth scanning me now to check on my progress?
I hadn’t appreciated the degree to which you are in a system when you have treatment. There’s a flow chart, and the one thing a patient can’t do is change the chart. ‘The research shows a double dose is most effective in the majority of cases’, the doctor said. ‘But I’m not a case!’ I felt like screaming.
And when we stuck to the plan I had a severe allergic reaction to the chemotherapy. It was terrifying – all I remember is three doctors and seven nurses around me, putting me on oxygen, injecting me, and talking too fast and technically for me to understand much.
My second round of chemo was halted and, a few days after the reaction, I had a scan. The tumours in my glands had all but disappeared, and the main one in my neck had dramatically reduced – the doctor was amazed, saying he couldn’t remember seeing such a good reaction. I felt like saying, ‘I tried to tell you this!’, but smiled instead.
I still had my month or so of radiotherapy to endure: I lost 20 per cent of my body weight in just a few weeks, and was reduced to a shuffling walk. I would scream with pain when I tried to eat.
The treatment obliterated my cancer – and also took part of me. But I believe the cost to myself was less than it could’ve been because of how I managed my treatment, trying to maintain as much control as possible. We’ve since moved to Cardiff where I now work. I’m not the same Mike I was: I tire more easily, and my outlook on life has changed.
I don’t know why I got cancer, but I know doing too much and exhausting myself might risk bringing it back, by weakening my immune system.
So I’ve learnt to take it easier on myself; to say no to work projects that might threaten my sense of physical equilibrium. It’s been a rocky path and one I often forget to take but it is the right one for me and my family.
- Adapted from Lump In My Throat by Michael Handford (Cambridge University Press, £25), published on June 11. © Michael Handford 2026. To order a copy for £22.50 (offer valid until June 6, 2026; UK P&P free on orders over £25), go to mailshop.co.uk/books or call 020 3176 2937.
