I’m sitting in my comfortable sea foam green chemo recliner on day 2 of my last chemo treatment. When I am unhooked from my chemo pump tomorrow, I will not be scheduled for this chair again. No more chemo. At least until my appendiceal adenocarcinoma pops up again, if ever.
I’ve been pondering the cancer recurrence scenario a lot lately. As I’ve been approaching the end of my treatment, it’s been difficult to not worry about what the future may hold. I was in a mild funk over this for about a month. Around a week ago, I finally came out of the dark mood and am back to my optimistic attitude. Hey, we are all human.
All kinds of statistics are given for different types of cancer recurrence at various intervals (1, 3, 5 yrs, for example) and are derived from looking at large populations of cancer patients. But those statistics aren’t exactly helpful on an individual basis. At the individual level, my chances are binary at 100% or 0%: either it will or it won’t return.
I took on the binary approach when dealing with the statistics for possible rupture of my cerebral AVM (my other rare malady). Either it will happen or won’t. I decided long ago when my AVM was first discovered (1982) that I was just going to live my life regardless, damn the torpedoes. I’m still here, rupture-free, in spite of the statistics.
I’ve been trying to maintain the same attitude with the cancer situation.
A good friend forwarded an article in The New York Times Health section to me about this very issue. It was written by Dr. Peter B. Bach, about his wife and her breast cancer. They were looking for “the number,” a statistical answer or the odds of her cancer recurring. But her doctor wouldn’t give them a number. They were shocked and demanded to know what the odds were.
“Ruth’s oncologist elaborated on his refusal, promising he would tell us the number just as soon as we told him what probability of recurrence would cause us to make different choices for our lives. Neither of us had an answer. What he was proposing was that we adopt neither Dr. Gould’s rosy view that our chances are somehow just better than the statistics, nor take Dr. Gawande’s implicit advice that we confront the number and plan accordingly. Because the truth is that no number, no matter how low, would have let us go skipping out of the office confident that this monster was slain for good. And no number, no matter how high, would keep us from living our lives.”
Numbers are an attempt to weasle out our chances of living a bit longer. But we are all terminal. So why not spend less time thinking about cancer recurrence and spend more time living my life – all of it.
(By the way, I really appreciated both Dr. Gould’s and Dr. Gwande’s essays. Highly recommended reading.)