I’ll never not be a cancer survivor, at least as long as I survive. What that means has changed and will continue to change as each day puts me a little farther from it, although, unlike objects in the rearview mirror, it will always appear closer than it is. Some days the only reminders are the scars I’ll always carry or the medications I have to take, or the doctor’s appointments I now have to make more regularly than I once did. Then there are reminders I don’t expect. Less than a week ago I went to the dentist for a routine check-up and cleaning, and the hygienist told me she was going to do a routine oral cancer screening.
“It’s a very simple procedure, very straightforward and non-invasive, just like a prostate exam,” she said.
“Well, I can tell you’ve never had a prostate exam if you think they’re non-invasive,” I replied, and we both laughed about that so much I didn’t even stop to think if I should let someone who couldn’t tell the difference put her fingers in my mouth.
This particular cancerversary is a significant one because September 22nd, 2019 will mark five years since I finished chemotherapy. Even though the doctors will say I didn’t get the real all-clear until the surgery I had three months later I was the one with cancer and I get to choose the date. There’s not a lot I could control while I was being ravaged by a cluster of runaway cells so I get to have some say over the things I can. That’s a lesson I’ve taken away from the cancer experience—and one of the lessons I still have to remind myself of on a regular basis.
Being a five-year cancer survivor is significant because, while your cancer may vary and doctors differ in their opinions, there is a broad consensus that most people who have been in remission this long are “cured”. Of course within twenty-four hours of my diagnosis on June 17th, 2014 I had doctors telling me that I was lucky and that my particular cancer had a good chance of being “cured”. I keep putting that word in quotes because another lesson I’ve taken away from the cancer experience is that there’s no such thing. My biggest mistake at the time was hearing the word “cured” and thinking it was going to be easy, that I didn’t have to be responsible, that it was all going to take care of itself.
Not that I really believed it was going to take care of itself. Even before the toxic cocktail of chemotherapy started dripping into my veins, even before the first surgery, even before a gaggle of doctors came to talk to me about my prognosis and options, my brain was stirring up a brew of its own. I say that by telling my wife over the phone rather than giving me the news in person my regular doctor deprived me of the chance to make a joke, but there’s more to it than that.
The day I was diagnosed with cancer the tech who performed the ultrasound spotted a blood clot in my leg, which is why, on our way home, my wife and I had to turn around and rush to the emergency room. Later, at nearly midnight, I was wheeled upstairs in my hospital bed for a second ultrasound and the news that there was no blood clot. I don’t blame anyone for the false positive but it did leave me feeling falsely positive. If the blood clot wasn’t there, I thought, maybe the cancer wasn’t either. It was hard to take cancer seriously when there was a possibility, however small, it wasn’t real, and, being terrified, it was even harder to accept that it was real, and that I needed to take it seriously. I didn’t take it seriously, not even when I was undergoing chemotherapy, not even when I started having side effects my wife shouldn’t have had to point out but that she did. And there’s another lesson from the cancer experience: nobody knows my body better than I do. I have to listen to what it’s telling me because most of the time I’m the only one who can hear it.
And did I mention that I’m easily distracted at the best of times? I might have had what’s known as “chemo-brain”, but who could tell? One day while I was getting chemo I went to the restroom and got lost. A nurse had to take me back to my room. That might still happen now. The infusion clinic I went to has a very confusing layout. That reminds me of a joke: two oncologists walk into a bar and one says…no, wait, never mind, it’s gone now.
Add to that mix of fear and denial a desire to not be a burden, although that probably feeds into the denial. There have only been a few times I’ve gone to a hospital emergency room seeking treatment–in college when I started having stomach cramps in the middle of the night and again when I had a pulled tendon in my foot, decades later when I had what turned out to be a kidney stone, and for that phantom blood clot, but I’m pretty sure the first thing I always said to the admitting nurse was, “Excuse me, I don’t want to bother you, but…” And that, like all the others, is a lesson I have to remind myself of: it’s okay to speak up. I think most people would agree that it’s better to go to a doctor and start treatment, or, even better, be told, “It’s nothing,” than assume it’s nothing or that whatever it is will clear up on its own. Even doctors can make mistakes, miss things, misdiagnose, but I’ll take that chance. There’s always a possibility I’ll be hit by a bus but I can at least lower my odds by looking before I cross the street.
And not everything is predictable. The dental hygienist I was briefly afraid might try to floss my colon and I talked about how cancer isn’t like, say, the measles, or chicken pox. There are vaccines that lower the odds of certain kinds of cancer but there’s no vaccine against cancer itself. The odds that I’ll get the same cancer I’ve already had are many decimals to the distaff side of zero, but having cancer once, or even multiple times, is not a prophylaxis against a repeat performance. Cancer’s ancient association with the crab is apt: it’s tenacious, good at hiding, and it can pop out anywhere. Cancer is unpredictable as a wild animal too. You don’t have to smoke to get lung cancer, spend a lot of time in the sun to get skin cancer, or link independent clauses to get colon cancer.
I wish I could say I’ve learned all these lessons, or that I already knew some of them, but there’s a big difference between knowing and applying what you know. Like Lewis Carroll’s Alice I give myself great advice; it’s following it that’s the problem, and cancer is no wonderland. None of this is easy for me, and probably not for most other people. Perspective also changes with time. I’m bound to learn new lessons, and what I think I know now may look different in future hindsight. I’ll take now, though, because now is five years from where I was.