Hello! I’m still basking in the glow of yesterday’s good news. In the afternoon, my son Sean’s soccer team, the Sandy Spring Friends School men’s varsity Wildebeests, won their league tournament championship in a too-exciting game against their archrivals, Washington International School. It was sweet. There was, in particular, one very lovely goal. The November sun was shining on the fall foliage. Nobody got seriously hurt.
Earlier in the day, I had my LAST miserable radiation treatment…YAY! They said the burns were likely to get worse for about three days, and then they would start getting better. I am ready for that. Also, I am ready to have three hours a day of my life back! What will I do? I will paint! I may finish the laundry! They actually have a support group for people who need help figuring out what to do now that daily treatment is over. I told them I didn’t think I was going to have a problem with that.
The best part of yesterday, for me, though, was my radiation oncologist laying out what she thinks my prognosis is. It turns out, it is very good.
I was prepared for not-good news from her. About two weeks ago, I had asked her when I could have the “Katie beat cancer” party.
“Are you asking me when we are going to say ‘You’re cured?’” she asked.
“Yes, I guess I am.”
“We’re not.”
“Not now, or not ever?”
“Not ever.”
Damn.
She told me, flatly, that I was never going to hear the word “cured” and I should get my head around that. Once cancer goes as far as mine had, spreading to a bunch of lymph nodes, you can never be sure you’ve killed every last cancer cell. This is going to be a lifelong project. We just hope it is more like a chronic illness in the background than an active crisis. She said, basically, my kids can declare my final victory over cancer when I’m 90 years old and I die of something else.
To use a tired military analogy, this is not like fighting the Civil War, where at the end of the day someone signs the surrender papers and hands over his sword and it’s finished. It’s more like fighting Al Qaeda, where you only know if you’re winning when, over time, nothing blows up in your face. You never assume it’s over, because you just never know.
So I am sitting there looking distressed, apparently, and trying to digest that she had just told me this was NEVER going to end. Damn. And then she asks if I want to hear the good news.
Yes. Yes, I did.
The really good news, she said, is that I was already in remission. I asked what that meant, exactly, and she said it means that as of right now, they have poisoned or bodily removed every cancer cell they can find. That means I can currently say I’m “cancer-free.” This does not mean cancer won’t blow up in my face in the future, but it means right now, I’m healthy, as far as anyone knows.
This is another example of how the English language doesn’t stretch quite far enough to cover certain scientific truths. All we can talk about is probabilities and risk, and we aren’t good at doing that with any precision or clarity. Right now, I am not cured, but I am not sick. I will “have cancer” the rest of my life, but simultaneously, I can be “cancer-free.”
(I am worried about people misunderstanding that distinction. My kids are, this morning, excitedly announcing on Facebook that I am “cancer-free” and counting the “likes” this gets. This has been a gratifyingly large number. But, although it is true to call me “cancer-free,” it is also misleading. I have explained the difference to my kids between “cancer-free” and “cured,” and they get it. Even Matthew, who does not handle uncertainty very well, seems to get it. But other people are clearly assuming this means I am cured, it’s over, and we move on, and that is just not true.)
It took me more than a week to process what my doctor had said. I could not tell even how I felt about it. So I convened what I think my Quaker friends would call a “clearness committee.” I needed a reality check. So I consulted two of my dearest friends, Sharon and Pam, and also my mom. I ran it past them. I told them what the doctor had said. I told them I didn’t even know how to feel about it. Was I happy or sad?
They were unanimous.
“Oh, you’re happy,” they said. “Definitely happy. Very, very happy!”
Of course, this was the right answer. I have spent every weekday morning for the last six weeks waiting around at the Sibley Hospital cancer center. And being a former reporter, I basically eavesdrop on my fellow patients and the medical staff all the time, which is naughty, but there you go.
My fellow patients are both men and women, most of them older than me, but not all. They have all different kinds of cancer. You can sometimes work out what kind of cancer they have by observing the hospital gowns they are wearing. In women, a short teal-blue gown often means breast cancer. In men, a long dark-blue gown often means prostate cancer. It’s much easier to figure out the situation of the people who are gabbing on their cell phones, about even the most intimate details of their conditions, so loudly that even people who aren’t actively eavesdropping can’t avoid hearing.
Most of these people would give anything to hear the word “remission.” Some of them are just trying to stay alive long enough to make it to a certain wedding or see a relative through his own medical emergency, or hold the first grandchild, or whatever. To think they could be declared “cancer-free” for an indefinite period of time is beyond their dreams.
So I’ve slowly been working into happy. Happy, with just the right amount of caution. We don’t want to get cocky, or jinx this. I am a Cubs fan. I understand that too happy would not be prudent. I can think of myself as “cancer-free,” but only with an asterisk. The footnote says, “For now.”
But then, yesterday, I had my exit interview with my radiation oncologist, and it was hard not to be too happy. She told me things had gone very well, indeed. Bottom line was, she thinks there’s a very good chance—she estimated 70 percent or slightly more—that this cancer will not come back at all. She called that option “permanent remission.” It’s like being cured, only you can’t confirm that you’re cured. And even if it does come back, she said, we have plenty of treatment options that could give me another 15 years or more from that point.
This is much better news than I had thought I was going to hear. Mind you, the most recent book stats for a person in my own situation said it was 56 percent chance of surviving a while, 44 percent chance of dying, which had scared the hell out of me and those of my friends who had tracked down this information. That book is old, I am told, and does not include the new generation of chemo drugs I’ve taken. Also, the stats include so many people who are much older and sicker than me that the numbers are meaningless for my situation.
I was, in fact, pretty lucky. In a nutshell, because of the specific type of breast cancer I have, and my relative youth, and my overall good health, my odds are much better than average. For example, I don’t have underlying heart disease, which meant they would whack me extra-hard with chemo drugs, and that helps.
I had also thought previously that, if breast cancer did recur, you are automatically toast. It turns out this is not true; it depends on what kind of breast cancer it is, and a bunch of other variables. The kind I’ve got, even if it comes back, there are still a bunch of things you can do about it. It isn’t an immediate death sentence.
So, in the end, I went home and celebrated. Prayers of thanksgiving. Loud music. TWO glasses of wine with dinner! Woo hoo! Lots of hugs and high-fives from the soccer folk. Everyone in the house posted the good news on their Facebook pages, and was amazed by the number of responses there and the pure love in so many of them.
There are a couple of new organizations that have sprung up nationally to advocate for younger cancer patients. Technically, I am too old to belong to these organizations, but I appreciate their edginess. They do not do the pink ribbon thing. Instead, they organize happy hours and singles nights and such. They are not so much about finding “the cure” or remembering the dead, but about making the most of the here and now. Their motto, which you can find on their web sites and their T-shirts, is, “GET BUSY LIVING.”
I’m with them.
I’m cancer-free, for now. What had I been thinking, that I was going to get a guarantee for the future? Nobody gets that. It doesn’t matter whether you’ve got cancer, or not. So get busy living.
My radiation oncologist, Dr. Victoria J. Croog
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