This is the final post in a series of seven. To read from the beginning click here.
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Part Four: Living in the Reality of the Present
As I indicated in my previous post, I had surgery for prostate cancer in October of 2017. Three months passed and I had the first of the every-three-months blood tests to check the status of my cancer following surgery. The test showed undetectable levels of PSA (prostate specific antigen). We were pleased to get the test results, but the status of my cancer was no different than the day before. We just had the additional bit of information indicating surgery had apparently removed the cancer from my body. Six months, then nine months, then twelve months brought similar test results: undetectable, the word one wants to hear in this situation. Another milestone had been reached. Now I could move on to the every-six-months testing schedule.
I know I’ve written this before, but it bears repeating because it expresses my feelings at each stage since first learning I had cancer: I’m still the same person, wanting to continue doing the same things which are important to me with the same people I love and care about. Nothing feels different on a testing day. The test will either show cancer is present in my body or it won’t; the result of the test will not change who I am. However, the first of the six-month tests in May of 2019 did show different results, as did a follow-up test several weeks later. No longer undetectable, my PSA level had increased, indicating a likely recurrence of my cancer. Even a small increase after surgery is a big deal. Most of the cancer had been surgically removed, but some cancer cells had remained. They were growing again.
Studies indicate treatments at the time of early PSA increases yield more positive results than waiting for the disease to progress. So it was time to have more tests, to consider options, to make decisions, and to take what we determined to be the best actions available. No certainties, no guarantees, no sure idea of what might lie ahead. But then that’s true of every aspect of our lives. We think about what we want to do in our lives, determine the things we would like to have happen, and plan the actions we believe most likely to produce those outcomes. And then we step out into the unknown and do it all again with whatever we find there.
In mid-July I was scheduled to have a special PET scan, a relatively new imaging procedure using radioactive tracers intended to show the location of the cancer cells. My cancer was quite possibly at the site where my prostate had been prior to my surgery—if it had not spread to other areas. That scan and a rescheduled one the following week were both canceled after Carole and I had begun our hour-long drive to Hickory, the closest location where the test is available. The nuclear pharmacy supplying the radioactive tracer for the scan wasn’t able to deliver the required material from its locations in Columbia or Winston-Salem in time for my appointment. We were frustrated by the delays, but the PET scan was finally done on July 30 of 2019.
A week later I was due to have another PSA test and to receive the results from my PET scan. I expected my PSA test would show another increase; the rate of change would indicate the aggressiveness of my recurrent cancer. I anticipated the PET scan results would show whether the cancer cells had moved into other parts of my body. I was eager for the clarification the tests would provide to the uncertainties of the past few months. Not that anything about my cancer would be any different than it was before the tests, but I was anxious to know its current status. I wanted to learn about the next steps to be taken and the timeline ahead so we could get on with other activities in our lives.
My appointment was apparently the last one of the day. My blood was drawn for another PSA test, but because of some miscommunication in the office, the lab machines had already been shut down for the day; my test could not be run until the next day. To add to my frustration, the out-of-town imaging center where my PET scan was done had sent my doctor someone else’s scan report. Again, more waiting. Neither delay would really make any difference. The PET scan results had already been evaluated and the PSA level was already in the tube containing my blood. But the information contained therein had not yet reached my doctor or me. Another period of uncertainty.
So Carole and I went to the car, talked briefly about what had just taken place in the doctor’s office, and took what seemed the best next step—we headed off to a favorite Asian restaurant for dinner. At the end of the meal we got the customary fortune cookies. Given the uncertainties of the day, we were curious to see what our fortunes would say. Carole read her fortune which was one of those suitable for anyone in any life situation. I looked at mine and said, “Mine says: Your fortune today has been delayed or canceled. Please try again some other day.”
No, of course the fortune cookie didn’t contain those words, but it would have been appropriate. Laughing to each other, we drove to Blowing Rock for two hours of the twice-monthly music jam performance (bluegrass, folk, country, gospel, whatever someone wants to sing) we’ve been attending fairly regularly for the past several years. The jam features amazingly talented musicians, both regulars and anyone else who wants to perform, including a young neighbor who started playing instruments at age three and is now incredible on any instrument with strings. The night’s performance was especially lively and entertaining. Our day had certainly not been what we expected, but what a great ending.
The frustrations of the delays, cancellations, and miscommunications seem to all be behind us for the moment. My blood test did show the expected increase in PSA. The PET scan showed my cancer had not spread beyond the original site in my pelvis. We have met with the radiation oncologist and have begun procedures leading to an eight-week-long course of radiation treatment to start shortly. I have already begun hormone therapy intended to stop the growth of my cancer cells. I finally have a sense of the treatment timeline before me.
We know there are still uncertainties ahead in our new adventure. No doubt we will encounter the unexpected many times. It has seemed strange all along the way that something having such a profound effect on my life has had no obvious physical symptoms or effects so far; we know that is subject to change. But I expect to continue living my life pretty much as I have been doing. Ignoring or failing to acknowledge the reality of my cancer will not lessen the undeniability of its presence. But worry won’t help, wishing it away won’t help, calling on the universe to change the realities of the way things work won’t help.
As I wrote more than two years ago when the biopsy first confirmed the presence of my cancer, I don’t really feel much different since cancer has become a part of my life. Many things are part of my life, no one of which defines who I am. All the experiences and actions of my life, the people I have known and loved, the things I have learned and thought and believed, and everything else which has affected my life and influenced the person I have become, those are the things which define me. I have cancer, I have been treated for cancer, and I am living, even though I am still living with cancer. However, I definitely do not think of myself as a ‘cancer survivor,’ the term so frequently attached to people in my situation. Cancer and all the things which go along with it—physical effects minor and major, multiple medical appointments and treatments, concerns of family and friends, uncertainties of all sorts—have now taken a place in my life and sometimes in my daily activities, but they are by no means the predominant part of my life or the most important to me. Very soon cancer will demand even more attention, more time, and more energy. I hope all the most important parts of my life can continue pretty much as they did before I knew I had cancer. I’ll do the best I can to make it so.
Life is good—every moment of it, with cancer or without. Each precious moment is ours to appreciate and enjoy and savor with the greatest mindfulness possible. The cool mountain air flows in through our open windows. The colorful blooms of the flowers are everywhere within my field of vision. The birds are calling and singing in the trees and bringing food to their young ones. The young mother raccoon comes to our deck each afternoon for a bit of food and to peek in our door; now she brings her adorable kits to continue a tradition going back many raccoon generations here at our homeplace. The love of my life sits nearby, sharing the wonder of this place with me every day. Yes, life is indeed very, very good. I couldn’t ask for anything better than what I have.