Monday, July 19, 2010

Cancer Survival

I don't constantly think about the fact that I had cancer. Well, that's not exactly true. I think about it everyday in tangential ways. I have physical reminders that I see everyday. I have to take a pill everyday. I frequent a particular breast cancer bulletin board fairly regularly, at this point to offer support or answer questions more than seeking support for myself.

However, thinking of myself as an active cancer patient is not something I do. I pretty much feel like I am over the crisis of cancer and its treatment. It doesn't have any immediate, urgent hold over me.

I do sometimes wonder about what will happen 20 years down the road because the type of cancer I had was one that likes to recur many years later and, in fact, the more years that pass by the higher my individual risk of recurrence becomes. That is mainly a result of my age and the fact that my cancer was hormone positive. If I had been 55 at diagnosis, 20 years later would put me at 75 and chances are that I would be dealing with other health issues, and even if I wasn't, I might only have another 10 years or so of life expectancy.

Being diagnosed at 34 skews the picture somewhat. 20 years from my diagnosis I'll only be 54. 30 years later, only spring chicken by any means, but by today's standards, still a relatively vital age and young time to die. Of course, recurring doesn't mean that I would die from cancer. There are people who successfully fight cancer multiple times and beat it.

So what's got me thinking about all this?

One of the posters on the bulletin board I frequent died this past week. This happens on a regular basis because although many people will deal with breast cancer only once, there will always be some who will develop metastasis and eventually pass away. Even with good odds, someone represents the bad odds. If 90%-95% of women with my type of cancer never develop metastasis, there is always someone who is in the 5%-10% of those who will.

Being a part of a breast cancer community bears this out.

Communicating with many other women about breast cancer turns one into a mini-expert, supplemented with the PhD. in medicine that most of us earn from Google University. You start to learn the differences between triple negative cancer, hormone positive cancer, Her2+ cancer, and all the different treatments that people get and why they get them.

You also learn statistics; how particular statistics impact you or don't. It's easy to start to feel as if you have a talisman of knowledge that soothes and comforts you. You hear of someone who develops mets and then see that their cancer had worse characteristics than yours, or that they were diagnosed at a later stage, or with a larger tumor.....all things which are extremely relevant to the stats game.

It's easy, as an early-stage survivor with good stats, to gain a sense of, "Well....that's scary, but it probably won't happen to me." Maybe that's even necessary for healthily overcoming fear or worry.

However, every once in a while your little good stats bubble will burst.

Like this week when the woman who passed away had almost identical stats as me....same stage, same grade, almost identical hormone responsiveness...and actually her stats were slightly better, being completely node-negative while I had those stupid Isolated Tumor Cells in 2 of my nodes. She had no lymphovascular invasion and I did.

She was diagnosed with cancer at 33. I found my lump while I was 33.

She developed bone mets within a year or two of her diagnosis, and then it eventually progressed.

It kind of took the wind out of my sails and downgraded the power of my talisman.....because there is no known reason why things should have played out that way for her....which in turn means there is no known reason why they shouldn't play out that way for me.

One of the wise things a now deceased member of the bulletin board reminded us, right after another hard-to-understand, defiance-of-the-good-stats passing of a member, was that we shouldn't write ourselves into other people's stories. Each person had their own story and it was theirs no matter how similar we might seem to others, it didn't mean we had the same story or outcome.

It was true then, and it is still true now.

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