The Twlight Zone of Cancer
Most people who are not living in Cancer World assume that there are two possible ways to have cancer: either you are cured or you are dying. As we residents know, that is far from the truth. First, it is the very rare person who is ever pronounced "cured". The most we can hope for is something along the lines of "Everything looks fine" or "You are doing great" or "NED" (no evidence of disease). That is the lot of us luckier natives. For people who are living with advanced or recurrent or metastatic cancer, the landscape if murkier and the language is even more complicated.
Doctors like to talk about cancer, recurrent cancer usually, as a "chronic" illness. That has always seemed a little like gilding the lily or white washing the reality or denial to me. Yes, people live with metastatic cancer sometimes for years--and that surely is good news--but most other so-called chronic diseases don't kill people. I think of a chronic illness as something that can be controlled with medication and good self-care, with, perhaps, occasional flairs. Metastatic cancer, however, leads to death.
In my wonderful group for women with advanced cancer, we talk about this a lot. There are no road maps and few guides for this journey. Each must find her own way, and the landmarks regularly change. Trying to live with one foot in the world of the well and the other in the world of the dying/chronically ill/worried ill/whatever is very tricky. Some days feel easier than others, and we all agree that the goal is to follow the old maxim of hoping for the best while planning for the worst and, in the meantime, to concentrate on living life as well as possible.
This is the theme of this most recent article from Susan Gubar from the New York Times. I give you the start and a link and much encouragement to read it.
Living With Cancer: Chronic, Not Cured
by Susan Gubar
At the end of yoga sessions for cancer patients, we are told to say to ourselves, “I am whole, healed and healthy in this and every moment.” Perversely, since in yoga we express aspirations as if they were already so, the sentence reminds me of people who congratulate me on being “cancer free.” Stable disease often goes unrecognized.
Perhaps the concept of chronic cancer has been hard to comprehend because public discussion tends to focus on the initial diagnosis of breast cancer. Early detection of breast cancer yields good survival rates and many patients can consider themselves cured. Often we assume a clear-cut partition between survivors and the terminally ill.