Friday, April 13, 2007

An Unwanted Journey: Day 0506 - Remission and/or N.E.D.

Do I still have cancer? Is it correct to say that I am a cancer survivor? Am I in remission? Or am I simply in a state of No Evidence of Disease (NED)?

Others in similar situations have written about the experience of no longer receiving treatment for cancer. While that happened to me in late September 2006, the end of active treatment was followed by a series of tests that lasted until just recently. The signature moment for me occurred when the most recent CT scan was done and my medical oncologist told me that there was no evidence of disease. It was a pivotal moment mainly because I had no further medical appointments on my calendar directly related to cancer diagnosis, treatment or followup procedures.

There will, of course, be many followup procedures and tests over the next few years, but until and unless there is some indication of recurrent cancer, I can realistically consider myself in a different category. So why, then, do I hesitate to call myself a survivor?

It's not about pessimism, nor about an unfortunate loss of hope. It's more about a permanent shift in my knowledge and understanding of how cancer works. Doctors have told me that they no longer talk about a cure for cancer. They talk about treating cancer as a chronic disease, sometimes with acute phases, but chronic nonetheless.

And as I have become better educated about the causes of cancer - especially the genetic underpinnings of the disease - I can appreciate what the medical authorities are trying to do be reiterating their message of "no cure". It's all about vigilance and learning to live with the after effects of treatment protocols. The specter of cancer seems omnipresent after you have been bombarded with radiation, after you have undergone serious surgery, or after you have experienced chemotherapy and its lingering side effects, months, sometimes years after the cessation of treatment. You know how awful treatment can be, so vigilance seems like a simple dose of common sense. But you pay for that vigilance whenever anything, anything at all, happens to your body.

For me, a simple gastrointestinal ailment is a serious problem both physically and emotionally. Not only does my body demonstrate that it cannot handle the distress of a GI infection very well, but my emotions betray the fear that cancer has reared its ugly head again. But then I bounce back to the realization that things are better, much better than they have been for a very long time. And I succumb to gratitude.

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