An Unwanted Journey: Day 0959 - Optimism and Realism

It's stage IV metastatic colorectal cancer with metastases to the liver.

So, it's official. The tumour board meets next Friday to review my case and determine a treatment plan. I will almost certainly have chemotherapy as a primary treatment protocol, using avastin with Folfiri. I may be involved in a clinical trial for a PET scan. And, if I am really lucky, I'll be eligible for a liver resection.

Why lucky? Because surgery is just about the only treatment currently which can speak of a curative plateau. Optimistically, I'm young enough and healthy enough with liver lesions in a location where we can seriously consider resection. But realistically, five-year survival statistics aren't great, less than 50%.

I will choose both optimism and realism - optimism because I truly believe that thinking that way improves my mental health and helps prepare me for the rigours of chemotherapy and surgery - realism because there isn't any point in ignoring statistics and general outcomes completely.

One of the strange things about today was my relative calm. My wife and I asked questions, I got some more blood work done, and then we both went back to work. Sure, we talked about some of the implications of the diagnosis, about the seriousness of the anticipated treatment, and about the uncertainties of the prognosis. But for both of us, there was a sense not of resignation, but of peacefulness which I can't really explain.

Perhaps it's because we've both been here before. We know what to expect from both surgery and chemotherapy. We know that we have a reserve of strength and the support of family, friends and colleagues. We know that our medical team is excellent. And I guess we've learned that there are no guarantees in life, that it's foolish to expect life to be fair, and that there are some things beyond our control. But what is in our control is how we react to what life throws at us.

Maybe we've learned that choosing optimism is a very realistic and sensible approach to even a life-threatening illness.