Monday, September 22, 2014

Two Autumns

Outside the air grows crisp, the brisk wind nips, and we all await and hope for the riot of autumn’s color. Fall rhythms have already begun, as summer vacations pass into memory.

I love autumn. It’s a time of renewal, unlike spring. It’s a time for hope, a time for newness, with the promise of the holidays just…there.

I’m weird that way.

By the time I was settled into the high school from which I would graduate, I had started six schools in six years. So, for me each fall was a new beginning. It was hope and newness and promise, while spring was a time for endings and goodbyes.

Adulthood blurred those lines, but parenthood reinforced the pattern. Your child’s first day of school is all hope and newness and promise…some things never change.

Last autumn, however, was…different.

Labor Day weekend gifted me with a(nother) cancer diagnosis. September and October were spent with tests and scans and doctors and hospitals and opinions and counter-opinions and fear. November saw me begin hospitalized chemotherapy.

This autumn is much the same.

- - -

I write this on a northbound train. I’m travelling to New York for a scan.

Such simple sentences. Such complex meaning.

The odyssey that started on July 13, 2006 continues. (Ironically, my journey also paused for seven years. He had Calypso. I had “everyday life”. I’m not sure who had it better…)

And like Odysseus, my journey remains fraught. I seek guidance from godlike beings, I steer toward and away from danger as best I can, and I have faith. I rely on my wits, my will, and the (immense) support of so many—friends, family, colleagues, and those in-between. I trust in the kindness of strangers.

And today I take another huge step along the path…

- - -

There are two simple questions out there: what is my tumor doing, and what do we do with it?

See? Simple.

Today’s irradiated, tubular visit will help answer both questions.

The protocol for my particular cancer (as closely as they could diagnose it, based on their limited access to the tumor), was to resect the tumor and follow with chemotherapy. (Even as I write that I am shocked how simple those words sound, compared to the reality they describe.)

However, the size and position of the tumor made that initial plan unsupportable. I could have the surgery, but I might lose my leg in the process. Not good.

The secondary plan was that I would have surgery after my chemotherapy. The procedure would remove the mass and scar tissue, reducing my risk of future cancer and enabling the doctors to (finally!) learn exactly what type of cancer I had.

But, life does not go as planned. While chemotherapy was effective—killing the malignancy and shrinking the tumor—the bastard still sits on a nerve and an artery. So, the initial post-chemotherapy decision was to not pursue surgery. This would give me time to recover from the debilitation and horrors of chemo. We would monitor my tumor through nuclear imaging, monitor my general health, and hope for the best.

They warned me that were my cancer to reignite, it would come back this year. Statistically, more than 80% of the late-relapse returns occur within 12 months of ceasing chemotherapy.


Hope for the best.

Could you do it?

So, I enter the tube today to discover if the fucker is growing, and to see precisely what we are dealing with, now that my body has significantly recovered from chemo.

- - -

...September and October were spent with tests and scans and doctors and hospitals and opinions and counter-opinions and fear...

This autumn is much the same.

It’s September.

Tests and scans and doctors and hospitals and opinions and counter-opinions are upon me. In the next three weeks I will visit Memorial Sloan-Kettering Cancer Center (twice), Georgetown University Hospital, and The James Cancer Center at Ohio State University. I will see three oncologists and two surgeons. I will virtually consult with another surgeon at Indiana University.

I got doctors.

They got opinions.

Where do we stand today?

Every doctor agrees that I should have my tumor removed.

The surgeons, however, are of differing opinions about what should or could be done now.

  • My MSK surgeon is deeply concerned about the risks of my surgery. I’ve written about it before.
  • Indiana University believes that the surgery is possible.
  • Both surgeons agree that “monitoring” is a viable option.

So, what to do?


Hope for the best?

Could you do it?

- - -

Today my odyssey continues. I enter a tube; I exit with images.

In a few weeks, my godlike guides provide me with answers…and opinions. I’ll consult with oracular nurses and survivors.

I’ll then go deep inside. I’ll muse.

- - -

Outside the crisp, morning air nips as I sip my coffee. Autumn has begun; summer fades.

What will be will be what will be.
I’ve got this.