05 November 2015

Oh Joy! It's Metastatic :(

   So, CTCA called today to let me know that my scans were read by a radiologist and that my cancer is metastatic. I have a small nodule on my spine and liver and my bilirubin count is low. God! I cannot catch a break for anything. I need for November 16th to hurry up and get here. I needed to be at UT like yesterday. I have been so sick for the past two days. Today, I was too sick to even teach the kids. I am beyond ready for answers and treatments...and I never have understood why I am always having to wait. It is what it is.

   Kevin and I named my creature (cancer) "It". Kevin has a fear of clowns and it is because of the book "It" ;so what better name for something so terrifying such as this, lung cancer, than that? 

   I told Kevin that I feel isolated. I have my mommy who never minds me calling her up and crying about my cancer, but I want to connect with people like myself who are my age dealing with Stage IV Metastatic Lung Cancer. Everywhere I look, I see seemingly healthy people. I feel like none of them could possibly comprehend my fear, my sadness, and my anger. I desperately want to talk to someone who is going through the same things. And learning that my cancer is terminal, my sense of isolation has only increased. I think I will research support groups online and reach out to women who are going through this monster too.

   On another note, we have field mice in our house. Our cat is too lazy to catch them. Although I am not pleased with the destruction they have brought about by their nest building, I do not take it personally. They are simply doing what is their instinctive imperative and no offense to me or my family was meant. However; I am not obligated to allow them entry into my home and unlimited access to and destruction of my possessions (they even ate my Taco Casa hot sauce packets I had been saving). What is good for them is bad for me.

  I cannot help but see the parallel to cancer in this situation. It is hypothesized that we may all have circulating cancer cells at any given time. These are generally kept in check by our immune systems, and have no noticeable effect on our well being. However, an external event, such as exposure to one or more carcinogens, can upset this balance and the cancer cells may proliferate to the point where our health is compromised. This is when we generally become aware of our "host" status to an uninvited lodger and we do our best to evict "It" (the cancer).

   I am pretty certain that we will always have some mice (again I have a lazy cat), but if we can find a way to deplete their numbers, we can minimize the damage that they do and carry on with living. We may feel occasionally unsettled, as we hear them rustle in the walls, but the situation will not be untenable.

   This is such an apt metaphor to my cancer. Cure is almost certainly not possible, but as long as we are able to keep the cancer at a level where it is not severely compromising my health, I am able to go on with my life. However; just as I will be kept awake occasionally by the sound of mice in the cabinets, so too will I listen to the beat of my heart and think about the cancer that is traveling through my veins. Should I find more evidence of proliferation, it will be time to clean house. 

   I believe in luck, fate, karma...faith. Good luck and bad luck I have both experienced. A bumper sticker that was once popular several years ago read," Shit Happens". By definition, luck of either variety is out of our control. However; this doesn't stop me from trying to attract luck of the positive kind. To this end, I have several good luck charms, or talismans in my possession. One just happens to be a cross...and another is the matching tattoo I have on my left shoulder that my husband also possesses. 

   The term cancer survivor has become part of our everyday lexicon. Even within the cancer community, there is confusion as to what it exactly means. According to the National Coalition of Cancer Survivors, survival is from..."from the point of diagnosis forward."

   When considering overall survival statistics for a particular cancer, there is a more specific reference point: it is the percentage of people who will still be living after five years (excluding those who die from other causes). Before I go any further, it is important to clarify that survival statistics should be viewed as estimates, and not actual predictors of an individual's prognosis. Statistics describe a trend, or a likelihood of an event (in this case, death from cancer) in a large group of people. They are based on actuarial tables that are by necessity at least five years old, and thus may not reflect recent treatment advances.

   Statistics are in essence a fraction. When you read that lung cancer has an overall survival statistic of 15%, it means the number of people diagnosed with lung cancer over a period of five years (the denominator) has been divided by the number of deaths over that same five year period (the numerator). Overall survival statistics are all inclusive as type (NSCLC and SCLC) and stage, and do not address other considerations such as disease or progression free status.

   Survival statistics that are broken down by cancer type and stage, are most useful for evaluating treatment options and for predicting prognosis. But, it is possible to focus too much on these stages. "What stage?" is often the first thing we ask after we are given a cancer diagnosis. In essence, we are asking whether or not we have reason enough to hope. 

   After my thoracotomy, my surgeon knew immediately that I had cancer. My oncologist calls it Stage 1A but stage IV. I know it sounds confusing, and believe me it truly is. Stage 1A means it has not spread to other organs but she staged it at IV because it spread to both lungs. And now it is metastatic. 1A is worse than 1B and spreads faster. You know how I just said we ask about staging to see if we have reason enough to hope? I will never lose hope..I have too much to live for. It doesn't matter what stage I am, I cannot lose hope and I cannot give up.

   I became all too aware of staging when I went from Stage 1A to Stage IV. It was devastating. My cancer was essentially the same cancer, but now, statistically speaking, the situation seemed hopeless...but I promise I am not hopeless.

   The Merriam Webster definition of survivor is: 1. to remain alive or in existence, to live on. 2. to continue to function or prosper.

   I am certainly not prospering, and I am always questioning how much longer I would be able to function or even exist. And yet, indeed I remain hopeful and there is no question that I am still alive. Does this make me a survivor?

   Survivor seems to me to imply that the trauma has passed. You've faced a great challenge, yet you have persevered. There is no question that I am facing a great challenge, but I know that it is highly unlikely that ultimately I would either persevere or prosper.

   I don't refer to myself as a lung cancer survivor. I prefer to say that I am surviving lung cancer. To me, this clears up misconceptions about both my status (terminal, rather than in remission or cured) as well as to the degree that I am still involved in this battle. Each day is a fight for survival, every new breath is a victory.

   2 Corinthians 4:15-16
All this is for your benefit, so that the grace that is reaching more and more people may cause thanksgiving to overflow to the Glory of God. 16. Therefore we do not lose heart.  Though outwardly we are wasting away, yet inwardly we are being renewed day by day.
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