April 14, 2013 
Monday at the Cancer Clinic—I’ve never experienced so much cancer on display, never witnessed so many visible signs of it.
It starts in the parking garage at Seattle Cancer Care Alliance. I am in space D353, and the couple in D352 walk with me to the elevators. She is chemo-bald. Straight to the lab services waiting room we three go, I for my quarterly blood draw.
While waiting to be called, I notice another chemo-bald woman, and then another, and still another. Highly unusual. So I begin surveying the crowded waiting area — it’s standing room only (“I’ve never seen it this busy,” one regular declares) — and start counting the women without hair: five, six, seven, eight, nine…I’m distracted by four people sharing their stories of stem cell transplants…”he’s 59 days out and, see, his hair’s growing back”…10. Finally, number 11 takes her place in the queue for check-in.
Behind 11 is a young boy, probably about 10 years old, in a wheelchair. His father is reviewing the day’s schedule of appointments; it spills across two pages. The boy’s pre-pubescent alto voice, loud with excitement, abruptly calls hello! to the phlebotomists. They return the greeting; they’re all — and how many appointments does this take? — on a first-name basis. The obvious glee among them torques a round of laughter from the serious and silent rest of us.
My turn. My blood is drawn so quickly (or my mind is so elsewhere), it is over before I even sense the prick of the needle’s entry into the crook of my right arm. As I leave for the quarterly appointment with my oncologist, chemo-bald woman number — no, wait, I can’t count this person as woman #12: This person is so young, so hairless, I can, on passing, discern no identifiers of gender.
I’m in a snow globe of despair, but instead of flakes, it’s cancer swirling around me.
***
Upstairs, two weeks into the seventh year of my cancer journey, I report for my check-up; my PSA is once again undetectable. I remain no evidence of disease (NED). But my oncologist and I talk not about a cure but about how much longer I can go before my prostate cancer comes back. (I did, after all, have cancer in two lymph nodes at surgery.) He tosses out markers: another year, three years, five, and why each increment is better than the previous.
It was a hopeful discussion about an uncertain and unknowable future. Very much unlike my April 2012 check-up, which brought the despairing, hollowing out news of possible recurrence. With that came a sense of futility we cancerians know all too well: No matter what I do, I can’t get a break. It’s the point in your disease where you think you’ve hit bottom, and then someone shows you to a door leading down.
But today, my oncologist — who cautioned me a year ago not to read too much into those disappointing test results — actually sees me as NED since January of last year: Despite the scant and receding traces of PSA measured in April and July of 2012, I’m 15 months no evidence of disease.
From despair to hope — what a difference a year makes.
***
My visits to the cancer ward tend to be emotionally uneventful, but this time, I knew both despair and hope, raw and in full measure: despair that so many lives are marked by cancer; but hope that the wizardry of modern medicine can, if not save, at least meaningfully extend our lives. And that is why we were all there on the morning of Monday, April 8, 2013.
Each of us had an appointment with the doctors of hope, standing room only.
In This, My Eleventh Year
“You should write something,” she said, “like, ‘I’m still here.’”
As in, I’m still alive.
It’s my 11th year now – 10 years and counting – since they found cancer in my pelvic lymph nodes. In this decade of the ups and downs of cancer, I find that I pass milestones less frequently, my self-discoveries strike increasingly sporadically, the observations at the cancer clinic dawn less often. Yet one thing remains all too consistent: the disappearance of a fellow cancerian, never mind the precise genus of cancer, into the vanishing point of memory. What was her name? Celeste? Yes, that’s it. Celeste.
My cancer journey has been long enough now to ignite a singular light, which could even serve as a True North, of a sort, for almost every cancerian: the beacon of hope. There’s always hope. But reasonable hope, to be sure. Not faux hope that’s wishful, or fantastical, or even pie-in-the-sky. And certainly not the crossed fingers that put some cancerians on life support in the ersatz hope that something unknown today may, out of the clear blue, abruptly announce an arrival tomorrow, and, voilà – we’ll all be cured!
No, reasonable hope approaches in steps, incrementally, their tracks to be read for a saving grace. Since my diagnosis on March 26, 2007, seven new drugs for prostate cancer have jumped the hoops of federal approval. Seven, in large measure the product of Mike Milken and the Prostate Cancer Foundation he founded.
Mike Milken (left), founder of the Prostate Cancer Foundation, and Fred Hutch prostate cancer researchers at the Seattle Mariners’ Safeco Field, as the PCF inaugurates its annual Home Run Challenge to raise funds for prostate cancer research. Seven new prostate cancer drugs have been approved since I (far right) was diagnosed.
Thank you, Mike; thank you, PCF.
Which brings me to my most recent six-month check-up. PSA – you can argue the pros and cons of PSA as a screening and diagnostic tool – nonetheless remains the gold standard for monitoring a contest with prostate cancer, and the lower your PSA number, the better. And my PSA, on an early Wednesday morning in May, was a negligible 0.08 ng/mL. That was up a trifling 0.01 over the past six months. Heck, the rise may even be within some margin of error, or the result of rounding or…or…
0.08. Ten years in. Not bad, considering that my surgeon, after reading the pathologist’s post-surgery findings to me, advised me that he had another patient just like me, a patient with cancer in his lymph nodes, who was still alive six years after surgery. All this news stunned me – my cancerous lymph nodes, the metastatic march of my cancer, another’s ephemeral six years of survival – it all sounded to me, and there are no words to cushion this for a soft-landing, like some sort of indeterminate death sentence.
Which is not to say that I’ve beat cancer, or that some oncologic god has called, “Olly olly in come free!” No, just that, for the nonce, I’m holding my own in Stage 4-land (there is no Stage 5). Holding my own as doctors continue their search for an eighth, a ninth, even a tenth drug. Holding my own as they experiment with the optimal timing and/or combinations of these new drugs: When do you get the best results with X? Should Y drug be administered in concert with Z drug? Should an old drug be retrieved from the shelf and used in a new way?
Someday – hopefully soon – we should know the answers to these questions, know what is today unknown. Reasonable hope, yes; but the question still hovers above all: when?
Meantime, I’m still here.