July 10, 2018 
“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.
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.
My First Cancer 
Speaking of Cancer…
cel·e·brate
v. to observe a notable occasion with festivities
I never look to celebrate the anniversary of my prostate cancer diagnosis, not at all.
I’ve never seen it as notable, never seen it as an occasion worthy of any festivities. It’s more like something to pretend doesn’t exist, to just…elide over.
And I’d never — never — celebrate today, the day of my ‘second’ diagnosis, the one where I learned they had discovered a lifetime’s worth of cancer in my tissues sampled at surgery: There was cancer hiding in my lymph nodes, two of them. “In the lymph nodes” had long struck me as medical-ese for “uh-oh.”
That was 14 years ago today, the dawning days of my cancer, days saturated with hopeful disbelief but mostly denial…and questions, many questions. After all, I hadn’t even glanced at the chapter in the book I had bought, the chapter titled, “Advanced Prostate Cancer.” It just wasn’t intended for me. Except now here it was, a defining part of me from here to eternity: I owned a case of advanced prostate cancer as cancer had extended its reach into my lymph nodes.
Uh-oh.
One of the first things I learned about having cancer is that we all handle it differently, be it my way, your way or some other way. There’s no one way to do it, no Right Way. Better to just explain your decisions, why you did what you did, and not prescribe what you think someone else should do.
So let me tell you what I decided after I was informed of pathology’s hostile findings. Not what you should do, how you should handle your nasty case of cancer. Just what I decided to do to inform my looming and long pilgrimage with cancer: I’d seek to learn about cancer intimately; I’d hang out with the fellow cancerians I had joined; and I’d bear witness to scenes I’d never, ever see if I hadn’t been tagged with cancer.
Cancer would take from me, that can’t be skirted. But I would take something from cancer.
Oh, not that there wouldn’t be those eager to tell me what I should do. What food I should eat, or not eat. What I should do to counter my cancer, or not do. What supplement(s) I should take, or not take. Et cetera, et cetera. And usually this advice, however well intentioned — and it was always well intentioned – came from those who did not have, perhaps never had, cancer, and never been summoned to make a life-or-death decision of what to do about their cancer, to live longer, or not.
(If you just can’t resist speaking your mind to a cancerian about their diagnosis, please first read Comfort In, Dump Out, above.)
There was my friend, saddled with a mean case of breast cancer, who decided to do whatever her oncologist suggested – radiation, chemo, whatever — at each milepost of her cancer journey and to show her cancer it would not have a free ride: “I told myself that at each stage of my cancer, I’d do whatever I could,” she said. And she wanted to send a message to her cancer, personified: “You give me any trouble, I’ll come after you.”
And there was the 37-year-old woman, diagnosed with cervical cancer, concerned about the toll of chemo and radiation treatment’s side effects on her marriage — her very quality of life. “Mom,” the young woman plaintively explained, “I was just married three weeks ago! How can I do that?” She chose to pass on radiation and chemo, the standard of care, in favor of a popular but ancient and natural therapy from a distant land.
Neither woman possessed the prescience of knowing what her outcome would be, even whether her decision would matter, in any way, to the outcome. They were two women, taking two approaches to cancer, but sharing one common reality: Each would live, or not, with her decision, a choice made amid the fog of what an unknowable future would bring. And no mulligans allowed.
I hope you never get the chance to show you’ll do it ‘better.’