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.
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.’