From time to time I offer reports on my progress with cancer, because I know that many of you care. For that, I’m immensely grateful.
The latest happened yesterday, when my surgeon went into my bladder laparoscopically to see if there was any cancer left, after my recent chemotherapy session. This was the third-such excursion in the eighteen months since I was diagnosed.
The first thing she said was, “I don’t see anything.” I thought I’d misheard her (she was speaking through a mask so her voice was muffled). I mean, the first two reveals had been shattering: lots of tumors despite the chemicals that had been thrown at the growths. So, naturally, I was expecting more of the same.
I’ve struggled psychologically with trying to stay upbeat and positive (as many people urge me) versus the reality that I have a very aggressive form of high-grade cancer. Cancer is, after all, incurable: doctors never refer to anyone as having been “cured” of cancer. They will simply say the person is showing “no evidence of disease,” or is NED, in the acronym. NED is what I’ve wanted to be, of course, but it hadn’t happened in a year-and-a-half.
The relationship between cancer patients, like me, and their loved ones is strange and fraught. One of the challenges is that well-meaning people tell you things that they think are helpful but in actually can be confusing and anxiety-inducing. This is particularly true when it comes to religious or spiritual matters. I have friends who are devout Christians and they send me tracts about Jesus Christ being the source of all healing. I have Buddhist friends who feel the same about their religion. I have friends who are spiritual, in a new-agey sort of way, and they recommend all sorts of holistic practices, including Ayurvedic medicine. Then there are the diet-and-supplement people who tell me about miracle treatments I can buy at the health food store. And of course everybody instructs me to remain positive, think good thoughts and visualize. It can be quite overwhelming. I want to be polite to these friends and acknowledge their loving concern, but really, I wish no one would offer me any advice at all! Just give me your love, I’ll give you mine, and meanwhile I’ll trust in my medical team at Kaiser.
Anyway the upshot of all this is that I’m now NED. It’s semi-official: I need first to get the results of a urine test but my surgeon is certain it will be negative. Once I’m officially NED I’ll be put on maintenance therapy, which is monthly chemo treatments, presumably for years. But as the chemotherapy is intravesical, meaning it goes into the bladder directly and not into the bloodstream, there are none of the dreadful side effects from conventional chemotherapy. (If you have to get cancer, the bladder is, in that sense, the best place, since it’s the only self-contained organ in the body.)
I should be turning cartwheels but my joy is tempered by a hard fact: recurrence is very, very common in bladder cancer, even when one is NED. It can return with a vengeance, spreading rapidly to the lymph nodes, the pelvis, and other nearby organs. (This is the reason for the maintenance therapy.) So it is with decidedly mixed feelings that I awoke this morning, after yesterday’s emotional roller coaster ride. Obviously I’m thrilled the surgeon found no cancer. But the road ahead remains filled with shadows. However, as I tell myself constantly, that’s true of everything and everybody. All we can do is our best, every day, to enjoy life, make our city better, and be civil to others. All else is maya, the dream.
Steve Heimoff