Jay Lake: Writer

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[Cancer]

[cancer] Status check

I have another oncology follow-up today, this one with the surgical oncologist who handled my hepatic resectioning of last September, in order to close out the case. This should be my final visit with him, barring future scanning artefacts on my liver. This of course follows on last week’s oncology visit with my medical oncologist, who has a permanently open case on me until death do us part or my return to full health after five clean years. (I also have a longer baseline of continuing visits to my colorectal guy to monitor for any possible recurrence of my primary cancer.)

After today, my next activity on the oncology front will be a CT scan currently scheduled for Thursday, April 14th. I then see my medical oncologist the following Monday, April 18th for the results. I know from experience that my anxiety and upset will peak at the CT scan itself. This isn’t particularly logical, as the information doesn’t arrive until the post-scan consult, but that’s where my brain fixates.

At this point, I have about a 40% chance of seeing a new metastasis at the April scan. Were that to happen, I would expect surgery in May (assuming a surgical cure is reasonable — if the metastasis were a bloom, or in my lymphatic system, that would not be the case) followed by another six months of a more difficult chemotherapy than I experienced this past year. Of course, the converse is that I have a 60% chance of enjoying continued good health for another six months, until the October scan.

If I stay clean, those odds drop year-over-year. In 2015 or so, I’ll be released to the general population with a roughly 2-3% chance of metastasis as my long-term baseline risk. Still rather higher than the average bear, but not the current order of magnitude higher. At that point I would have beaten the 50% mortality odds currently on the book for me.

It’s hard to look into the future with this in front of me. I’ve been much taken by short-term thinking lately. This is true with respect to my writing, my Day Jobbe, my personal life, my financial planning, and so forth.

Yet this doesn’t keep me lying awake at night in a sweat. The blunt reality of my health is horrifying, but the days go by just the same, with parenting and writing and work and laundry and morning showers and so forth. At the moment, I would say I’m pretty overwhelmed in a philosophical or spiritual sense (yes, I am an atheist with a well-developed sense of spirituality), but mostly I just keep living my life.

We all have a bullet coming. Most people my age don’t see the one with their name on it. I do. Whether it hits me or not is an open question, but boy howdy do I see it coming.

So I live as well as I can right now. April might be the end of my tomorrows, or it might be just another day at the oncology unit.

I don’t know how my doctor does it.

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