"Just do what you normally do"

My final major surgery is now over a week behind me. Because of the good recent PET scan there is no more chemo scheduled. No more radiation. Basically, I'm done with my cancer treatment, for now. I still have some recovery to do from the ileostomy reversal a week ago, and my newly 'reconnected' body definitely needs some time to adjust (I've been reading a lot about sphincters, rectums and microbiomes - interesting stuff), but then - in theory - I can return to my normal pre-treatment life.  Sounds easy, but I confess I'm really struggling with it. I touched on this a bit when I wrote about the concept of 'survivorship', but I feel I need to elaborate a little. I'd love to hear how others - particularly other Stage 4 'survivors' - have dealt with this.  

For a start, I haven't been at work for 10 months. Before my cancer diagnosis I think I'd taken 2 or 3 sick days in my entire working life - and I'm including my teenaged part-time work in that too. So I'm strangely nervous about going back. But this isn't my biggest problem or my biggest concern. 

I'm struggling most with the uncertainty. As a Stage 4 cancer patient I've been told from the beginning by my medical team that I have at best a 50/50 chance of surviving (which technically just means being alive 5 years post diagnosis). My odds are far worse (like 10-20%) if you use published survival curves as your guide. And that hasn't really changed just because I got one clear scan. Given the level of lymph spread and liver involvement, the odds that the cancer will return in the near / medium term is very high (up to 70% based on some stats I've seen). If there is one thing I've learnt it's that these medical stats are somewhat meaningless because everything is so uniquely individual. Nonetheless, I feel like I am skating on very thin ice. 

So, after months of daily treatment activity, coupled with spoken and unspoken allusion as to my poor prognosis and my need to prepare for the worst, I am suddenly told that 1st line treatment has ceased and I can come back again for another scan in 6 months. In the meantime, just "do what you normally do". How does one return to 'normal' with such a huge cloud hanging over them ? For example, should I just jump right back in and go back to work 5 days a week - and try and recover something of my corporate "career" - or, should I account for the fact that I'm still likely to exit life quite early given my diagnosis, and instead only work 4 or even 3 days a week and use the rest of the time on 'bucket list' projects and with our young kids ? Or being even more extreme, should I continue with my previous working life or instead pursue something more directly 'purposeful'. I decided early on, for a host of practical reasons, that it makes sense to go back to my old job, but that doesn't stop these thoughts from rolling around my head.

I keep telling myself (and others like to tell me) that my situation is really no different to anyone else. No one really knows when death will visit them and so the best approach is to just assume the best and live each day as such. But really, things feel a little different when you're a marked man, when upstairs has given you a stern warning that you might be on borrowed time. And we're talking wildly different scenarios here - from cancer back with a vengeance in a potentially untreatable fashion at my next 6 month scan and death a while later, to a full cure scenario where I live another 50 years. We've been dealing with this strange new duality (long life v short life / imminent death) since my diagnosis and called our approach to it 'dual tracking'. But somehow it seems a little more surreal, vaguer and littler harder to navigate, in this post-treatment but 'pre-cure' period.

I think the best thing I can do is modify my treatment period 'dual tracking' a little - to live as if I'm living the best case scenario, but also invest a least a little time and effort to ensure I and my family are prepared for a worse scenario. Exactly what this means in practice, well I' not sure, but I have a couple more weeks to figure it out.     



The Cost of Cancer

A few words of thanks