Cancer free? The all clear?

Now that the heavy treatment has ended the most frequent thing I hear is the question about whether I have had the “all clear” and if I am now “cancer free”. 

This is a really tough one to understand, let alone explain, but essentially and unfortunately, there is no such thing.  Once you hear those words – in my case “highly suspicious of cancer”, there is no turning back.   You can’t put the lid back on the box, life changes forever.  The tumour has been cut out, along with any surrounding tissue which might be affected, including lymph nodes by the dozen.  My whole system has been blasted with 8 cycles of super chemotherapy which has destroyed any fast growing cells (including cancer cells which might have been lurking after the surgery) and also laid waste to my immune system, red blood cells and still affects the nerve endings in my fingers and toes.  Massive doses of radiation in the area local to the original tumours have swept up any final vestiges of any cells attempting to break away and try and re-group into a sinister manner.  And now the Tamoxifen is blocking hormone production which can spark new naughty cell activity.  So all in all, a massive arsenal of heavy duty medical might has been used to destroy the cancer and any remnants there could be.

And that’s marvellous, trust me.  It is highly reassuring to know so many powerful agents have been used to obliterate any cancerous attempt on my body.  However, there are no guarantees with this beast, and recurrence or even spread and secondary tumours are entirely possible.  The best to hope for is that the regular checks find “No Evidence of Disease (NED)” The longer you hear the magical NED following diagnosis, the better the statistics are and the prognosis in the longer term.  Hence the regular monitoring and follow up, and the reason why it is every 3 months for the first 2 years. 

So, I am no longer a “cancer patient” in that I am no longer undergoing treatment.  I am still here, so I am sure I can now call myself a “cancer survivor”.  However, I cannot call myself cancer free as I have no idea if there is or will be any re-grouping of those dangerous cells.  After 5 years without recurrence the checks reduce to an annual basis because the statistics indicate that recurrence is less likely after 5 years.  Even then I cannot be cancer free. 

That is on the medical and physical side.  On the psychological side, I hear a reprise of “things will never be the same again” picking up. I can do many things now that I could not even a month ago and am getting stronger every day.  However, my mind is always alert to my vulnerability.  I am hanging on to the next appointments and checks with the Drs W and W2 in the hope that they will tell me that everything worked and I have no need to worry now.  But we all know that it won’t happen.  The best I can hope for is NED.  I know I should not try to read little clues into everything Dr W2 says as it does not reassure me, but I find myself unable to do otherwise.  His reluctance to remove the port or de-port me convinced me that he thought I was a certainty for recurrence.  Equally difficult is the fact that I can no longer take my professional path for granted.  Would I be too great a risk to employ after my current contract finishes?  I know I need to just put many of these things to the back of my mind, but that is way easier said than done.  The appearance of that small lump on my neck last week and the sinking feeling it brought indicate the precarious nature of my relationship with the cancer beast.

So cancer-free I am not, and never will be.  However, I will have those regular checks and very careful monitoring and I have to be confident that if the cancer beast makes any attempt to show its face again it will be spotted very promptly.  It will also be met with another arsenal of treatment and as unpleasant as that is, I know that I can cope with it.  As long as the sun keeps rising in the East, or rises anywhere really, I have to remember how much I have to be thankful for.

Onwards and upwards it is then…………