Everyday, I think about having cancer and everyday I forget that I have cancer. Reminders of my illness abound. It does not take much to make me hesitate and ponder the calculus of my future.
For example, because we live in a remote area, I often shop on the web. Just last week, I procrastinated about some sports equipment I’d found on sale. As I anticipated hitting the purchase button, I thought, “Wait a moment, maybe I should first hear what my oncologist has to say at my upcoming visit.”
Then, our roof needed replacing. Currently, it is bald. I couldn’t help but think how it resembled my head following chemotherapy. The sun exposed all the irregularities: its bumps, the blistered surface, and the misfit sheeting. Soon, new shingles will cover the imperfections much as my hair hides the lumps on my skull.
So it goes…
I expect the cancer to return. I think about it but seldom worry about it. I stay informed on the latest developments in research specific to multiple myeloma. I’m comfortable with the options in my future. Life’s surprises are not limited to anticipating what the illness will do. I attempt to take things a day at a time. I accept that I am occasionally sidetracked by irrational anxiety.
This week, marks two years of drug-free remission since my stem cell transplant at the Seattle Cancer Care Alliance. My health during that time stabilized about three months after the procedure.
I received the complete battery of childhood vaccinations at one-year post transplant. I opted for both flu shots last season and will follow the recommendations again this fall. This year, I’ve had a colonoscopy (normal), PSA test (normal), and lipid panel (excellent). In May, I underwent dental surgery for an extraction and insertion of two implants.
I see my oncologist, Dr. M, at 60 to 90 day intervals. Multiple myeloma is a blood cancer. Accordingly, routine blood draws determine its status. Overall, things look good. I not only feel well, but my blood work confirms that I am healthy. Low-grade anemia is the only question mark on my CBC test. The chemistry panel, which measures organ function, looks fine. For the last 24 months, my M-Spike, the best indicator of disease, hovered between too small to be quantified and 0.1 g/dL. This month, for the first time, the number ticked upwards to 0.3 g/dL.
Dr. M has a cheery disposition. I’ve been a boring patient. Usually, he stands and delivers a rambling somewhat incredulous exposition about my remission. Today, he entered, shook my hand, and took a seat. Though my lab tests look good, the ascending M-Spike prompted him to discuss with me the value of what is referred to as maintenance therapy. He knows I am determined to remain drug-free. We will more closely monitor my blood to determine if this is just an aberration or a trend. Until further notice, I am now on a monthly visit schedule.
Remissions are, by definition, temporary creatures. Multiple myeloma, on the other hand, endures. Like a dragon sleeping in the cave of my marrow, it is destined to awaken. The question for patients is whether to risk going after it using weapons that carry their own dangers or wait until it’s actually breathing fire.
That proposition led to an awkward moment in Dr. M’s office. He is a compassionate man. No doubt, some of his patient’s pain and uncertainty leaks, by way of empathetic osmosis, into his life. For a while, we’ve been able to tacitly ignore that this cancer has staying power. I felt guilty, as if I’d done something wrong, broken the pact we had between us. Yet, given the realities of MM, this development was inevitable.
I am a well-informed patient. Dr. M is an experienced oncologist. The tiny bump in the M-Spike number showed that the myeloma stirred a bit in its lair. When it comes time to go after that dragon, I’m glad someone who cares will come along.
P.S. Today, I’m more relaxed. Technically, the remission is intact. Many of my acquaintances with MM can only dream of such a modest number as mine. So, I have reason to rejoice. This is just another day in the life of a survivor. There’s unreasonable fear, confusion, as well as good old forgetfulness.