I've arrived at another PET scan eve, and I find myself more nervous than I have been in awhile. I feel healthy, alive, happy. I have no reason to suspect that anything cancerous is happening in my body. My brain knows these things. However, something inside of me is whispering to my brain that I may have reached the statute of limitations on clean PET scans, even though my brain knows that that is nonsense and border-line superstitious. This thing reminds my brain that the interval between my two separate breast cancers was two years, and we've nearly reached the two-year anniversary since my last mastectomy, so the next cancer must be just around the corner. My brain counters this voice with a resounding, "Nonsense! Those data are statistically unsound, and also meaningless because you've continued tri-weekly treatments with Herceptin plus a drug (Perjeta) that didn't exist the first time you had cancer. Any cancer inside of you is continually beaten down, and it will continue to be beaten down indefinitely. Besides, there's nothing to be afraid of, it's just a little PET scan."
Just a little PET scan.
The brain continues. "Silly girl, the PET scan serves an important role for someone who is living with stage 4 cancer. The cancer could indeed flare up at any time, and that's why we do the PET scans. To catch the emerging cancer. Avoiding PET scans would be irresponsible at best, and negligent at worst. Stop this fear-mongering, take your PET scan, and chillax."
Oh, brain, what would I do without you?
This conversation with my brain reminds me of another one I had back in June. My dear friend R was visiting from Massachusetts, and we were having a normal conversation about normal things. Somewhere in that normal conversation I said, "...when I get cancer again...". She stopped the conversation in its tracks, and instead we discussed my choice of the word "when". R prefers the word "if", as in, "if I get cancer again". I reasoned with her that I used to use the word "if" when I was a cancer-free human, and I even permitted myself to use the word "if" during that time between the cancers. I have since tried to refrain from using the word "if" when I talk about my future with cancer because it causes my heart to jump into my throat. You see, the problem with "if" is that it comes with a truckload of uncertainty, and that uncertainty breeds fear. I hate living with fear. In contrast, the word "when" takes the uncertainty out of the equation and reduces my fear. It helps me to accept the entirely probable possibility that I'll have to deal with cancer again in a big way in my life. Indeed, I continue to deal with cancer every third Friday when I go to the clinic for two hours of cancer-fighting drips. But this kind of dealing-with-cancer is easy to marginalize because it doesn't interfere with my quality of life.
I learned from my conversation with my friend R that the problem with the word "when" is that it unnerves some people, including some of those in my support network. Cancer-free humans probably take comfort in the distance provided by the word "if" because they don't have to visualize cancer or its fall-out. That's understandable. But those of us who've had cancer lack the luxury of distance, and we benefit from the power that comes with the word "when". It's a small power, but important.
I feel very fortunate to even be having these conversations with myself. I was diagnosed with stage 3 inflammatory breast cancer almost 6 years ago, the diagnosed with stage 4 ductal carcinoma in situ breast cancer with lung metastases nearly 2.5 years ago, and now here I am with no evidence of disease. It stuns me to think about it, so I don't think about it very often. I just breathe deeply and express my gratitude for this day, and the next day, and the next day...