Countless movies feature cancer as a key plot element. Heroes or villains are extra heroic or villainous because they secretly know they only have six months to live. They have nothing to lose, and they’d just as soon go out in a blaze of glory. Or, to cover the cost of all the huge medical bills over his remaining six months, our protagonist begins cooking meth. Or, in a cancer love story, a couple falls deeply in love. Unfortunately, one or both of them have only six months left to live.
Sometimes it’s three, nine, or twelve months. But it’s almost always six. And in the movies, oncologists giving their new patients an initial diagnosis invariably include this information. Immediately.
None of mine ever did. They never said anything at all about how long I had left. Once I asked my radiation oncologist about this. “Was it,” I asked, “because you didn’t want to create a self-fulfilling prophecy, and have me just give up and expect to die after six months?”
“No,” he told me. “Nothing like that. And yeah, oncologists always say that in the movies. But the truth is, we just don’t know how long a patient will survive. We almost never know.”
I’m not a doctor. Not even in the movies. But here’s my inexpert advice. Decide to stick around a while longer. Because we almost never know.
Early-stage cancer that hasn’t spread can sometimes be treated with precisely targeted radiation, or even removed surgically. When dealing with a discrete tumor, oncologists can sometimes be quite confident that all of the cancer has been removed or destroyed. But even then, they may ask patients to return for “routine scans” at certain intervals.
If your cancer has spread and metastasized, you’ll definitely be back for “routine scans,” and maybe even a biopsy. (Actually that “metastatic” cancer word simply means the cancer is moving, spreading, and “beyond static.” Meta Static.) And even if radiation, chemotherapy, immunotherapy, or targeted therapy seem to have worked, there’s always the chance your cancer could return later. It only takes a few of those malignant cells lurking in some dark corner of your body.
So once you go metastatic, you’ll never go back. Best case, you’ll still be returning for ‘routine scans.” If those scans go well, their frequency will decrease from once every month or two to invervals of three, six, and twelve months—and maybe even once every five years. (Personally, I’m just now moving up from three months to six.)
Rationally, of course, there’s no reason to become extra anxious during the days, weeks, or months before these “routine” scans. After all, the news will rarely be black-and-white. It will never be “all clear forever,” and it will never be a final death sentence. It’s only a snapshot, and there’s always one more thing your oncologists can do. Still, if you’re the patient and it’s your scan, it will never feel routine.
If you’re the patient, it’s as though you have the Tumor of Damocles hanging over your head. Forever. What do I mean by that?
If you haven’t heard the original “Sword of Damocles” story, Damocles was a guy in ancient Greece who, as legend has it, hung around the court of King Dionysis I of Syracuse. Like many, he spent just a little too much time flattering the king. He told the king incessantly that he was a great man, a wise ruler, and incredibly deserving of his wonderful, luxurious life of ease.
So eventually the king grew tired of this and asked Damocles if he’d like to switch places for a day and actually experience a king’s life of luxury and ease. Of course, Damocles agreed immediately. Next day he’s sitting on the king’s throne amid piles of gold and silver, young girls feeding him grapes, that sort of thing.
But then he looks up and sees a sword hanging over his head, held only by a single hair from a horse’s tail. Suddenly the king’s velvet throne feels a little less comfortable.
King Dionysis explains that when you’re king, you have a lot of enemies. Sure, you have riches and treasures. And you are king. But you’re always watching over your shoulder. It’s like always having a sword hanging over your head by a single hair.
So Damocles, I suppose, must have told the king “Point Taken,” or something like that.
Which returns us to our “Tumor of Damocles.” If you have one hanging over your head, then what do you do with your newly acute awareness of your own mortality?
I can’t answer that for you. I’m still working on the answer for me. But I think it might be something like this…
Be worthy. The past is past. Now live life to the fullest. Make plans, but live your life and make your choices knowing that every year, month, week, or day could be your last. Be the best, kindest person you can be.
Come to think of it, that might be an OK plan for just about anyone.
Pink gets all the ink, but cancer comes in many colors.
Here’s a thing I remember: I was once in the oncology waiting room when a woman sat down nearby who was sporting a teal-colored running jacket, black-and-teal running tights, and formerly blond hair that had been dyed a lovely shade of teal.
(At the moment I wasn’t sure that was the color’s name, and I’d never really noticed a duck with that precise color anywhere on its head or wings. But if I had, it would have apparently been a teal.)
I complimented her on the fun hair that matched her outfit, and she explained that it signified ovarian cancer. She then told me she was a member of MOCA, the Minnesota Ovarian Cancer Alliance. (This acronym sounds like it should have something to do with coffee or chocolate. But no.)
Rather at a loss for words, I said simply “Oh.”
I thought of telling her that that as far as I know there’s not a club for people like me with advanced Stage IV metastatic melanoma. I was already an outlier, and it would be a small club with a rapidly dwindling membership. Later, when telling my wife about this encounter, I joked that my club would probably have very few members. I might be the only one. Our club’s cancer color, then, should be an appropriate shade of black.
But I said none of those things. I just said “Oh.”
Only much later did I learn that the official cancer color for melanoma actually is black. Who knew?
Around the internet you’ll find long lists of specific cancers that merit their own color that’s not pink. This list at VeryWell Health includes over 50 colors and cancers. Meanwhile, it’s become an evening tradition around America to light up local landmarks with these various cancer colors. (I just checked, and it’s gone global. Apparently the Eiffel Tower, for example, is regularly lighted pink.)
The closest medium-sized city, and the one where I see my oncologist, is Duluth, Minnesota. Its iconic landmark is an old lift bridge that’s regularly lighted pink, blue, or teal—and maybe even a few other colors. That day it was visible from the oncology waiting room where I encountered Ms. Moca.
But how could we possibly light the bridge black? (And no, shining a black light on it isn’t quite the same thing.) I guess if I were to successfully lobby for my own cancer holiday, we’d just have to paint it black.