When you have cancer, everything is different. Even mosquito bites.

It’s summer here in northwest Wisconsin. We’ve had some warm, humid weather, and some excellent crops of mosquitos are hatching. And yes, there’s a connection between mosquitos and cancer. But don’t worry. Mosquitos don’t carry cancer.

Here’s the connection: If your oncologist prescribes some sort of immunotherapy, it will rev up you immune system so it works harder to destroy cancer cells. Your immune system may also react more strongly to other threats—including mosquito bites.

As mosquitos feed they inject saliva, which contains an anticoagulant so your blood stays nice and thin as they begin sucking up their lunch. Proteins in the mosquito’s saliva trigger your body’s immune system, which in turn produces histamines that result in redness, swelling, and itching.

After enough exposure most people develop a tolerance, and mosquito bites become less painful and itchy. (I’ve found when traveling, though, that mosquitos in other parts of the world seem to have something diffferent about their saliva. Initially, for example, bites from Norwegian or Chinese mosquitos felt like bee stings. Later, they weren’t quite so bad.)

The moral of the story: If you’re on immunotherapy, you may find that your body reacts differently to mosquito bites. Consider wearing long sleeves or using extra mosquito repellent.

When you have cancer, you may experience the Rip Van Winkle Effect.

You won’t find this syndrome in any oncology textbook.  I just made it up. But I only made up its name. The Rip Van Winkle Effect is very real.

Rip Van Winkle, you may recall, is a story by Washington Irving. It was published in 1819, but takes place much earlier. It’s about a guy living in colonial America who’s out in the woods one day squirrel hunting and meets some mysterious men wearing outdated clothing and bowling in the woods. Although this might have made him suspicious, he accepts their friendly offer and drinks deeply from their jug of liquor. He immediately falls into a deep sleep.

When he awakens 20 years later his beard is long and gray, his musket is rusted, and his faithful dog is nowhere to be seen. When he gets back to his village, everything seems different. Initially, he recognizes no one and no one recognizes him. He’s missed the American Revolution, his wife has been dead for years, and his children are grown. He meets two people who share his name. They’re his son and grandson.

When you have cancer, you may at times feel like Rip Van Winkle. You’ll spend most of your time sleeping, wishing you were sleeping, and going to doctor appointments. Meanwhile, life goes on around you. It may seem like everyone else is going places and doing things while you are… not. It may seem that time is strangely different for you. It is.

Although I’m no astrophysicist, I’m pretty sure all this is explained by the space-time continuum being distorted slightly as an observer passes too near the black hole of cancer—which of course has a rather strong gravitational pull. Or, maybe it’s simply explained by the general theory of cancer relativity. You’re traveling rapidly on a different journey than everyone around you.

Or maybe it’s just the Rip Van Winkle Effect. Fortunately, it’s only temporary.

Below: A YouTube clip that’s totally irrelevant. Except for the beards.

When your cancer fades, you may experience oncology separation anxiety.

For over three years, my oncology appointments were quite frequent. During one stretch of targeted radiation treatments, they were daily. The longest gap was about three weeks, between routine infusion appointments that involved getting my blood drawn for tests (this bloodletting is known euphemistically known as “labs”), seeing my oncologist for a brief appointment, and then getting an IV inserted and sitting in the infusion chair for a while.

Right now, however, I’m partway into a three-month gap. My next appointment will mean a return for “routine scans,” which are of course never routine. Things look promising, but I’m not out of the woods yet. (And why do we always say that like it’s a bad thing? I live out in the woods here in northwest Wisconsin, and the woods are good.)

For a while, especially back in the covid times, altogether too many of my social interactions were in a medical setting. But it was OK. The oncologists and nurses were all very positive and encouraging, and it was a wonderfully supportive environment. Plus, I always looked forward to the diet ginger ale and cookies I was offered while in the infusion chair. I called them my “chemo cookies.”

All this may help explain why my welcome break from the oncology department initially felt less delightful than I’d expected. At first it actually felt uncomfortable. I was feeling some real anxiety, and after a time I realized it was oncology separation anxiety. Eventually, when your cancer fades, you may experience it too.

If you do, remember this: You’ll get over it. Just enjoy the memories.