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Column: “Early Results Show Stable Disease”

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Kenneth B. Lourie

There’s five words e-mailed from my oncologist that I can live with (Duh!). Certainly better than the previous nine words e-mailed eight weeks ago regarding my then current CT Scan: “Scan results show progression. We’ll talk more on Friday.” Not that early results (I think ‘early results’ means after the first two infusions) guarantee any future results, but half good is better than all bad. Continued ‘progression’ (growth and/or movement; meaning the chemotherapy was having zero effect) would have been disappointing (you think?), so reading ‘stable’ in my doctor’s message was welcome news indeed; any port in a storm, as they say. And make no mistake about it, when you’re diagnosed as a terminal patient, who’s now outlived your original prognosis – by years – every day is a storm, and any place of refuge, leaky or otherwise, is a welcome sight. Just as pilots say: “Any landing you walk away from is a good one,” I’m going to create a corollary for cancer patients: any scan that doesn’t cause your oncologist to advise you to get your things in order (“Five Wishes”) is a good one. And so Tuesday, February 18th was real good – for “Kenny-with-cancer.” Alive and reasonably well.

However, just as life goes on, so too do the diagnostic scans and all the associated anxiety – and hopes and prayers as well. It’s a balancing act to be sure, to be always living on the edge (make that precipice), but obviously I’m grateful to be doing so – despite the emotional upheaval. Though I’ve been there – and still doing it, it doesn’t make any of it easier going forward. Being familiar with the chemotherapy (the “second line” I’m now enduring) – and its side effects from three years ago when I was originally diagnosed and treated, doesn’t really lesson the anxiety of it, it more reinforces the fear of it. Regardless of the success I’ve had fending off cancer’s ravages, it’s difficult to rid yourself of the inevitability of its power.

At least now there are e-mails (and Web sites to access) between doctor and patient to maintain the lines of communication and facilitate the prompt exchange of information, and to shortcut the previously interminable waits patients had waiting for scan/lab results. The results are not immediate, let’s be realistic; but they are sort of predictable, time-wise, and in that predictability evolves a certain calm. And however ‘calm’ can be introduced into the doctor/cancer patient equation, it exponentially improves the patient’s quality of life.

Now when you have your follow-up appointments – and certain information has already been communicated, these appointments can be more productive, less emotional and more strategic moving forward rather than spent reacting to medical facts only recently in evidence. After all, the oncologist is trying to keep you alive, and any methodology that enhances that relationship and improves the quality of the time between doctor and patient is better for all concerned. The e-mails blunt some of that unproductive but predictable emotion, which then enables the doctor and patient to more intelligently and dispassionately consider the options/treatments available. At some point, however, reality has to be addressed (I wouldn’t say embraced, though). Way back when, my oncologist advised us that none of this was going to be easy, and he was right. But his honesty – and treatment has made it a bit more bearable for me. I wouldn’t characterize or dare say that there’s a recipe for success in anything he or I have done together or that I’ve done independently of him; so far, so good though. I am alive three years post-diagnosis after originally receiving a less than encouraging prognosis: “13 months to two years.”

Within the next month, I will have had two more chemotherapy infusions followed up by yet another CT Scan, and this fun will begin all over again. I can’t really say that I’m looking forward to it, but being terminal is all it’s cracked up to be, and looking forward is still better than not being able to look at all.