Opinion: Column: The Weak Before

Opinion: Column: The Weak Before

Hardly am I Robert Johnson, but every time I'm about to be "CT-scanned," I feel like I'm at a crossroads.

And though I've never made a deal with the devil for good scan results (at least results with which I can live), I have to admit to making a momentary prayer of sorts when I see an email from my oncologist. An email that, given its arrival in my inbox, five days or so after my scan, is generally the one containing the results of the previous week's scan.

So, I take a deep breath and then exhale as I prepare to click until I see his words. More often than not, almost every time, in fact, his words: "CT scan looked good," as an example, have been encouraging. Although, as with many things, past results don't guarantee future performance – or a reasonable facsimile thereof.

Each good scan result (stable, shrinkage) does not portend another good result in the future. The results, both good or bad quite frankly, are kind of a limited offer. If it's good, it means your treatment is likely quo. If it's bad, it probably means your treatment is about to change.

Whatever treatment protocol you start or stop or continue is only good, bad or indifferent until your next scan (when the rubber hits the road, so to speak). Which for me, according to my current bi-weekly immunotherapy infusion schedule, is every two months. So next week, the hammer comes down or rather the slide (the thing you lay on) comes out of the CT scanner and in and out I go.

Typically (meaning during my previous 10 years of chemotherapy), I have been mostly symptom-free – other than the symptoms/side effects of the treatment itself, not from the underlying cancer cause. I have rarely felt anything and I certainly haven't/didn't/couldn't see anything.

It's/I'm different now.

Now I can see and feel something; that something, located under my Adam's apple, is what precipitated the change from chemotherapy/Alimta to my current immunotherapy/Opdivo. The tumors in my lungs (mediastinum), which is where this whole mess began, remain stable. However, the appearance of the "Adam's apple" tumor changed my reason for living.

And my new life, or rather my new cancer life, has been tightened/shortened up. Now my infusions are every two weeks, instead of the most recent seven-week intervals (with Alimta) and my CT scans which had occurred every 12 weeks are now only eight weeks apart.

All of which means I am constantly in the throes of some kind of cancer anxiety ("labbing," infusing, scanning, meeting with my oncologist).

Not that, after 10 years, I am unaccustomed to this sort of "cancer-centricity," it's more that its crushing regularity is a constant reminder of my mortality.

And not that I'm "woeing" is me, hardly. I'm lucky to be alive. You all know I know that.

It's more the recurrence of "scanxiety" (not my word, although I thought it was when I first used it), the anxiety one feels waiting for the life-and-death scan results, especially so if the results come more frequently than previously. And believe me, that extra month is well worth not having to wait.

So the news of my possible negative (not good) scan results hopefully will be exaggerated, along with my demise. And in that exaggeration perhaps I can find some solace and humor.

'Solace' in that it turns out: what's all the fuss? Humor, in that "It's better to look good than to feel good, and you know you are, darlings," as when Billy Crystal invoked his inner Fernando Lamas in his famous bit from his 1985 year on Saturday Night Live! In summary, it's nothing until it's something, and even if it's something, it might not be anything.

This sort of confusing mental gymnastics is what occurs before, during and after these diagnostic scans. And until you hear back from your oncologist, you really don't know whether you're coming or going, or whether it's too little, too late.