Opinion: Column: Growing Pains

Opinion: Column: Growing Pains

After more than six months away from the infusion center, due to the treatment for my papillary thyroid cancer stage II, I make my return on Wednesday, July 22. My non-small cell lung cancer stage IV, for which I have been treated since early March, 2009, once again becomes front and center after having been back-burnered since early January while we addressed my thyroid cancer. Out of an abundance of caution and concern for the risk of miscellaneous drug/treatment interactions, both cancers couldn't be treated simultaneously. Now we go forward in hope, just like we did 11-plus years ago.

Having completed the thyroid cancer treatment protocol after a recent CT scan showed no residual signs of cancer, I am now free – so to speak, to return to the scene of the crime – to euphemize, and resume treatment for my underlying/pre-existing lung cancer. I am also returning for treatment because during the six month interval when I was not receiving any current lung cancer treatment, the lung cancer tumors grew. My oncologist was unable to characterize the growth, other than to say there was growth everywhere, (he didn't say a little; he didn't say a lot). For some context, he did read aloud some comparative tumor measurements written in the radiologist's report which were less than ideal. No matter. Cancer is by itself less than ideal, so that's nothing new, really.

The theory of immunotherapy is that it trains your cells to fight the cancer regardless of whether the patient receives current treatment or not so the battle continues. Now whether my six months of not receiving treatment was responsible for allowing this growth or kept it from getting worse, my oncologist wouldn't say. What he did say/recommend was that we restart the Opdivo (immunotherapy that I had been on for the previous year) since it had been effective for the year during which I was receiving regular bi-weekly infusions. However, I'm scheduled for my next CT scan in only two months instead of the usual three months so that my oncologist can make an assessment sooner rather than later. In the absence of any new symptoms before or at present, the scan becomes the arbiter of my destiny. (I imagine waiting for the results of that September scan will be stressful.) But this is life in the cancer world, and the longer I experience it, the luckier I'll be.

In the interim, I am happy to go forward and resume my treatment. Nearly all the medicine that has previously been prescribed for me has been successful at managing my cancer (keeping it stable) so I have a reasonable expectation that my next two infusions will yield encouraging results. Nevertheless, I am well aware that any guarantees left the building on February 20, 2009. That is when I first received a phone call from my internal medicine doctor advising me that the previous week's lung tissue biopsy had indicated a malignancy.

Slow forward to the present (one does not go fast forward enduring cancer) and I will be back in a very familiar place: the infusion center. Though I don't view my return as one of a conquering hero, I am still alive and reasonably well after being treated for a second cancer while my original cancer was not in remission. (No small accomplishment.) Nor was it in hiding. To invoke one of my late father's favorite words: the treatment for my lung cancer had been held "in abeyance."

Now the "abeyance" is over and I am back to being a garden variety non-small cell lung cancer patient. The delay in my treatment caused some damage I presume, but it doesn't really worry me yet (talk about naive). I'm glad to once again be current – and active, in my treatment, and I continue to remain positive about the negative. My oncologist has referred to me as his "third miracle" (after having survived so long after an initial "13 month to two year" prognosis). However, that was then. This is now.

I don't think my ship has sailed, but there does appear to be some activity down at the docks. No matter, I'm an excellent swimmer.