From the beginning, there were so many signs that my cancer didn’t have a chance.
First, there was the rock-hard lymph node above my collarbone that disappeared with one night of steroids, even before I started chemotherapy.
Then, there was the chest x-ray done only a few days after starting my first round of chemo. It’s not pretty, and you can see that the lining of my left lung is still filled with fluid, but the large, shadowy mass when I was first diagnosed had largely melted away.
Right hand side is before I started chemo, left hand side is about a week later, after chemo
Then, there was the chest x-ray taken less than two weeks later, before starting my second round of chemo. The mass is almost completely gone.
Two weeks after the last x-ray, right before starting my 2nd round of chemo
After my second round of chemo, my oncologist, Dr. Eradat, prepared me for the possibility that I might already be in remission. A chest x-ray is not precise enough to visualize the entire tumor, so he said we would do another PET CT. If things looked good, I would still need a full course of chemo to make sure every last cell cancer was gone, but I could downgrade to a less miserable regimen.
So this past Thursday, I go in for the scan. I recognize the technician from when I had my last scan, when I was first diagnosed. We joke about how I forgot to take off my bra beforehand, and she had to stop midway through so I could go change (I was such a cancer newbie then!).
As I work at the same medical center where I get my care, I have both the blessing and curse of being able to access the electronic medical record and obsessively read my own chart. So the second I get home, I log in. The images are uploaded, but there is no official read from the radiologist. As it’s late in the afternoon, I know it’s unlikely the radiologists will get to it before the end of the day.
I try to read the images myself. Unfortunately, psychiatry residency has not prepared me to diagnose myself with anything on a PET CT other than chemo-induced flabby butt syndrome (see photos).
Seriously though, what’s going on here?
The next day I have my weekly appointment with Dr. Eradat. We open the images but there is still no read, and even he needs the guidance of the radiologist, since reading a PET CT involves lining up the CT scan (which has excellent resolution, but is in greyscale) and the PET (which has poor resolution, but glows where the cancer is).
Because the results aren’t back yet, I have to talk in theoreticals. I know it would be a really good sign if I’m in remission, but I want to know how good.
“So, Dr. Eradat, how awesome would it be if I’m in remission right now? Like on a scale of 1 to 10?”
He looks at me quizzically. “Well, if you’re talking about a prognosis, it’s hard to give an exact percentage …”
I interrupt him. “No no,” I say. “I don’t need a percentage. Just give me a quartile. What quartile would I be in of cancer-fighting awesomeness if I’m in remission?”
He laughs, which is of course a natural response because I’m pretty funny, but I still don’t have an answer.
I change my tactic. “Ok, if you were to give me a grade, from A to F, in how good I would be at fighting cancer if I’m in remission, what grade would you give me?” I want to make sure he understands the question, so I gently suggest an appropriate answer. “A+?”
I never do get my answer, but it doesn’t matter. The next bit of news is so good it makes my jaw drop.
“Well, if you’re in remission,” he says, “the chemo regimen we change you to will be outpatient.”
He goes on, “Yeah … it would be a 30-minute infusion a day.”
You have to understand — up until now my only experience with chemotherapy has been Hyper-CVAD, which is essentially the most terrible regimen every invented. Six highly toxic drugs, at insanely high doses, administered in constant 24-hour infusions, in the hospital, while I am getting a zillion other drugs to prevent the chemo drugs from destroying my organs.
So hearing this news, I think my head might explode with excitement. Outpatient? Thirty minutes a day? Are you kidding me? I could do that in my friggin’ sleep!
I am ecstatic at this possibility, but we still need the PET CT results to make any plans. Dr. Eradat says he will track them down and call me when he has more information.
It is a few hours later when I get the call. I am at home. Peter and my parents are there. I answer the phone. Dr. Eradat, my angel, gets right to the point.
“Yup!” he says. “You’re all clear.”
Dear reader, let me break down this amazing news for you. In about six weeks, this tumor grew from a single cell to a giant mass that was compressing my lungs, impinging on my major blood vessels, and encasing my heart. It had metastasized to lymph nodes in my upper chest, lungs, and abdomen, and to the fluid collections in my lungs. I was at stage 4.
I had trouble breathing and my heart was beating out of my chest, coming close to not being able to do its job because of the pressure surrounding it. I had to start treatment emergently and did not have time to consider things like second opinions or my future fertility. It wasn’t until weeks later that I could even process what was happening to me.
In only five and a half weeks, this tumor has been knocked into oblivion. There is no evidence of any cancer on my scan.
Can you believe it? But also, didn’t you see it coming?
I owe so much to the medical system that has helped to heal me. Let’s be honest — had I been born 100 years ago, before chemotherapy, I probably wouldn’t be here right now.
I did not have a lifestyle cancer that could be cured with nutrition and exercise. I did not have a slow-growing cancer that afforded me the time to lackadaisically explore treatment options. I had a monstrous, aggressive cancer that randomly strikes young, healthy people without rhyme or reason, that could have killed me within weeks, but that is curable with medical treatment. But this is about so much more than some medications injected into my body.
Could you tell me that the kindness and compassion of my treatment team did not also heal me?
That the unwavering love and support of my family and friends did not also heal me?
That the positive thoughts and prayers of so many people who do not know me, but nonetheless hold me in their heart, did not also heal me?
That my will to survive did not also heal me?
That there is not some force in the universe that knows I still have something important to contribute that did not also heal me?
You could tell me these things 1000 times and I would not believe you, because I know with my entire soul what is true.
It’s not over yet, and I still have a hard road of treatment in front of me. But I have no doubt in my mind that everything will be okay, that I will be okay.
Fuck you, cancer. I win!
Elana Miller is a psychiatrist who blogs at Zen Psychiatry.