If a Milestone Falls in the Forest, Does it Still Make a Sound? (Update #14)

Milestone in a forest

Five years ago today, I checked into the hospital for an out-patient biopsy that was supposed to be NBD and woke up to the worst news of my life.

In general, I don’t mark my “cancerversaries.” I prefer to reserve anniversaries for days I want to remember, celebrate or honor. Lord knows I don’t need any help remembering the shitty day of the diagnosis. I wish I could forget it. And, I certainly don’t like the idea of celebrating or honoring it. My typical approach has been to ignore it; give it the bird by living my damn life as best as possible.

But this year is a little different, because historically year 5 has special significance in the cancer world. Typically, the longer a patient maintains a stable remission, the higher the likelihood that they will stay in remission and eventually earn the “cured” designation. Often the 5 year marker triggers a “graduation” of sorts, a change in treatment, less frequent monitoring with scans and labs, a scaling back in medications. In fact, most statistics I have seen stop even tracking patients after 5 years. I’ve always known that Stage IV lung cancer patients had a 1-2% chance of seeing their 5 year anniversary. What are the odds for year 6? I have no idea.

Year 5 is different for people like me, with Stage IV diagnoses. We don’t get to “graduate.” Year 5 for people in continuous, ongoing cancer treatment (even if that treatment has held them in remission or NED for a long time), is just another day on the calendar. There will be no scaling back, no stopping of medications, no reduction in the frequency of scans and labs. In fact, paradoxically, it’s the reverse.

Since my medicine is not a cure, and the expectation is that it will stop working at some point, the longer I am on the medicine, the closer I am to that not-working end point. A year ago, I dabbled in stretching out the intervals between my scans from every 2-3 months up to 4-5 months. But by this past Fall, my doc put the kibosh on that Pollyanna shit: “Lisa, you are not out of the woods, you are deeper in, the trees are dense back here, and the paths are not well-marked — we need to stay on top of this and go back to scanning you every 8-12 weeks.” Joy.

So, I’m still all up in a fucking lung cancer forest. I’m happy and very, very grateful to be here at year 5 (Update 14: December scans were good). I am also petulant and disappointed at the reminder that, while many cancer patients get to exit the train at this station, many others of us do not. My next scans are already scheduled. This interminable ride that was exhausting me with its never-ending-ness 3.5 years ago, continues on. And I just have to keep learning how to appreciate the forest view.