The Essential Tool for Managing Cancer

Aside from the fact that I really (really, really) dislike starting Chemo Thursday -- well, Tuesday in this case -- in the afternoon, today was actually pretty non-eventful as far as these things go. 

It was confirmed by my oncologist that every too months is actually too frequent for scans, but since that's what the protocol I'm on calls for it is what it is. In any event, there was exactly no change -- literally, no difference at all -- between this scan and the last. Of course in a cancerland, no change is considered a good thing, so I guess we can call that a win. 

The tumor markers were at 11-something, down a bit from the 14-something they were at last time, but in the realm of the 11-something they were the time before that. As my oncologist put it, it seems my markers "fluctuate" regardless of what's going on with the tumors so eleven's as good as anything.

The oncologist was less convinced than the palliative nurse and the PA that the dex was causing my post-infusion insomnia, but he was willing to go along with cancelling it provided I was okay with the increased risk of nausea. As much as I hate vomiting, at this point sleep is more important to me so we took the risk -- and I got a prescription for Ambien so at least I've got that option at hand. 

And as soon as the flight to Sydney is wheels up, I'll be trying it out. With any luck, I won't be one of those who reacts with sleepwalking as that could be embarrassing on an airplane full of people. 

So that was the boring stuff. The interesting stuff came at the end of the appointment. I mentioned the upcoming expiration of my short-term disability and the likely need for some sort of medical attestation to my current life expectancy, and my oncologist had an interesting, if easily anticipated, response. He said, "I can't say anything about your life expectancy, I can only speak to the medians." 

As the conversation continued, he made one more interesting comment. He warned me not to spend all my money. He said he'd had patients, as had other oncologists he knew, quit their jobs and spend all their money expecting the cancer to kill them only to survive. He didn't want me coming back complaining that he told me the cancer would kill me if it didn't. 

All of which brings us, yet again, to the most essential tool necessary for coping with cancer: an understanding of the bell curve -- i.e., this...

At it's core, everything that happens to you during cancer is going to be driven by a bell curve. 

When I mentioned our conversation to one of the sibs, they got all excited wondering what prompted my oncologist's new optimism. I had to explain that it wasn't optimism. He was simply reminding me that cancer's all about the bell curve. The likeliest outcome is that big hump in the middle, but there's always the chance -- slim though it may be -- that you're individual experience will land at one of the tails. 

Happily, we know I'm not at the left had tail (which is made up of all the people who don't make it through their first year). And there's certainly the possibility that I'll wind up somewhere towards the right hand tail with all my fight club colleagues who've survived for five or even ten-plus years post diagnosis. 

But the question is, how are you going to play the game? Knowing that your individual outcome is going to land somewhere on that bell curve, with the likelihood of any given outcome defined by the curve, are you going to swing for the fences or play the odds and plan on something in the middle of the hump?

Me, I'm playing for the hump. I get what my oncologist was saying, but I'll take the risk that I wind up spending all my money and yet surviving. I'm a realist, and the odds of that happening are actually pretty slim. 

It's all about the bell curve -- or, as I wrote awhile back, anecdotes are great, but statistics run the world.