The first time I heard the word “prognosis” as part of this little breast cancer adventure was back in July when I was diagnosed. 80% was the magic number. I had an 80% chance of survival. I remember saying, “Can’t it be 90%? I don’t do Bs.”
A month later I saw my surgeon again and, as he was online pulling up my PET/CT scan results, I asked him just what that meant; would I survive for five years or permanently? He looked up from the screen and said, with a twinkle in his eye, “Permanently. You will have to die from something else.” I appreciated his sense of humor. And then the smile faded from his face. “This isn’t good,” he said. “It’s in the bone.”
Well, he didn’t talk about prognosis anymore. I didn’t ask. My former oncologist never mentioned it either. I didn’t want to ask, to be honest. I had read enough articles to know all about five year survival rates. It was not unheard of to survive ten years, but it wasn’t common. The first time someone actually gave me a prognosis–based on averages–was when I went for a second oncology opinion in September 2012. I heard what the doctor said–three years–but he was quick to add that it could be longer. I believe the longest survival rate that he knew of was twenty years.
I wasn’t fazed, you know. The Death Star was in its boob orbit, outposts had been established, but I felt fine (save for TFK fatigue). Then TFK, fickle bitch that it is, decided to stir up the pot and hand me a good tumor response by making the outposts in L4/S1 GROW! I’ve not been without pain since and, as pain is wont to do, have been demoralized and fatigued as a result.
I saw my oncologist yesterday and asked about prognosis and his answer was 2.5 to 3 years. He qualified the answer: I was having a good response to TFK and that was a good sign. I’m not fatalistic by any means, but those numbers took on new meaning and they’ve had me in thought for the last 24 hours.
Because I’m such an over achiever, I just automatically assumed that I would be around for the next twenty years. Me succumb to cancer in anything under a decade? Bite me. Anytime someone asked me I’d always spin it to meet my expectations: “I will probably be around for another ten to twenty years.” “You won’t get rid of me, Boss.” “I will outlive my cats.”
But this pain dance I’ve been performing throughout October and November has made me look at things in a more measured fashion. Let me be clear: I’m not bemoaning my lot or having a self-indulgent pity party. I’m serious. The fact of the matter is that the average is about three years and every month and year after that will be, as I have termed it, celebratory gravy. I need to start planning.
First there are the matter of fact things: wills, end of life decisions, care of my animal friends, etc. If I didn’t plan this I would be a fool. A control freak like me leaving important decisions like this to someone else? [Insert laugh track here.] Besides, if I do it now and beat the odds then it’s done, right?
Then there is the matter of working: I refuse to stop. I’ll work with my employer and my physicians to come to some reconcilable arrangement. I have not yet explored targeted radiation to address the pain from the lytic lesions, but perhaps that is an option that will help to make things a little easier for me. Clearly a topic for discussion with my new oncologist later in December.
And, finally, there is life. I sink a lot of money every month into retirement. A LOT. I am going to halve that number and throw it into easily liquidated savings. And with that money I am going to do the things I’ve been putting off: that knitting trip to the UK, that vacation on Sannibel Island, visiting my friends around the country, and knitting my hands off (when I’m not writing). Passport renewal here I come.
And my student loans?