Until last week, I was one of the millions living with cancer who became complacent about my uninvited guest. That abruptly changed.
Complacent
For 15 years, every three to six months my anxiety rose before a checkup and then subsided when my oncologist said those magic words, “the cancer is still controlled.” I am sure the feeling of reprieve created by the phrase is similar to what those waiting execution experience when they hear their sentence will be delayed pending an appeal.
The emotion occurs if someone just finished chemotherapy, had their cancer controlled for fifteen years or shows no evidence of cancer for twenty years. Although we experience euphoria when hearing the good news, our joy has a flipside—complacency.
The more we hear the “good news,” the more complacent we become. Why review the difficult, painful, or embarrassing things we did when we can put them off for later? Where’s the urgency? The adage “if it’s not broke, don’t fix it” applies not only to physical objects but also to attitudes. The “good news,” is a wonderful reprieve but also one that delays self-reflection.
If you read my articles or books on living with cancer, you know I never use the phrase, “cancer survivor.” I prefer “a person living with cancer.” I do not have an aversion towards being hopeful, but if one cancer cell remains, it will try to divide uncontrollably, if not today, then tomorrow or next year.
Shocked Out of My Complacency
Since my PSA (Protein Specific Antigen)—a measure of prostate cancer—remained low for fifteen years, I almost unperceptively reverted back to my unexamined pre-cancer life. I am the nonsectarian equivalent to a religious “backslider.” As long as my testosterone level was low (regular hormone injections bring it down) so was the PSA. Small PSA numbers are a sign circulating cancer cells remain microscopic—too small to develop tumors.
Despite a perfect statistical relationship between low PSA and low testosterone levels, a new disturbing finding became apparent. My PSA is taking longer to go lower and the levels are not approaching past reductions. These are indications some cells are no longer dependent upon testosterone for food; they are learning how to get nourishment from other sources.
These cells are not concerned how little testosterone is in my body; they will keep growing unless something either kills them or keeps them perpetually hungry. A phenomenon of most cancers is their ability to outsmart drugs and medical procedures designed to destroy them. I have been lucky until now my cancer is a slow learner.
An Antidote for Complacency
Complacency is a translucent curtain many people living with cancer create when results are negative over a long period. It is so much easier to assume nothing will change, and there is no need to plan for a difficult treatment protocol or a shortened life. Complacency in some cases prevents us from dealing with death.
So what’s the next step? My oncologist was never complacent about my treatment and is preparing if the assault materializes. Although I was complacent, I radically changed my diet—something I should have done years ago. No more complacency about what I can do physically to combat my cancer. That is the easy part. So what am I doing with my mind?
I do not intend to go back to bed and spend my time watching reruns of Law and Order as I did when I first learned I had cancer. Instead, I hope to regain those emotions and thoughts I had following the first years of hearing the “good news.” It is not a depressing choice, but an enlightening one taught to me by hospice patients.
A Lesson from Hospice
I served hospice patients for eight years and learned from them how to die and therefore how to live. One of the greatest lessons was the importance of preparing for death every day. Tibetans have a saying, “Tomorrow or Eternity. We never know what will come first.” The message is clear: live every day as if it is your last—the lesson I forgot after hearing the “good news” at least forty-five times over a fifteen-year-period. Maybe I am the slow learner.
I am no longer so delusional to believe I will outlive my cancer’s ability to form tumors. Unless I am hit by a bus, my cancer will eventually take my life—not in the immediate future, but probably before Superbowl LVIII. And if the cells do not; if advances in immunology and lifestyle hold them in check? The worst thing that will happen is my disease will become a distant memory, and I re-examined my life making it more meaningful.
Few people wake up in the morning and with gusto contemplate their death. Yet, maybe that is what everyone should do—especially anyone who lives with cancer. Of course, I wish to die of “old age,” (whatever that is) rather than from prostate cancer, but I already had a fifteen-year reprieve. And with luck, I will be around long enough to teach my three-year-old granddaughter how to flyfish and tell her stories about my life she most likely will not believe.
Never took you for a ‘Law and Order’ kind of guy. Miss you. Can’t remember the last time I was in SF. Soon—-you, me and Greg!
I miss our lunches. As the Tibetans say, “Tomorrow or eternity, we never know what comes first.”
Stan, you are an amazing person!! I admire your attitude about life and hope to emulate it into mine.. I too treasure each day and my connection with friends and family. After, that’s what it’s about. Love the pic of you and Matea( she looks exactly like you!). Happy fly fishing 🎣 to you two. Love Linda and Allan
Thank you both for your kind words. I can imagine how difficult it has recently been given yours and Allan’s loss.
Thank you Stan for the beautiful words and the truth of the importance to stay in the moment no matter cancer or no cancer. My sister has been dealing with lung cancer (Mesothelioma) for a year and a half now, and has been an inspiration to us all as to how positive she has stayed. Pat and my thoughts are with you in your journey.
Thank you David and Pat. Hope to see you both if our hiking group ever gets reformed. Those were wonderful days
Dear Stan,
Just took the time to read your article, and so glad I did! The “distance” of time since my cancer treatment has made me happy, but also forgetful of all I need to be mindful of, and grateful for. I’m sorry for what you are going through, but hopeful that advances in science and efforts to live healthy lives will pay off in longevity for you…and all of us! Sending love…
Thanks for your kind words Maryann. I’m glad the article resonated for you. It’s so easy to become complacent when things are going well. When we receive that “wake-up” call, we can choose to ignore it, pretend it’s meaning isn’t foreboding, or thankful for the additional time we were given and make the rest of what’s left as meaningful as possible. I choose door number 3, Monte!
Hi Stan,
A lovely, thoughtful article on the fragility of life – I try to remember, everyday, that it might be my last, and to appreciate the beauty of nature and our relationships. You are a natural writer!
Thank you, Kimberley for your kind words.
Another great article, Stan. You’re such a wonderful writer! And I love the picture! I’m excited to hear the article about the fly fishing lesson she gets from you, even if I have to wait 15 years.
Thanks Sharon. I hope it will be 15 years–at least
Stan, I love you. I stand with you. I appreciate all you have done for me and all you have taught me on my cancer journey. I’m grateful for your 15 years plus each additional day as it comes.
Thank you Bernadette,
Your words humble me. I hope to increase our 15 years by many more.
Stan,
About 15 years ago, you wrote a blog page that all but said “Goodbye” to everyone. I wrote you that was so simply wrong — and you have been taking now at least one supplement we send you all this time. Here is more “data” on another one: “Melatonin increased the rate of complete or partial remission by nearly 50%.[8] An Italian researcher, found that patients suffering from glioblastoma, a lethal type of brain cancer, and receiving conventional radiotherapy plus 10 mg of melatonin reaped the benefit of a 43% one-year survival rate, compared to a survival rate of less than 1% for the placebo (supportive care only) group. Metastatic breast cancer patients who took 20 mg of melatonin alongside Tamoxifen had a one-year survival rate of 63%, in contrast with a mere 24% survival rate for the placebo group.[9] ” Those are astounding results. And that is just for melatonin [super safe and trivial and cheap]. For those not so married to the presumption that the world of oncology has all the options, there are a few more of these with equally surprising benefits. So I will email you [yet again] about a few of them. All your fans will be so appreciative if you would review these and consider adding a few. We’ll all chip in and pay for it. So far my average client is 19 years into their Mayo Clinic “prognosis” that they have about 6 more weeks to get things in order. Don’t make me have to come there and beat sense into your head. Advice from a friend and GREAT admirer.
Thank you Steve. I will add melatonin to my daily regime (food, supplements, meditation, exercise, etc.). You won’t have to come to SF to beat sense into my head–although I visit to relive our days at Pitt is always welcome.
Forgetfulness, complacency, seems to be our common condition. Living with full awareness and appreciation, as you describe, really takes effort. But even a little goes a long way!
I hope you see that Super Bowl, and we continue to have the benefit of your wisdom.
Thank you Michael for your good thoughts. Wouldn’t it nice if we could learn the most fundamental truths about life over a vintage Bourbon rather than a deadly illness? But alas, I guess our mind needs to be shocked out of its complacency. If the 49er’s will be in the Super Bowl, I’ll be around to cheer them on.
I learned so much from my oncology and Hospice patients! I do not fear death but I love my life! For me, this is huge opportunity to experience Life, birth of my grandsons, heartache and unbridled joy. I’m going to squeeze every bit out of this gift I can and yet… I long for the day to return Home!!
Blessings to you and yours🙏🙏.
Thanks Becki for your kind words. We are on the same page.
Succinct and “spot-on.”
Thanks Chuck.