Category: January 2021

It’s been very hard for me to believe, emotionally, that my cancer might be gone, because my body is not yet completely well. What I don’t actually know is whether or not I’m still fighting cancer, or if I’m just still recovering from the surgery and chemo.

Because my body is clearly still struggling, I feel like I still have cancer, so I tend to think I still have cancer (even though I don’t consider myself to be typically a pessimistic person). Intellectually, I know there’s a darn good chance that my body will fight off this cancer; has fought off this cancer. But it seems like I can still feel the cancer lurking in me. That makes for a little bit of an awkward conversation when people ask me how I’m doing. I’m a very truthful person, and for me the truth right now is, “We can’t currently detect any cancer (yay!), but I might still have it, and I do still feel like I have it.”

In addition to not feeling as well as I did a few years ago, before I had cancer, I’m still feeling significantly worse than I did a year ago, right before the diagnosis, when I definitely had cancer. How could I not have cancer now, when I feel so much worse than I did last year when I did have cancer?

My type of cancer is slow growing, so it will be awhile of waiting. If my cancer still exists, we have to give it enough time to grow enough before we can see it. My next set of scans and colonoscopy will be this coming March.

Meanwhile, my migraines are coming back, which – although of course I hate migraines – I’m taking as a very good sign. My migraines had started slowly going away about 3 years ago. At the time, I welcomed the change and assumed that I was heading into menopause, because migraines often improve at that point due to changes in hormone levels.

I started getting hot flashes the week after I started chemo. And I wasn’t having migraines anymore. Chemo often brings on menopause, so I figured, well, I’m old enough, so here we are. So many hot flashes! All day and all night, all through chemo. And then they started tapering off, slowly, after I was done with chemo. Had I completed menopause, or what?

Well, according to my bloodwork done in October, it looked like I was actually heading back out of menopause. Seriously? I’m 54 years old. But that’s what my doctor said. Very little sign of menopause at all. Well. Whatever. And – I’m not getting hot flashes anymore.

Now my migraines are coming back. Migraines suck! But here’s why I think it’s a good sign. I’ve always felt like my migraines are connected to my immune system somehow. In fact, I’ve even wondered if they were some sort of autoimmune response, because there are a lot of similarities between my migraines and all the autoimmune things in my family.

I’m not a doctor, and I’m just making stuff up here. But my immune system had been overwhelmed by the cancer and my white blood cell count had been down for a couple of years at least, corresponding with the time that my migraines were less frequent.

I believe that if I start to feel like I felt before I had cancer, then I would be able to convince myself that I don’t have cancer. That would have been at least 3 or more years ago. Back when I had migraines all the time.

Even better, of course, would be to finally reach menopause – with no migraines AND no cancer! I’ll take those hot flashes, any day, all day, all night, whatever – no problem! Hot flashes (although super annoying and disruptive) are far less debilitating than migraines.

Here’s to getting older! I would truly be a new person with no cancer OR migraines!

Meanwhile, here’s pictures from our hike on Friday. I’m grateful to be well enough to hike again!

We didn’t take any photos of me. You’ll just have to believe that I was there too! I guess with the mask and the hat, you can’t even tell this is John. Could be any skinny guy hiking in the desert!

To send Kristina a comment, email turning51bykristina@gmail.com

I almost titled this post, “Contemplating Dying” but I didn’t want to panic anyone! I’m doing fine. I seem to be continuing to recover from my cancer treatments and don’t have any solid reason to expect anything other than continued recovery. I just felt this morning like I wanted to write some more about how to best use my life – particularly now that I’ve realize that our time here is very limited. So yes, the idea of impending death. We all face it someday, and as a society we don’t talk very much about it.

This is a follow-up post to an earlier one this July, when I first I started to really think about the concept that I could actually die relatively soon, rather than in some vague distant future. I still believe that I could die relatively soon (because that’s what the data says), but I’m feeling more settled about it.

The data, by the way, in case you missed that post, says that I have somewhere between 20% – 40% chance of not living for more than 5 years. So let’s say – 30%, but who knows? Logically, if there was anything else in my life that had an approximately 1/3 chance of happening (like pregnancy or a change in job or whatever), I would do some planning for it. I wouldn’t count on it happening because 30% is less than the 70% chance that it doesn’t happen. But I certainly wouldn’t ignore a 30% possibility.

I started talking about the big “what if?”. This caused some consternation among my friends and family, because it’s a hard topic that nobody wants to face. But it’s a very relevant topic to me. My question to myself was, “If I were to die in the next few years, is there anything I would have wished I had done differently?”

There were a few answers to that question that came under the category of “settling one’s affairs.” For example, John agreed to give significant assets to our kids if we knew my death was eminent, rather than waiting until we both die and our estate is settled. I also reached out to various people and said some things that I felt needed to be said – sometimes for my own sake, sometimes for theirs.

Other things had to do with shifting from playing a “long game” to a shorter game. John and I had been diligently preparing for an eventual retirement. But since my diagnosis, we’ve made a series of choices (selling rental properties, walking away from my environmental science career, and purchasing a home in Tucson) that have significantly decreased our ability to rapidly save for retirement. Because of those recent choices, we will not be able to retire as well, or as soon. But we decided the next couple of years were important to us, and we didn’t want to spend them working so hard. We wanted to spend them being together.

In July I started talking about bucket list items. At first, I thought this would be an important way to prepare for the potential end of my life. But then I realized I don’t really have any outstanding bucket list items. I realized it doesn’t really matter to me if I ever see Europe or not. Of course I would like to see Europe before I die, but it’s not like if I go to see Europe, then I would somehow magically be ready to die.

I don’t want to die in my mid-fifties, and it’s not because I did or didn’t get a chance to see Europe. It’s because I want to be there for John and the kids a decade from now, two decades from now, three decades from now. And I can’t rush that. I can’t somehow condense all those times I could help and support my friends and family over the next three decades into a one-year or two-year timeframe. There really isn’t a big thing that I could complete now, and then feel content that I’ve done what I’ve wanted to do. Ta-da! Ready to die! (Not.)

All I really want to do right now is the same things that I want to continue to do for the next three decades. Spend more time with John and the kids. Reach out to my friends and family. Support them in small ways; try to make life a little easier for everyone, including myself.

It’s seems like I should end this post with some sort of awe inspiring, metaphorical photo, but I don’t seem to have one that’s current. Here’s the view out my window this morning.

It’s raining! I guess that explains my mood. In the desert, we welcome the rain, but that doesn’t mean I actually like it! Plus, my ever-practical, house-oriented mind is like, “Huh, the water’s not draining off the patio. It looks like we ought to install a French drain.” By the way, the pool water isn’t actually that blue; that’s the plastic cover we have on it until spring.

Oh look, I found a cactus close-up I took yesterday. Not sure if that’s exactly the metaphorical mood I’m going for. Beautiful but covered in spines? Not a huggable cactus!

I’ll leave you to contemplate cactus spines and I’ll write about something more cheerful next time, I promise!

To send Kristina a comment, email turning51bykristina@gmail.com

For Christmas my brother Steven sent me a book about the history of cancer and cancer treatment. It’s called “The Emperor of all Maladies: a biography of cancer,” by Siddhartha Mukherjee. Steven sent it somewhat hesitantly because, as he warned, “It’s not a light, uplifting read.”

Very true. It’s neither light nor uplifting. It’s a brutal read. But it was absolutely and entirely fascinating; I was completely transfixed. I could barely pay attention to our holiday proceedings (such as they were in a pandemic lockdown) because I was so intent on this book.

It’s not just that I have an obvious interest in the topic. The author is fantastic. Now I want to read everything he has ever written. I like science books, but they can be dry. This one is not dry. I’ve never before been spellbound by the details of drug trial phases (for example).

I’m also going to reread this book. It’s accessible, but dense, and my focus is lacking since my chemo treatments. I would not have been able to make sense of this book during my chemo treatments, and I’ve only barely recovered enough to make some sense of it now.

I’ll warn you though – it’s not pretty. Cancer is a killer. And the treatments throughout history – up until and including now – are only sometimes tolerable. By the way, the term “tolerable”, when used in reference to chemotherapy, doesn’t mean what you would typically think the word means, i.e. “not too bad”. Nope. In this context, “tolerable” means the treatment didn’t kill the patient faster than the cancer was expected to kill them.

The trials were considered successful if it held the cancer at bay for one or two months, even if the patients had catastrophic relapses immediately afterwards. The researchers called the trials “successes” if the drug had any sort of measurable impact, never mind the utter misery of the patients who are being pushed as close to death as absolutely possible, in the wild hope to cure them (or others like them, some many years later, after the drug has been refined).

It’s sad how often researchers have thought they were very close to a cure during this past century, always to find cancer one step ahead. Only very recently have researchers managed to develop a few very effective drugs for a few specific types of cancers.

More generalized, older-style chemotherapies do kill cancer and I’m not recommending against them. Unfortunately chemo can cause enormous collateral damage and it’s too often not a cure. The descriptions of surgeons trying to cure breast cancer with surgery only, before chemo was discovered, were equally brutal. They did not understand how metastatic cancer worked, so they would try to take more and more of the upper body (essentially trying to “get it all”), but in the case of metastatic cancer (stage 4), it would never work. You cannot cure metastatic cancer with surgery alone.

However, as horrifying as that all was, I found the book to be more interesting than depressing. And the detailed knowledge the researchers are gaining just this past decade is encouraging. It’s clear that for the drugs to be truly effective, they’re going to have to be very, very specific to the type of cancer and the genetics of the individual patients. That’s a huge task, and it’s a long road ahead, but it’s a path forward.

To send Kristina a comment, email turning51bykristina@gmail.com