by Stan Goldberg

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.