Mets Day 236 – Negative Scans

Jennifer and I spent today at Fox Chance Cancer Center.  Being in the control group of the Dendreon trial, the company pays for scans every two or three months.  I donated another bunch of vials of blood, had the CT and MUGA scans, then met with Dr. Betsy Plimack and her fellow.  They told me that the CT scan did not indicate any solid tumors.  Yay. 

The absence of bad news from the scan is good news, I guess.  Jennifer and I had the same reaction at the news, however:  we felt no great elation.  Instead, we nodded our heads, and waited.  Next?  This is my third round of scans, and the novelty has worn off.  We now are deep into enduring to the end, and having these ongoing scans is not a satisfying experience.  I think that we have accepted that the cancer – including the information from the scan – is wholly outside of our control.  A negative scan means that we continue to live in uncertainty.  A positive scan means that we have been given the certainty that the final year of my life has started.  

I realized this afternoon that I had been mentally preparing myself for bad news, and that those preparations had been a heavy burden to carry.  The negative scans did not relieve me of that burden; it merely deferred it until the next scan in three months.  In that sense, the negative scan was not a relief, it was just a deferral. 

I need to reorient my mindset.  Cancer is a chronic disease with widely different prognoses.  My form of metastatic urothelial cancer has no treatment, no cure, and a 90% mortality rate over five years.  Today I realized that, with every scan, I am waiting for the other shoe to drop.  I need to let go of that attitude, and get on with my life (so to speak). 

On the drive back, I told Jennifer that this disease has destroyed my mental framework for many of my life decisions.  Before Cancer, I worked to support my family, in furtherance of a commitment I made to myself, Jennifer, and to God.  After Cancer, assuming the insurance companies agree with my disability applications, much of the economic motivation for my working will be removed.  BC, I could make long-term plans for my advancement in my profession; AC, I appear to winding down my legal practice.  BC, I could plan for activities with my wife after my nest was empty; AC, there is a significant chance that I will not see my youngest son graduate from high school.  BC, Jennifer and I could talk about retirement activities, such as humanitarian service, church missionary activities, travel, doting on our grandchildren; AC, I may not see my grandchildren.  The scaffolding of my mental rubric has been inexorably changed by cancer. 

I am still groping at how to construct a new analytical framework for my life.  How can I make long-term plans when I likely will not have a long term life?  What should I do with my remaining time?  How can I be a better husband, father, and friend?  I feel that I am in some ways redefining myself, but I do not know the boundaries of my chrysalis or the duration of my metamorphosis.