Real Cancer

Image: Lung cancer cells.
Anne Weston, Francis Crick Institute.

We had switched from text to telephone as the significance of the conversation ratcheted up.

“This feels like real cancer.”

My friend’s observation was jarring. Over the course of seventeen years, she had survived three cancer attacks. Biopsies of the tumours had revealed adenocarcinoma. She was a victim of real cancer.

But I understood her perfectly.

Like me, her first three cancers had been cured. We had both sacrificed whole lobes and parts of lobes to surgery and aggressive radiation treatments. Blessedly deemed sufficiently cured to be declared NED: No Evidence of Disease.

Among survivors, we develop our own vocabulary for risk.

The difference this time was the combination of a new nodule in her right lung and malignant cells in an adjacent lymph node. Her fourth cancer had skipped the fence. Daughter cells had reached the gateway to the body’s lymphatic highway. Once cancer gets onto that road, it can travel anywhere.

The medical term is metastasis.

In the beginning, I was afraid of everything. Surgery. SABR radiation therapy. Bronchoscopies. PET scans. Those fears receded with experience.

But the fear of metastasis never left.

I always carried a quiet suspicion. Had the treatments really captured every cancer cell? It only takes one crazed daughter cell to start the duplication and destruction process all over again.

That lurking fear is what causes scanxiety to raise its ugly head in the days leading up to a surveillance CT scan. It creates an infinitesimal pause each time someone asks how I’m doing.

“Last scan was clear,” is my standard response.

I am now three years beyond my last diagnosis. Ten years beyond my first. But I am either a realist or a fatalist.

I expect a fourth cancer.

Let it not be real cancer