When I began chemotherapy in September, six months of treatment sounded like an eternity, not something I needed to think about for a long time.
Instead, I reasoned, just show up once a week for the infusion, take the oral chemo at home daily as prescribed and find out in March 2018 what good, if any, it had done.
Like some other new experiences I have encountered since the June diagnosis of pancreatic cancer, things are not necessarily as easy or as obvious as they were BD (before diagnosis).
First, there was no forgetting. During the day or two leading up to each weekly visit to the chemo clinic, the questions rolled around in my head: Is this working? What will be the outcome in March? Is pancreatic cancer painful toward the end? Will I still be here at the end of 2018? Or not? And so on.
Generally, I have been able to, as they say, hold my shit together when I am with other people. Alone, however, I've been known to pull off the road or street I'm driving on to wipe away the tears at my unknown future.
According to different sources, between five and nine percent of people diagnosed with pancreatic cancer are still alive five years later.
(I am not unaware that at my age, 76, I could be dead of all sorts of other things by 2022, but pancreatic adenocarcinoma – the type I and about 85 percent of all pancreatic patients have – is one of the top four or five deadliest cancers so I cannot go around fooling myself about my predicament.)
But there have been questions I haven't asked, places I have not wanted to go or, more truthfully, have not be able to make myself face. One of those, through these three months of chemo so far, is to ask what is the range of possible outcomes from the surgery and now, chemo?
What is there, I have wondered between “Congratulations, no detectible cancer” and “Sorry, it didn't work”? I have not been able to say those words yet.
Until Wednesday this week.
It wasn't on my written list of topics for the medical oncologist. It just popped out toward the end after she had given my other four or five questions positive reponses.
As I felt tears welling up, I also managed to mention that I have a growing terror of what she will tell me in March, and I had only half jokingly been considering asking to keep up the weekly chemo sessions into an indefinite future so the question would never come up.
But my mouth had got ahead my fear and there was the question floating in large letters in the air between us.
The doctor repeated what she said a few minutes earlier, that even with my huge drop in red blood cells last month requiring an overnight stay in hospital to transfuse four units of blood, I am doing well with the treatment.
She believes, she said, based on knowledge and clinical experience, that there is an 85-to-90 percent chance of not finding detectible cancer in March.
Then my tears broke through. Tears of relief.
One of the things they don't teach you in life is what to do when, for example, you are presented with a terrible diagnosis and death looms. After many months of suffering uncomfortable sitting, I finally decided a few weeks ago to buy a new desk chair. But then, wondered I, what difference does it make if I'm not going to live much longer.
I wavered for a few weeks – go head and buy. No, don't bother. But my neck hurt at the end of each day at the desk so I reluctantly bought the chair.
Yesterday morning, after having slept happily on the doctor's prediction, I easily bought a pair of silk pants I've been putting off for months for the same reason as the desk chair. Now I know differently: so what if I die before wearing them more than once; it's not like the price broke my bank.
Yes, I know. Statistics cannot reveal individual outcome, and even the best professionals' predictions can be wrong for all kinds of reasons.
Nevertheless, I was cheered by her answer and more importantly, understood finally that I must go on living - in all ways - until I can't any more from whatever cause, and if that means a new pair of white silk pants, go for it.
After my meeting with the doctor, as the nurse was preparing my infusion, she told me the story of another patient, a man in his 70s, who was in the chemo clinic for treatment of lung cancer.
He told her that 10 years previously he had been successfully treated for melanoma and that 35 years ago he had had the Whipple Procedure. The nurse told me she couldn't figure out if he was lucky or incredibly unlucky.
To me, however, the man's 35-year-old Whipple is what stuck in my mind. I wonder if, even through fear and tears, we are all supreme optimists until the very end.
It was a magnificently clear day Wednesday so I could see Mt. Hood out the windows of my treatment room. That doesn't happen much in winter so I took it as an omen. Whether of good fortune or the black cat variety, we'll need to wait until March.