December was a big month for me. I turned 40 and celebrated my 2nd birthday and 2nd Christmas with metastatic breast cancer. Turning 40 was big for me, not because I expected to feel different, but because I have had two drastically different emotions pulling at me, gratitude and disappointment. I was diagnosed with what can be an extremely quick-moving terminal illness when I was 38. I am obviously thankful I have reached my forties and it doesn’t escape me that my luck continues to grow as the years go by. On the other hand, I had big plans for 40 that didn’t involve metastatic breast cancer. My plans specifically involved a big 5-year survival bash that would coincide with turning 40. Had my cancer not returned, this upcoming March would have marked my 5-year survival mark. This is the point at which the chance of a cancer recurrence becomes minimal, a real holy grail for any cancer survivor.
In addition to my somewhat higher state of emotion surrounding my birthday, I am learning that holidays in general, but maybe Christmas most of all bring such an awareness of my probable limited time left. I continue to struggle when I encounter “milestone” situations. This past fall we got to see ninth graders get confirmed in our church. It looked like a special moment shared between the kids and their parents and all I could think was that I might not be up there with my kids when it’s their time. Last Christmas I was really sad because I had to work on what I thought might be one of my last Christmas’s. This year was better, both because I didn’t have to work and I feel more confident that I’ll have more holiday seasons to enjoy, but I still wrestle with the sadness of a shortened life and the anxiety of trying to create the perfect holiday in light of that. My vision of normal life progression is that you spend your time in your 30s, 40s, and 50s as the sandwich years….time where you both care for your own kids, work hard in your career, and begin to take care of your parents. It’s not necessarily a fun or joyful time of life, but you get through it to hit the “glory years” of retirement, the time when you can do whatever you want because, heck, you’re old. I’ve alluded to this before, but one of the hardest things for a super-planner like me is letting go of my plans. Realizing the odds are against me to hit retirement and enjoy my probably overhyped and delusional concept of old age.
I refuse to apologize if this seems like a message of despair. Over the years of writing this blog and talking to different people about my cancer I’ve gotten a fair amount of good-intentioned feedback and comments basically telling me to “keep my chin-up”. I feel like I have kept up a pretty good attitude, but I can’t escape the facts….at this time about 10% of patients with metastatic breast cancer are still living after 10 years. I’ll admit that I didn’t do a bunch of research to support that number for a variety of reasons. No one can really know the specific prognosis for each patient. The first question I asked my doctor…” Could you tell me about how long….” That’s all I could get out before he answered a harsh “No”. I tried a different tactic with my next doctor… ”What’s the longest survival you’ve had for a patient with metastatic breast cancer?” Her answer…” definitely into the double digits…11-12 years”. Fortunately, these numbers are drastically changing. I fully expect the 10% number will go way up in the next 2-5 years. I really believe there is a decent chance a cure will happen before my time is up and even if there isn’t a cure, there is already a large array of options to try when treatments start becoming ineffective. As daunting as it seems at times, I think a realistic vision of my life is a continuing attack on cancer with better, more targeted treatments coming just as one treatment stops working.
The realization I’ve come to with all the contemplating and processing I’ve done this holiday season is that I need to be intentional in my day-to-day life. To that point, shouldn’t we all try to live that way? We all have choices we can make every day that affect how we feel about ourselves and our lives. I became resentful when I first was diagnosed with metastatic breast cancer that my time was being taken away from me. I felt it was unfair that I was having to spend free time in waiting rooms commiserating with a bunch of senior citizens. Over the past 18 months I have been able to manage my appointments and labs so that I only spent about 8 hours total in appointments, scans, and labs in 2019. Some of that was just general good luck with treatments and response, but there was definitely some proactive planning that I did to take back control of my time and I am really proud of that. As I enter 2020, I hope and pray for continued good health and “No Evidence of Disease” or NED, but I also have the confidence and faith that I will be able to manage whatever happens.