28.) The Comeback Trail

No doubt about it, the ole “comeback trail” can be a long, hard, and often lonely road to travel.

As I’ve already mentioned, I like to run; but not for competition, not for accolades, and not so that somebody will be impressed or celebrate “me.”  I run for the discipline, for the joy of it, for the freedom, and for the celebration of “life.”  I prefer to run alone, or maybe with just one or two other running partners who are in it for the same reasons I am. But finding those kinds of running partners is super hard these days—everyone seems to be in it for the competition, or not at all—so, I run alone.

I run for health, for fitness, for endurance, and as part of my ongoing spiritual training.  My runs are typically couched in prayer and surrounded by praise.  Taking my cue from Colossians 3:17, I try to offer up each run as a living sacrifice of praise unto God.  If I run in some small competition from time-to-time, perhaps a 5K or a 10K, I run for the comradery, to help build local community, and for a cause—to try to raise funds for organizations such as CRF (Christian Relief Fund)—one of my favorites.

For me, running, like a healthy diet and accompanying cross-training, suits my lifestyle.  Even though research indicates that I’ll never “outrun my fork”—diet is far more essential to weight management than is exercise—still, running, I believe, helps me control my weight.  It provides me with some viable measure of personal control over my health and body maintenance.  It’s a general indicator of how well I’m doing overall—physically, emotionally, and, to some extent, even spiritually.

So, of course, when I think of “coming back” from the ravages of cancer, one of the first areas of consideration that I’m going to focus in on is my running.  In that regard, however, first let me say that I’m just glad to be here and to be, once again, back out on my running trail two or three times each week.

I am both humbled and haunted by the fact that this whole battle with thyroid cancer could be much, much more difficult for me than it is.  There is a type of cancer—anaplastic thyroid cancer—that is a virtual death sentence.   Shomon (2004) reports that, “The prognosis for anaplastic cancer is very poor, and less than 5% of patients survive 5 years. An estimated 10% of patients are alive at 3 years.  Most people do not survive longer than 6 months, and 80% do not survive beyond a year.”  While anaplastic cancer cells can develop from other types of less traumatic cancer, such as papillary and follicular thyroid cancer, I am grateful to God that, thus far, I have not been diagnosed with that.

But even for the significantly less deadly varieties of thyroid cancer—papillary, follicular, and medullary—the prognosis depends a great deal on the staging of the cancer.  According to the American Cancer Society, those diagnosed with Stage I and Stage II of these types of cancers—such as myself—have a five year survival rate ranging from 98% to 100%.  Those diagnosed with Stage III range from 73% to 91%.  But those diagnosed with Stage IV range from only 28% for medullary to 51% for papillary thyroid cancer (American, 2013).

For some people, looking in from the outside, some of these percentages and survival rates may not appear to look all that bad; hence the creepy idea that thyroid cancer is, somehow, one of the “good” cancers.  But try telling that to the person who happens to fall within the 2 or 3, or even the 20 or 30—depending on the type—out of every 100 people for whom thyroid cancer will prove to be 100% deadly.

So, while it remains to be seen what God’s plan for me will be over the long-run, for now—in the short-run—I’m just rejoicing that this cancer hasn’t been any worse for me than it could have been, and is for some.  I rejoice that I have a great medical team working with me and that, so far, the medical procedures have all gone smoothly enough.  After six months of some pretty radical stuff, I rejoice to say that I’m back up on the “comeback trail.”

However, I think it’s important to recognize and acknowledge the fact that, even after having overcome some of the major hurtles and, perhaps, dodging the proverbial bullet, if I’ve dodged it—perhaps I’m already shot through and just don’t know it, yet—that doesn’t mean the battle is over; not by a long shot!  In fact, I guess for some, recovery can be the toughest and most discouraging part of the journey.

This ole comeback trail, I’m finding out, can be a pretty tough row to hoe.  Being acutely aware of how much ground I’ve lost, and that I need to try to make up since being diagnosed with cancer six months ago, can be incredibly discouraging.  And, there are all kinds of other “bumps in the road” that an effect one’s recovery on this long and arduous comeback trail.

For example, I recently had to undergo surgery for umbilical hernia repair; something that should have been taken care of last year but had to be postponed until we could get a better handle on all this cancer stuff. This was my third major surgery in the past six months and the procedure left me very sore and unable to engage in any strenuous activity for quite a while.  Every medical procedure, at this point, seems exasperated by the fact that I have not yet fully recovered from my bout with cancer.

The comeback trail can not only be pretty tough physically, but it can also be rather “taxing” on relationships.  This, I think, is due in part to the intensity of the emotions involved.  Being diagnosed with cancer, or facing any potentially life-threatening situation, changes you.  Jeff Tomczek described this process well, I think, when he said:

Do not be too proud to speak to someone. You cannot afford to store up the intensity of the emotion that comes with fighting a life-threatening illness. Let it out for yourself. You will begin to hear your voice changing. That voice is who you are becoming in the face of mortality. Listen to that voice. It will be the purest, most authentic version of you that you have ever known. Bring that person into the world—strengths and vulnerabilities and everything between. Be that person forever. (Tomczek, 2012)

That doesn’t mean, of course, that everyone changes in exactly the same way; but—for better or for worse—we all change.  As Jeff goes on to note:

Your body will change first and your mind will follow. You won’t lose your mind, memories or sensibility. It will all come back. But, you will be different. You will never have the same sense of self. You should embrace this. Your old self was probably really great. Your transformed self will be even better. Give in to what is happening and trust it. (Tomczek, 2012)

The thing is, while I, myself, struggle to “give in to” this new person I am becoming, others are having an even harder time accepting the new me; and some people, I’m afraid, simply aren’t going to like this “new version” of me very much at all.

One thing that does help with all of these changes, however, is that I do have a few “advocates.”  Every cancer survivor, every person who has ever faced a potentially life threatening illness or situation, every person who has lost an intimate someone very close to them, every person who has been diagnosed with PTSD—regardless of the origin—every person recovering from a medical condition or addiction, every person on the “comeback trail” needs advocates. We need enablers who will stand beside us, helping us interpret life and what is going on within us and around us. We need people who will help keep things in perspective for us, who will help us communicate with others and help others understand us, and who will serve as a buffer between us and this big, wild world all around us—a world we once thought we knew and understood, but which now seems to have shifted, somehow, to a whole new reality.  I am learning that a huge part of what we call “ministry” involves “advocacy”—simply “being there” for one another.

As Jeff noted in one of the quotes above, there really is a lot of “intensity of emotion that comes with fighting a life-threatening illness.” In that regard, there are a lot of things in this world that I seem to be growing increasingly passionate about; and other things of which I am, seemingly, becoming increasingly intolerant.  However, I don’t know if I sincerely care any more deeply about any of these issues than I once did, or if they simply serve as a potential temporary outlet for some of that pent up emotion.

My wife, Ne’, is quick to point out that I probably don’t want to allow myself to fall victim to one of the first things of which I,  myself, am becoming increasingly intolerant—that is:  puffed-up people who come across as being a little too full of themselves and seem to think they have all the answers; as well as people who just can’t seem to help being “stupid in no-stupid zones”—and, yes, I know I’M perpetually teetering on the brink of THAT one.

She is also quick to point out that all the various political, social, and spiritual “issues,” as important as they may seem at the moment, do not begin to compare with our overall mission as servants of Christ—loving, serving, reaching, teaching, and helping people fall more in love with Jesus!  “Why risk hurting a single individual,” she says, “or wounding a precious heart and, perhaps, turning them away from the Lord, for the sake of some social, cultural, doctrinal, or political issue?” And, I supposed she’s right—“again!” At least the Apostle Paul seems to agree with her, or she with him. He put it like this:

For though I am free from all men, I have made myself a slave to all, so that I may win more.  To the Jews I became as a Jew, so that I might win Jews; to those who are under the Law, as under the Law though not being myself under the Law, so that I might win those who are under the Law; to those who are without law, as without law, though not being without the law of God but under the law of Christ, so that I might win those who are without law.  To the weak I became weak, that I might win the weak; I have become all things to all men, so that I may by all means save some.  I do all things for the sake of the gospel, so that I may become a fellow partaker of it. (I Corinthians 9:19-23, NASB)

So anyway, I bend down to lace up my old, beat up Saucony runners and think about all the miles they’ve traveled, and how far they still have to go.  I imagine them asking me, if shoes could talk, why they’re not as fast, bold, and courageous as they once were, just a few short months ago?  I don’t know if I have the heart to tell them that they may never be that fast again.  (Yikes!  Now I’m carrying on full conversations with my shoes—still a little hypo???)

Shoes strapped up, muscles stretched, I turn and press myself into the wind, feeling the sun beat down on my dry, chaffed face and blistered lips.  Swallowing hard, I tentatively summon the strength to just put one foot in front of the other, then again, and again; settling into a slow-but-steady pace as the empty path stretching before me bids, “press on.”  The plethora of little aches and pains seems accentuated by the notion that all this effort is likely to produce little or no tangible results—at least, not in the short run—but, still, I’m compelled.

No doubt about it, it’s going to be a long, hard, lonely road—this comeback trail!

19.) The “Good Cancer” Bus

I was recently told—by a medical technician no less—that, “Well, at least you’ve got the good cancer!”   Hummmmm…  I wasn’t sure whether to breath a little sigh of thankfulness for that, or to clobber her!  I mean, good cancer? Really???

You know, all this “waiting” has got to be one of the hardest parts! It has now been three months since I first discovered the lump in my throat and that initial doctor visit; and, since that day, my life has been pretty much turned on end. While I’m blessed to have a medical provider that jumps on things pretty quickly and keeps the ball rolling—I’ve never had to sit and wait for insurance approval—still, it sure seems like a lot has had to happen just to get to this juncture. I’ve been through a couple of ultrasounds, a five sample needle biopsy, more consultations—phone & clinic—than I can count, more lab tests and blood work than I can possibly keep track of, two surgeries—one requiring a five day hospital stay—and eight flights to and from the island of Oahu. And I just now, finally, have some preliminary inkling of the extent and staging of the cancer—maybe.

However, even now, both the ENT surgeon and my endocrinologist have warned that they can only offer a “preliminary” prognosis at this point because nothing will be known for sure—if it ever is—until after the WBS (whole body scan), which will occur one week following the internal radiation treatment, or RAI—radioactive iodine ablation—which is still more than a month away. And even then, more will be known only after months of testing and a second WBS, yet to be scheduled six months after the first one.

But, according to my doctors, the cancer is “currently” designated as T2N0M0 Stage II differentiated papillary carcinoma of the left thyroid. “T2″ means that the initial tumor was larger than 2 cm but not larger than 4 cm across—it was 3.5 cm—and that it did not appear to have grown outside the thyroid. “N0″ means that there appears to be no spread to the lymph nodes. “M0″ means that it doesn’t look—for now—like the cancer metastasized to any other organs of the body. In consultation with my endocrinologist following the second surgery, I was informed that the pathology report revealed a second tumor had been found in the right hemisphere of the thyroid—about .5 cm—but that did not change the current staging.

I guess age 45 is the “cut-off” date used to help determine general prognosis for those dealing with thyroid cancer. I’m 10 years beyond that cut-off—yikes!—meaning that, even though the cancer does not appear to have spread, I am automatically assigned a higher level of staging based upon my age. According to Columbia University Medical Center, using information “extrapolated from a number of sources including the American Cancer Society, the National Cancer Institute, and the National Comprehensive Cancer Network, among others,” for my age, stage, and type of cancer there is a 7% chance of recurrence, a 7% chance of distant recurrence, and an 89% survival rate at the 10 year mark (Columbia, 2011, para. 7). Other sources state:

While the prognosis for most people with thyroid cancer is very good, the rate of recurrence or persistence can be up to 30%, and recurrences can occur even decades after the initial treatment. Therefore, it is important that you have regular follow-up examinations to detect whether the cancer has recurred. Health monitoring should continue throughout your lifetime. (ThyCa, 2011)

What does all this mean? I don’t know for sure. I guess it means that, initially, for every 100 people over the age of 45 who are diagnosed with this particular cancer, 89 of us will still be here in 10 years, while 11 of us will have died from this disease. I’m not sure just how I should take that. Do I just relax, smile, and say, “Oh, well, that’s only 11 people out of every one hundred, or 110 out of every one thousand, or 1,100 out of every ten thousand of us; so, why be overly concerned?”

It’s kind of like being walked out into a huge parking lot and being shown a whole row of deadly buses destined to crash sooner or later. There’s the melanoma cancer bus, the breast cancer bus, the pancreatic cancer bus, the liver cancer bus, the leukemia bus, the lymphoma bus, etc., etc., on and on, and let’s not forget that damned ole Ewings sarcoma bus, chalked full of kiddos—very deadly. Oh, but then there is that bus way down near the end, one of the “good cancer” buses—the thyca (thyroid cancer) bus.

crashed school bus

Yes sir, if you’ve got to ride a bus, this is one of the buses you wanna ride! Sure, it will crash sooner or later and, yes, you’re going to get hurt, beat up, broken up, cut up, and poisoned. You’ll probably spend a few days or, perhaps, even weeks in the hospital by the time it’s all said and done. And, yes, your life will certainly be seriously disrupted, to say the least. But, hey, the good news—only a little more than 10% of you are gonna die from your injuries. Oh, and you should probably know that, once you’re on the bus, you’re always on the bus and, for every 100 of you that survive the initial crash, up to 30 of you may have to go through yet another crash somewhere on down the road…  “Hmmmmmm…. and that’s the ‘good cancer,’ hunh?”

Like most cancer patients, I’m often suspicious that I’m not being told the whole story. I feel like I’ve been put on a “need to know” status and my doctors are not going to tell me anything more than I really need to know at any given time; which, in my case, is probably a good thing because I can barely process what little I do know as it is carefully threaded out to me. Probably better to leave room for my imagination to run a little wild than to fuel my nightmares with the actual facts—ha!

Still, I find it amusing how that my doctors and technicians continually use “qualifiers” when discussing any results or prognosis with me; how they are always careful to “encourage” without “promising” anything.

When I went to my local doctor for the first time, she told me, “It’s ‘probably’ nothing serious, ‘but’…”

Then, before the first surgery, the ENT said, “It is ‘unlikely’ you will need a second surgery, ‘but’…”

Later, just before the second surgery, he said, “You ‘should’ come through this just fine and be on your way home tomorrow, ‘but’…”

Five days later, as they prepared to wheel me out of the hospital, he said, “I ‘doubt’ you’ll ever have to come back and see me, ‘but’…”

Now my endocrinologist is saying, “Everything ‘looks’ good at this point and I ‘think’ you’re going to do just fine, ‘but’ there is still that “minimal” chance that you may have to deal with more treatment beyond the initial radiation therapy.”

So, remembering my research, I asked her, “About a 30% chance of recurrence?”

She smiled, “Well, yes, about that!”

I just laughed and told her, “Well, with the way my luck has been running with all these percentages you guys keep throwing around, please make sure to keep me outta Vegas!”

For some reason, that didn’t seem to amuse her as much as it did me. Which, again, made me wonder, “What is she ‘not’ telling me?”

But, for now, I just keep waiting and trying to be a “patient patient,” enduring each new procedure and this crazy hormonal roller coaster they’ve got me on, while awaiting further analysis and trying to salvage the ragged pieces of my life following the bus crash. I also try to do what little I can to help other crash victims—some far more banged up than I—while playing the percentages and hoping the dice finally roll favorably in my direction.

Of course, I know that, for the child of God, life is a whole lot more than just a grand and glorious “crapshoot.” The Bible says: “The mind of man plans his way, but the Lord directs his steps” (Proverbs 16:9, NASB).

Oh, and by the way, people, there is no “good cancer.”