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The Uncertainty of Cancer
Bob Riter
bob@ibca.net
Before you get diagnosed with cancer, you assume that it will be an unpleasant
experience, but one that is pretty straightforward.
But the experience is filled with potholes of uncertainty and those uncertainties
begin almost immediately.
Men with prostate cancer may be given the options of surgery, radiation, or
watchful waiting. Women with breast cancer may be given the option of a mastectomy or a lumpectomy
followed by radiation therapy.
People with an especially aggressive cancer may be given the option of radical
surgery that offers a slight hope of a cure or forgoing treatment to focus on
quality, rather than quantity, of life.
These decisions are difficult because they are always made with incomplete information.
Your doctor might say, “Ninety percent of people with this type of tumor
never have a recurrence.” But nobody knows if you are in that ninety percent
or in the other ten.
And uncertainty with prognosis is only part of it. There’s also uncertainty
with treatment. Prostate surgery might cause incontinence and impotence. Chemotherapy
might cause nerve damage. But, again, no one can say for sure if you’ll
be lucky or unlucky.
As someone who has had cancer, I can say that this all really sucks.
The uncertainty continues after you’ve completed treatment. The big question
for most people is whether the cancer will return.
I changed the planning horizon I use when making big decisions such as taking
a job or buying a house. I stopped looking 30 years into the future and began
focusing more on the present.
I was walking my dog on a cloudy Ithaca day when she came across a ray of sunlight
hitting the sidewalk. She immediately sat down, closed her eyes and relished
the pure joy of sitting in the sun. That image of her living purely in the moment
stays with me.
And my cancer, as cancers go, was pretty good. That is, my risk of a recurrence
is low, especially now that several years have passed. But I no longer feel
invincible.
Everyone who’s had cancer has a different set of calculations and their
own set of values. But living with uncertainty is something we share.
Of course, you don’t have to have cancer to face uncertainty. It’s
part of the human experience. Several people have said to me, “Too bad you got cancer, but life is uncertain
for everyone. I could be hit by a bus tomorrow.” (I’m never sure
how to respond to this comment. “God willing” seems a bit awkward).
Cancer and uncertainty do go hand-in-hand. It’s good in some ways and
bad in others. Like many other realities, it just is and we go forward the best
we can.
From the Ithaca Journal, August 16, 2007
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