Remission Accomplished

The summary of “Last Damn Chemo,” is that we have some relief in knowing I successfully completed one round of chemo, consisting of 6 cycles of infusions, pills, and injections. The uncertainty was that we did not know if the cancer was fully gone or if I would need more treatments (or a stronger medical approach if there is one). On Monday April 11, I went in for a final PET scan, like the one I had done back in October. I knew things would be OK. My oncologist and everyone around me reassured me that the medicine did its job, but there was still the small but still very real chance that the cancer was not fully resolved. I did not wait too long to get results. On Wednesday, 2 days after the scan, Rosy and I had a follow up appointment with my oncologist to discuss results. It is with great closure and happiness I can finally announce my cancer is in remission!! 

This means I can go back to living my pre-cancer life starting tomorrow, right? Wrong. As stated in “Last Damn Chemo,” I have a long road to recovery ahead of me. Cancer is not like a flu, or even a broken bone. It is such an unusual disease compared to most ailments we will face in our lifetimes. Before being diagnosed, I wasn’t presenting obvious symptoms. I was working 50-60 hours a week, training and running marathons, handling my business, and taking care of my household responsibilities. My untreated/undiagnosed cancer itself did not disturb my routine or lifestyle; it was the chemo that threw me off course. If someone breaks their leg, every day from that point brings that person closer to full recovery. The time of injury is the lowest point in the curve. The cast aligns the bones and time allows them to rebuild. Once you start taking effective medicine for the flu, you get better continuously until its gone. Cancer treatments are different in that on the day I was diagnosed, I was in the best shape of my life. It was the treatments that made me weaker, worn down, symptomatic, and generally feeling worse than the day I started. So yes, the cancer is gone, but at what cost? Cancer remission isn’t the end of the struggle, it is just changing the target from fighting cancer to rebuilding from my own weakness. 

I named this post “Remission Accomplished” to imitate when former President George W. Bush announced the end of major combat operations in Iraq back in 2003. For those who remember, he famously stood in front of the nation on a naval ship with a huge American flag banner that said, “MISSION ACCOMPLISHED.” That sign would be a talking (and laughing) point for years to come. That banner was the butt of many jokes in pop culture, television, and music. It sent the wrong message, and completely undermined the future events and the long road to stability that needed to take place. American troops did not halt combat operations for another 8 years. One example of how far off the mark the phrase “mission accomplished” is that on the day Bush gave that speech, the death toll in Iraq was 104 American troops, but over 3,400 more troops would die until the US ended combat in 2011. I will give some credit to former Secretary of Defense Donald Rumsfeld, for when he was given an advance copy of the speech, he edited it by taking out every mention of the phrase “mission accomplished.” He claimed that it was too conclusive. He understood the nuanced volatility and long-term implications of the situation and didn’t want to claim victory when they didn’t have a right or reason to. I’m not here to write about politics, war, WMDs, or if jet fuel can melt steel beams. I do, however, want to draw some connections from my (and many others’) experience with cancer to Bush’s announcement.

In the picture above, I am standing with “The Bell,” which many cancer survivors have rung before me to signal the end of their cancer treatments, but unlike Bush, I am aware that the road ahead is much longer and equally as difficult as the short months behind me. The immediate and urgent threat was a ruthless dictator with threats of nuclear weapons. The most intense season of fighting was to neutralize that threat, regardless of the cost, incidental and collateral damage incurred along the way. Accomplishing that task would mark the end of major combat operations. The cancer has been neutralized and resolved, but the damage done still needs to be repaired. Stability and health have not yet come to the affected regions. Cells (like civilians) need to be restored to a new level of comfort and thriving. The tissues and towns that were demolished need to be rebuilt. The 4 months of chemo were aggressively targeting a major threat, but we know building up is more difficult and time-consuming than breaking down. From a cellular/molecular level all the way to holistic and mental health. My white blood cells, hemoglobin, energy levels are still low. My fingertips and toes are always numb and tingly. I have a total of 6 hairs on my head, eyelashes, eyebrows, and nose hair included. (Between writing this and posting it, that number has dwindled to 1, a single eyebrow hair lol). My digestive tract is sometimes unpredictable. There are so many other mildly inconvenient symptoms that I’ve simply gotten so used to, I forgot what life was like without them. 

I will be on health monitoring for 2 years and will consider myself to be in recovery/rebuilding mode for at least an entire year. I gauge my health in so many ways: hours of sleep per night, times I use the bathroom, nutrition, running speeds, weekly running volume, frequency of random pains/symptoms, etc. When those categories look like my pre-cancer life, then I can say I have returned to normal. It would be foolish of me to think the battle is over and my body is the same as it was back before I had cancer. They say hindsight is 20/20, but there is also no way of knowing when I had it. I was diagnosed in the first week of October but for it to have grown and spread, it is likely that I had it shortly after having Covid back in April. I don’t even know what standard to hold my body to. Should I expect Summer 2021 health or Winter 2020, or something in between. There is no clear-cut line of “pre-cancer” and “post-cancer,” so it is difficult to target my past health as something I should aim to be like. Like Iraq, we can’t expect things to go back to the way they were, but we must build towards a “new normal” that looks different but accomplishes the same goals. We can’t go back to “the good old days” because those days had problems of their own. What we can do it build better days ahead, after having resolved those problems. 

We are learning that together as a planet after the Covid-19 pandemic. We can’t go back to the normal that we know and love, but we must redefine “normal” altogether and get used to things being permanently different. This concept reminds me of something that I learned in an anthropology class: the act of distancing yourself from things you know to take a more analytical look at them, as well as learning about a culture’s rituals through the eyes of its participants, not an outsider. We used to say, “The familiar becomes foreign and the foreign becomes familiar.” That is the approach I am taking towards my future. My medical history and past activities are now foreign to my body, and I will have no choice but to familiarize myself to the uncertain future and a new normal. We can say “Remission Accomplished,” but let’s not think the job is done.