[2022-11-09] The controllable and the uncontrollable

I found myself thinking about cancer recurrence more today than I had in many months. It was not lost on me that the four survivors who shared their stories last night as part of Ovarian Cancer Canada's National Symposium had all experienced multiple recurrences.

I didn't dwell on the possibility of recurrence, but it was there. So I did what I always do when an unsettling thought about an issue over which I have little or no control enters my mind: I take out my little mental broom and sweep the thoughts away.

But as I thought more about that idea—"an issue over which I have little or no control"—I wondered whether that was entirely true. While some things related to cancer are beyond my control, others are very much within my power to influence. And I'm doing a lot to stack the deck in my favour.

Here's what I can control:
  • Taking a drug to inhibit cancer recurrence. Since my diagnosis in July 2020, I have followed my doctors' recommended treatment plan. Beyond surgery and chemotherapy (in the case of ovarian cancer) and surgery and radiation (in the case of perianal skin cancer), I take a drug twice a day to curb the growth of new cancerous tumours.
  • Going for monthly blood tests. Every four weeks, I go to the Irving Greenberg Family Cancer Centre to give blood that can be analyzed for two things: any rise in the level of cancer antigen (CA125) in my blood, and any egregious results that might suggest my maintenance drug is doing more harm than good.
  • Attending quarterly appointments with my oncologists. Every 3-4 months, I check in with my gynecologic oncology team (in the case of ovarian cancer) and my radiation oncologist (in the case of perianal skin cancer).
  • Getting an annual mammogram and breast MRI. Because of the inherited mutation in my BRCA2 gene, I am at a high risk for developing breast cancer. Consequently, I am in the Ontario High-Risk Breast Screening Program, which means I'm eligible for diagnostic testing every year rather than every two years.
  • Living a healthy, full life. I try to eat well, get exercise and take care of the non-cancer aspects of my health (through regular appointments with my family doctor, optometrist, dentist and dental hygienist). Equally importantly, I try to do things every day that bring me joy, meaning and fulfillment.
  • Reducing stress. In response to last night's post, a friend wrote to me today to say: "I've decided to stay outta the fast lane and simply slow down and enjoy the beauty around me. Life is precious and you remind us daily, to live it gracefully." My friend's comment reminded me of perhaps the most significant choice I made to take care of myself, which was deciding to retire. That one decision relieved me of a tremendous amount of day-to-day stress and created the space for me to enjoy every minute of every day.
Here's what I can't control:
  • Cancer recurrence. If it happens, it happens. I would once again follow my doctors' treatment plan, trusting science and my incredible body to heal itself once more.
  • The date of my prophylactic bilateral mastectomy. It's been more than a year since I signed the paperwork to have a mastectomy to greatly diminish my chances of developing breast cancer. Because of the surgery backlog caused by COVID, it may be years before I get the operation. (No one has said it will be years, but since the queue I'm in hasn't moved in many months, I'm not holding my breath.) In the meantime, I'll continue to go for my annual mammogram and breast MRI.
It's interesting that the things I can control start with action words (things I can do) whereas the things I can't control are nouns (like immutable facts I must accept).

I don't often focus on the possibility that my ovarian cancer could recur, and even more rarely write about it. But I have found it useful to make this list of the controllable and the uncontrollable. It's calming to remind myself that I'm doing everything I can to stay healthy.

Today, I went for my monthly blood work. The woman who took my blood told me that she was Japanese.
— "I don't know any words in Japanese." I said. "How would I say 'thank you' in Japanese?"
— "Arigato," she replied.
— "Arigato? The Styx song 'Mr. Roboto' has that word in it. I don't know Japanese, but I'm learning Portuguese."
— "I learned Portuguese," she replied enthusiastically.
— "Obrigada," I offered, to thank her for her service.
— "De nada," she replied with a smile.
— "Prazer em conhecer você," I concluded.
— "Nice to meet you, too," she responded.
This little exchange put a smile on both our faces.

All day, I waited for the results of my CA125 to come in, a little concerned that last night's stories would somehow be reflected in my cancer antigen numbers today. Just moments ago, the result arrived: another 8. A glorious, steady, no-evidence of disease 8. An all-good-here-kid 8. A breathe-a-sigh-of-relief 8. A sleep-well-tonight 8. A life-is-good 8.