It's been a busy week for health-related appointments: dental cleaning and check-up, follow-up with my plastic surgeon regarding my breast reconstruction, flu and COVID shots for Chris, and today's follow-up with the gynecologic oncology team at The Ottawa Hospital's Cancer Centre.

This morning, I met with Dr. Le, whom I haven't seen in person for several years. He performed my ovarian cancer surgery in August 2020, removing my uterus, cervix, ovaries, fallopian tubes, omentum, and countless tumours.

The focus of today's conversation was the maintenance drug I take, namely, olaparib (marketed under the brand name Lynparza). This drug, known as a PARP inhibitor, impedes the growth of new tumours. It seems to be working, as my CA125 has remained low and steady during the more than 3½ years I've been on the medication. Some people experience unacceptable side effects on olaparib, such as impacts on the blood and nausea. I don't appear to be suffering any downsides to the drug.

That said, Dr. Le noted that the longer I'm on olaparib, the greater my risk of developing a blood cancer in the future. He asked my views on remaining on the drug, and I said that I would look to him and his colleagues to advise me. He proposed a CT scan in the next month or two to look for residual ovarian cancer, notwithstanding my low CA125 levels. If the CT scan shows no evidence of disease, Dr. Le said he would recommend that I come off the drug. This sounded like a wise plan to me.

After I left the appointment, however, I started second guessing myself. Should I have opted to come off olaparib immediately? Have I robbed Peter (reducing my risk of ovarian cancer) only to pay Paul (increasing my risk of blood cancer)? And if I come off the drug, will my ovarian cancer return, as it does for the majority of people treated for the disease?

It all feels heavy after an already heavy week.

But perhaps I should count my blessings instead. My CA125 remains low. I show no evidence of a recurrence of ovarian cancer. I'm not experiencing loss of appetite, nausea or abdominal pain. My blood results remain solid. The CT scan will be an additional tool to assess whether cancer might be lurking in my abdomen. Should the CT scan confirm no evidence of disease and support my coming off the drug, the risk of side effects, including blood cancer, would be reduced.

Though this reflection might have brought me out of my funk, what really cheered me up was the arrival of a beautiful bouquet of flowers, with this message from a friend: "Hopefully this will provide a little joy today." It did. I texted my friend: "This lifted my spirits more than you could know." And she replied: "No platitudes from me, but just to say your beautiful spirit deserves joy."

As I conclude this up-and-down day and this up-and-down week, I'll take comfort in the words of Alphonse Karr: "Some people are always grumbling because roses have thorns; I am thankful that thorns have roses."