“You are in complete pathological remission…”: These are the words that every cancer patient longs to hear. Of course, for me, a person diagnosed with Stage IV breast cancer only seven months ago, these were incredible, amazing, and dumbfounding words that I never expected to hear. I´m pretty sure my doctors never expected to say them to me either. But, last week, these were the sweet words that joyfully flew from my doctor´s mouth as we met to discuss my pathology report.
Following my operation, Dr. Buhler told my mom and Jon that it would probably take a week to get the pathology report back on the lymph nodes and tissue that were removed during the surgery. He said that we wouldn´t be able to make any predictions about the future or discuss what the next step in treatment would be until we received these results. I wasn´t quite as nervous about these results as I had been about the Pet Scan back in January, but I guess I really should have been. Unfortunately (or fortunately) no one had really discussed with me what was at stake had the results turned out differently.
Early last week following my surgery, my mom and I went in to meet with Dr. Majlis for a routine checkup and to schedule my next anti-body treatment. While there, he said that unfortunately the pathology results hadn´t been posted online yet, but that he would call the lab and see if they were ready. My mom and I sat there in the office listening to Dr. Majlis nonchalantly chatting with the pathologist, asking if they had received any results for Timms.
I stared out the window at the smoggy view of the Andes while I heard him chuckle in disbelief, “Nada… nada de nada?” This went on for a good two minutes. “De verdad? Nada…” He hung up the phone and goofily turned around to me and declared, “There was no more tumor. All 29 of your lymph nodes came back negative. You are in complete pathological remission. You have no more cancer.”
Well, I did what any lucky person who just found out they had survived stage four cancer would do; I blinked, thought for a minute, and began slowly weeping tears of relief… tears of joy… tears of thanks… tears of sheer disbelief. My mom began crying too, and Dr. Majlis declared it was time for some pisco sours and that we should go off and celebrate. I could have kissed him, I was so happy. That evening the three of us (me, Jon, and mom) had drinks up on the open-air terrace of the Hotel Noi, and watched the sun go down over the Santiago skyline. A few friends who were able to make a last minute dinner invitation joined us for food and wine, and the evening passed in a remarkably celebratory mood. The unexpected magic of the evening made it one of those moments I will remember forever.
A few days later my mom and I decided to go off on a somewhat impromptu celebratory trip to San Pedro de Atacama, and we had a fabulous time. When the doctor told me I had no restrictions, I decided to take that quite literally… haha. Whether he truly meant for me to fly off and spend four days in the remote deserts of Northern Chile, we will never know. I´m pretty sure my dad thought we had lost our minds! But, I know both my mom and I were glad we decided to take a chance and hop on that plane. Atacama was, indeed, an out-of-this world destination, and is a must-see for anyone thinking of visiting Chile. During our time there we were amazed at the depth and variety of the area´s natural beauty and wildlife. Although, I must say it wasn´t the easiest or most luxurious vacation I have ever taken. The tiny tourist town of San Pedro consists of a few dirt roads lined with mainly tourist agencies, hostels, and pizza places, as well as a few adobe homes with thatched roofs. There are no street lamps to light the way for tourists heading to their hostales on the outskirts of town. The weather, like most places in the desert, ranges from below freezing at night to sweltering during the day. Also, the tours and activities begin at ungodly hours and require quite a bit of travel. But it was all worth it. We awoke in the dead of night (3:30 AM) to visit the world´s highest geothermic fields at sunrise. We hiked over 10 kilometers to clamber up a hill beside the area´s most famous Pre-Incan ruins. We photographed flamingos feasting on high altitude lakes bathed in pastel pinks and blues from the morning sun, their reflections clear as glass in the salty water. We watched groups of vicuñas and guañacos galloping through the shadows of 6,000-meter tall volcanoes. We traipsed through aptly named geographic features such as the Valley of the Rainbow, Valley of the Moon, and Death Valley. I´m not sure that most people would have chosen this destination as a celebratory, “I beat cancer” vacation, but, for two people who grew up collecting the black brochures of U.S. National Parks, it was the perfect place. Honestly, I was so in awe of the surrounding scenery that I almost forgot I had had surgery the week before. There is no better pain medicine than witnessing the glory of nature and spending quality time with family. Again, it was a trip I will never forget.
Upon returning home though, life quickly returned to normal. Mom had to go back to the states to fulfill her tutoring obligations and I have returned to my usual routine of watching the dogs, working on my digital photo albums, grocery shopping, and setting up doctor´s appointments. In the aftermath of all the excitement, I am also trying to come to grips with the reality of what cancer remission means for me. Yesterday I went to see Dr. Buhler to remove some of my stitches and he told me that the oncology committee was meeting on Wednesday to see if they think I still need to do radiation, considering I am already in remission. He then asked me what I´ve been doing during my days and recommended that I go back to work. “Young, intelligent, and healthy women should not be sitting at home, “ he said. To which he then offered to write me a note that says I am 100% healthy and able to resume my work duties…. “Awkward….” I thought. We then talked statistics, which is never a fun task when you are discussing cancer. For a few weeks now, I´ve been foolishly wondering why there aren´t very many stage four patients commenting on my breast cancer apps and websites. Well…. it turns out, it´s because there aren´t very many of them out there to begin with. But Dr. Buhler assured me that although the long term survival rate of people diagnosed with stage four cancer is still pretty poor, the best and really only statistical chance for stage four survival is if your body has a complete pathological response to treatment like mine did. Honestly as Dr. Buhler sat staring at my results on the computer screen and shaking his head in disbelief I think I finally realized how rare my recovery has been. I am truly so fortunate and lucky.
But I know the road isn´t over yet. It would be a lot more exciting if remission meant that I am now cured and that my cancer will never return. Unfortunately, though, that is not a certainty. I will never again be able to hear the comforting phrase, “Don´t worry, everything´s going to be fine,” and truly believe it. Cancer has meant the loss of my innocence. I will never know if everything´s going to be fine or not. But does that mean I should live my life as though it has an expiration date in the near future? Should I sit around and wait and expect that my cancer will return, like some would have me do? No- I don´t think so… but can I ever think about the future as a blank, wide-open space stretching on into infinity…? No, I don´t think I can do that either. So here I am in cancer remission land, a strange and mystical place where some dreams are realized but most simply hang in the air uncertainly. But for now, I guess I will just continue to enjoy it. Life is what you make of it. If I only have six months of remission, or one year, ten, fifteen, twenty or more years left, I want to live it fully, happily, and with no fear. I vow to do my best.
I did, however, find this article written a few years ago by a stage four survivor, which gives me a little hope. Maybe seventeen years from now I will be this person. I can only hope.