Facing Mortality After Cancer, and Choosing to Live Fully

Recently, I saw a meme in a cancer support group that said “We all have expiration dates. Cancer tricks you into believing you know yours.” And it does. Cancer was once a death sentence; treatments for anything but very early-stage cancers were ineffective, and mostly aimed at extending life, at providing quantity at the expense of quality. Even the most effective treatments had horrendous side effects; a friend of mine was successfully treated for pancreatic cancer about 15 years ago, but later died after surgery to release adhesions (places where his internal organs were growing together) caused by the radiation treatment that successfully treated his cancer.

When I was diagnosed with follicular lymphoma (a form of blood cancer) in 2020, I was convinced I now knew when my expiration date was; so much of the media information around cancer - and particularly around fundraising for various cancer organizations - highlights that if you don’t donate, people will die simply because they have cancer. Even fiction highlights the idea that cancer is a death sentence, although less than it did when I was younger; a short story by Ben Bova, a science fiction author, “The System”, published in 1968, predicts a time when everything but cancer will be cured, but when a cure is found, it’s shelved, because society needs a source of death to renew the population. This type of fatalism is pervasive in portrayals of cancer, even today; the ad for a well-known cancer research foundation notes that 1 in 5 children diagnosed with cancer will not survive, rather than celebrating that 4 in 5 such children DO survive because of the efforts of this organization and others like it.

Even talking to my oncologist and doing my own research, seeing how effective cancer treatment can be, I was convinced I would be a member of the small group that was resistant to treatment. I was pleasantly surprised to find that I wasn’t. Even my oncologist was surprised at how well I responded to the standard treatment; when my post-treatment PET scan showed a complete response to treatment, he actually said that he hadn’t expected treatment to work, or at least not to work that well. At the time, I didn’t really appreciate the comment; actually, I’m still not sure I appreciate the surprise in his voice. Regardless, I’ll take it!

Most people, unless they have a chronic or degenerative illness, don’t think about their potential expiration date. But being diagnosed with such an illness — with cancer, or multiple sclerosis, or diabetes, or any one of a long list of such diseases — makes you think about such things. It makes you reconsider plans — especially long-term plans. With something like follicular lymphoma, which is known to recur, sometimes years or even decades after successful treatment, long-term plans are particularly difficult; trips, large purchases, new pets, etc., all come with the concern that the cancer might come back, and concerns about paying for something you may never use. It’s true, that is an issue that affects everyone, and yet, it seems more of an issue now than it did before cancer — before there was another ticking clock on my expiration date.

I am far more aware of my expiration date than I was before diagnosis 5 years ago, and yet, I go back to something else my oncologist said: that he didn’t treat me to have me hide in my house, but so I could go live my life. That’s what I’m trying to do now: live my life. Be aware that life ends, certainly, but don’t let it stop you from living your life.

This piece reflects the author’s personal experience and perspective. For medical advice, please consult your health care provider.

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