The last couple of months, I’ve gotten a few text messages and e-mails inquiring how I have been, especially since the lack of blogging was concerning. It’s wonderful to get these messages because it’s always an opportunity for a reciprocal check-in and the sharing of some fun or delightful news, which is always novel to me because I’m not on facebook, twitter, instagram etc. At the same time, every message reminds me that I ought to be posting something, anything, because otherwise people will worry! So, hence, the title of this blog post, as suggested by a friend. It pretty much sums up my blogging M.O. Though, I’ll admit that at this point, I fear that I’ve used up my bank of goodwill and am not sure if anyone is tuning into this channel anymore after so much silence!

If you’re here, though, rest assured that I am doing well! Here are the quick bullets:

• Completed radiation therapy on 5/28 (27 sessions total) marking the end of “active treatment”! (Does that mean I’m cancer free? More or less?!?)
• Started hormonal therapy drug Tamoxifen, which blocks estrogen from binding to my cells; will be taking this daily for the next 5 years to prevent recurrence
• Started training with the Cancer to 5K program and ran/walked the Spectacle Island 5K on June 12 and then ran/walked a 4 mile race on July 4th
• Started work again on my dissertation proposal and hoping to be done with school before the next decade (sounds like hyperbole, but I’m being serious)

As I’ve mentioned to some people, my cancer diagnosis and treatment pretty much paralleled the academic year. I was just about 3 weeks into the school year when I initially went to get the lump checked out and my last day of active treatment was on the same day of commencement at school. I was so happy to be well enough on the previous day’s  “robing” ceremony (that’s the ritual that marks the conferring of the doctoral degree) and to be able to see friends make it to the finish line and receive their degrees. At the same time, I’d be lying if didn’t admit that it was also bittersweet. While there was no chance that I was going to graduate this year, it did feel like a lost a year of progress… being in the midst of one of the happiest days and moments reminded me how much I had been away from and how disconnected from school I felt. It was a little like being on a lonely island, with the disappointment not directed at myself, but just at the fact that it all had to happen.

The last day of treatment was rather anti-climactic, which I was already prepared for based on what I had read, my previous meetings with doctors, and conversations with other women. For 27 days (not including weekends), I had the same ritual: arrive at the clinic, scan my card, change into a hospital gown, wait in the lounge, be called in, lie under the machine, hold my breath, get zapped, change back into street clothes, go home and repeat… the last day was a shorter dose and then that was it. The radiation techs congratulated me, I walked out to the lounge where some of the women gave a little whoop and well-wishes and then I… went home.

So, two questions I’ve received: What’s next? and Are you cured/in remission/ free of disease?

The most accurate answer is that I’m done with active treatment! I know that sounds a bit evasive or unsatisfying, but because I’m a realist and I like precision in language, that’s about all I can say (and all that doctors have really told me). Before this experience, I had seen in television and movies that people celebrate when cancer has gone into remission, but I have never heard any of my oncologists using that term. And I don’t mean that I haven’t heard them use that term for my case in particular, but just that it’s not a word I’ve come across in the parlance of my doctors. According to the National Cancer Institute, remission is: “A decrease in or disappearance of signs and symptoms of cancer. In partial remission, some, but not all, signs and symptoms of cancer have disappeared. In complete remission, all signs and symptoms of cancer have disappeared, although cancer still may be in the body.” (http://www.cancer.gov/publications/dictionaries/cancer-terms?cdrid=45867)

The next time I go in to see my oncologist (in mid-August) I’m going to ask him specifically if my cancer is “in remission.” But until then, from what I understand, there are no further tests at this point that can definitively indicate that I have no evidence of disease (or NED, which is another term I’ve come across). Instead, based on the protocols, pathology testing of the tumor and lymph nodes at surgery, outcomes of the mastectomy and presumed effects of the radiation therapy, I am all clear. Given that my flavor of cancer is estrogen-receptor positive (meaning that it is “fueled” by estrogen), I will be taking Tamoxifen for the next 5 years, which blocks the effect of estrogen in my body. Additionally, I get a Lupron shot every 3 months or so, which  lowers the production of estrogen in my body. Because the risk of recurrence is highest in the immediate 5 years following diagnosis, fidelity to this regime is incredibly important. If you come to my house, you’ll see that there are “Tamoxifen” reminders pasted all over, in strategic spots (bathroom mirror, above the coffee making station, by the kitchen table, P’s laptop). I’ve never even been able to successfully take a multivitamin daily, so these reminders, while a bit of overkill, are probably critical. Meanwhile, I’ll continue to get regular mammograms and check-ups on the other side.

In the end “graduating from treatment” is probably the best way of explaining where I am right now. If I do think of it like getting a degree, the degree is but one milestone and not a culmination. The milestone is worthy of celebration, but our eyes are always trained on the horizon, right? I’d like to be able to cleanly bracket the entire cancer experience and reassure myself and everyone that it’s over, but the truth is that it’s not really. The most intensive and invasive treatments are over, for which I’m grateful. The side effects, including chemo brain and fatigue, will linger for at least a year longer (according to what I’ve heard and read and certainly what I’m feeling).  I have a new body with one less organ and effectively in menopause, including achy muscles and creaky joints, and almost 15 extra pounds. And the psychological processing will continue a long while yet, I think. If I sound a bit embittered, I don’t mean to… instead, I’m still learning about what it means to be this person now, still me, but version 33.6C.