Recently I had my six-month oncology checkup. In some ways, these appointments have become routine-like. In other ways, the very fact that I have oncology appointments at all still seems quite remarkable. Requiring an oncologist is not something one ever expects. Still, after four, almost five years, I am not as nervous about oncology appointments now. For the most part, I know what to expect. I know that more than likely there won’t be any big surprises because my oncologist follows the guidelines. This means he orders no tumor marker tests. He orders no tests period unless I have symptoms, which thankfully, at this time I do not. I do have lingering side effects from chemo and other various side effects from Aromasin, but I have no symptoms suggesting cancer recurrence. I am still NED (no evidence of disease). And yes, I am grateful.
But cancer still has a way of reeling me back in. This is the nature of the beast.
Oncologist number four (I’ve had five) and I meet for about half an hour and talk about how I’m doing. My blood pressure is elevated, but this is normal for me at these appointments. They even have a name for it, white coat hypertension. Pretty self-explanatory I guess.
We talk about my AI (aromatase inhibitor) side effects; fatigue, hair loss (yes, we even talk about my hair at these appointments), hot flashes, joint pain, bone health, weight gain, sleep issues and so on. We talk about other medications I’m on. We continue the discussion started six months ago; the one in which we discuss me staying on an AI longer than five years. I tell him I am undecided at this point. He suggests I should consider continuing because the data is starting to indicate this might be wise for someone like me. He picks that moment, the perfect moment, to remind me that I am still young – his words, not mine. It might be worth it for someone my age. Of course it’s totally up to me he quickly adds. I appreciate that. He reminds me I don’t have to commit to another five years. It’s not like I have to sign a contract or something. I could keep going another month, or two, or six, or twelve, or none at all; however many I choose. Again, I appreciate his reminder that it’s up to me.
“But, Nancy, remember you did have node positive cancer,” he gently reminds me. As if suddenly I have become too far removed from my cancer reality.
His comment pulls me back in a bit.
Next we have the discussion once again about my brca2+ status. I ask the same question I always ask at these appointments, “Am I at higher risk for recurrence since I’m brca+?”
He answers how he always answers, “Probably not, but no one knows for sure.”
“Am I at an elevated risk for other cancers?” I ask. I always ask this too. It’s like we both have our scripts to follow.
“There is still much we do not know he reminds me. But yes, you might be at higher risk for a different cancer altogether; such as melanoma or pancreatic. These are the two most common new cancers for someone like you. Is your PCP on top of this?”
“Yes, she is,” I tell him.
I’m reeled back in little bit more.
And then we discuss my kids and siblings. I am reminded why there is that shadow in families like mine.
I’m reeled back in further still.
We end the meeting exchanging pleasantries. “It’s been good to see you,” I say and then immediately think to myself, really? It’s been good to see an oncologist, seriously? Still, it was good to see him.
Finally, I get a nice surprise at the end of the appointment. “Let’s schedule our next meeting for eight months from now,” he says.
Wow, eight months I think. Progress!
And that it’s it.
Then as I always do, I make a beeline for the doors, the cancer doors. I can’t wait to be on the other side of those cancer doors.
I step out into the cold January air and breathe it in deeply. It’s an escape of sorts, and I literally pull away.
I will not allow myself to be reeled back in any further, not today.
Today I am NED and I am grateful.
How often do you see your oncologist?
If applicable, does your oncologist follow the guidelines ordering no tests without symptoms of recurrence?
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