March 5, 2008 - Unpreventable

This afternoon I have my 3-month appointment with Dr. Lerner. He looks over the radiologist’s report from my Valentine’s Day CT scan, and confirms that, yes, the cancer is stable. If anything, he says, one of the enlarged lymph nodes in my mid-section seems to have diminished slightly in size – although it’s by such a small amount that it is, for all practical purposes, the same.

His physical examination of me – palpating the lymph-node areas around my neck, armpits and groin – reveals nothing out of the ordinary.

Pointing out that it’s been six months, now, since the cancer has grown, I ask him if this long stretch without changes is something he sees often. Yes, he says, this is the way indolent lymphomas often behave. Sometimes they move ahead for a time, sometimes they stall, sometimes they even diminish in size. As long as I’m feeling well and have no symptoms, there’s no call for treatment.

I ask him if there’s any scientific explanation for why indolent lymphomas grow in fits and starts like this. He says no, science doesn’t know why this cancer behaves this way. “There’s nothing we can do to prevent it, either,” he goes on. “We just watch it, and when the time is right, we treat it.”

“Incurable, but treatable.” I’ve been familiar with that terse description for some time. To that I can add another adjective: “unpreventable.” Incurable and unpreventable – now, there’s a surefire recipe for feelings of helplessness! My doctor’s just told me there’s nothing I can do – no diet, no exercise, no medicine – that will have the least effect on how rapidly my malignancy advances (not anything modern medical science is aware of, anyway). The best I can do is to remain vigilant and strive to live an ordinary life, trying to ignore the cancer monkey clinging to my back.

There’s nothing I learn today, from Dr. Lerner, that I haven’t heard before. For some reason, though, the word “unpreventable” seems highlighted in my mind. It’s actually a comforting thought. It’s reassuring to know I’m not falling down, in some way, in my preventative self-care.

I know there are a lot of alternative therapies out there. I could pursue some of them, were I of a mind to do so. But, I’m not. I’m skeptical of purely anecdotal claims of effectiveness – which is mostly what I hear, in favor of such nostrums. I suspect part of the appeal of these treatments is that they’re a way for patients to feel like they’re doing something, at a time when there’s not much to do, other than wait.

Unpreventable. Assuming you already know you have cancer, it’s a good word to hear.