Second Opinion

Last week, the new oncologist's nurse phoned me. "Can you come in next Thursday?" That was quick. I took it as a good omen. My husband worked from home that day so he could accompany me.

Ah, back to the good old Cancer Center. It was late afternoon, and most of the chemotherapy patients were gone for the day. The remaining patients in the waiting room looked unremarkable--perfectly healthy, actually. I guessed that many of them were waiting for regular post-treatment appointments. Outside, the snow fell in a thick curtain, blocking our view of the lake.

An oncology fellow examined me, first. She took my history and summarized the findings from the scans. "We don't see any obvious signs of metastasis in either your bone or CT scan." Tears of relief welled in my eyes. However, there were a few things which demanded closer scrutiny. The abnormalities, located in my lung, hip and uterus, were likely due to arthritis and other common, but non-lethal conditions. I was going to need further testing to eliminate any doubts.

Dr. C arrived and introduced herself. She was dressed in an attractive sweater and skirt, with black patent pumps. "I have to tell you that I'm allergic to wearing white coats. You'll never see me in one." My husband had some questions for her. "When will Elisa be cancer free?" Dr. C shook her head. "I never use the term. There is no such thing." Even with chemotherapy and radiation, she explained, there was no way to kill all of the cancer cells that may have entered my bloodstream. Therapy from now on would focus on keeping them in such small numbers that they could do no harm. After my radiation was finished, I should start taking Tamoxifen, a drug that inhibits the growth of ER+ breast cancer cells.

I think it shocks many people when they first really understand that it's impossible to "cure" cancer. Cancer will go into remission, a state where no disease is detectable, but that in itself doesn't mean that all the cells are gone. Most researchers don't hope for a cure per se; they look to a future where cancer will be manageable as a chronic disease, much the way diabetes has become.

I won't go into the rest of our visit with Dr. C, other than to say that I felt she addressed my fears with respect and candor, and yet left me with much hope. My husband asked her how she felt about my long-term prognosis. "Knowing what we do now, I am optimistic," she said, smiling.