Hope vs. Science

I didn’t have to take an AP Biology class to understand how the body works. I just had to start running. By simply putting one foot in front of the other I came to understand a great deal about the body, how it gets stronger, how it weakens, etc. It was absolutely fascinating….and also quite easy to figure out. Cancer, on the other hand, has a complexity in process that continues to baffle patients and doctors alike, forcing us to take shots in the dark regarding treatment and “cures”. I’m in an even more remote corner of that “dark” in that my cancer is quite rare, so the understanding and treatment of it baffles even further. Hell, have you even HEARD of Psuedomyxoma Peritonei? When was the last 5k for stomach cancer you entered? Yeah…on the hierarchical pyramid of cancer awareness, it feels like PMP is a stone that has fallen off the bottom corner.

Regarding the treatment of my cancer, the confusion continues unabated. I get the sense that the doctor’s are at such a loss for direction that they throw me chemo drugs that work for other cancers in close proximity to mine (colon/pancreatic) in hopes that I respond, although my surgical oncologist let on that most people DON’T respond to the chemo treatment I’m receiving. My medical oncologist affirmed that perspective when he encouragingly expressed,

“SOMETHING you are doing is working. I don’t know what that is, but keep doing it anyways.”

But you know what….I’m so tired of this. I’m tired of the back and forth degeneration of my body, the consistent, daily discomforts that consume my every step, the now total inability to engage in intensive physical activities. I can no longer run, bike, hike or anything else that involves any significant impact on my body. Even if I were able to push through the discomfort…why? It’s simply not enjoyable. The last thing I want is a negative association with the activities that give me so much enjoyment and comfort, so I consume myself with other non-physical activities until something forces my hand in either direction.

But what does that entail exactly? As far as I can understand, my doctors plan on giving me chemo until I’m forced to back off, or they continue to hope for a regression of cancer growth in order to make a final surgery an option yet again. Or..I guess…we wait till cancer reproduces beyond all efforts. I don’t know…those are potentials. And all this seems to lie on the premise of taking shots in the dark…right now, indefinitely.

And so I feel a sense of desperation creep in, not so much in a now or never type of futility, but more an influence on my psyche, grasping for potentials, options, alternatives, hopes. Let’s remember, in the doctor’s words, SOMETHING is working..just not working ENOUGH to afford me a physical life I want to tolerate till the end of my days. And so, since SOMETHING is working, I feel compelled to consider the “somethings” that just might be…which brings me back to considering how the body works and what that might mean for my current cancering diagnosis…even if it is fueled by a sense of desperation.

Anyone that knows me well enough will tell you I reject new-age theory, ideas that SOUND good, action based on hope. I look for evidence, concrete conclusions, and philosophical sensibility…but that doesn’t mean all the answers I seek come black and white. Any good scientist will tell you the best answer can sometimes be, “I don’t know.” And so when we talk about all the unknowns related to cancer and the processes of the body that interact with all these unknowns, well, sometimes those forces come together to create unexpected outcomes. Sometimes cancer goes into remission…the process of cancering stops and the tumors die off. Sometimes people stop chemo or outright reject it from the beginning and the cancering stops. Sometimes people make a lifestyle change after diagnosis and the cancering stops.

And we don’t know why.

We can’t point to any one action and say, “THIS is why your cancer stopped reproducing.” We just know it stops…and that’s all we care about.

Here is the consideration I have been bouncing around lately related to all this…what if, just what if ONE way to alter the cancering process involves a connection between a certain mental state and how that plays into the processes of biological functioning. What if our mind has more control over how our body works than we are able to determine at this point?

Now, here’s where I feel compelled to dissuade anyone from drawing conclusions that simply aren’t there. This is all a CONSIDERATION. Just because something sounds GOOD doesn’t mean it’s TRUE…no matter how much our desperation wants us to think so. Just because an eternal afterlife sounds good, by no means makes it a reality. Just because stating that vaccines cause autism gives a sense of comfort, by no means makes it true. Just because stories act as explanations, does not mean they are based in fact. You understand what I’m getting at here.

There are, however, many examples of the mind/body connection that lean towards the idea that we can help our body heal itself through positive mindsets, or even a fundamental shift in perspective. Running taught me more than anything else that when the mind is properly focused, the body can do amazing things, even in the midst of muscle-deteriorating run. I could never recall how many times a deliberate shift in mental perspective during a run allowed me to not only reverse the sense of deterioration in my body, but to then run faster and longer. That, however, does not mean I altered my physical structure in some way. There are other examples though, such as the effect of mental stress upon the immune system and how aggravating mental factors can allow the body to deteriorate, to weaken and become more susceptible to sickness and disease.

Cancer, of course, is a little more complex than that…but I still can’t help consider that there might be more to reversing the cancering process that also entails a shift in mental perspective. What if…and this is another huge IF…the reversal of cancering has more to do with a shift in mental state (stresses, accomplishments, comfort, etc.) than it does with chemotherapy?

Through this experience I’ve heard countless stories of patients who, after diagnosis…or somewhere along the path of treatment, made a significant shift in either their lifestyle (diet, activity, habits) or overall perspective (mortality, quality of life, etc.) and then watched their cancer go into remission…or simply change in some way.

Granted, as much hope as one can draw from such examples, I’ve also experienced a degree of frustration watching individuals adamantly attribute their change in lifestyle as the CURE to cancer. Whether it’s switching to a vegan diet, following a certain method of eating, rejecting chemotherapy, etc., they suddenly claim to have the answer to cancer. In my situation, however, it’s a little frustrating to watch so many people make a change in lifestyle that mirrors what I’ve been doing for countless years now (eat fruits and veggies, be physically active, etc.) and say this is all one needs to do in order to ward off or reverse cancer. Yeah? That sure SOUNDS good.

And here is where my latest consideration grows. What if it’s not a change in lifestyle that helps alter the cancering process, but rather a shift in mental perspective that works in concert with the body that helps stop cancer? What if it isn’t that someone is eating vegan, but that their newfound sense of hope and agency through this lifestyle change has somehow triggered a healing process? What if it isn’t that someone has now started going to the gym every day, but that the power they feel from being physically active and actually making an effort against cancer has triggered a healing process? What if it isn’t that chemo is killing the cancer cells, but that one’s newfound sense of mortality (or immortality for that matter) has triggered a healing process?

My cancer is slow growing. Very slow growing, which means that I was probably dealing with this for a long time before everything came to a head…and that makes me consider what was going on in my life leading up to diagnosis and how this might be playing into the fact that cancer has now suddenly stopped growing in me (in so far as the CT scans tell us). I can tell you this. Although I was eating vegan for 19 years, incredibly physically active, and doing what I felt were all the “right things”…I was also EXTREMELY stressed. Some of this was of my own making, some related to my Type A nature, and some a part of external factors I had little control over. I’ll spare you the details (and spare the emotions of the other individuals involved) but being an adult…with a kid (and a half)…in a deteriorating marriage…in an unsatisfying job…balancing finances…and trying to keep semblance of a very precarious situation led me to a level of stress I couldn’t find an escape from (save the time spent running).

Suffice to say, I was incredibly stressed.

Further, no matter what cathartic releases I had found to deal with the stress, I was still subject to a level of pettiness and frustrated displacement that I’m embarrassed to admit to today.

And then…cancer.

As I continued to walk a tight rope of stress each day, always feeling as if one false move might send my stability into complete disarray, my cancer was growing inside me until it had no more room to grow. So then surgery, and chemo and all that fun stuff…and cancer has stopped growing. But it’s not that simple. Or it MIGHT not be that simple. Through this past year I’ve come to realize that cancer was a positive dynamic in disguise.

It wiped my slate clean.

Life as I had known it completely stopped. My running goals stopped. My financial stresses were erased. The visitation schedule with my son was finally resolved. My unsatisfying job disappeared. Pretty much everything in my life that had me on the edge of collapse dissipated and I was left with a completely clean slate…well…save that whole dying from cancer thing. And that’s where my consideration becomes clearer, because although I could have seen this whole cancer thing as the darkest of corners to reside until something changed, I found a way to not only make the most of it in terms of perspective, but to also use that emptiness that once housed my previous life to build something new, to take advantage of aspirations I had prior to diagnosis, but couldn’t find a path towards.

And MAYBE, just maybe, that shift in perspective has triggered a process to halt my cancer. Mind you, I have ZERO evidence of this, but in the face of so much confusion related to my treatment and the lack of evidence my doctors also seem to harbor..well…why not hold on to the consideration? What if ONE of the factors that allowed my body to start cancering out of control were the stresses that have now been forced from my life? What if ONE of the factors that caused my cancering was related to my inability to focus on the overall positives in my situation in life instead of always being overly critical? What if ONE of the factors that caused cancer reproduction was my displacement of personal frustration onto others instead of finding a new level of security and emotional comfort? So what if I finally found a way out of all that…found a greater value in life…a new level of quality that resides in my mental/emotional sphere and directly plays into my biological processes?

What if I’ve helped stop cancer growth, not by my veganism…not by my running…not even by eliminating the physical stress factors in my life…but by the newfound mental/emotional positivity that I’ve tried to foster in the face of this cancer process?

What if getting off Facebook…pursuing my long-held freelance designing/writing aspirations…not internalizing others negative self-destructive attitudes…allowing myself to love again (and finding someone worth of love)…acting to benefit others at every opportunity…and generally shaping my life in a way that gives me the deepest level of value, has had a greater effect in halting my cancer growth than the destructive powers of chemotherapy?

What if?

Let’s be clear though. These are CONSIDERATIONS. These are mired far more in hope than they are evidence…and that is a precarious place to be, leaving us unable to draw any definitive conclusions either way. That doesn’t mean they are invaluable, however, because when science is offering us little more in the way of both treatment and correlation, all considerations should be up for grabs.

This may be more desperation than grounding, or more hope than truth, and maybe just SOUND GOOD instead of ABSOLUTE TRUTH…but with little else to go on, I’m going to continue pushing this idea of a good life creating a healthy life and see where it takes me.

And it’s never too late for all of us to play out this consideration, diseased or not. After all, what do we have to lose except our frustrations, and nothing to gain but a better life?

World Cancer Day

Yesterday was World Cancer Day (I think…I don’t pay much attention to that sort of thing). It was also supposed to be my 12th and final infusion…supposed to be. It wasn’t. Like everyone else, I went about my normal routine, actually not giving much thought to cancer, also probably like everyone else, even though the specifics had me dealing with it directly again. It has become all too routine, just a minor intrusion in my morning when I’d rather be at home reading with a cup of coffee as company. It has become so routine that the nurse even let me weigh myself at the infusion while she ran my blood work to another office. As mentioned in a previous post this just seems to be what I do now…like going to work. Necessary, unpleasant, and seemingly inescapable. And although I have fallen in line, going about the motions, waiting for SOMETHING to happen, I don’t enjoy the simplicity of the routine, the avoidance of the emotional weight tied to the whole circumstance. That consideration, that weighing upon my days, that cloud that hangs…I just can’t imagine becoming comfortable in its presence. And I don’t like when others become comfortable with it either.

Then I caught her conversation with the nurse in the infusion room. She was young, maybe even younger than me. Her friend, an off-shift RN in blue scrubs, sat by her side as the attending nurse warned her to brace for the stab into the port buried within her chest.

“Take a deep breath..”

A silence followed, then broke,

“OH! That was it?! I didn’t even feel it!”

Her excitement bared her newness to this process, realizing that the physical pains aren’t so bad…at first. She hasn’t been scarred by accumulation, by the things that can go wrong, by the poison that will soon begin to course through her veins, getting pushed outward into her body by a still strong heart, the medicines seeking a specific culprit, but needing to slash and burn through the veil of nerves, capillaries, and anything else that stands in its way. She has yet to feel the life sucking power of ceaseless nausea. It was heartbreakingly sad.

I felt compelled to walk over to her, spare any time-wasting niceties, and just get to explaining the torrential downpour that lies in the bagged storm hanging just above her head. I wanted to warn her, give her advice, hope for the best, but prepare her for the worst. I, however, also didn’t want to be a buzzkill…to rain on her parade of what seemed like a fear-masking enthusiasm. I really just wanted to help, but I walked away and figured she’ll either get more advice than she cares for or just figure it out along the way…like most of us have been relegate to do.

Seeing this new inductee into the Chemo Club and it being World Cancer Day, I started to think a little more about my experience and what I could offer those who have suddenly found themselves in this confusing and quite strange world, where we are in the contrasted positions of having to face down our abbreviated mortality, yet also find our way through the world still. And that’s just those of us who have no choice.

I also thought about what I could say to those on the other side of the bubble, that envious position of great privilege and, I now realize, an incredibly care-free existence…because no matter how fundamentally different our perspectives may be considering the positions we have found ourselves in, what side of the line we stand upon, we still get to interact with each other. Cancer, fortunately, doesn’t lock us away into iron lungs.

With all that in mind, the following suggestions came to the forefront without me giving it much thought and so seemed pertinent enough to offer up for consideration. It should be noted right away, however, that the cancer experience is HIGHLY individualized and my suggestions will not work for others and vice versa. This is just one more contribution to the canon of experience. Do with it what you will.

Live Your Life

Cancer patients have little agency over what is actually happening to us, over the biological cancering process. Yes, if you smoke…don’t do that. If you eat foods shown to increase cancer risk (though that evidence…across the board…is quite shaky) don’t do that. If you do all those things that you obviously shouldn’t be doing, that lead to higher cancer risk (drinking carcinogenic chemicals and stuff)…don’t do that. But really, there isn’t much more to do in actually stopping the cancering process. There isn’t much “Fighting back” or other feel good phrases offered up to us. That, however, does not mean you roll over and die. One of the most powerful ways to respond to the cancer experience is simply continuing to do what you did before cancer, living your life.

Here’s the catch though. If cancer doesn’t stop you in your tracks, chemo might. The physical problems associated with chemo “side effects” (they should be called “Forefront effects”) might literally prevent you from living your previous life. I’ve basically been rendered unable to run or cycle at this point. It’s difficult to do anything physical besides basic routines, and even those involve a great deal of discomfort I’ve learned to tolerate. I have also, however, been able to continue on to some degree. I haven’t given up EVERYTHING. I’ve always read from a young age and cancer has not stopped me from doing that. Every morning I get up and read while drinking cups of coffee. That has always been a part of my life and I don’t intend for it to be taken away. And that is key to remember, that the little things no longer become little…they can mean the most when you have so little left. They are a piece of your life that the cancer experience can not take away and it is crucial to hold onto them, focus on them and do your best from letting them slip away…whatever they may be.

Your life WILL change. You will not be able to continue on as you once did, but that doesn’t mean it’s ALL gone. Live your life, no matter what part remains.

Check In (for the non-cancering)

The cancer experience is not easy, I dare say, for anyone unfortunate enough to face it down. And depending upon how we carried ourselves prior to diagnosis, our ways of processing everything that comes along with it will vary too. Some of us will find strength, others fear, and others may find themselves emotionally crippled. Probably more common, we will go through a process of emotional highs and lows, finding value in the experience one day only to be completely worn out the next. It is crucial to recognize each emotion and each moment as valid, because they are, but this poses complications for those around us. It is understandably difficult for you to navigate our emotional fragility and seemingly bi-polar swings of demeanor, but there is one way to keep everything as stable as possible…check in first.

Check in with us. ASK us how we are doing first instead of crashing in with jokes, complaints, and frustrations. Walk softly around us until we give signs of our current mood and follow that lead, because although you may want us to be in a specific mood that suits your circumstance, ours can tend to be a bit more pressing. It’s not easy, I know, but I’ve come to realize that so many small things can become huge triggers to my emotional state. Songs, movies, commercials, conversations can snap me from my light-hearted mood or expected routine and shove my potentially abbreviated mortality back in my face. It’s hard because the person we were prior to diagnosis is often the person you expect us to be…but that can all change with these darker considerations. It is crucial for you to see us in a new light, as we have now found ourselves standing beneath, and always check in with us. Ask us how we are doing in the moment and follow our lead.

Do The Research. Ask The Questions.

I walked into this new world expecting all the confusion to sort itself out, to be guided by the hand through the process and told exactly what is going on. I was going to be told my survival rate. I was going to be told all the specifics about the cancering process. I was going to be told about chemo side effects. I was going to be told about options and future plans and anything and everything. Guess what…I wasn’t.

In just a few weeks I went from a seemingly healthy and capable individual to being pointed to the surgery entrance, unaware just how serious my cancer was, how far it had progressed, where I sat on the “points scale”, and when the surgery had a very limited effect, I felt like I was told even less. I didn’t know my chemo schedule was going to change until I almost hit my last infusion. It was never explained how cancer even works in the body. Alternative options to treatment were never explained (I wouldn’t have taken them anyways). It wasn’t explained that I needed to get nausea pills after my first infusion. It wasn’t explained that I needed to reorder chemo pills on my own. No one tells you how specific chemo medicines even work or IF THEY WORK. An oft-used phrase I’ve learned is, “The truth in small doses”, meaning the patient isn’t given the entire grim picture, because the fear is the patient can’t handle it. I’m not that type of patient.

So, a little late in the game, I found myself asking more and more questions. Instead of just letting my oncologist run down the checklist and sending me away, I started asking more “What ifs”. “What if the chemo doesn’t work?” “When can we consider surgery again?” “Does the cancer grow if we start to back off from meds?” Etc. etc. I also started reading. I wasn’t that compelled to read books on cancer, but the more I realized how little the general public, including us patients, know about the cancering process, I realized I needed to educate myself more, if only to become more calm in the truth of it all…in much larger doses.

Be Skeptical…Very, Very Skeptical

In a way, cancer is no different than pregnancy, well, in the way that EVERYONE KNOWS WHAT IS BEST FOR YOU. It is different than pregnancy, however, in that most people who know “how to cure cancer”….have never had cancer. In pregnancy, people speak from experience. In cancer, people speak from identity. I’ve come to understand that the general public really doesn’t know how cancer works in the body (because the complexity of it can’t be contained in cute, succinct sound bites) and so many individuals are prone to buying into secret, simple solutions. THIS chemical compound. THIS diet. THIS ingredient. Etc. etc. etc. Everyone has THE SECRET to CURING CANCER…but, of course, only THEY know about it because the “cancer industry” and “pharmaceutical companies” don’t want you to know about it!! You think this is exaggerated, but I hear this sort of non-sensical drivel all the time. In most situations, it’s mildly annoying..in others it’s downright infuriating. Be prepared for it.

You WILL find yourself WANTING to believe these miracle cures. You will consider juicing, only eating greens, debating the potential of stopping chemotherapy, getting your chakras aligned (ok, maybe not that one) or whatever. The cancer process is so complex and, at this point, impossible to pinpoint that we are left struggling for answers. Hell, even the doctors will tell you they are often taking shots in the dark with medication and hoping that SOMETHING works for as long as possible. The picture isn’t pretty and the desperation can look even worse.

All I can offer as comfort is do what feels appropriate to you, but also do the research into determining what has been PROVEN to have solid results. Consider where the information is coming from and if the person giving it to you actually cares about your well-being or if they are extending their personal identity or agenda.

Reject The Cancer Identity

The cancer experience sucks. I don’t care what value one derives from it…the physical difficulties of dealing with cancer are NOT fun. Some people lose their hair, some can barely walk, some puke incessantly, some feel disgusting all day every day, some bleed from their hands, some lose control over their bowels, and on and on and on. You may be fortunate to have very few side-effects from chemo or direct effects from cancer, but no matter how small, you’ll wish you never had them in the first place. You’ll want them to go away. And this is why I’m confused when people wear cancer like a badge of honor. For those of us dealing with it, we have no option but to accept it in our lives to a degree, but it confuses me when others take it on completely, even celebrating it.

Mind you, I don’t fault anyone for doing whatever they have to do to get by, to make the experience a little less shitty, but I’m not sure how I feel about the celebration of cancer by both patients and supporters. I’d prefer us all be honest about the nuances involved. The last thing I want is the newly diagnosed feeling they have to “be strong”, to feel compelled to celebrate their circumstance, to wear a bald head like a crown…when in actuality they want to be allowed to be weak and frail, to wallow in their frustration and hide their physical appearance. They should be ALLOWED to do that. They shouldn’t have to be “fighters”, “survivors”, etc. If they need that identity, then go with it, but it seems to me that our culture ONLY gives us that option and not the alternative.

Don’t get sucked into the identity of cancer that says you have to be positive, strong, a pink flag flying warrior, an inspiration to others, or any of that other campaign created persona. You are what you are and that’s good enough. The cancer experience sucks and the only obligation you have is to exist through it…that’s all.

Give Credit

I wish, when a cancer patient “defeats” cancer, they could say, “I beat cancer! I did it! All by myself!”…but that’s not how it works. In actuality, there are countless numbers of individuals that worked together and by themselves to help stop the cancering process. Some of them are scientists in labs, some are doctors, some are nurses, some are fundraisers, some are visionaries. The cancer patient, unfortunately, may do the least in the whole process. That isn’t to say we don’t have a bit of agency over our outcome. The fact that we don’t throw ourselves off a cliff while smoking cigarettes, stuffing hot dogs in our mouths, and drinking bleach says SOMETHING about our attempts. Still, the nurses that comfort us. The doctors that evaluate our progress (or regression) and change our meds. The fundraisers looking to finance crucial studies. The scientists peering into the microscopic world looking for answers. All these people are working to help us live the fullest lives possible and they deserve more attention than we give ourselves. At every chance you get, give them thanks for the work they do and the strides they’ve made in helping us understand cancer and experience life for as long a possible.

Live For The Future…And The Now

When you really have no idea how long you are going to live in the face of cancer, whether that is a full life or something more abbreviated, it makes it hard to really plan for the future. You doubt relationships, kids, employment…everything. And that’s understandable. When the hours you have left on the earth suddenly become potentially numbered, you find yourself not wanting to waste a single one. Unfortunately, this can become a crippling stasis. The desire to throw yourself into long term projects holds a sense of futility, but without other viable options for short-term living, you find yourself hanging in the balance, lost as to where to put your efforts. You have to make a choice one way or the other…or both actually.

I hate it when people say, “Live as if every day was your last!” If we followed such empty phrases literally, we’d all be broke and either addicted or dead. It’s NOT a good way to live your life actually, and for those of us who are accepting that we may actually have to consider living an abbreviated timeline, it’s helpful to ignore such advice and take a more nuanced approach. I DO think you should live for the future, making long-term plans and investing in long-term projects, using this opportunity to build the life you want…yet at the same time not taking advantage of those more immediate moments, those opportunities that will fade and disappear in the obligations of everyday life. The problem, is balancing the two. I can’t give you advice on how to do so, but I will reiterate that you don’t have to deny either. There is a way to live for the future, but take advantage of the now as best you can. If the alternative is simply hanging in the balance, WAITING for cancer to decide for you…well..you’re missing out on a lot in life. Don’t let cancer dictate your options.

Swallow Your Pride And Accept Help

When I made my diagnosis known, people came from the far reaches of the world (literally) to help me. Being a prideful and self-reliant individual, I had a hard time accepting their offers. I wanted to deal with finances on my own. I wanted to make my own food. I didn’t know how to sufficiently repay others for their support and kindness…but then I realized, these friends are as helpless to cancer as I am…as we are. They WANT to help because, to them, it’s the only way they know how, and to leave their offers unfulfilled, also leaves them unfulfilled, as helpless as they were before. When I finally came to terms with that realization, it was only a matter of swallowing my pride and allowing them to help, even if I didn’t need it so greatly, I knew they did and that was just as important.

There is no reason to go through the cancer experience alone and considering some have no greater support structure to deal with their personal battle with disease, it is insulting to not accept the support and encouragement of others. Having to swallow your pride is far preferable to swallowing loneliness.

Love Yourself By Shaping Your Influences

You may find yourself very sensitive to your surroundings…at least I did. The emotional intensity of this whole experience has left me susceptible to so many different emotional triggers, whether they be movies, relationships, friends, etc., and sometimes those influences can be supportive and sometimes they can be negative. It’s up to you to shape your influences, to take in what you feel will best support you emotionally.

I used to be a Facebook junkie, but after coming to terms with what I was putting out in the world I backed off, but just as equally, I realized I was receiving so much negativity and petty complaints through the medium as well. At some point I had to completely deactivate my account as engaging with it left me either frustrated or just plain sad. All the same, I’ve found that I just can’t handle certain people anymore and I’ve had to minimize them in my life, but on the other hand, I’ve also been able to bring other influences into my life that give me great joy, whether that is specific music, certain friends, or other activities that help protect me. You may find yourself building walls between your new life and your old, and that’s completely ok. What is most important at this point is to protect yourself emotionally. You have enough to worry about and the best way to handle this new emotional weight is by creating your life in a way that makes dealing with it as easy as possible.


To reiterate the initial point, these suggestions are what have resonated with me through my experience and yours may be entirely different. Don’t think you have to take my advice or that I have any secret to this process…I don’t. I’m just as scared and confused as everyone else and am just trying to make it through as best as possible. Unfortunatley, I’ve had to stumble through this from day one and learn a lot of these lessons on my own, so I only hope that some of these suggestions will stick with you and you can use them should you have to face down similar obstacles. I wish for you the best.

Building Up. Breaking Down.

I’m fascinated with the process of running progression, primarily because it requires a deliberate destruction of the physical body. You simply can’t become a better runner without pushing your body past its previous boundaries, without stressing oxygen delivery systems, without tearing muscle fibers. You just can’t.

Fortunately, over time we’ve figured out how to precisely damage the body in a way that is controlled, restrained and does not lead to complete deterioration. On the contrary, we’ve learned to damage ourselves in increments, subtly, so that we are able to continue running through the damage and allow the body to repair itself, in effect making us stronger, more efficient runners. It’s a fascinating process and it was crucial to always keep in mind during high-mileage training in order to keep myself from running recklessly, from not letting my body recover from previously sustained damage and therefore damaging myself further. As my coach would put it, “From saving you from yourself.”

The process went like this. Run HARD during Tuesday speed workouts. Push the oxygen delivery systems to their breaking point and deplete the body. Strain the interconnected muscle fibers throughout the body, creating micro-tears that resulted in soreness and precarious steps the following day. Then back off. Run EASY the following day and allow the systems to recover, the muscle fibers to repair and rebuild…even stronger. Then run HARD on Thursday, mimicking the previous damage from Tuesday’s workout. Follow that up with an EASY run on Friday, repeating the same necessary recovery. Put in a long run Saturday, straining systems in a different manner, breaking down muscles more and more…then repeat the recovery on Sunday and Monday. Wash, Rinse, Repeat. Over and over. Damage, repair. Damage, repair. Damage repair.

It sounds mildly masochistic, or fulfills the idea that “One definition of insanity is repeating the same thing and expecting a different result”, but the most important dynamic of this process is the strength gained in recovery. We create not only a process of reparation, but also of progression. We get better. We become more efficient. We get stronger. We get faster. And that’s why we force ourselves to break down in a controlled manner, so that we can build back up ever so slowly, increasing our ability to run at new speeds, new distances. Very few people can just leave the house and run 26.2 miles, but leave the house and run further and further, in increments, and suddenly you go from exhaustion after 3.1 miles to euphoria (well…and exhaustion) after 26.2 miles. You get the picture.

I’ve always been fascinated by that controlled progression, feeling it’s upward trajectory, it’s positive outcome, and I’ve always tried to hone it to my utmost advantage….

Which is why I’m struggling so much now.

I’m trying to engage with that process of damage and repair, of breaking down and then building back up, but the effects of accumulated chemotherapy have now become so strong that the procedure has been reversed, the terms switching places. I’m now building up incrementally only to be broken down to a greater degree. I run at every opportunity I can get, trying desperately to stress my systems yet again, to create tears in my muscle fibers, to push my oxygen delivery systems to their brink, then let the repairs take over and create a stronger, faster me. But chemo is too strong and I can no longer run with any sort of consistency, any reliability, and repetition. I’m now relegated to running one day, ANY day I can, breaking my body down, letting it recover…but then unable to build it back up again to create that continued progression where I’m getting stronger and stronger.

Instead, I’m breaking down, building back up ever so slightly and then breaking down even further. Building back up just a bit, then breaking back down again. Over and over. I’m now running only trying to maintain small progressions, to slow the deterioration process as much as I can. Maybe at some point I’ll hit a happy medium, a stabilization of sorts, but in no way am I able to get stronger and stronger anymore, as I was trying to do after my surgery and through the first handful of chemo treatments. Eleven, going on twelve, treatments, and the chemical foe is proving stronger than my physical resolve.

I don’t mean to be such a downer though. This is, undeniably, not a fun process to experience, but it’s not like I’m being pushed into a dark corner, blanket over my head, waiting this whole thing out like a seed in winter. I’m still trying. Every opportunity I can get, whenever my feet are free of pain and not disabled from “falling asleep”, I get to the gym and run. Even if just five miles, I still manage to run and try to retain some sense of strength, of continued progression, of fighting back the breakdown of my body. If there is any agency I have over this cancer experience, keeping my physical self as strong and as healthy as I possibly can is it, so all I can do is keep at it and wait for that moment where I can switch the ratio of building then breaking back to breaking and building.

Run Easy. Run Hard.

I was recently asked to contribute a piece geared towards new runners joining a vegan running group in the Boston area. I kept it pretty simple and since it applies to all new runners I thought I’d share it here as well. Some of this (most of it?) has been written about on the blog in the past, but hey, it was nice to get out of my head and just focus on running instead of all this other stuff going on at the moment. Enjoy.


Here’s the thing with running. It’s really easy.

And here’s the other thing with running. It’s really hard.

It’s easy because it involves a very simple act, putting one foot in front of the other and then repeating this motion again and again until you decide to stop. That’s it. Considerations about hydration, form, shoe selection, matching apparel, complex equipment, interval training, weather, terrain, and so on…well, that’s all secondary, and often unnecessary. The most important thing to always keep in mind is that running is simply doing just that, running. There is something very comforting about this simplicity, about marking off a mental checklist as you head out the door, “Shorts? check. Shoes? check. Ok, then…let’s go run!” In that, running is easy.

But let’s not mince words. Running is also hard. It’s hard because it involves continuously pushing your body’s physical limits to a threshold, whether that is through speed or distance, and that is not easy. It is a stressor placed upon the body’s systems, but this stressing is also a necessity in order to push those limits further out of reach and therefore making you a better runner. To know that you are going to willingly push your own body into that zone of discomfort is NOT an easy thing to do, but as it is said, “Nothing worth doing is easy.”

With that in mind, I can offer some advice that has worked for me in the past, when I first started running again, and even now, after putting an absurd number of miles into many demolished pairs of shoes, that will help tip the ratio of easy/hard to the former.


Runners and vegans/vegetarians alike often have an obsession with eating, whether that is an interest in new foods or for athletic performance…I’m no exception. As a long-time vegan, I certainly enjoy visiting vegan restaurants in new towns, trying out the latest junk food concoction or experimenting with my own banana bread recipe, but as a runner I also pay strict attention to fueling needs, nutritional concerns and portion sizes (usually making sure I’m getting ENOUGH!). The good news is that because vegans/vegetarians often pay attention to the foods we eat, we’re already comfortable making changes where necessary or have a leg up (pun intended) on others when it comes to eating nutrient-dense, energy-rich foods for running. I could go on about this forever, but for brevity’s sake, I’ll highlight one aspect of eating that has benefited my health and my running.

Eat simply and diversely. This means eat foods that are quick and easy to prepare (that don’t involve trips to South America to discover secret grains eaten by tribes that have yet to have contact with modern civilization) and that contain a variety of ingredients. I like to refer to this as “the kitchen sink method”, which means eat everything including the kitchen sink. The obvious benefit to eating this way is that you are constantly getting a diversity of nutrients into your body, so that you reduce the risk of becoming deficient in any one thing, which can lead to compromised running performance. A lack of iron creates anemia and significant fatigue and recovery reduction. A lack of calcium can lead to stress fractures in your bones. A lack of protein can lead..well…no one ever ends up with a lack of protein.

How I like to prepare foods in this way is to have a “base” and then add as much extra as possible. So if I’m making stir-fry, I’ll start with a bag of frozen veggies and then add any number of ingredients including almond slivers, sesame seeds, flax meal, raisins, spices, spinach, kale, tofu/tempeh/rice/or cous cous, more veggies (red pepper, avocado, etc.), bragg’s amino acids, nutritional yeast, etc. etc. etc. Now, you don’t have to add EVERYTHING, every time, but the more ingredients means more nutrients, and if you mix it up each time you won’t get bored with with what you create and you make up for things you might have missed last time. I do the same with oatmeal, creating my “base” of oats and bananas and then adding everything plus the kitchen sink, like peanut butter, raisins, spices, almonds, cherries, flax meal, protein powder (usually for flavor), etc. etc. etc.

Both of these meals, I hope you notice, take VERY LITTLE preparation time and involve whole foods that usually just need cut and heated up before eating. I stick primarily to meals such as this and have yet to develop any nutritional deficiency or experience performance sapping fatigue even during my most intense periods of marathon training, which would max out around 110 miles a week. Although it can’t hurt, you absolutely don’t need to use obscure ingredients, spend hours preparing a simple veggie patty, or supplement your meals with protein powders or specially concocted energy bars and expensive nutritional products. Just simple EAT FOOD and eat a variety of it. That’s all. Keep it simple to keep running easy.


To succinctly offer training advise is difficult as each runner is performing with individual limitations and goals. Some of you may only be able to run 3 days a week, some 5, some every day, and each training plan will be adjusted to your ultimate goals and abilities, so no one plan will work for everybody. With that said, I can offer you what sort of plan I worked from during the height of my training and you can determine what you might consider cherry picking to suit your needs.

To start, a plan that involves running every day of the week consists of three different types of runs. A recovery run, a speed workout and a long run. The speed workout and the long run, which total three days of the week, are the most crucial for stressing the body’s various systems and pushing your abilities as a runner, and the recovery run is just that, to recover from those stresses and allow you to do it again and again as your training progresses. So for me, a typical week was as follows:

Sunday – Recovery run (10 – 12 miles)
Monday – Recovery run (10 – 12 miles)
Tuesday – Speed workout (10 – 15 miles)
Wednesday – Recovery run (10 – 12 miles)
Thursday – Speed workout (10 – 15 miles)
Friday – Recovery run (10 – 12 miles)
Saturday – Long run (20 – 22 miles)

The speed workouts, as the foundation of quick, competitive running, were highly varied and where one day consisted of measured intervals of high intensity, other days would be long runs at a slightly lower intensity, or hill running with varied intensities. The long run, being the basis of your endurance, most often consisted of simply an even paced long run, but at other times during training involved higher intensity intervals of 3 – 5 miles during the run. The recovery runs were just that, very slow running that maintained fitness, but allowed the body to rest and relax from the stresses of the speed workouts and long runs, setting you up for more of those at a higher and higher intensity.

For your individual purposes though, it will be up to you to decide if you simply want to run a distance to finish, to compete against others, to run a PR, etc., and then adjust your training plans accordingly. The problem is that could involve any number of variations on your runs, and without a training group or coach to guide you through that, you’re left to scouring the internet…which can be very helpful if you look in the right places. Personally, I would advise reading running magazines as they are always filled with either general advice or specific training plans and workouts. That is exactly what I did when I was first fumbling through my attempts to get better at running and it served me quite well. I would only advise that you don’t take everything as gospel and simply pick and choose what sort of training plan or workouts sounds appealing to you. That will allow you to shape your training as you go and not stress you out if you can’t keep to the suggested intensities or goals. Again, keep running easy by keeping it fun and fluid, varying your runs as what feels best for you each day.

Avoiding Mistakes.

Avoiding mistakes is easy advice….don’t. I made mistakes all through the beginning of my training and that’s how I learned to get better, whether that involved the right clothing, more honed training methods, race strategy, etc. etc. etc. All that learning has kept running interesting even years down the line and ultimately made me a better runner, able to gauge when I’m screwing up and adjust accordingly. I can highlight this point with two examples.

The VERY FIRST time I went out for a run as an adult I was wearing worn out shoes a full size too small for my feet, swimming trunks with a mesh lining, and a cotton t-shirt. I decided to run into the town I was living and back, but by the time I arrived home everything in my body hurt…EVERYTHING. It felt like my lungs were going to burst, I was drenched in sweat and it felt like someone had shot me in my shoulder. I had run 5 miles unwittingly and probably too fast at that. It was as awful as it was exciting. But you know what, that experience allowed me to appreciate all the changes I started to make from there on out, from more manageable mileage, to a tempered pace, to appropriate shoes, to shorts that didn’t chafe, to tech-T’s, etc. etc. etc. The “mistakes” I made didn’t kill me and won’t kill you either. And down the line, I continued to make mistakes and learn from them, feeling shin splints and getting advice on fixing them, and so on. It has made me a more knowledagble and effective runner.

Secondly, even after honing my body to run further and faster, I had an issue with running. When the gun went off..so did I. My second half-marathon I ran involved a first mile at 5:05 pace…which did NOT translate into my best race. My tendency to start off very quickly was noticed by my teammates and coach and after some simple suggestions, I learned to pace myself better, which ended up in many PR’s and podium finishes. The thing is, since making those mistakes and now knowing what that quickened pace FEELS like, I can now temper myself if I start off too quickly or better understand when I’m running past my limits. Those speedy mistakes and subsequent corrections, again, made me a better runner down the line.

Of course, there are things you certainly want to avoid in terms of not injuring yourself, but to be honest, the factors that can affect your running are many and I wouldn’t want to overlook anything specific. I can really only advise you to build slowly, listen to the messages your body is giving you and adjust accordingly. Making those small mistakes is one thing, but learning from them is the most important thing you can do to avoid making the bigger mistakes down the line. If a pain is not going away…back off until it does. If the pain gets worse, seek professional help to diagnose the issue and make the corrections so that running which has suddenly becomes hard, becomes easy again.

Remember, running is easy and you can keep it that way. But also remember that running is hard, and that’s what makes it so rewarding.

Trapped Inside

The temperature has been cold here lately. Genuinely cold. Brutally cold. -35 degree (F) wind chill cold…and I hate it. I don’t hate it, however, like most of Facebook hates it, complaining about putting on an extra layer just to drive to work in a heated car and into a heated office complex. Or how parents hate having to actually be parents and entertain their kids as day after day of school is called off. Or hating the cold because hating a change in temperature has become a self-fulfilling prophecy. No, I hate it because I can’t be in it.

One of my favorite rewards of being an everyday runner was experiencing the very subtle changes in the seasons, shifting from one range of temperature to another, taking in the smells and visuals that accompany these changes, and yes, finding out what it really feels like to run in the extremes of Summer and Winter.

The extremes of Summer have their own distinct forms of suffering – the sensation of breathing through a wet blanket, the chafing that comes with excessive sweating, the slow burn of sun on skin. But all that is relatively tolerable. Winter, on the other hand, isn’t so forgiving. There is both a physical preparation in figuring out just the right amount of clothing for any given temperature, but also a mental effort just to get out the door and hit that point in the run where pain and discomfort warm up, literally, to an invigorating pace. Then there are those negative wind chills, where any tiny bit of exposed skin burns with the pain often felt after getting stung by a wasp. There are ice drops that form and pull down at the end of eyelids. There are icicle stalagtites that shoot upward from the breath trying to escape your face mask. And there is, of course, the machismo that comes with the post-run brag about putting down another 10 miles when the city has warned everyone to stay inside for their own safety.

Honestly…I miss that. I miss those subtle shifts in the seasons and I miss those moments of extreme adversity that offer both new experiences and yet another opportunity to overcome. There is a reward that only a relative few of us know from forcing ourselves into those circumstances, from scoffing at the treadmill and preparing to do battle both against and in concert with the elements.

And damn I miss it, because I’m trapped inside.

Over two weeks have passed now since I ran my last 5 miles on the treadmill, confined to the indoors from the accumulated cold sensitivity of my latest chemo treatment. It’s funny, because I wrote that on my calendar, “5 miles”, as I decided to start keeping track of how much I end up running each week, as both encouragement for myself and to see how I’m handling each session of treatment. And although I planned on getting up the very next day to add another “5 miles” to the calendar, I knew the second I put my foot down that the day would be left blank. My feet were in pain. Great pain. I felt them a little on the treadmill the day before, but sometimes the hand and foot syndrome attacks me rather suddenly and intensely, and I’ve learned that when my feet feel a certain way in the morning, there is going to be no running that day…barely even any walking. Since that day my calendar has stayed blank. Not a step of running. And that’s when I realized I’m not only trapped inside from the cold sensitivity, hiding from the dangerously biting air, but that I’m now also trapped inside my own body.

The deterioration of my hands and feet has hit a point that I can’t simply grit my teeth and fight through. I can’t start running and hope the adrenaline numbs the pain. I can’t tell myself to suck it up and just go. This time it’s too much, far too much. This past week has been so incredibly bad that the moment I step out of bed I have to take incredibly soft steps just to get to the bathroom, to make my coffee, to somehow work up the will to go to work where I’ll be standing and moving on my feet all day. This is all very sudden and I’m trying to find a way to deal with this emotionally.

As I explained in a recent post, the side effects have gotten so bad that we had to take out one of the drugs from my infusion and alter my Xeloda schedule so that I can hopefully manage the pain and not become completely immobile. I know that sounds like an exaggeration, especially considering how much I’ve talked about running and being physically active in the recent month or two, but this has come on quite suddenly and put a little scare in me, to be quite honest. Each step, all day, is like walking on sandpaper, sharp pebbles, burning asphalt. If I step on any uneven surface in the morning, even a folded up towel after getting out of the shower, my body threatens to buckle under the pain. After some significant work to get my socks and shoes on as painlessly as possible, I can then at least move around for a couple hours with a little less abrasion, but the weight only builds on the pain until I’m seeking relief at any opportunity.

I’m still having trouble accepting that this is my body, that I’m breaking down like this. I’m a fucking distance runner, damnit. Just last week I inadvertently hit the buttons on my watch up against a box, triggering a sequence that brought up one of my last speed workouts prior to diagnose, that I had never erased.

5:30, 5:35, 5:26, 5:28, 5:24. Mile splits.

I looked at them with a mix of both excitement and pride, yet frustration and dejection. They were like reading the times of another runner, another person. It’s been that long and I’m not convinced I’ll get back there again, no matter how deep a fire still burns within this body. It’s a fire that is trapped inside me, continuously smothered by the accumulation of poisons that prevent me from using my body in the way I so desperately desire.

And yet, I still have complete freedom in my mind. I am entirely conscious, able to process and reconcile my situation, draw value from the experience and attempt to relate it to others. In that, I can hold onto some sense of not feeling trapped, of being able to progress in some way, mentally and emotionally if not physically. But that scares me too. Because I can’t bare to lose that.

My sister wrote a blog before and during her cancer experience, and one of the hardest parts was reading her last posts where the drugs were taking over her ability to communicate well, to be aware of her reality. It was consuming every part of her, even the seemingly untouchable part that lets us endure through some of those worst pains and depressions. I don’t want my mind to become as trapped as my body.

Last night was rough. I searched the internet for ways of alleviating my hand and foot syndrome, but the suggestions seem to be more akin to appeasement than actual solutions. On the contrary, the clinical descriptions of the symptoms were less hopeful and only stated that the pains would go away after the dosage was dropped or eliminated from the infusion schedule, something we haven’t done yet. And so my physical situation feels worse than it ever has at this point, at least as far as side effects go. I continued looking and stumbled across some blogs where people detailed their fruitless efforts at dealing with Xeloda side effects and as I continued down some of their worm holes I found myself reading story after story of physical digression, until some of the posts started to mimic my sister’s in their lack of lucidity. Their mind was going along with their body.

And there I had to stop. I went to bed fighting back tears brought on by a sense of futility.

I woke the next morning with very little relief in my hands and feet, spending the morning building the drive to get ready for work, to prepare for a day of physical activity that I knew was only going to get worse as I stayed on my feet. I felt trapped inside, in my body and in my circumstance…

But…well, there are small victories that I have to rely on right now. I tapped the Instagram community for suggestions on physical activity that doesn’t involve my hands and feet. It was suggested that I resort to swimming, but the water would only make things worse for me. Yoga was suggested, but ANY pressure on my hands and feet is out of the question. All I could think of was doing core exercises I used to do to supplement my running, and so that’s what I did. I pulled out my padded mat, turned up the metal and got a very small workout in that had me putting most of the weight on my butt and back instead of my hands and feet…so…that’s something. It’s not much, but at least it’s not giving up…and that’s something.

And when I got home after work today, when all I wanted to do was go to my bed and lay down, taking all the pressure off my useless feet, I decided that the 30 degree weather and the little will I had left to be physical would be well spent shoveling my elderly neighbor’s walk, if not only because she no longer has the ability to do so (something I’m trying to avoid), then at least to make myself feel a little less helpless. And so that’s what I did.

Now I wait. I wait to see how my feet will feel tomorrow. If I’ll wake up with bloody creases in my fingers again. If I’ll struggle to pull on my socks. If I’ll remain trapped inside, inside my own body, or if there will be a little more relief, a little light creeping under the door that might give me hope that I can get out of my indefinite state of relative helplessness and, even maybe, back into the cold winter air to remember what a biting air feels like on my ankles.

I genuinely hope you are of the sort that finds the same reward in loosing your chains to get outside, to feel the subtle changes of the seasons and to overcome the adversity when things get downright dangerous. I may be trapped inside right now, but I’m quietly cheering you on.

Smoking Doesn’t Cause Cancer

When I was first diagnosed with cancer it really took a lot of people by surprise, myself included of course, however, it seemed I was a little less caught off guard than others. I remember sitting in the parking lot immediately after that fateful doctor’s appointment and calmly thinking,

“Ok…I have cancer. I wonder what comes next.”

And that was it. I didn’t gnash my teeth, punch the steering wheel, break down into hysterics or anything like that. I just accepted it and moved on. Others, I came to find out, were a little more introspective, which is understandable. They didn’t have to figure out how to deal with cancer physically, but were left to just debate the how’s and why’s of it all. Admittedly, I didn’t realize just how many people were confused by my diagnosis and how deeply it affected some of them. Little by little though, friends and acquaintances of mine let on that they were really confused by the diagnosis and it really shook their perception of health, both in general and for themselves. A couple people even contacted me privately to inquire about my symptoms before diagnosis, afraid they might be dealing with a similar circumstance. Fortunately, nothing turned out as dire as expected.

The surprise and confusion others felt was related to the perception that I was “that healthy guy”, the one doing all the “right” things to avoid cancer. I was active, eating a vegan, primarily whole foods diet, etc. etc. For ME to get cancer was just absurd and, in some people’s minds, meant that they were all the more susceptible. Now, I’ve always taken every opportunity to negate the “bulletproof” health claims attributed to a plant-based diet, but it wasn’t lost on me that I was following all the suggestions related to diet and lifestyle in order to “fight cancer”. Eating more fruits and vegetables? Check. Getting at least 30 minutes of exercise 3 times a week? Try at least 60 minutes, 7 times a week. I was doing everything “right”.

But here I am with a scar that nearly cuts me in two, a body filled with poisons, and no end in sight.

So what went “wrong”?

Honestly….nothing. Nothing went “wrong”, the process of evolution and biological “imperfection” simply went “right”. That is to say, the process of cancering was triggered in me by a number of genetic misfirings that enabled my cancer to reproduce out of control, or from the perspective of my cancer, it subverted all my biological checks and balances and managed to succeed in winning the game of survivalism. It kept itself alive with a vigor that we all aspire to achieve amidst all the things that could go “wrong” in our existence. Just as the lion kills the lamb. Just as tornados wipe out entire towns. Just as pine trees choke out the sun from fledgling saplings. Just as armies kill invading armies. Just as surgeons slice out disease.

So does disease consume bodies.

There is no moral right or wrong to this process…it is simply a process of evolution and biological living and dying that is a tiny part of a much larger picture of existence, of population control, of genetic culling, of unconscious, unintentional reproduction. That’s it.

However, this idea of chance and circumstance and evolutionary biology has not resonated deep enough in our collective psyche to dissuade us from looking for an enemy, a singular force that uses cancer against us. We look for something to blame, to explain it all away and afford us the idea that we have some degree of control over this process, that we can know EXACTLY what to do in order to avoid getting cancer. And so we look for that singular enemy. Industrial pollution. Smoking. Carcinogens. Sugar. Meat. Nitrates. Stress. Coffee (ridiculous, I know). Etc. Etc. Etc. We want to believe that one thing or another CAUSES cancer, so that we have somewhere to point the finger and can explain away why people who do all the “right” things still get cancer.

I used to think this way as well. Before actually getting cancer I really didn’t understand the process of how it develops, but now that I’m in the thick of it, my knowledge has grown and I see the inadequacy and confusion popular culture inadvertently creates through addressing singular cancer causing agents. Most people are led to believe that individuals who smoke get cancer because they smoke. At best they are pitied, at worst they are vilified. We are led to believe that maybe drinking contaminated water creates cancer in people and so fingers are pointed at polluters and corporations (which isn’t the worst thing if you ask me). We are led to believe that any one lifestyle habit creates cancer and so it’s the fault of the person who gets cancer that it happened. There is one problem to this though.

People who smoke their entire lives often don’t get cancer. Notice I said “Often”. That’s because, statistically, those that smoke their entire lives and don’t get cancer are not anomalies….they are the norm. And people who eat hot dogs in excessive proportions don’t often get cancer. And people who are glued to cell phones, live under electrical wires, drink suspect water, etc., don’t often get cancer. Statistically, it has been shown that any ONE factor simply doesn’t CREATE cancer.

I read a quote recently that said, “We don’t get cancer…we are always cancer-ing”, which is to say that cancer is a PROCESS. We ALL have cancer cells in our body that are reproducing, but we have biological checks and balances that reign in the growth and kill the reproducing cells. The problem begins when those walls of defense against cancer growth are somehow subverted, and not just ONE wall, but multiple walls of defense.

Cancer cells reproduce out of control when an aggravating factor leads to a genetic misfiring, or informational signals between cells get crossed, and then happens again, and then again, and then again, and then again….and suddenly cancer cells become “Cancer”. They go from being small C cancer to big C Cancer. But it doesn’t just happen because a person smoked cigarettes and the toxins in the cigarettes somehow caused cancer to simply form and grow. And that’s why I say, “Smoking doesn’t cause cancer.” Smoking is a proven aggravator to cancer reproduction, but it isn’t THE factor, because it is merely ONE aggravator among a handful of other aggravators….and in that is why cancer is so seemingly impossible to “cure” in the way we’ve almost cured Polio.

We can’t simply find ONE enemy that creates cancer and legislate against it, or find ONE drug that stops cancer from reproducing, because it is seemingly more than one disease….it is like a unique disease to every individual unfortunate enough to have all the misfirings lead to full blown cancer. And finding out what those misfirings are in each individual is a, as of now, impossible puzzle to decipher. That, of course, doesn’t mean we shouldn’t try.

This awareness that cancer is unique to each individual and is caused by so many misfirings or genetic abnormalities, however, helps me to reconcile the fact that there are those of us that happen to “do all the right things” and still get cancer. Yes, certain lifestyle habits aggravate cancer reproduction and increase the probability of getting full blown cancer, and I would never advocate smoking, eating animals, drinking contaminated water, living next to nuclear reactors or any other such habit, but to singularly blame one factor or another is misunderstanding how cancer reproduces and leads to a lot of confusion and heartache for those that are unfortunate enough to get it.

I DO understand why friends and acquaintances want to explain away my cancer, want and almost NEED to find an enemy to point to…because I think it not only helps them reconcile my situation, but also gives them some comfort in relation to their own circumstance, to convince themselves that they will most likely not get cancer because they didn’t grow up where I did, or don’t engage in some of the lifestyle habits I do. Unfortunately, this is just an act of appeasement and doesn’t address the specifics of the biological process of cancer reproduction, but then again, when it seems like we are just banging our heads against a wall of ineffective treatment and only episodic “cures”, it’s understandable that we are compelled to seek some manner of control and reconciliation with this losing battle against evolutionary checks and balances.

Trust me, I fault no one in this perspective. Until I had to face it head on, I grasped onto the same simplistic justifications to explain why cancer rates continue to rise, why my sister died, and why my friends continue to get cancer.

It’s much easier, and human nature, to point a finger at the intentions of an enemy or conscious force than it is to just accept that we live in an abstractly defined “imperfect” world, that we are pushed and pulled by forces beyond our control, and that we are merely physical beings subject to all the processes of a physical world that we arbitrarily define as good or bad. Sometimes “bad” things happen and we have no comfortable grounding or perspective to make sense of it…and that’s just how it is.

Everything happens without a reason.

This Is What I Do Now

My oncologist has an unfortunate facial feature, or perhaps it is only unfortunate for his patients. When he talks, the corners of his mouth turn up and his teeth show through slightly, giving the impression that he is enjoying the information he is offering you, unable to stifle a smile. I’ve noticed this accidental smile when during previous meetings I have found myself almost smiling back, despite the information he gives me being nothing to smile at. Often, quite the opposite.

Today was no exception.

I walked in for my 11th of 12 scheduled infusions, though if I’m to be totally candid, I assumed that my infusions were not going to stop at 12. That didn’t keep me from getting lost in my daydreams for the week leading up to this post-CT scan meeting. I not only thought about a meeting that ended in legitimate smiles, but even let myself get carried away in the emotional wave of it all. I envisioned my oncologist bringing in other doctors to help deliver the news, exclamations of an astonishing and dumbfounding reduction in my cancer, plans for a final surgery, and continued expressions of my singular and unique recovery from the edge of the cancer cliff. I let myself get so carried away that I almost started to believe it was a possibility, a probably reality, though I’ve always seemed to recognize that if I’ve even imagined something so grand it’s more than likely not going to happen, as if I’ve jinxed myself simply by considering the extravagance of it all.

When my doctor began the meeting with the same formalities as before, I knew my daydreams were just that, dreams. I could only hope a more dire revealing wasn’t to come.

We talked briefly about my recent travels and general activities, this time confiding that I haven’t been able to run much at all due to heightened side effects from treatment. He distractedly responded as he typed away at the computer screen positioned to his side. I told him about how useless my hands can get. I told him about the sensitivity to the cold. I told him about the dead spots in my feet and how they feel as if they’ve completely fallen asleep now. I didn’t try to brush aside the complications in an effort to continue working through them. I was tired of it and I wanted to let him know.

All this was enough to trigger a change in treatment without hesitation as he quickly explained we would immediately take away the Oxaliplatin to reduce side effect accumulation. For this treatment and the next we would give my body a break from the onslaught, eliminating the cold sensitivity, part of the hand and foot syndrome, the nausea, and other effects I might have forgotten about beneath all the other discomfort. Oxaliplatin is the drug that attacks not only the cancer cells, but all the cells in the body, bad or good, leading to so much deterioration where problems didn’t previously exist. The consideration, of course, is if taking away this drug is going to allow the cancer to take hold elsewhere or give it free reign to grow. I am still administered Avastin, which is a drug that targets the cancer cells only (we hope) and so doesn’t wreak so much havoc in the rest of the body.

Further, we are also adjusting my Xeloda (chemo pills) schedule, so that I am only taking them one week on then one week off, and repeating until a change is needed. This will give me another form of respite from the deteriorating effects of these drugs.

I was relieved to hear I have a break from the discomfort, a period of healing that will hopefully allow my skin to grow back on my hands and feet, the pain to fade away and maybe a strength to take its place that will allow me to run more consistently again. Admittedly, I don’t know how this is going to play out, but I can tell you that I feel as if I skipped my infusion all together today with only the Avastin deliver in a quick 30 minute session. Minimized is the cold sensitivity, gone is the overwhelming feeling of grossness and nausea, the horrible taste in my mouth, the cold sweats, the fatigue. Now I just wait for the other effects to dissipate in the coming days and weeks. I hope. I’m not sure how this is going to play out.

We then talked about the scan itself, and just as I suspected, nothing was different. His inadvertent smile may have been more genuine when he explained that no cancer was found anywhere else in the body and although no reduction was found, neither was any growth. We are still completely “stable”. The cancer is a strong foe, but I suppose my body’s defenses in conjunction with the chemotherapy treatments are equally as strong. SOMETHING is working. It’s a little disconcerting, despite his smiling words, but he again let on that most people with stomach cancer don’t respond to the treatments, implying that the cancer usually grows, so it follows that we have something to smile about considering that mine is just in a holding pattern. My excitement at this news has become tempered, worn thin.

Without dwelling on this repeated diagnosis I asked the question pressing more heavily on my patience, “So we scheduled 12 of these treatments…since the cancer has stayed the same…what happens after the 12th? Do we keep doing this or is there a possibility for surgery? Or is this just indefinite?”

This is where I could have gone without the accidental smiling.

“Well, we know Dr. Arregui (my surgical oncologist) had problems removing the cancer at this point, and most people just don’t respond to the treatments, so right now we are in a “management phase”. We will follow up with Dr. Arregui in a couple months, but while we keep the cancer at bay, this is what we will continue to do. If the cancer starts to grow, we will add another medicine, but as long as it stays how it is, we will continue this management indefinitely.”

Indefinitely. That word was like a kick to my stomach.

I felt an initial sense of relief that I had an answer from him, a projected plan of sorts that gave me a sense of what to expect for the time being, but quickly it turned into an unavoidable dread that this is now WHAT I DO. I’m a chemo patient. There is no part of my daydream to draw from. There is no triumphant return to running. There is no sense of relief that I can just let go and feel my old life again. There is no seemingly miraculous turnaround. This is just what I do. I get chemotherapy until something happens either way. This is what. I. Do.

Forgive me for my lack of clarity in this realization or an absence of reconciliation….right now I’m still struggling to internalize that for the time being, into a future I can’t see, this is just what I do. I am, again, left with a number of NEW questions to consider as I wait through this process again. What are the chances my cancer will grow? What will my quality of life be like with reduced side effects, how much of my old life can I get back? How often will we reintroduce the more debilitating chemo drugs? How do I conduct my life from this point? What is worth pursuing and what do I need to leave behind? This is, for the time being, what I do….but what does that mean for who I am?

I didn’t want this. In a more desperate state I wanted to be told that I would either live indefinitely, or die definitely…that way I could at least make a solid decision about my life and start from there, but again, I’m left in a sort of limbo, as if I have more questions unanswered than answered. The only definitive I have at this point is that chemotherapy is what I do.

There are positives in this scenario, I know. My foundational circumstance is still that I am here to even have these considerations, and I will surely address them soon, but for now, I need the time to really sift through what my life has become and how I take this realization and get the most out of it. Honestly, Im’ not sure what that is right now, and I have no choice but to leave it at that until I figure it all out.

In the meantime…I guess this is what I’ll keep doing. Time to drop my head and push forward.