SURVIVORSHIP - WHAT'S UP WITH THAT?

In December I told myself that I wasn't really that sick - that I'd somehow keep on going and figure out how to tame this cancer. But there was part of me that knew this is a deadly disease and over 9,000 people in the US die from melanoma every year. So even though I held onto hope to keep living, I had to come to terms with my own mortality. It may have been uncomfortable, but, under the circumstances it was necessary.

Fast forward to today when I'm truly optimistic about sticking around for a while. Although death is inevitable for all of us, putting it off as long as possible seems like a good idea - there's too many things I still want to do.

But between that acceptance of impending mortality, and then, a couple of months later, seeing future horizons expanding, there's an emotional disconnect. Part of me had to concede that I was likely to die soon and now that part is saying "Whoa, what's going on here? Why aren't you dead?" As much as I like the current outcome of my therapy, there needs to be a reconciliation with the part of me that expected death.

This is not a terribly unique situation. People who have survived plane crashes when other have died, for instance, or military personnel after being in action can get into a "survivor's guilt" mode. It is, thankfully, more common now with cancer patients who benefit from advanced therapy. It is still something that has to be dealt with, but it's a burden I happily bear.

As I did some research on cancer survivorship, I was surprised at the wide range of meaning this has to different people. Some people say you become a cancer survivor the day you are diagnosed and remain one until you die. Others argue that one is a survivor only after the successful therapeutic fight against your disease. I am not going to align with any one camp on this. My general view is that if you have cancer and are actively fighting it, or if you have had cancer and you are still alive, you are a survivor. Regardless of anyone's definition, cancer survivors are different people than who they were before any cancer diagnosis. "Normal" went away the day they heard the diagnosis. From that point on there becomes a series of resets to "new normals" without ever having the option of going back, even if the disease is beaten.

The new normal often includes challenging questioning about the selectivity of survival -- why did I survive and others didn't. About the meaning behind being a survivor -- does this mean there's something I still need to do, that I'm obligated to do? About the durability of survival -- is this just a short respite before I'm back in the same threatened position? Questions that may not have answers, but still need to be recognized.

Although good advice exists on many practical activities for cancer survivors (consolidating medical records, keeping or developing a healthy lifestyle through good nutritional and exercise habits), there aren't comprehensive guidebooks that will work for everyone. Making the effort to chart one's own course after the storm is still a good exercise, even if the wind is calm and the water flat.