Simply put, cancer is chaos.
There’s the havoc it wreaks in the days and weeks after diagnosis as your oncologists—because now you have to work with specialists rather than a PCP—scramble to get a full picture of what you have and what needs to be done. Then there’s the loss of control you feel as you watch your calendar fill up with appointments for difficult conversations, more examinations (some of them damned uncomfortable) and more tests. Get through that and the shock, the outrage and despair and one day, quite suddenly, you’ll surrender out of sheer exhaustion. And in that surrender you begin to accept—uneasily—that you’ve moved from the upheaval of ground zero to the relative quiet of the edge where you can observe. Because until that nasty inconvenience in your body is removed, your focus must be on fighting the disease and not yourself.
Some days will pass more easily than others. That’s the way of all journeys, though, including this strange one your disease has compelled you to take. There are days that feel like a slip-and-slide; there are others that feel like a forced march. Gradually the fear lessens when it becomes clear that the cancer in your body is slow-growing, low-grade and contained. But there’s the fear you get from others when you tell them what you have, which makes you mindful of how you speak about your condition if you speak about it at all. You realize it’s the randomness of the disease that frightens them the way it frightened you.
But there’s more to it than that. No matter how mainstream cancer and cancer-awareness have become, it’s still a disease that triggers primal—even irrational—responses in people you know. You, and in particular, what is in your body, represent the mortality they refuse believe is coming for them. Not me. Never me. You can’t really blame them because once you were just as immersed in and blinded by the mundane dramas of your own life. Still, it’s hard when those people, who know your diagnosis quietly dismiss themselves from your life as if what you have is something they could catch like some new strain of COVID.
Living things die and are reborn, microscopically and every day, through cellular death and regeneration. With cancer, that process gets disrupted when the DNA commands that regulate cellular activity becomes unintelligible to a cell. This happens when genetic codes stored inside the DNA helix develop defects, as can happen when (for example) those codes get exposed to toxic levels of substances like nicotine, pesticides and hormones. By the time cancer develops, the cells carrying the disease have gone rogue. Rather than move through the normal process of maturation and death, “outlaw” cells mutate and overproduce themselves. And do what cancers do best: spread, blindly, randomly.
Looking at your own diagnosis, you see that the complications don’t stop with DNA malfunction. The tumor in your body, at just 8 millimeters, is actually comprised of two cancers. One, a ductal carcinoma in situ, is a pre-cancer; the other, an invasive carcinoma, is newly-formed enough that it is still be confined to one location. This is one of the many reasons your disease is so frightening, though the doctor tells you that your cancer will only require a short course of radiation after it has been removed. Part of a tumor may respond to one treatment while another part may not respond at all and require other forms of therapy.
You begin to understand the war metaphors associated with your disease. You don’t simply have it like you have the flu; you battle it. Cancer is the enemy: wily, unrelenting, unpredictable. In stealth it gathers strength then emerges out of nowhere, with the terrifying ability to replicate and mutate and the power to not only ravage but completely annihilate entire systems. In this war, you and your doctors are soldiers. But there’s no equality here. They are the generals who give the orders while you, the patient, are the butt-kicked boot camp private masquerading as the down-for-anything kick-ass warrior.
Still, your oncologists are encouraging. You’re lucky, you know. Very lucky. One in particular, the surgeon who will cut the tiny cancer cluster out of your body, called the tumor well-behaved. That almost sounds affectionate, like something you might say about a cat or a dog, though you know better than to call your disease a pet. It’s far too destructive for that, enough so that you resist the temptation to name it. Instead you think of it as a slow and patient thing that you’ve carried with you like a secret and that you now purge like darkness for light.