AsSeenBy Susan

An Epiphany and Closure

As my first post-treatment homework assignment from my counselor at the Cancer Center, I was asked to make a chronological list of the events of my cancer journey. To do so, I had to go back through Providence's MyChart to see where it actually all began, which as it turns out, was nearly two years ago in August, 2019. It was a routine colonoscopy where the gastroenterologist mentioned he had seen an anal lesion, and then added, "I'll see you in 10 years." 

My journey ended for me on June 23, 2021 when I had a 7-month follow-up exam by the colorectal specialist in Spokane, the same doctor who had finally diagnosed my anal cancer last August, 2020. To realize it had been nearly a two year journey surprised me but also angered me. 

Fortunately, this last time the news was good. After a physical exam viewing my anal canal in four different directions (I know, TMI), the colorectal doctor declared me free of visible lesions or tumors and gave me a positive prognosis. YAY!

And yet, this wasn't my first declaration of NED (no evidence of disease). I had had two CT scans at three weeks (12/20) and six months (4/21) post-treatment that were both clean. And a physical exam in April by my radiation oncologist rendered the same conclusion. But I still had a niggling feeling in the back of my head along with lingering depression both of which haunted my waking hours. 

At my six-month exam, my oncologist recognized my emotional state as the veil of sadness and grief suffered by many cancer survivors. And by naming it, I immediately felt validated. Physically, I felt good, almost normal. I was still swimming laps and even started taking Qigong and TRX classes at the YMCA. Then in April I began teaching my own water aerobics classes five mornings a week. But behind my aura of good health and positivity, I felt fear, sadness, and anger. A lot of anger. 

My oncologist recommended talk therapy and referred me to the social worker at the Cancer Center. I had already visited with Alex last September, shortly after my diagnosis and right before I met my two oncologists for the first time. At that time, it was a proactive step on my part to meet all the people who would be on my cancer team. 

Today, Alex is my lifeline to understand this existential threat (my cancer diagnosis) and learn how to become a cancer survivor. The chronological list of events made clear the initial missed opportunity for a timely referral or diagnosis; an unnecessary hemorrhoidectomy; and lack of urgency to meet with the colorectal specialist. 

This retrospective examination of events also changed my emotional reaction to them: from my initial relief that there were no red flags or sense of concern to outright anger that those who I trusted to have known what an anal lesion meant, didn't know zip. Instead, I was passed from one doctor to the next, completely oblivious that I had anal cancer living inside of me. 

Add to that was my eleventh-hour disqualification to a post-treatment clinical trial which left me feeling betrayed, disappointed and fearful. Looking back allowed me the perspective to view my overall cancer journey as beginning and ending with two negative events. Little wonder I was angry and depressed. 

With this positive confirmation from the colorectal specialist, I had an epiphany. It didn't happen right away, but after teaching my water aerobics class the next day, which, by the way, is a source of joy for me, I heard myself saying to a friend who had asked about my doctor visit, "I think I'm ready to put my cancer journey to the side and move forward." 

Wow! That's a huge step for me as I feel like I've been living my cancer story for what seems like forever. But now I'm ready to put it to the side. Not behind me as in forgetting about it, but no longer front and center in my life.

In addition, I will continue to be observed for five years -- every three months for the first two years, and twice a year for the remaining three years -- and live my life as a survivor and a thriver.

I will continue to educate anyone who will listen about the human papillomavirus (HPV) and its relationship to anal, cervical, and throat and neck cancers. I will also continue to urge anyone from 12 to 45 to get the Gardasil vaccination to prevent these horrific cancers.