Hope, You Fucker

Jun 28 2025

1.
Don’t blame me for the profane title. That’s CancerShrink’s doing. I can’t help that the greatest coping skill I’ve gotten from cancer is the ability to see the absurdity in most things—or that sometimes he laughs too. I can’t help that even the most serious of our discussions might be tinged with laughter, cynical or otherwise. So last week, when a hard nugget of reality lay unwrapped on a table between us, a moment of hilarity ensued. That’s when this post’s title was born.

Say you’ve spent 1,642 days learning to live in cancer’s shadow. Whether you’re alone, at the movies, working, reading a book—it’s always there. The months pass; you hear that one friend or another’s disease is back, or that someone else has died. You’ve begun to develop a sense of when death is close. These are grim reinforcements of the hardest truth you’ve come to terms with: death will probably come earlier than it might have, and the road there will likely be very hard.

So, what happens when you might not die?

Anxiety, that’s what. Big, messy anxiety.

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2.
I plopped myself onto the leather couch. “The anxiety is back,” I announced. “Bigtime.”

He looked surprised. I felt surprised. (Actually, I felt more like WTF?) So we started unraveling.

It had been a couple of eventful weeks. The usual chest scans at the beginning of the month were one thing, but with the hoarseness returning, I was solidly back on the “do our due diligence” road to adding more scans. I learned from my mistakes this time and made sure the scan of my chest and my sinuses and throat happened at the same appointment.

For those of you needing a refresher: I was hoarse most of last fall. I told Drs. Primary Care and EarNoseThroat that hoarseness can be a sign of lung cancer progression, and they poo-pooed me. But when I mentioned it to Dr. Oncology, she immediately scheduled a CT scan. A couple of weeks ago, Dr. EarNoseThroat wanted a CT of my sinuses. Whatever. I’m still hoping I’ll someday spontaneously glow in the dark.

The real shocker came in the mail the Friday of Memorial Day weekend. Dr. Oncology was writing to say she’d be closing her practice as of July 5. I skipped the blah-blah-blah about being placed with another member of their wonderful team and went straight into panic mode.

I spent the night and following day ping-ponging among a million thoughts. There was a screechy echo in my head, and sometimes it was hard to take a deep breath. I held on for dear life to one thing: If I decided on a specific plan, I’d feel better. By Sunday, I’d decided not to wait to be told who’d be taking over my care, but to make an appointment with the oncologist many of my local cancer friends see—a brilliant researcher who is hard for some of them to deal with.

3.
Dr. Oncology was thrilled with my scans. So was I. Everything was stable. We had a long talk about working with NewOncologist.

“With your mutational profile, she’s the one who would be best for you,” she said. And she knew I’d built an emotional support network outside the cancer center, so…
“I’ll be fine with an emphasis on the science,” I said. I added, “If there are adjustments to be made in communicating, I’m aware I’ll need to be the one making them.” We had lots of hugging and best-wishing. Then I left.

Five days later, I sat in Dr. Oncology2’s examining room. She was kind, matter-of-fact, and thorough. She, too, was pleased with my scans and my long run of stable health.

There’s a lot of chatter about the health considerations lung cancer folks should keep in mind. I made an offhanded remark that I wasn’t worried about being overweight now because the next line of treatment can have difficult side effects. That’s when the ambush happened. It was so laid back I didn’t even realize what had happened.

Maybe there won’t be more treatment.

She weighed her words carefully. Sometimes, some people go through treatment and—even if there’s a single Stage 4 metastasis—once it’s taken care of, that’s it. Other people enter the whack-a-mole sweepstakes: the cancer pops up in one spot, gets knocked down, then pops up elsewhere again and again. The thought has always been that this is eventually what every lung cancer patient will experience. Except, there’s starting to be conversation in the research community about whether these different paths may have implications for clinical practice and patient expectations.

Because maybe there won’t be any more treatment necessary.

It was as if I’d been struck by lightning. I’m sitting there, talking with her, while at the same time frantically thinking: wait, what’s that feeling? It’s so unfamiliar. Wait, I’ve almost got it… oh. It’s hope.

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4.
Not gonna lie, my first thought was, “Aw, man, now I really gotta lose weight.”
My spoken thought: “Huh, that’s interesting. Let’s knock on wood.”

But as the days went by, I felt increasingly jangled up. I couldn’t pin the feeling to any circumstances—everything was reasonably good. Then CancerShrink and I started poking.

Dr. Oncology leaving? Hard, sad, but OK.
Dr. Oncology2? Great visit. The transfer will be smooth.
Except she said this thing…

And there it was. Hope, laid bare.

Should I share it with my group? I hesitated. “Survivor guilt,” I said. I was thinking of a friend, with 50 brain mets and new signs of cancer in the lining of her lungs, and others in the group. One suffered tough side effects from a trial she was in. Another’s recent scans showed hazy gray spaces and new nodules in the lung that had been cancer-free. I couldn’t imagine signing into our meeting and announcing Dr. Oncology2’s remark.

Now what? Should I get a job?
That was a joke—it had taken four years to begin to accept an unchosen retirement.
“We worked so hard on that,” I laughed to CancerShrink. “No friggin’ way.”

It’s not like the changes I’d made in my life were things to let go of, either. I was mentally healthier than I’d ever been—maybe even in better shape spiritually. My dietary changes had also been positive. But it was, as I was learning, a big shift in perspective.

CancerShrink and I started listing all the mental adjustments I’d made, speaking over each other in a rush to capture them. I was just sitting there, shaking my head from side to side, snorting with laughter that hope could trigger so much emotion. How many things would I need—or want—to reconsider?

That’s when CancerShrink shook his fist at the ceiling and said, “Hope, you fucker,” and we both just cracked up.

5.
Late last night, one of our large old trees broke in half and that half fell into the street. Luckily, we have a good relationship with our tree guys; it’s only early afternoon, and the whole tree has already been cleared.

I was watching the guys work from across the street—they’d sent me there because the tree was so rotted out they couldn’t predict if something else might fall. Although the air was starting to heat up, in the shade the breeze was still cool. It struck me how much lighter I felt as each of the huge branches dropped.

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Thanks for reading. Hears hoping your loads are light and easily set aside.

Here are a few more links on survivor guilt.

Survivor guilt: what it is and how to manage it

Life after cancer: Coping with survivor guilt