They Say I'm Going to Need More Chemo, I say No, No No

It has been three weeks since my surgeon, Dr. Black, confirmed that my Hogdkin's has returned, or perhaps never really went away. My first encounter with Dr. Black was in May, 2007, when he performed a biopsy on the lump in my neck, which revealed that I had Hodgkin's lymphoma. I endured the usual course of treatment and began to move on with life. Yet my treatment had scarcely ended when a so-called routine set of scans in late January revealed some strange new lesions. And so, it was Back to Black for a second biopsy.

When Dr. Black called me a week later to say that the Hodgkin's had returned, I was certainly not shocked. After the ominous scans, the biopsy was almost a formality. It was only my family that was floored by the surgical results - they had dunked themselves in a denial heavily shellacked with hope.

Truth be told, I had my own suspicions that the cancer had returned even before the worrisome scans. I have this foreboding itch that actually allows me to monitor my cancer. It's somewhat like living in your very own horror movie. The Itch remained lurking throughout my chemotherapy, then flared up uncontrollably a few weeks later, and finally started to subside after starting my subsequent radiotherapy. That is, until one evening in early January when I was casually watching television with my husband. Suddenly, I felt a wave of the Itch run up my left leg and down my right leg. It was like looking around the room and seeing a fleeting shadow on the wall or hearing a mysterious creak in the floorboards, signalling that a new wave of horror wasn't far off. The Itch continued to haunt during the weeks that led up to my January scans.

So in many ways, I was prepared to hear the news from my surgeon. I knew the results of the scans were ominous and I had governed myself accordingly. I put myself in the mindset of being back in the throws of chemo, and even went ahead with fertility treatments before receiving the biopsy results. So I pretty well knew that the cancer was back, and that the treatment for relapsed Hodgkin's is a stem cell transplant.

However, there is always a difference between theory and reality. Even with all the signs flashing, until you get a biopsy result it's still all theoretical. Technically, the PET scan could have been a false positive and the lesions that had appeared on the CT scan could have been some sort of benign reaction to the radiation and chemo I had previously received. And the itch, technically, could have been just a vestige of my Hodgkin's - something that might never go away, but did not necessarily mean that there was still disease. So when my surgeon called me up last week and told me that the biopsy results showed Classical Hodgkin's, I guess you could say that while I was not surprised, I was still shocked

When my relapse was merely a possibility, I could mitigate my fears with the fantasy that the cancer wasn't really back. I could imagine that this was all a terrifying false alarm, and could envision my surgeon calling me up to tell me that it was all a mistake, it was just a benign growth. I could feel the warm and wonderful sense of relief flow through me as I heard the good news.

Three months ago, I had completed my chemotherapy and radiation treatments and thought that I could put the experience behind me and move on with my life. Just when life was just getting back to normal, my world came crashing down for a second time.

In some ways, the news this time around was far less emotionally debilitating than when I was first diagnosed back in May, 2007. When you first find out that you have cancer, you feel as if your life is being brutally interrupted, you feel the tablecloth savagely pulled out from under you. Yet when you relapse, you quickly get over your shock and move into acceptance. You reacognize that cancer must simply become a fixture your life. You acknowledge that it is not just a phase that you could deal with and put behind you, no longer a dirty little secret you could push under the rug if you chose to do so. This time, cancer didn't just rent a room in your mind - it bought a condo.

And this time, you don't know if you'll be okay. At the time of my original diagnosis, I mourned the loss of so many months of my life to nausea, fear and uncertainty. I felt like I was falling, falling into a great unknown, but that there would be a soft landing and I could ultimately dust myself off and pick up where I left off. This time, I don't mourn as much for the time I will lose to fighting this disease. I can barely mourn for the years that will be snatched from my life due to the toxicity of the treatment I will require this time around, that is, if the treatment even works. My innocence, my carefree life disappeared when I was diagnosed the first time around, and so this time the shock, bewilderment and anger just aren't there anymore in the same way. I can no longer get angry at cancer. Now, cancer just is. When cancer comes back, it officially consumes you. Your chances of recovery are often decreased. The risk of other cancers down the road increases.

Cancer has become my new job. I don't go to work anymore. I go to chemotherapy. That is what I do. I get nauseated and puke. I rest. I try to eat. On good days, I can get in a work out. I know that my energy levels won't last long, and that I will be weak for months as my treatment intensifies, culminating in a stem cell transplant followed my months of recovery.

This past Monday, I began a new round of chemo. I will need four to six weeks of so-called low-dose chemo in order to shrink the tumours and stimulate the stem cells. After that, more chemo and neupogen shots and then my stem cells will be collected for a few days. Assuming that they gather enough stem cells, it will then be time to check in to the hospital as an inpatient. The plan is to receive several days of high dose chemo which is intended to completely obliterate my immune system. The goal of this treatment is to destroy my bone marrow. Stem cell transplants are the Hiroshima of chemotherapy. After the high-dose chemo, the stem cells will be defrosted and if all goes well, they will be injected back into my blood street to "rescue" me. I will need to spend about three weeks in isolation at the hospital as my body is broken down, devastated, torn and burned from the inside out, and struggles to rebuild itself.

Sometimes I can't quite believe this is all happening. Other times, it all makes perfect sense and it is crystal clear in my mind that I was meant for this. Before my diagnosis, everything in my life was going so smoothly I sometimes could not believe it myself - I met my soulmate and had a fairy tale wedding. I have an intellectually stimulating job at a great firm.

For about a year and a half before cancer came into my life, I just remember thinking how swimmingly things were going for me and for my extended family. Everything was going so well. Bullets may have been flying around us as we heard of troubles afflicting other families, but we were all succeeding in life, careers and love. Everyone in the family seemed so fortunate. Something had to give. I knew that something had to change and I felt it in my bones. Perhaps literally. And so when I was diagnosed, it made sense in my mind that I would be the recipient of the bad luck. It is possible that this sense of foreboding that had been plaguing me for a solid year and a half was really my unconscious mind telling me that something was not quite right. Perhaps that magical horseshoe that had been stuck up my ass my entire life became dislodged. I don't know.

All I can hope for now is that this awful stem cell procedure works. It is not out of the question that the transplant could actually cure me. I am staying positive about this possibility, but cannot be optimistic. It is what it is. I hope for the best. I want to move on and be well and continue to share every day with my husband, because he is a sheer joy and is my brightest star. Maybe we could even start a family. Such a normal part of life for so many people, yet such a brazenly indulgent thought for me.

Sometimes my mind plays tricks on me. Is this all really happening? Do I actually have cancer, and is it really back? Could this all be a bad dream or am I perhaps just a brain in a vat? Do I really need more chemo - could it be true? There are brief moments in time where I am overwhelmed and struggle in this way.

Is it all gloom and doom? No. That would just be too much to handle. And besides, it would get pretty dull. I have been involved in some intense complimentary therapy in preparation for my hospital stay: retail therapy. The plan is to have several brand new, comfortable yet stylish outfits to wear. I have spent days on my shopping mission and have procured a number of loose t-shirt dresses and cool robe-like sweater scarves. Gradually, I have accumulated quite the trousseau of cute outfits for the weeks I will be spending away from my husband and instead with that other force in my life that has swept me off my feet. I know that cancer doesn't care how I look. But if anything can cheer me up in the face of sheer adversity, isolation and bland hospital decor, I expect it to be some fresh style and colour.

So this is where I am right now. Dealing with the magnitude of the battle I must fight, and all the while starring in my own Sophie Kinsella novel, Shopoholic Gets Cancer. I can only dwell on the fear and sadness for so long. There is only so much time you can spend contemplating your own mortality, and then, you just want to rejoin the happy people walking down Yonge street on a sunny afternoon, and just celebrate all that life still has to offer. In the words of that suddenly famous beehived-hair girl, tears dry on their own.