Decision

It was time to make this decision, finally. I had the surgery to remove the second cancer (recurrence or new one, I will probably never know) in January, and it's now October: long enough to make up my mind.

"Go with your gut!" people say, but how can I have a gut feeling when I'm flying blind? I tell you, if I could have an iron-clad guarantee that I would not die from another recurrence, I would not have the surgery; I hate the idea of having no breast there at all (and the success of reconstruction is iffy, says the plastic surgeon, thanks to previous radiation). And not least, I hate the very idea of surgery itself.

But though metastasis is a small risk (according to my surgeon -- everyone else is deliberately vague and stresses that it's impossible to estimate), even a small reduction in the possibility of dying from this is beginning to sound better. The turning point came when I went to an oncologist outside my hospital, someone recommended by a friend of a colleague. He didn't examine me, just spent an hour going over every detail of my records to draw the big picture. Much of this I already knew by heart, but he said one thing that stung: "They threw everything at you the first time, and it didn't work." Therefore, he implied, it's more likely to come back, for reasons we don't know. And since the last time it didn't show up on imaging, that could happen again; yearly mammos and MRIs may not help. He didn't ask this, but I asked myself: do I want to go through this again?

No, I don't. So I think I've decided to get the surgery, I hope in January so I can finish out the semester and also finish my book, now in the last stages of revision. I haven't yet informed my doctors of this, and I feel strangely reluctant to. Some people know, and I've had a bad reaction to telling them, as if I don't have to face the decision if no one knows about it. I'm still a bit in denial in other words, but that probably just means I need more time to accustom myself to the thought of it.

I'm both relieved and scared to have decided.