Sunday, January 20, 2013

Survivorship and Superstition

When it comes to cancer, there's a lot of confusion about a very common word: survivor.

Some define survivorship as five years of remission. By that definition, after five years of follow up with No Evidence of Disease, you are a survivor. Great. But what are you in those intervening years between treatment's end and survivorship's beginning?  A patient? A patient in remission?

Others mark the beginning of survivorship from the moment of diagnosis. Under those rules, once you know you have cancer, you are immediately a patient and survivor until you are no longer either.

And still others, mostly patients, avoid the term altogether for fear of jinxing the remission, not unlike baseball players and a no-hitter (a no-hitter is when a pitcher allows no hits over the duration of an official game). Baseball superstition holds that players never acknowledge the ongoing streak of hitless innnings, particularly to the pitcher working on the feat. If you've ever seen a no-hitter in progress, you'll notice the players keeping their distance from the pitcher as the game moves into the later inning. Even the announcers will often refrain from acknowledging it -- relying on graphics that show the score and the conspicuous zero in the hits column.

I don't think superstition holds much sway over genetic mutations and runaway cell growth, but I do find myself dancing around the term, and around the whole prospect of remission. A casual search of this blog doesn't turn up any posts with the word "survivor" in them (until this one, of course). Statistics would say that I have a good chance of years of remission; but then, statistics would also say that my lifestyle would give me a good chance of not developing cancer in the first place. And we know what my favorite author Mark Twain says about statistics.

When treatment ends in a few weeks, I hope that it marks the beginning of a long period of remission.  If I'm fortunate enough to throw up a string of zeros, so to speak, I'm sure I'll note the time that's passed. I just might not use the word: survivor. Why jinx it?

-- michael