March 28, 2025
At the cancer treatment center, there is a big bell hanging on the wall, and when a patient has reached remission, they ring the bell and everyone claps and cheers for them.
The day came when they declared me in “functional remission”, but the bell never rang for me. I told myself that it doesn’t matter. I don’t like public “rah-rah” shows of support that much, anyway. But I have discovered over the last six months that it has mattered. In fact, what that bell symbolizes, and not ringing it, has mattered a lot.
“Functional remission”, means my cancer is under control. But not all Multiple Myeloma cells can be completely eradicated with current treatments, so there are always a few cells hiding out, cloning themselves and waiting until there are enough of them to do some damage.
Each type of treatment kills a percentage of the cancer cells, but those that survive are immune to the chemotherapy drugs that were used on them. Those survivor cells clone themselves with their resistance to that set of chemicals, so when they discover that the cancer is growing again (falling out of remission) the doctors have to try a different treatment against them. This usually works pretty well for a few cycles. The problem is that each subsequent treatment or set of drugs is less effective than the previous ones, and with each new cycle, a higher percentage of cancer cells survive, with immunity to all the drugs that worked before. When there aren’t any effective treatments left to try, the cancer cells can clone freely and take over.
That’s why Multiple Myeloma can’t be cured, and why I have to stay on some kind of treatment. The good news is that they’re regularly finding new effective therapies, with the hope that they can keep knocking down the cancer cells with new cycles of treatment, buying the patient more time, until they finally find something that can outsmart the Myeloma and eradicate it completely.
I have been blessed with miracles of modern medicine all my life. And even though I know these chemicals they pump into my body to treat the cancer are poison, and someday they’ll look back and hardly believe what doctors used to do to treat this disease, it’s the best we have right now. And I am in awe at the brilliant researchers and doctors who have learned to target cells and treat disease with this rate of success. My grandma died of leukemia in 1947, less than a year from her diagnosis. Her treatments were experimental and ineffective. They have come so far since then, and I am the beneficiary of it.
In the six months since my bell didn’t ring, I have had a hard time holding onto the positivity that characterized the first 10 months of this journey. As a matter of fact, I’ve come to understand the weight and darkness of prolonged depression. There’s a reason that there are only a few blog posts from this time: I really hate being negative. It is not that I don’t accept reality. I just hate broadcasting a negative reality to others. Mostly I really hate having anyone pity me and I don’t want anyone to be sad because of what I’m experiencing. There’s enough sadness in the world. That old adage, “If you can’t say something nice, don’t say anything at all” runs deeper in me than I knew. So in this case, no news isn’t really good news.
A therapist I saw said I’m depressed because my body “betrayed” me. I am not so sure about that. A betrayal is a broken promise, a deliberate act, and I was never promised anything from my body. To assign it evil intent would make my body the enemy, and my body has served me well. Mortal bodies were built to break down and decay. And although some people don’t get serious arthritis or GI problems or heart issues (or any number of other things) as they age, most do get at least some of them, and many people suffer from a number of health problems, in a never-ending stream or in a deluge, like a dam bursting. I have watched enough of people’s lives to know that there are few who escape these, and I didn’t really expect to get old without being in the shop a lot. Did my body really betray me? I’m not convinced it did.
So what is it? Here are some possibilities I’ve been thinking about:
Waiting for the other shoe to drop? I am constantly waiting for the next physical disaster. That’s no way to live, but I’ve had a long enough string of them, and my cancer will fall out of remission eventually, that I haven’t figured out how to not feel that anticipation.
Unfulfilled expectations? Remission was supposed to be a time of freedom from illness. I’ve been told that you even “forget” that you have cancer. Hmmm.
Nature? Maybe depression is the psyche’s natural response to prolonged illness, just as weakness and atrophied muscles are the body’s natural response to having to sit around a lot.
Am I mourning the loss of capacity? I can do so little compared with 18 months ago, and that is so little compared with three years before that. But I saw that happen with my mom, too. It is a natural result of aging. It just happened over many years with her, and wasn’t this bad until she was in her 80’s. Ugh. I’m sure that’s part of it.
Is it that my future is so uncertain? Let me be clear, I am not afraid of what happens after death. I have absolute confidence in God’s promises about my eternal life. It’s the space between now and then that makes me crazy. I can’t predict what I’ll be able to do this evening, let alone in two weeks or six months or three years. I have stopped making promises to anyone for anything. Signing up to bring cookies to an evening event is risky. Planning something where people are really counting on me? Out of the question. In this way, I feel like I’ve lost who I am, and who I want to be.
Is it part of God’s design, to teach me compassion? Maybe depression is something I needed to experience to be able to better empathize with much of the world’s population. Being so new to it, I am bewildered by it and feeling really impatient with it. I have kept up the good habits (exercise, sleep, diet, personal worship, connection) that should work against depression. I at least have the will to make myself do those things. But, unlike other times when I was just having a pity party, those good habits haven’t pulled me out of it. I don’t know what will. Maybe just time and continued effort and talk therapy will eventually work.
What more can I do? Focused spiritual study and intentional gratitude. I have had a terrible time focusing during this time. I study, but it really feels like I’m going through the motions. I feel like I have a grateful attitude, but I need to do something more tangible, like thank you notes and a gratitude journal. I feel certain that the positivity I held onto the first 10 months of this journey was fueled by these, especially an intense, focused study on hope and God’s eternal promises and the Savior, Jesus Christ. I can at least try harder to focus again on those things. They may be what pulls me back up, or they may just help me be patient.
That is a lot of “I”. I think I need to forget myself and go to work.