The cancer's gone, so what's next.  What do I do now?   I know I do not have to make a "bucket list" so I think I'll concentrate on my "to do" list.  I have put off some really important things since the C-crap entered my life.  So here goes:  Clean the garage, do all the gardening I have put off (now that the rain has stopped), start a real fitness program (I have said this for five years),  return to the Y tai chi, keep writing this blog (I will find things to say), stop spending so much time in front of the computer, make a will, learn to play the ukulele (well, maybe), learn how to use my cell phone and figure out all the frustrating intricacies of facebook.  I guess I am returning to the real world.  During the cancer treatments I often had strange feelings of isolation and that I was watching my life as a spectator and really not participating. I felt that I was in some kind of drifting shell looking out a window fully cognizant of what was going on (even when driving) but somehow detached from everything.   Now I am re-attaching and not living in the shell anymore. It’s great to be back!

How do you react when the doctor tells you you are disease free (okay, he said "in remission")? I did not have one of those standing-on-a-mountaintop-legs-spread-wide-arms-stretched-to-the-sky-gazing-at-a-glorious-sunrise-breaking-over-the-horizon-while-angelic-choral-music-swelled-in-the-background moments.  No. I said, "Are you sure?"  My first reaction was disbelief.  Could there be some mistake?  Is it really, really gone?  Are you kidding me?  The doctor was adamant, the tumor is gone.  I am still trying to accept that.  After just about four months, it's gone.  I had heard stories from friends and on the internet about six months, eight months, a year or more chemo treatments and I was astonished my ordeal was over so quickly. Of course, they were "aggressive" as clinics like to describe their treatments.  From day one:  Radiation five days a week for five and a half weeks, chemo in a pump I wore 24/7 injecting cancer poison into me, and five hours of chemo at the clinic every three weeks. Actually, I had the last five hours of chemo boredom yesterday.  I guess that was the "one for the road" treatment. I would like to thank all my friends who responded to yesterday's post with their obvious joy that I came through this.  I can't tell you how much it meant to me.  My friend Catherine Henry sent me a link to Ray Charles singing "Hit the Road, Jack, and Don't You Come Back No More."  Very appropriate. I've been humming it all day

The results of the endoscopy and PET scan are in. And the winner is...?   Me!  The endoscopy doctor said he did not see any sign of the tumor.  The chemo doctor said the PET scan results of the radiation and chemo combo showed the tumor "disappeared."  Score:  Doctors 2, Cancer 0.  At one point in today’s meeting the doctor said the cancer was "in remission."  I really don't like that term although in cancer parlance it is supposed to be wonderful. In researching my illness which all of us who have cancer do, I discovered there are some doctors who prefer the term "cancer free" instead of "in remission."  I do too.  If you have the flu and get over it, you are medically "disease free."  The illness is over, cured and you hope you do no get it again next year.  I like to think of my cancer that same way.   It's done, cured, get on with your life and stop worrying about it.  If I think of my cancer as "in remission" that implies it is still there, lurking in the shadows, ready to swoop out at any moment to stab me with more cancerous misery. I'd rather not spend the rest of my life looking over my shoulder to see if remissive cancer is waiting to pounce.  So if you don't mind, I shall consider myself "disease free."

Sideblog:  Even though the doctors have pronounced me "disease free," the blog goes on.  I still have a lot to say about cancer and the presidential elections are coming up.  Why is it I see a lot of similarities?

Blog closed for the weekend.  PET scan today was too dull to write about.  Results Monday.

It was the great disappearing act although I slept through it.  After my endoscopy on Tuesday my doctor declared, "the tumor has disappeared."  He was comparing it to the endoscopy he did about four months ago so that counts as good news.  He also said he took several biopsies tumor or not.  He actually told this all to my wife because I was still asleep and incoherent in the recovery room. Anyway when I woke up enough to grasp this information she told me I was pretty happy.  I did not run right out to get a cheeseburger to celebrate, however, because my throat still hurts like hell.  The doctor said he saw some irritation which probably caused my painful swallowing all week and which I'm sure was exacerbated by shoving something like a thin garden hose down my throat. So now we wait again.  The biopsy results?  The PET scan I will have Friday?  I was going to close with some trite phrase about the light at the end of the tunnel, then I remembered a remark by some European politician who said "The austerity measures are so severe we had to turn off the light at the end of the tunnel."  I thought that was funny. 

This week the endoscopy and PET scan should let me know if the cancer situation is 1) better, 2) worse or 3) the same.  In moments like this, “hope” usually makes its appearance since there is nothing anyone can actually do between now and the tests.  I really do not put much stock in hope because it is an abstract term and does not influence the outcome of anything.   Hope is something you want very badly but you are not sure you are going to get it.   Sometimes you don't (your hopes are "dashed"), but sometimes you do (your hopes are "realized") which is why people contiue to hope.  Why do you think people keep on playing the lottery when they lose week after week ("never give up hope")?  Don't get me wrong, I like to hope as much as anybody. I am not giving way to pessimism.  I do hope the results are favorable. However hopes are often confused with expectations.  Someone once said, "If you do not have any expectations, you will not have any disappointments." (If no one said that, I just did.) So let's hope the results are good.  If not, let's hope I can just deal with it and move on.  Remember, another thing they say about hope is: "you never run out of it."

Several of my friends have commended me for remaining upbeat during this unpleasant encounter with cancer. They have even mentioned my demonstrating a sense of humor.  There are reasons for this.  First, I don't know what is going on inside my throat.   I have always avoided creating problems before they exist, so I see no point in agonizing over treatment results until I know what they are. Second, I tend to be inherently optimistic. Now I will be put to the test.  Next week it's show down.  The cards come out on the table (really the computer) for my doctors to see.  I am scheduled for an endoscopy next Wednesday and a Pet scan next Friday.  Then the suspense. I will probably not know the results until I meet with my doctor on Monday the 25th when I am also scheduled for another dreary five hour encounter with chemotherapy.  But finally we will know something! The tests next week should indicate who is prevailing in the battle over my esophagus, cancer or the doctors.  Obviously, I am rooting for the doctors. 

Two of the major risk factors for esophageal cancer are excessive smoking and drinking alcohol.  Both the Mayo Clinic and the American Cancer Society web sites say the exact cause is not known but those are right up there as big time risk factors.  How do I know?  Google has made researchers of us all.  You can consider this my confessional blog.  I began smoking at 16 and when I quit in 1983 I had reached five packs a day. (Yes, five.)  I have not smoked a cigarette in 29 years.  Drinking alcohol is a different story.  I spent 33 years in the sales and marketing business when the "three martini lunch" was, in fact, the way business was done.  Twelve of those years were in Europe where wine at lunch and dinner was considered normal nutrition.  I still think a dinner without preliminary cocktails is barbarian.  Alcohol was an integral part of my lifestyle.  So I guess we could say: "Live by the life style, die by the lifestyle."  At this point I am not really concerned with what caused my cancer or why I got it.  Remorse does not seem to serve any useful purpose. When I was enjoying my "singing in the tavern days," the last thing in my mind was esophageal cancer that might hit me 50 years down the road.  I am reminded of one of my favorite verses from the Rubaiyat of Omar Khayyam:

The moving finger writes, and having writ

Moves on: nor all your Piety nor Wit

Shall lure it back to cancel half a line

Nor all your tears wash out a word of it

But that addresses the past.  What about tomorrow?  Omar also wrote:

I heard a voice within the Tavern cry,

Awake, my Little ones, and fill the cup

Before Life's liquor in its Cup runs dry

I don't think it's dry yet.

In 1969, Elisabeth Kubler-Ross introduced the concept of the five stages of grief in her book On Death and Dying.  It was originally intended to apply to how people approach their own death and how those who remain deal with it.  Over the years is has been applied to just about everything from the demise of your pet canary to not getting the latest iPad for your birthday.  You can imagine how pleased I was to discover that, "After terminally ill patients, the group most likely to exhibit the five stages of coping are mediocre golfers."  Yes, how heartening it is to know that mediocre golfers throughout the world are going through exactly the same things I am experiencing with esophageal cancer.  Amazing. (www.mrgolf.com/stages.html)  Just in case you have forgotten what the five stages are, let me refresh your memory:  denial, anger, bargaining, depression and acceptance.  Since I have not yet been officially declared terminally ill and I am not a mediocre golfer (I don't golf), I am not exactly sure what stage I am in. Of course, at first I denied it.  Why would a nice guy like me get cancer? Why? Why?  Then I thought "Why not?"  I don't recall cutting any deal with the great unknown for a cancer waiver.  Anger?  Yes I'm sure at one point I felt anger but then I couldn't find any one or thing to be angry at.  Bargaining.  We've all been there.  "Just give me a few extra years and I'll never touch another drink of alcohol again."  Fat chance.  Depression. Believe it or not, I have very little experience with that, so I'll probably have to work on it.  Acceptance.  Do I have a choice?  Maybe I should take up golf.

Sideblogs:  Newspaper stories have sidebars, dinners have side dishes, I will now be offering sideblogs, short quips not long enough for a full post, but on my mind nevertheless.  Here's the first one. 

Philadelphians will appreciate this.  In my never ending attempt to eat solid foods again, I made scrapple for breakfast Sunday. When non-Philadelphians ask me what it is, I tell them the operative syllable is "scrap" or "If you have to ask what it is, you don't want to eat it."  Anyway, I managed to get it down with a minimum of discomfort. It was absolutely delicious.  Four slices of scrapple made my day.  It's the little things.

Upon learning about my illness, a friend wrote to me:  "I don't know why, but you were one I thought would never have anything like this."  I never thought I would have anything like this either.  I know where my friend is coming from.  If you have a friend who is five feet eleven inches tall, 205 pounds, active, energetic, and thoroughly enjoying life, you certainly don't think, uh-oh here comes cancer.  Think about your friends and relatives.  Can you look at any one of them and say, "Hey, Walter looks like he's about to have cancer."? Cancer does not have an early warning system.  In my case, once we suspected something was cancerously wrong, it was.  My melanoma of two years ago was just a little smooth lump.  Even the surgeon had his doubts and had the biopsy done twice.  Last November I had a slight discomfort when swallowing which I attributed to a minor cold I had at the time. I enjoyed a great holiday season--mountains of food and rivers of drink.  Three months later I'm getting radiation and chemotherapy.  Perhaps I am taking issue with the current medical position that too many tests like annual physical exams and PSA are unnecessary and too costly.  Undoubtedly some of them are.  But, based on my experience, when there's a valid suspicion of cancer, do the test.  If a CEO and a professional football player are worth tens of millions of dollars, I guess I'm worth a PET scan.

In my very first blog post, I noted that lots of people who get cancer think it is a good idea to write about it.  I made no pretence that I had invented a new literary form.  If you Google “cancer blogs” you get over 35 million (that’s what I got tonight).  If you Google esophageal cancer you get 458,000.  If you read them, you are very likely to get depressed.  You will be subjected to descriptions of funerals, tragic family stories of young people with cancer, children with cancer and more explicit detail than you’d ever want to know.  One woman posted images of her scan results and pictures of where the incisions were made in her breast.  If you have esophageal cancer, like me, it is even worse. I did not find any blogs brimming with optimism. Dr. Herman Kattlove, an oncologist, headlined his blog “Esophageal Cancer—Death by Slow Starvation.”  How’s that for getting your attention. Most of them were so dismal I had to read my own blog to cheer myself up. In all honesty, there were some stories of cancer going into remission and pictures with sunny smiles and a t-shirt saying “I’m a cancer survivor.” The cheeriest of all was Mayo Clinic’s which was a string of success stories of how good they are at defeating cancer.  Cancer treatment marketing at its best.  I must admit I have had a few low moments in all of this and tonight's little research trip was no help. I suppose if you don't want to know something  you shouldn't go looking for it. One thing for sure, no more cancer blogs.  (Except mine.)

Today was a rather uneventful day.  All I did was drive 80 miles round trip to Jacksonville for an injection that took one minute.  Then I had to sit there for a half hour to be sure I had no adverse reactions like seizures.  They told me the five hours of chemo I had yesterday will destroy my white blood cells so this injection is to force my bone marrow to spurt out a great quantity of them right now to keep the immune system going.  It seems with chemo treatment they pump you full of stuff that can kill you so they have to give you other stuff to make sure it doesn’t.  I was actually feeling pretty good today since yesterday’s chemo did not make me nauseas and the swallowing pain has subsided considerably. I was even fantasizing about real solid food.  (Yes, I have become obsessive about food.)  Then as I was leaving the nurse pointed out, “This injection can cause you back pains.”  She made my day.  On the drive home all I could think abut was those two beers.

Great news at the oncologist meeting today:  I can drink two beers or two glasses of wine a day!  (Cocktails are not sanctioned because the alcohol content varies in the eye of the beholder who is pouring.) For me, this is a significant lifestyle milestone in the course of my treatment. Up until last week alcohol burned when it went down but the lava flow has stopped. So now when I break the sore throat swallowing barrier and can eat solid food again we are off to a Jacksonville Suns baseball game for hotdogs and beer!  You see, when you are going through what I am, a simple pleasure like going to the baseball park, becomes enormous.  I am learning it should be that way whether you are cancerous or not.  Don't wait until a simple pleasure is taken away before you realize how much you loved it.  It is that lesson you have heard before many times and it is trite, but it is true:  Never take anything for granted, like beer. Oh, on to serious medical considerations, the doctor said I will have a PET scan in two or three weeks and an endoscopy to see if any of this magic medical misery is working. More time to reflect on the unknown I suppose.  I was zonked with five hours of chemo today.  Let's see.  Two weeks, that's 14 days, times two, we will deal with the next diagnosis 24 beers from now.

This blog has been written in something of a time warp. My top 10 complaints about esophageal cancer posted five days ago on Wednesday, May 30, cover my first nine weeks of radiation and chemotherapy treatments.  Obviously they were not fun.  However, for the last two weeks I have had not had any treatments at all.  I feel almost normal with the exception of the damn sore throat which still has me on a soft food diet.  The doctor told me this treatment hiatus is "to build my strength back up."  My question is, for what?  We enter into the next treatment galaxy on Monday when I am scheduled to get a full day (five hours) attached to drip bags for another chemo jolt.  At this point I am getting a bit frustrated.  I have read those admonitions in just about every magazine and health web sites that says: “You the patient must take control and participate in your treatment.”  I don't know that I can control much but I have a little notebook with all the questions I want to ask the doctor on Monday and at the top of the list:  When will we know if the treatments done so far have had any effect?   In other words, what is the return on the agony invested?  Hopefully I will get some answers which of course will be duly posted on Tuesday. So here we go into the next phase of this adventure into the unknown.  On the positive side I have an iPad.  As the chemo drips slowly into me I can ignore it by watching movies.  Isn’t technology wonderful?