Skipping my monthly targeted treatment (Avastin) because my kidneys are under stress might be a good thing. It might mean my body doesn’t need (it certainly doesn’t want) to be infused. Alternatively, it might mean that, after nearly 33 months of it, it can’t take it anymore (even though it may need it). Outliving your original prognosis and existing between the cracks – and beyond the cracks – of heretofore standard protocols/life-expectancy for stage IV lung cancer patients who live years longer than anticipated, presents its own unique set of problems (maybe challenges would be a better description). Although many books have been written on the lung cancer subject, the number of chapters written about individuals who don’t succumb to their disease – according to the statistical history of similarly diagnosed patients, is unfortunately a function of supply and demand/cause and effect: there aren’t enough survivors.

As one of the few-and-far-between survivors, my treatment is subject to change and subject as well to how I/my body tolerates what is going into it and how that is measured coming out. Whatever I think I feel is not nearly as important as what the lab work indicates is happening – internally. Absent any complaints/observations from me concerning my symptoms – or lack thereof, the tale of the tape is the blood and urine that I provide every month. After providing an early morning sample, later that day or mid morning the following day, I will have received confirmation that my ongoing treatment can proceed or that it can’t. Sometimes my treatment has been delayed a week, other times by as long as a month; waiting for levels to return to semi normal – for me, under treatment, that is.

Given that I am now officially an anomaly: still alive; what happens next, what timetable for treatment will likely follow, what schedule of medications and/or scans will occur going forward, is cast in quicksand. Ever-changing, always in the pursuit of prudence and of not causing collateral damage/making matters worse by being too aggressive or unresponsive to what my body (via the lab work) is indicating, is the bane of my rather fortunate existence. Commonsense medicine becomes the order of the day, and the night, too. It’s all one big definite-maybe, a process with which I am happy to live (live being the operative word).

I remember the early days of my diagnosis/prognosis when I was undergoing the heavy-duty (I call it “’Big”) chemotherapy, an every-three week, six-hour cocktail infusion of three drugs which naturally took its toll. Like the Fairy Tales, my prognosis was grim. I recall asking my oncologist for a scenario-type assessment of my future. He was not particularly encouraging; he was honest, as I asked him to be. Nevertheless, I persisted and when the opportunity presented itself, I would ask him if it was still OK for me to buy in bulk. As I continued to not decline, his answer was always “Yes.” Nearly three years post-diagnosis, I can’t help wondering if skipping treatment because a certain level of something or other is off the standard charts (high or low), should I stop buying in bulk or rather continue what I’m doing because whatever it’s been, with my oncologist’s help, it’s been working?

I don’t want to make too little of what’s now not happening as regularly as it once did, but it’s becoming increasingly difficult to not make too much of it, either.

Kenny Lourie is an Advertising Representative for The Potomac Almanac & The Connection Newspapers.