Right now the second massive hurricane of the season barrels down on the US after leaving the Caribbean in shreds. Mexicans are digging out from their terrifying earthquake. There was the little-covered (by the US or NZ papers, anyway) Himalayan flooding that killed more than a thousand people and displaced millions. These huge natural disasters are upending the lives of people all over the world, making my own little life seem small and smooth sailing. And still, the winds have been blowing—metaphorically—for me too.

The many tests I have had over the past months have left me with new conclusions and strange choices. My doctors, upon examining the original tumor, the regrown tumor, and my overall current health have downgraded my risk from “significant” to “not as bad as we thought.”  Basically, they have done the analysis that tells them that the first tumor was particularly aggressive—big and widespread and very very likely to recur. But the thing that regrew—my second tumor—was a docile sort of cancer. Their guess? All those years of taking careful care of myself and my good diet and exercise really did keep the original aggressive tumor from spreading out of my breast—my immune system was working well to keep it contained. And then chemo blasted it and killed the most dangerous cells, leaving behind the remnants that weren’t fast-dividing enough for chemo to kill (chemo only really works on aggressive cancer), and my supplements and Tamoxifen kept even the regrowing cancer slow and sluggish.

All of this means that now these doctors have a twin focus. Yes of course they want to keep cancer away, but they are also focused on keeping cancer treatment from destroying my life. These US oncologists are not coloring inside the simple lines my NZ oncologist wants. Since they don’t think the Tamoxifen failed, they want me back on that—it protects my bones and doesn’t have the side effect of the current treatment that makes me ache and groan like a 70 year old (there are estrogen receptors in bone, on muscles and tendons). And there’s an amazing drug called “metformin” that is not created to be used for cancer and yet has significant anti-cancer benefits (the story behind this drug is worth a blog in itself—but you might want to look it up). My NZ oncologist is angry at me, telling me that no new evidence will ever change his opinion of what my treatment plan should be (really? Is that what medicine is about?. So we will part ways.

And so, my life pivots again. Gone are the monthly belly shots (I was used to them, but never could be fond of them). Gone is the question about whether to have my ovaries removed. I have become mostly sugar free, low fat vegan (I’ve lost 1.5kgs). I do yoga and cardio at least 5 days a week, meditate just about every day. I take about 55 pills a day, each of them tuned to amp up my body’s ability to fight off this cancer forever.

These changes are wonderful ones, and of course there are no guarantees. This is a complex system I’m dealing with and none of my experiments are safe to fail. My oncologists want me to have a PET scan every year for the next several, to watch and check that the cancer doesn’t spring to life somewhere else. And they want me to take it seriously and change my life forever.

Me? For the first time in the last difficult four years, sometimes I take out my medical test results and reread them. I love all the “optimal” markings on my blood work. I love the lazy Ki67 number of the new cancer, the fact that some of my inflammation and other markers were the lowest one of my doctors has ever seen (low=good). I have gotten rather used to failing health test over these past years, and I’m grateful to be passing these.

And I also know that this will mark another transition. My hormones will take another wild ride. My body will learn to eat and exercise (and hopefully sleep) differently. And I have to now take seriously again how I want to remake my life as I begin to imagine myself working to keep cancer away for the rest of my life—and succeeding.

The one year anniversary of my diagnosis has come and gone. This Saturday I will be in a retreat center outside of Baltimore where my firm is having its semi-annual meeting. The last time I was there was on my 46^th birthday, 15 months ago. As I walked the beautiful labyrinth there on my birthday, from nowhere the thought arose: “I hope I don’t have cancer again.”  I hadn’t been afraid of a recurrence in nearly a year at that point. And of course, I did have cancer, although it would be three months before I was diagnosed. This Saturday I’ll walk the labyrinth again, as I peer into the future with more hope and genuine curiosity than I’ve had in a while. In other parts of the world, the waters will recede and people will begin to put their lives back together. And me too, in a way. May each of us find peace and learning and unexpected delights in whatever happens next.

ps the picture today is dawn in Byron’s Bay. Zowie.