Over the past three weeks my PSA only went from 44.7 to 46.3, making me very happy. But the previous rise from, 30.7 to 44.7, over seven weeks, was more concerning. My oncologist isn’t worried, as I’m not feeling worse. I shouldn’t be worried either, right? Right.
Cancer carries with it a host of small and large anxieties. Not all of them are unique to cancer. But some are cancer-related anxieties people without cancer may not be aware of. Rather than cataloging all my current anxieties (it would be long list) I will instead list the ones at the forefront.
- How will Liz get along when I am gone? We do so much to help each other all day long. Forty years of marriage can do that to you.
- Why is my PSA (tumor marker for prostate cancer) rising?
- With our new medical insurer, starting January 1, will we be able to get the drug companies’ help we rely on to help meet our out-of-pocket maximum? This one is complicated to explain, so I won’t here. If you’re interested, ask me.
- How long can I stay on Keytruda before the side effects become too much?
- How bad will my peripheral neuropathy get? When will I start falling over or become unable to walk two miles?
- After Keytruda, then what?
- Will Liz and I both feel good enough to go on the trip to France we just booked for late summer?
- How can I make myself write more regularly, especially given the irregularity of my energy level? Am I making enough progress to finish my projects before I can no longer write?
- Where can I find reasonably-priced cheese that doesn’t leave gross artifacts in my mouth?
- Will anyone ever produce a new Christmas movie worth watching?
Here are recommendations I’ve received for dealing with my anxieties.
- Medication. At my most anxious times, Klonopin made me able to sleep and stop losing weight at the rate of 15 lbs. per month. In a smaller dosage, it still helps me with sleep.
- Mind-body tricks. With apologies to proponents of any of these, cognitive behavioral therapy, relaxation breathing, guided visualization, and yoga have at best only helped me briefly, especially if the anxiety is strong.
- Pray, and let God take care of everything. This is too passive, even for the Bible. The Apostle Paul himself talks about being so anxious about how a particular church was doing that he couldn’t stand it any longer, so he sent one of his co-workers to check up on them and encourage them.
- The Serenity Prayer. In its most commonly used form, it says, “God grant us the serenity to accept the things we cannot change, the courage to change the things we can, and the wisdom to know the difference.” Sounds wise.
But the Serenity Prayer doesn’t help me much. I’ve never received special revelation from God telling me that if I don’t call the insurance company about a screw up, they will just fix it. So I call the insurance company. I do everything I can to make things work out. Sometimes I succeed and sometimes I fail. But how can I know at the beginning whether my efforts are necessary or futile? I don’t. So I try to change what I imagine I might be able to change. The gap between being confronted with a problem and knowing whether I can do anything about it I call the Interim of Unknowing.
Most of my anxieties I’ve listed above are anxieties because I DON’T KNOW YET whether I can change something or not. Well, #10 is beyond my control, so I will endeavor to accept that with serenity, watching bad Christmas movies instead (once we’ve exhausted the handful of classic good ones). For the other anxieties, I live in the Interim of Unknowing, trying to change things and seeing whether I can or can’t.
While in the Interim of Unknowing, I am haunted by the doubt that if I made just one more phone call or tried a little harder, I could change something rather than having to retreat into serene acceptance.
I survive the Interim of Unknowing with medication, some relaxation breathing, and prayer. But there is another scientifically established technique that helps me survive the Interim of Unknowing: petting the dog. Really. Just pet the dog.
Wishing you all a Happy New Year.