In the midst of the uncertainties of metastatic cancer, plans for treatment are the easy part. How to plan for life? That's more difficult.
In my house, making plans is a way of life, epitomized years ago when my middle daughter, then in 6th grade, planned a sleepover party for her friends that was detailed down to the minute. I remember patiently talking to her about how she might be able to follow that plan but that it was possible her friends — and there were a lot of them coming to the festivities — would not be as dedicated to following “the plan.”
I think she sort-of, almost, grasped the idea that as much as we’d like to be in charge and control every aspect of our lives, it just isn’t a reasonable expectation.
Learning that plans must be flexible enough to encompass change is a big lesson for people with any cancer, but possibly especially for those with metastatic cancer. I learned I had cancer in December 2014 and after all the tests were run and before I started treatment, the hopes expressed by various doctors had been extinguished and my plans for putting this behind me in six months—as prophesied by a radiologist I went to for second look—were shut down.
I wouldn’t be putting cancer behind me.
Instead, I needed to pull out the lessons I’d tried to teach my kids over the years about being open to what’s presented and find a way forward with a new plan. Now, two-and-a-half years into my life with metastatic breast cancer, I have many plans. I have a plan for if there’s no progression of the disease, a plan for the most likely next treatment if there is progression, a plan for the treatment after that. With scientific and treatment advances, I like to see my options extending for some time into the future. Knowing these plans, and thinking about them, provides some comfort about the unknown.
But that’s only for my medical treatment and, honestly, while planning for treatment is emotionally difficult, it is also logistically easier since there are standard steps to be taken that are dictated by own preferences first and by my doctors’ recommendations. Planning for my life is an altogether different matter. How to make plans when there’s no certainty? How to plan for the future when I don’t know if my next scan in a few months will show that I need a different treatment? What can a Plan A, Plan B, Plan C for my life look like in the midst of this uncertainty?
While being flexible when your friends aren’t as interested as you in making cheerleader-style pyramids is difficult for an 11-year-old girl, being flexible when you don’t know if you’ll be knocked down by a change in your cancer status requires both flexibility and vigilance. Plans must be made, but they can be plans that will provide what you need regardless of how treatment changes.
My plans encompass big things: being there for graduations, going on a trip. But I also plan for day-to-day happiness. I plan to spend as much time with my family as possible. I plan to pet the dogs that pass me in a walk. I plan to visit a friend who’s ill. In essence, the plan I live by is to care about the future outside my bubble of cancer.
Plans of any type imply hope. For me, they imply resolve as well. Like a gratitude journal, where you name a moment of happiness and love each day of the week, my life plans name in advance the things I want to remember and experience. They change frequently, as plans must, and help me see that my life is not stagnant, that there is much I can do whether it is a hug from my son or a visit with a friend or just a moment trying to find that woodpecker in the tree outside my house.