Putting Things Off: When Cancer Delays Other Medical Decisions

Health problems tend to multiply with age, and sometimes they intersect in unexpected ways. I have follicular lymphoma, a type of blood cancer that is considered highly treatable but chronic and incurable. I completed treatment in December 2021, and there were no signs of recurrence until a CT scan in January revealed two enlarged lymph nodes.

When One Scan Raises New Questions

Enlarged lymph nodes can have many causes, with infection being the most common. Autoimmune diseases can also be responsible. Because only two lymph nodes appeared enlarged, interpreting the scan became a matter of clinical judgment.

The radiologist noted that the enlarged lymph nodes were located in the same area where my lymphoma had first appeared. That was interesting because I was diagnosed with advanced-stage disease—a common occurrence with blood cancers, which often produce few or no symptoms until they are widespread or are discovered incidentally after another medical event. At the time of my diagnosis, lymphoma was visible throughout my body on imaging.

My oncologist, however, interpreted the scan differently, explaining that there was no clear evidence of lymphoma recurrence—and that was encouraging news.

An Unexpected Second Problem

At the same time, I was dealing with another reality of getting older.

Early in 2025, I injured my hip. At first, I assumed it would simply take longer to heal because I had recently turned 60. But as weeks turned into months with little improvement, I asked my primary care physician for a referral to physical therapy.

The physical therapist ordered X-rays, which revealed something I hadn't expected: eventually, I would need a hip replacement.

The process itself took months. From my initial visit with my primary care physician to seeing a physical therapist and finally meeting with an orthopedic specialist, nearly six months had passed—from September through February. By then, I had already undergone the CT scan that raised questions about my lymphoma.

Choosing to Wait

One treatment option for the enlarged lymph nodes was immunotherapy, but I chose not to pursue it—at least not yet.

There were two reasons.

First, much like antibiotics, certain cancer treatments can become less effective with repeated use as cancer cells adapt over time. I didn't want to use an effective therapy unless it was truly necessary.

Second, immunotherapy for follicular lymphoma targets B cells, the immune cells responsible for producing antibodies. While highly effective against lymphoma, the treatment also suppresses the immune system until those cells regenerate—and in some cases, they don't fully recover. With the possibility of hip replacement surgery on the horizon, intentionally weakening my immune system seemed like a decision that could complicate future surgery and recovery.

Instead, my oncologist and I chose to monitor the situation.

When Waiting Is the Best Option

Now it's June, and my follow-up CT scan is scheduled for the end of July.

Meanwhile, my hip pain comes and goes. Some days it's manageable. Physical therapy exercises help when I stay consistent, and prescription NSAIDs keep the discomfort under control when needed. Other days, it seems to flare up for no obvious reason—sometimes I think I simply slept wrong. (At least I haven't injured myself by sneezing... yet.)

As I look ahead, I know a hip replacement is probably in my future. Hopefully, it's still a long way off. But until I know whether my follicular lymphoma requires treatment again, I can't make an informed decision about orthopedic surgery.

So I wait.

I keep putting it off.

Putting Things Off Isn't Always Procrastination

Most people know someone who procrastinates over unpleasant tasks. Some avoid paperwork. Others postpone home repairs or delay making difficult decisions. Plenty of people even postpone one medical treatment because they're focused on another.

I just never imagined I would become one of them.

Living with cancer doesn't always mean actively receiving treatment. Sometimes the hardest part is navigating the uncertainty that surrounds it. Cancer has a way of influencing decisions that seem completely unrelated, forcing us to weigh risks, timing, and priorities that healthy people rarely have to consider.

For now, my job is to wait for the next scan, continue caring for my hip as best I can, and hope that when it's finally time to make the next decision, I'll have enough information to make the right one.

Sometimes, putting things off isn't procrastination at all.

Sometimes, it's simply the most responsible choice you can make.

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