I'm alive, I'm alive

I'm one month out from my last and final chemo. My PSA last week on the three-week checkup was 0.97. That's pretty amazing considering I started at 5,306 a mere 16 months ago. My first line-treatment (docetaxel and Lupron) only lasted about six months before my PSA started going back up, but we did get it from 5,306 down to 22, and that's a hell of a decrease. I started with such a high PSA that an improvement was almost a given during my first round of chemo. When my PSA started going up, I finally learned what cancer treatment disappointment is. I'm stage 4, so my cancer is incurable, but I had hoped the first-line treatment would have kept my PSA in the normal range for months, if not years. It was like the first time you nick a precious porcelain tea cup and you know it will never be the same even though the whole time you knew it was inevitable. But no matter how much time you have to prepare, you're never quite ready for it.

Today I read a post from a guy in a metastatic prostate cancer support group who said that his PSA had started going up after 20 months of being on abiraterone acetate (Zytiga), the same medicine I started a few months ago. This made me think of the stage 4 cancer as a chronic disease debate. Truthfully, as long as my medicine works, I can actually think of it that way. But once my medication quits working, and the medication after that quits working, and then when I'm all out of options, well there you have it, end of story.

Don't get me wrong, I'm absolutely grateful that there are medications (even the chemo) and options that can keep me a alive a wee bit longer. But the fact is, in the end I will run out of options. I play this over and over in my head, imaging how I'll feel the day my "chronic condition" goes terminal. I'm in this odd position of uncertainty and shaky middle ground, feeling somehow that despite have incurable cancer, I'm not sick enough to be in the "cancer club" (imposter syndrome) yet knowing the day will come when I most definitely will be.

I mostly focus on the present, enjoying life moment to moment. I still feel that I have so much to give before I go and that somehow I'm helping others. So the time spent feeling helpless is relatively small, which leaves me plenty of time to feel fearless. I have my bad days, don't ever think that I don't. But I do have really good days, days where all the little pieces of life seem to fit together. It's at those times when I want to scream, "I'm alive, I'm alive!" and know that I really am.